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Foundations II Final Exam ENDOCRINE
Terms in this set (76)
The endocrine system's most influential gland. Under the influence of the hypothalamus, the pituitary regulates growth and controls other endocrine glands.
What does the thyroid gland produce?
thyroxine (T4) and triiodothyronine (T3)
What do thyroid hormones do?
Lowers blood calcium levels by increasing its deposition in bone
Parathyroid glands produce
parathormone which causes osteoclast growth and bone resorption
The adrenal medulla produces
epinephrine and nirepinephrine
The adrenal cortex produces
glucorticosteroids, mineralcorticosteroids, and sex hormones
Beta cella of the pancreas secrete
alpha cells of the pancreas secrete
delta cells of the pancreas secrete
Physical examination of patient why endocrine dysfunction
-many disorders cause changes in appearance
-vital sign changes common
-thyroid gland should be inspected and palpated
-assess eyes and vision
-anterior pituitary gland tests
-posterior pituitary gland tests
-thyroid gland tests
-adrenal medulla tests
-adrenal cortex tests
Hypo secretion causes
the thyroid gland, adrenal cortex, and gonads to atrophy
Hypo secretion of ADH results in
Hyper secretion of ADH results in
syndrome of inappropriate ADH (SIADH)
ADH deficiency AE
excessive thirst (polydipsia), and large volumes of dilute urine
Neurogenic diabetes insipidus
results from damafe to the posterior pituitary gland
nephrogenic diabetes insipidus
results from drug related damage to the renal tubules
psychogenic diabetes insipidus
results from excessive water intake
Diabetes insidious treatment management
-adequate fluid replacement
-monitor patients weight
-monitor vital signs
-monitor I & O
-cant excrete diluted urine which leads to hyponatremua
-closely monitor fluid I & O, daily weight, urine, neurologic status
Most common cause of hypothyroidism
autoimmune thyroiditis (Hashimoto disease)
-monitor vital sings and cognitive level
-improve nutritional status
-improves coping ability and self esteem
-maintenance of normal body temp
-often accompanied by goiter
-airway maintenance, pain management, fluid balance
-monitor for hemorrhage, hematoma, hypocalcemia
deficient production of parathyroid hormone (hypocalcemia and hyperphosphatemia)
-goal is to increase serum calcium to 9-10
excessive production of parathormone
-surgical removal of abnormal parathyroid tissue)
a benign tumor of the adrenal medulla that causes the gland to produce excess epinephrine
-closely monitor vital signs, mental status, blood glucose and electrolyte levels
occurs when the adrenal glands do not produce enough of the hormones cortisol or aldosterone
-muscle weakness, anorexia, GI symptoms, fatigue, skin changes, hypotension, low BG, hyperkalemia, hyponatremia
-high levels of serum cortisol
-obesity, musculoskeletal changes, glucose intolerance
a condition in which the adrenal glands produce too much aldosterone because of hyperplasia or tumor
primary aldosteronism results in
hypokalemia and alkalosis
condition of thyroid hormone deficiency present at birth
what would happen is congenital hypothyroidism was left untreated for several months after birth?
growth failure and permanent intellectual damage
Manifestations of PEDS hypofunction
cold intolerance, lethargy, bradycardia, hypothermia
promoting growth for a child with congenital hypothyrodism
-measure thyroid levels ever 2-4weeks
-obtain tests ever 3-4 months for first several years
-every 6-12 after that
Parathyroid hormone (PTH) has which effects on the kidney?
Stimulation of calcium reabsorption and phosphate excretion
A client visits the clinic to seek treatment for disturbed sleep cycles and depressed mood. Which glands and hormones help to regulate sleep cycles and mood?
Pineal gland, melatonin
what medications would a patient require to help with adrenal insufficency?
Hypocalcemia is associated with which of the following manifestations?
Which of the following hormones controls secretion of adrenal androgens?
A client is having chronic pain from arthritis. What type of hormone is released in response to the stress of this pain that suppresses inflammation and helps the body withstand stress?
A nurse is assessing a client experiencing a severe anxiety attack. The nurse understands that the client's physiologic response to the unknown fear involves secretion of which hormone?
A client is diagnosed with pheochromocytoma. When reviewing the client's history and physical exam, which finding would the nurse most likely note? Select all that apply.
hypertension and tachycardia
A client is being screened for a thyroid disorder. The nurse would anticipate that the client would most likely undergo which test?
acute addisonian crisis
-Brought on by physical or psychological stress or inadequate steroid replacement
•Nausea and vomiting
•Severe hypoglycemia + hyponatremia, hyperkalemia
•Rapidly developing dehydration
•Hypotension leading to shock and death
-Evaluate ABC's q10-15 min
-Rapid infusion of saline and 5% dextrose (Increase BP)
-IV dexamethasome or hydrocorticone sodium succiate (replacement glucocorticoid)
-Administer vasopressors (Increase BO)
-Can lead to vascular collapse and death if untreated
A patient who is postoperative day 1 following neck dissection surgery has rung his call bell complaining of numb fingers, stiff hands, and a tingling sensation in his lips and around his mouth. The nurse should anticipate that this patient may require the IV administration of:
One of the most frequently occurring complications (55% occurrence) of primary hyperparathyroidism is:
kidney stones due to overproduction of calcium
A 42-year-old man with a history of pheochromocytoma is being treated in the intensive care unit after experiencing an acute exacerbation of his condition. This patient will require the nurse to perform which of the following assessments most frequently?
blood pressure and heart rate
The most common type of goiter is caused by lack of which of the following?
lack of iodine
A nurse is caring for a client with suspected diabetes insipidus. Which test does the nurse anticipate the physician will order to confirm the diagnosis?
fluid deprivation test
A sudden increase in the output of thyroxine and resultant extreme elevation of all body processes (HR< BP, Temp)
A female client with hyperglycemia who weighs 210 lb (95 kg) tells the nurse that her husband sleeps in another room because her snoring keeps him awake. The nurse notices that the client has large hands and a hoarse voice. Which disorder would the nurse suspect as a possible cause of the client's hyperglycemia?
A young client has a significant height deficit and is to be evaluated for diagnostic purposes. What could be the cause of this client's disorder?
A patient with a history of hypothyroidism is admitted to the intensive care unit unconscious and with a temperature of 95.2ºF. A family member informs the nurse that the patient has not taken thyroid medication in over 2 months. What does the nurse suspect that these findings indicate?
caused by extreme deficiency of thyroid secretion; also known as adult hypothyroidism
Which of the following assessments should the nurse perform to determine the development of peptic ulcers when caring for a patient with Cushing's syndrome?
observe stool color
A nurse caring for a hospitalized patient with hypoparathyroidism reviews his electrocardiogram (ECG) strip and completes a cardiac assessment. The nurse recognizes the diagnostic sign of:
prolonged QT interval
A 35-year-old female client who complains of weight gain, facial hair, absent menstruation, frequent bruising, and acne is diagnosed with Cushing's syndrome. Cushing's syndrome is most likely caused by:
a corticotropin-secreting pituitary adenoma.
toxic condition characterized by hyperthermia, tachycardia, nervous symptoms, and rapid metabolism; also known as thyroid storm.
A client is admitted for treatment of the syndrome of inappropriate antidiuretic hormone (SIADH). Which nursing intervention is appropriate?
A client has been diagnosed with myxedema from long-standing hypothyroidism. What clinical manifestations of this disorder does the nurse recognize are progressing to myxedema coma? Select all that apply.
hypothermia, hypotension, hypoventilation
A nurse is teaching a client about hormones within the endocrine system. Which hormones would be included as the hypothalamic hormones? Select all that apply.
-thyrotropin releasing hormone
-corticotropin releasing hormone
-gonadotropin releasing hormone
A client is transferred to a rehabilitation center after being treated in the hospital for a stroke. Because the client has a history of Cushing's syndrome (hypercortisolism) and chronic obstructive pulmonary disease, the nurse formulates a nursing diagnosis of:
Risk for impaired skin integrity related to tissue catabolism secondary to cortisol hypersecretion.
adverse effect of levothyroxine
When caring for a client with diabetes insipidus, the nurse expects to administer:
what would you administer for a client with SIADH?
The nurse is teaching a client about the dietary restrictions related to his diagnosis of hyperparathyroidism. What foods should the nurse encourage the client to avoid?
The nurse is assessing a 1-month-old girl who, according to the mother, doesn't eat well. Which assessment suggests the child has congenital hypothyroidism?
A pediatric client has just been diagnosed with diabetes insipidus. What is the primary consideration for this client?
The nurse is assessing a 5-year-old child whose parent reports the child has been vomiting lately, has no appetite, and has had an extreme thirst. Laboratory work for diabetes mellitus is being completed. Which symptom would differentiate between type 1 diabetes mellitus from type 2 diabetes mellitus?
recent weight loss
Which results would indicate to the nurse the possibility that a neonate has congenital hypothyroidism?
low T4 level and high TSH
A newborn is discovered to have congenital adrenogenital hyperplasia. What will the nurse most likely observe when assessing this client?
The nurse is assessing a 4-year-old girl with ambiguous genitalia. Which finding suggests congenital adrenal hyperplasia?
hirsutism and pubic hair
excessive hair growth
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