PASS OR FAIL IT DEPENDS ON YOU

UNIT 4 PATHOPHARM

Pituitary gland (master gland) regulates

Hormones into blood stream

Hormones are

chemical neurotransmitters

Hormones are regulated by

Negitive feedback and body functions

Endocrine glands

Pituitary, Thyroid, adrenal, parathyroid

Stimulation test shows

Confirmation of HYPO function of a gland

Suppression test

Confirms HYPER function of a gland

Stimulation test if it reacts

Disorder of hypothalamus or pituitary

Nikname of pituitary gland

Master Gland

Pituitary gland controls

Other endocrine glands and body functions

Anterior lobe hormones (pituitary)

ACTH, TSH,GH

Posterior Lobe hormones(pituitary )

ADH or vasopressin

Hypothalamus hormones/factors controls via

Releasing or inhibiting hormones

Corticotropin CRH or CRF

Released in response to stress

Corticotropin (CRH) happens when

When asleep

Corticotropin (CRH) diagnosises

Cushing syndrome

Thyroid releasing Hormone released

In response to stress and the cold

Thyroid releasing hormone diagnoses

Pituitary and Hyperthyroidsm

Somatostatin inbits

Growth hormone

Somatostatin regulates

Release of Glucagon and insuin in intestines and pancreas

Chromophobic tumors

90 % of pituitary

Treatment for Chromophobia tumor

removal of pituitary gland and radiation

Easinophilic - Pituitary hormone- early in life

Gigantism

Easinophilic - Pituitary hormone- adulthood

Acromegaly: excess secretion of GH

SOMATO statin

suppresses GH

Drug for acromegaly

Octreotide

Octreotide action

Mimics somatostatin

Octreotide effects

CV, CNS, Hyperglycemia

Octreotide NI

Withdraw drug for 4 weeks once per year

Somatotropin used for

Dwarfism

Somatotropin is

Synthetic GH

Somatotropin not effective once

Long bones close

Somatotropin used for

for children with impaired growth

Somatotropin Side effects

Not very common but hyperglycemia

 A clinic nurse is following a 9-year-old boy who is taking somatropin. What will the nurse monitor periodically?

Height

What is a pathophysiologic cause of gigantism

Excess secretion of growth hormone prior to puberty

Diabetes Insipidus (DI)

Deficiency in antidiuretic hormone (ADH

Most common cause of DI

Head trauma

Clinical findings of DI

Large volumes of dilute urine, extreme thirst. signs of dehydration

DI Urine amount

250 ml/hr and Spacific gravity 1.001-1.005

DI water drinking amount

2-20 liters a day

DI treatment

Desmopressin

Desmopressin why?

fewer vascular effects

Desmopressin action

reduces urine volume and increases reabsorption of water

Desmopressin have to give with

adequate fluid replacement

Desmopressin Adverse effects

BBW: CAD warning, Risk for hypoglycemia

Desmopressin BBW

Severe hyponatremia: seizures and death

 A nurse is caring for a client who has diabetes insipidus and is receiving desmopressin. The nurse should identify what as an indication the medication is effective?

Decreased urine output

Syndrome of Inappropriate ADH (SIADH)

Failure to regulate ADH (increased ADH levels)

 A nurse is assessing a client who was admitted with diabetes insipidus. What should the nurse expect to see in the assessment in a client admitted with this condition?

Dehydration

 Which of the following is characteristic of syndrome of inappropriate antidiuretic hormone (SIADH)?

Hyponatremia

Diabetes insipidus and SIADH both Present with

Extreme thirst

Do you lose or gain weight with hypothyroidism

you gain it

levothyroxine leaves what

t3 and t4 in the body

 A client taking propylthiouracil comes to the clinic complaining of sore throat and fever.  What should the nurse suspect is happening with the client?

They have developed leukopenia

Following thyroid surgery, the client should be monitored closely for signs of ________ an indicator of a disturbance in calcium metabolism due to injury of the parathyroid gland.

Tetany

Tetany

Low calcium (Positive Chvostek and Trousseau)

Most common cause of Hypoparathyroism

Removal of thyroid gland

Biggest deficits of Hypoparathyroism

Hyperphophatemia and Hypocalcemia)

Parathyroid hormone (parathormone) regulates

Calcium

 You are caring for a client with hyperthyroidism. On your morning assessment you note that the BP is 190/100. What medication would you expect to see ordered to treat the hypertension?

Propanalol

 You are caring for a client who is being started on levothyroxine for hypothyroidism. What would be included in the teaching for this client?

Take the medication before breakfast on an empty stomach

 Extreme fatigue, hair loss, brittle nails, and dry skin are common clinical manifestations of hyperthyroidism.

True

Thyroid gland secretes

T4, T3, Calcitonin

Thyroid gland affects what

Every major organ system including skeletal muscles, liver and kidney

Pathway of Thyroid

Hypothalamus→ Pituitary gland (TSH)→Thyroid hormones

Thyroid hormones require

Iodine

T3 and T4 functions

Cellular metabolic activity and cell replication

Is the thyroid hormone regulation system postive or negitive feeback

negitive feedback

Calcitonin is secreted in response to what

High calcium level

Calcitonin deposits what into the bones

Calcium

Serum TSH is primary for what

Screening for thyroid function

Primary or thyroidal

dysfunction of the thyroid gland and most common issue

Hypothyridism causes

Autoimmune thyroiditis or HASHIMOTOs disease

Clinical manifestations of Hypothyroidism

Related to decrease in metabolism: weight gain, dry skin, hair loss (everything slows)

Goiter

Increased size of thyroid gland - over stimulation of the thyroid gland

Myxedema coma is

severe life threatening - develops into cardiovascular failure and shock

Myxedema coma symptoms

Hypothermic, Hypotension, decreased respiratory drive

Drug for Hypothyroidism

Levothyroxine (leave thyroid)

L in LEVO (HYPO thyroid)

Life long nessary

E in LEVO (HYPO thyroid)

Early morning & Early stomach

V in LEVO (HYPO thyroid)

Very hyper all around the body

O in LEVO (HYPO thyroid)

Oh Baby (its safe for pregnancy)

Hypothyroidism Increase or decreases warfarin, bronchodilators, and Vasopressors

Increases

Hypothyroidism Diabetes

May need to change Dose of Insulin

Hypothyroidism may affect what in the morning

you ability to absorb nutrients

How many adrenal glands are there

two

Epinephrine

Fight or flight

what releases epinephrine and norepinephrine

Adrenal medulla

Mineral corticoids

regulate fluid and electrolyte balance in the body

Can you live without your adrenal cortext

No

Adrenal cortex how many types of hormones

three

Corticosterioids are useful for what

Supressing inflammation and allergic response

adverse effect of Corticosterioids

Hyperglycemia, GI ulcer, Glucose metabolism

Aldosterone major effect

Electrolyte metabolism

Aldosterone increases

sodium retention in blood

Adrogens

Adrenal sex hormones

Adrogens controlled by

ACTH