-
what is the term that means that the output signal has reveres the condition of the original stimulus?
negative feedback
-
what are the chemical messengers released in response to a change in the body's internal environment?
hormones
-
Name the two posterior hormones:
- ADH (Anti-diuretic hormone)
- Oxytocin
-
This pituitary gland secretes 6 hormones (GH, TSH, ACTH, FSH, LH, Prolactin). Anterior or posterior pituitary?
anterior pituitary
-
Which hormones of the endocrine system are most clinically used?
- growth hormone
- antidiurectic hormone
-
Name the disorders related to HYPERpituitarism
-
Name the disorders related to HYPOpituitarism
- dwarfism
- diabetes insipidus
-
what is the name of the drug that is a hormone antagonist (stops GH)?
Parlodel (bromocriptine)
-
What is Diabetes Insipidus?
- Lack of ADH
- Not related to DM - it mimics symptoms
- polyuria
- polydipsia
- dehydration
- dilute urine
-
What are the drugs used for treatment of Diabetes Insipidus (DI)?
- desmopressin (DDAVP)
- vasopressing (Pitressin)
- nasal, oral, IV, SQ
-
Name the nursing interventions of desmopressin/vasopressin therapy
- monitor I&O, dehydration
- monitor electrolytes, fluids
- check urine specific gravity
- care must be taken with CAD (coronary artery disease)
- excessive fluid retention
*if nephrogenic (kidney) then it's not DI and tx won't work
-
what is the mechanism of action of vasopressin?
- causes renal collecting tubules to increase permeability to water
- therefore enhances water reabsorption
-
adverse effects of vasopressin?
- angina, MI in CAD
- excessive fluid retention = water intoxication = death
-
what is SIADH?
- syndrome of inappropriate antidiuretic hormone
- body retains water and electrolytes in the blood
- symptoms of hyponatremia because so much fluid on board
-
what are s/s of SIADH?
- vomiting, irritability, HA
- combativeness, confusion, hallucinations
- seizures, stupor, coma
- weight gan w/o edema
- decreased urine output, increased concentration
-
what is the normal sodium range?
135-145 mEq
-
this hormone controls growth of bones and muscles
growth hormone
-
where is growth hormone produced?
pituitary (anterior)
-
this hormone increased reabsorption of water in kidneys
anti-diuretic hormone
-
where is ADH produced?
pituitary (posterior)
-
this hormone controls the rate of metabolism and rate that glucose is used up in respiration, and promotes growth
thyroxine
-
what are the s/s of cushing's syndrome?
- increased BS
- thirst
- polyurea
- impotence or cessation of menses
- decreased libido
- facial hair growth
- emotional lability (rapid changes)
-
what are the two main functions of the tyroid gland?
- secretes T4 & T3 to increase metabolic rate
- secretes calcitonin to decrease serum Ca+ (Calcitonin acts directly to cause calcium deposition in bone)
-
what is the main cause of Cushing's syndrome?
long term corticoid steroid usage
-
What is the name of the disease caused from too much TH hormone?
Grave's disease
-
s/s of Grave's disease (hyperthyroidism)
- fast metabolic rate
- heat production
- weight loss
- tachycardia
- anxiety
- exophthalmos
- (everything is REVED UP)
- thyroid storm
-
what is the drug used to treat Hyperthyroidism?
- PTU (propylthiouracil)
- Tapazole (methimazole)
-
what are the adverse effects of PTU (propylthiouracil)
- hypothyroidism
- rash
- transient leukopenia
- agranulocytosis
- hepatotoxicity and liver failure (black box)
-
what pregnancy category is PTU (Propylthiouracil)?
Category D
-
what are the nursing considerations of PTU (propylthiouracil)?
- monitor vital signs
- appetite
- weight
- heat/cold
- sleep patterns
- ADL's
- labs
- s/s infection
-
what is the most common disorder of the thyroid?
Hypothyroidism
-
what are the s/s of hypothyroidism?
- weight gain
- cold all the time
- goiter
- myxedema (weakness, cramps, dry skin)
- bradycardia
- slurred speech
-
what is the drug used to treat HYPOthyroidism?
synthroid (Levothyroxine)
-
patient teaching for synthroid (Levothyroxine) treatment
- take same time of day
- AM's only (may cause insomnia)
- life-long treatment
- thyroid panel labs every 6 months
-
Nursing considerations for synthroid (Levothyroxine)?
- monitor vital signs
- appetite
- weight
- heat/cold
- sleep patterns
- ADL's
- labs
- s/s infection
-
what are the adverse effects of synthroid (Levothyroxine)?
-
what is the pregnancy category of synthroid (Levothyroxine)?
pregnancy category A
-
the glucocorticoid helps cells obtain glucose for energy production and is secreted from the adrenal cortex
cortisol
-
this glucocorticoid maintains fluid and electrolyte balance and is secreted from the adrenal cortex
aldosterone
-
this glucocorticoid functions to maintain reproduction and sex characteristics and is secreted from the adrenal cortex
androgens
-
a person low in the glucocorticoids (cortisol, aldosterone, and androgens) have what disease?
Addison's Disease
-
what are the drug-drug interactions with glucocorticoids?
- barbiturates, phenytoid, rifampin - decrease cortisone levels
- estrogens potentiate effects
- NSAID's increase ulcers
- diuretics and amphotericin B increase risk of hypokalemia
- anticholinesterase may produce severe weakness
-
what are the short, intermediate, and long acting glucocorticoids?
- short acting: hydrocortisone
- intermediate: prednisone, methylprednisolone
- long: betamethasone, dexamethasone
-
nursing interventions of corticosteroid tx?
- monitor symptoms that is being treated
- monitor v/s
- lab work
- monitor BS
- s/s of ulcer
- s/s of infection
- mood swings
- increase ca+ in diet, weight bearing exer (Osteoporosis prevention)
- eye exams
-
what are the side effects of GH therapy somatotropin?
- hyperglycemia
- arthralgia
- myalgia
- abdominal pain
- otitis media
- HA
- bronchitis
- hypothyroidism
- HTN
- flulike symptoms
-
what is the action of GH somatotropin?
stimulates growth and metabolism
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