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adrenal glands

a pair of highly vascular organs that are triangular in shape, located in top of each kidney

medulla

the inner part of the adrenal glands is called the _____

cortex

the outter part of the adrenal glands is called the _____.

catacholamines, epinephrine, norepinephrine

When the sympathetic nervous system is stimulated the medulla secretes two types of _____, which are _____ and _____.

epinephrine, norepinephrine

These are neurotransmitters, release into blood stream, and circulate to target organs or tissue where they cause an effect on the adrenergic receptors

mineralcorticoids

these play a key role in regulating extracellular fluid volume and electrolytes

mineralcorticoids, glucocorticoids, androgens

three hormones secreted by the adrenal gland cortex

mineralcorticoid

aldosterone is a ______.

glucocorticoid

cortisol is a _____

glucocorticoid

regulates cell activity, controls CHO, lipid and fat metabolism, affects growth, stimulates liver to change glucose to glycogen, anti- inflammatory - blocks effects of histamine, also controls emotional state (stress hormone)

growth, muscle, fat

Decreased _____ hormone, decreased _____ mass and increased ____ storage are all age related changes

addisons disease

adrenal hypofunction, adrenocortisol insufficiency

primary addisons

caused by destructive disease process causing deficiencies in cortisol and aldosterone

secondary addisons

result of dysfunction of hypothalamus or pituitary (decreased ACTH)- aldosterone may or may not be affected.

aldosterone, hyperpigmentation

 Decreased levels of _____- alter clearance of potassium, water and sodium- leading to hyperkalemia; this leads to retention of hydrogen ions leading to metabolic acidosis, hypokalemia and hyponatremia- leads to retention of both
 Other characteristics; progressive weakness, lethargy, abd pain, malaise, _____ of skin

addisons crisis

acute profound Hypotension, tachycardia, dehydration, hyponatremia, hyperkalemia, hypoglycemia, confusion, and NVD.

low, high

In addisons crisis, if plasma ACTH is ____ then the pituitary is a fault, if ____ then the adrenal gland are at fault

electrolytes, dextrose, hydrocortisone

Addisonian crisis is treated with IV fluids, ____and _____ to restore normal BP, stat admin of ______bolus and continuous infusion

hypotension, irregular

In addisonion crisis, ____ is the most significant and dangerous assessment finding, along with ___ pulse

protien, cholesterol, potassium, salt

Pts with addisons should consume a diet high in _____, low ____ and ___, with ____ added liberally

Cushings

production of excessive amounts of corticosteroids, particularly glucocorticoids, can be caused by long term glucocorticoid therapy, tumors

exogenous cushings

single cause for this is prolonged admin of high doses of cortico-steroids. Inflammation disease i.e arthritis , COPD, crohns and others.

truncal, hair, facial

Physical manifestations of cushings include ___ obesity, excessive ____, and ____fullness

delayed wound healing

In a cushings pt, ____ may mask s/s of infection

insomnia, irrational behavior, mood disturbances, irritability, anxiety

name 5 emotional changes related to cushings

muscle, osteoporosis

Cushings may cause ____ wasting of extremities and ____ in bones

dexamethasone

___ suppression test may be done to diagnose cushings.

neuro status

In dealing with a cushings pt, the nurse should be aware of any changes in _____, such as headache, change in LOC, and papillary responses.

infection, reverse isolation

Cushings pts carry a high risk for ____, and may be placed in _______

pheochromocytoma

a tumor, usually benign on adrenal medulla causing excessive secretion of catecholamines

pheochromocytoma

characterized by episodes exaggerated flight or fight responses htn, hyper metabolism, and hyperglycemia

blood pressure

Cardinal symptom of pheochromocytoma is extremely high _____.

emotional stress

pheochromocytoma attacks can be triggered by ____

surgical removal of tumor or gland

treatment of choice for pheochromocytoma

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