Archer Endocrine Study Set: Key Terms & Definitions

hypothalamus releases what

TRH

corticoid releasing hormone

pituitary gland releases what

TSH

follicle stimulating hormone

lutenizing hormone

oxytocin

ADH

glucocorticoids

affects mood, causes immunosuipression, breakdown fats and proteins, inhibits insulin

mineralocorticoids

aldosterone

-retention of sodium and water

-excretion of potassium

how to remember steroid hormones effect

SUGAR SALT AND SEX

Glucocorticoids mineralocorticoids androgens

Methylprednisolone

- Corticosteroid

- inflammation, allergy, autoimmune disorders

-suppress inflammation and normal immune response

norepinephrine

increases BP, pupil dialtion, increases contractility, inhibits GI system activity

epinephrine

increases metabolism, increase glucose levels in blood by inhibiting secretion of insulin

look for issue with ADH if patient has what

craniotomy, head injury, sinus surgery

Levothyroxine (Synthroid) nursing considerations

- must be taking on an empty stomach

- take at the same time every day

- life long therapy

Calcitonin

produced by thyuroid gland, stops bones from releasing more caclium into blood, opposes PSH

Glucagon

causes glycogenolysis of glucogen in the liver, released when BG is low

iodine

used to reduce the size and vascularity of the thyroid gland in hyperthyroidism

what drugs decrease serum calcium

biphosphonates such as alendronate and risedronate and calcitonin

calcitriol

A hormone produced from vitamin D that acts in essentially the same manner as parathyroid hormone.

-increases serus calcium

rapid acting insulin

insulin aspart insulin lisper

insulin lispro and aspart onset

15 min

when is patient at highest risk for hypoglycemia with insulin

at peak

insulin aspart peak

1-3 hrs

insulin lispro peak

30-90 mins

insulin lispro duration

5 hrs

insulin aspart duration

3-5 hrs

short acting insulin

regular

short acting insulin onset, peak and duration

30 min, 2-4 hrs, 5-12 hrs

intermediate acting insulin

NPH

NPH insulin onset, peak, duration

1-4 hrs, 4-12 hrs, 10-24 hours

long acting insulin name

glargine

glargine onset, peak, duration

1-4 hrs, none, 24 hrs

mixing insulin

glargine cannot be mixed

draw up regular insulin, then NPH

RN

subcutaneous injection sites

abdomen, anterior thigh, flank, scapular, buttocks, outer aspect of the upper arm

how is glucagon administered

IM, used for emergency hypoglycemia treatment

Metformin nursing considerations

do not give to clients with renal or hepatic impairement

take with food

hold for 24 hr before and 48 hrs after any study withIV contrast

addison's disease side effects

fatigue weight loss hypoglycemia, confusion, bronze skin, hypovolemia, hyperkalemia, hypotension, hair loss, hyperpigmentation,

insulin is produced -> hypoglycemia (think of these effects)

treatment addison's disease

think shock

-increase IV fluid admin

-increase sodium intake

-rreplacement therapy

-monitor vitalas

-educate ons signs of adrenal crisis

-I&O

-daily weight

Addisonian crisis treatment

Shock management

Fluid resuscitation using 0.9% NS and 5% dextrose

High-dose hydrocortisone IV push (tapper slowly or they will enter adrenal crisis)

cushing's disease side effects

potassium excretion, fluid retention, immunosuppresion, hyperglycemia, mood alteration, fat redistribution (buffalo hump), muscle waisting

high bp-> they are holding on to water

you can test with dextamethasone supression test or 24 hour urine collection

treatment of cushing's

avoid infection, adrenalectomy (remove gland)

conn's disease is caused by

caused by tumor on adrenal gland and makes too musch aldosterone

conn's disease symptoms

hypertension, hypernatremia, hypokalemia

pheochromocytoma

tumor of adrenal medulla secretes excessive epinephrine and norepinephrine

important pheochromocytoma nursing consideration

don't palpate because it can cause an increase in fight or flight hormones

Pheochromocytoma symptoms

tachycardia, palpitations, hypertension, diaphoresis, abdominal pain, chest pain, severe headache

diabetes insipidus (DI) can lead to what emergency

shock

DI side effects

large amounts of dilute urine, hypotension, tachycardia, headache, dry eyes, lack of concentration + memory, dehydration

lab values in DI

decreased USG and urine osmolarity

increased sodium

increased sodium osmolarity

hyperkalemia

treatment for DI

vasopressin, replace fluids, MONITOR NEURO STATUS

SIADH symptoms

weight gain but no edema (kidneys are helping body stay euvolemic), anorexia, nausea, vomitnig, low serum sodium (watch for seizures, irritability, confusion, hallucinations)

low urine output

body is euvolemic (water is retained)

lab values SIADH

concentrated urine

increased urine sodium, increased specific gravity, increase urine osmolality,

dilute blood

increased blood volume, decreased blood osmolality, hyponatremia, anemia

treatment for SIADH

monitor serum sodium, seizure precautions, fluid restriction, hypertonic fluids

what is the fluid of choice for SIADH

hypertonic saline

Hypothyroidism symptoms

constipation, weight gain, puffy face, bradycardia, intolerant of cold, dry skin

hyperthyroidism symptoms

sweating, exophthalmos, goiter, arrhythmia, muscle weakness, hungry, weight loss

first line treatment for hypertyrodisim

methimazole - antithyroid medication

thyroid storm

fever, super high heart rate, palpitaitons, SOB

give BB or adenosine to help high heart rate

WITH THYROIDECTOMY, WHAT TO WATCH FOR

keep trach set at bedside

watch for hypocalcemia

Thyroidectomy complications

hypocalcemia = tetany (chvostek's/trusseau's) (because they can remove the thyroid )

paresthesia

thyrotoxicosis (thyroid storm)

throat swealling (glottal edema)

hemorrhage/hematoma

vocal cord paralysis (hoarseness)

dmg to parathyroid glands

Hypoparathyroidism symptoms

symtoms of hypocalemia

-Muscle cramps

-Tetany

-Chvostek sign (facial muscle contraction when tapping facial nerve)

-Trousseau sign (carpal tunnel spasm with BP cuff tight)

-Circumoral tingling (around lips)

-Tingling of hands and feet

-seizures and parkinsons or dystonia

-Cognitve changes

-Cataracts

-Hyperactive DTRs

how to treat hypoparathyroidism

calcium replacement and phosphate binders (calcium carbonate or tums)

-activated vitamin D

hyperparathyroidism tretament

take out gland

-only 2/4

can cause rebound hypoglycemia if you take out too much

type 1 diabetes symptoms

frequent urination, fatigue, irritability, extreme hunger, weight loss, increased thirst, blurred vision

diabetic ketoacidosis signs

polydipsia, polyphagia, polyuria, high serum potassium, kussmaul respirations (metabolic acidosis)

-difficulty breathing, feeling weak, dry flushed skin, high ketones in urine

DM type II symtpoms

blurred vision, frequent urination, excessive thirst and dry mouth, slow wound healing, tingling and numbness in hands and feet, sexual issues, recurrent fungal infections, sfatigue

why is perfusion bad in DM

sugar in blood makes blood thick and sticky, harder to get into capillaries

aspart

rapid acting insulin

cannot be given iv

only insulin that can be given IV

regular (short-acting)

store insulin

refrigerator

not in direct heat

only cloudy insulin

NPH

dka treatment

HOURLY BG AND K+ CHECKS

evaluate abg

prevent shock

NS to start then when glucose lowered to 250/300 use D5W to prevent hypoglycemia

lower glucose slowly

Hyperglycemic Hyperosmolar Nonketotic Syndrome (HHNS)

extremelly high blood glucose levels, blood becomes hyperosmolar, kidneys start producing more urine due ot hyperosmolarity of blood, polyuria leads to dehydration which leads to shock, no KETONES in urine

exercise with diabetes

eat before exercises, exercise when blood sugar is at its highest

basal/bolus system

long acting agent given once per day and rapid-acting agent given with meals to cover carbs eaten

Hypoglycemia symptoms

Tachycardia

Irritable

Restlessness

Excessive hunger

Diaphoresis (clammy)

how to treat hypoglycemia

1. have a snack-about 15 grames of carbs

-4-6 oz of sugar drink

-8-10 pieces of candy

2. wait 15 mins and check BG again

3. if still <70, have another 15 grams of carbs

4. after the BG rises, eat a snack with complex carb/protein to keep BG up

-crackers with peanut butter

what is client with hypoglycemia is unconscious

if IV access-push D50W

if no iv- iM glucagon