Hormones, Addisons, Cushings

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  1. Hyperpituitaryism
    too much GH
  2. Hypopituitaryism
    Low GH, ATCH, TSH, FSH, LH
  3. Diabetes Insipidus
    • Low ADH
    • watch for after surgeries and trauma

    causes hypotension and electrolyte imbalance
  4. Person with Diabetes Insipidus will have
    too much NA
  5. SIADH
    too much ADH causing dilutional hyponatremia...

    seizure precautions
  6. Hyperthyroidism causes....
    • Graves Disease
    • Thyroid Storm
  7. Hypothyroidism causes....
    Mixedema coma....heart issues

    Brady, hypotension, hypothermia, hypodynamic
  8. Hyperparathyroidism causes ......
    hypercalcemia and hypophosphatemia

    osteoporosis, nephrolithiasis, muscle weakness
  9. Hypoparathyroidism causes...
    hypocalcemia and hyperphasphatemia

    prevent tetany, watch for dysrhythmias and decreased CO
  10. Cushings
    Hypercortisolism....and lots of aldosterone

    think high everything....but low K
  11. Addison's Disease
    loss of adrenal hormones

    think low everything but high K
  12. Pre Op for Cushings
    • correct F&E imbalance (K, Na and glucose)
    • WBC's need to be WNL
    • Give IV glucocorticoids
  13. Post op for Cushings
    • watch for s/s of cardiovascular collapse
    • hypotension, rapid and weak pulse, decreased UO
  14. Addison's persons need to be watched for....
    Addisons crisis from a stressful event

    • Give IV hydrocortisone #1
    • replace what is missing...cortisol/sugar/salts
    • teach s/e of life long steroid treatments
  15. Hypopituitaryism can cause...
    • growth retardation
    • metabolic abnormalities
    • sexual immaturity
  16. Care for hypopituitaryism
    • probably from a tumor on anterior pituitary
    • surgery/radiation
    • life long hormone replacement
  17. Hyperpituitaryism can cause.....
    • gigantism(before growth plates sealed)
    • or
    • acromegaly (after growth plates sealed)
  18. Surgery for Hyperpituitaryism....post op management

    • monitor neuro status
    • monitor fluid balance and watch for DI
    • teach pt. dont sneeze/cough
    • floss and oral mouth rinse....no brushing teeth
  19. S/S of hypothyroidism
    • fatigue/lethargy
    • impaired memory
    • depression
    • decreased CO
    • constipation
    • cold intolerance
  20. Management of hypothyroidism
    Synthroid to replace TH
  21. S/S of hyperthyroidism
    • tachy
    • systolic htn
    • agitation
    • tremors
    • mood swings
    • confusion
    • seizures
    • fever
    • coma
  22. Management of hyperthyroidism
    • PTU-impairs TH synth
    • Methimazole-blocks TH action on body
    • Iodine therapy
    • Thyroidectomy
  23. Pre thyroidectomy surgery
    • control cardiac problems
    • prepare for possible airway complications post op
  24. Post Op thyroidectomy surgery
    • assess for respiratory compromise
    • monitor VS closely
    • assess for tetany
    • teach about need to follow up with labs and daily thyroid replacement
  25. Tests for hypoparathyroidism
    Chvostek and Trousseaus
  26. Management of hypoparathyroidism
    • treat tetany-IV calcium gluconate
    • correct hypocalcemia

    teach long term diet considerations with calcium and V. D supplements
  27. Management of hyperparathyroidism
    surgery-remove 3 of the 4 glands and resect the 4th...lets body keep making some calcium on its own
  28. Post op potential complications with hyperparathyroidism
    hemorrhage from vascular area around the glands


    respiratory distress....and tetany and hypocalcemia ...
  29. How do I prevent post op complications when the parathyroid has been removed
    • monitor for tetany....chovtek and trousseaus
    • admin. calcium gluconate prn
    • monitor I&O
    • teach importance of exercise and dietary need for CA
  30. Addison's crisis....s/s and interventions
    life threatening event with the major problem being profound hypotension and shock

    • promote F&E balance
    • monitor and replace glucocorticoids and mineralcorticoids
    • teach pt. side effects of life long steriod trtmnt
  31. What can cause Cushings
    • prolonged admin of steroids
    • tumors
  32. S/S of Cushings Disease
    • weight gain
    • thin fragile skin
    • hypervolemia/hypertension/edema
    • inhibited immune response
    • sodium and water retention
    • Hyperpigmentation of skin
  33. Treatment for Cushings Disease
    Transphenoidal surgery...hypophysectomy or adrenalectomy
  34. Pre op care before hypophysectomy for Cushings
    • correct F&E imbalances
    • monitor dysrhythmias from hypokalemia
    • control hyperglycemia
    • prevent infection
    • glucocorticoid therapy
  35. Post op care after hypophysectomy for Cushings
    watch for s/s of cardio collapse from insufficient replacement of glucocorticoids

    lifelong corticoisteroid treatment
Card Set
Hormones, Addisons, Cushings
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