Rasmussen NUR 2392 MDC II Final Exam
PT PAP HOT What are the glands of the endocrine system? (SATA Q?)
▪ Pituitary
▪ Thyroid
▪ Pancreas
▪ Adrenals
▪ Parathyroid
▪ Hypothalamus
▪ Ovaries
▪ Testes
Grave's disease an autoimmune disorder that is caused by hyperthyroidism and is characterized
by goiter and/or exophthalmos
Treatments HYPERthyroidism aka Grave's disease
▪ Rx: methimazole, atenolol, and iodine-131
▪ radiation therapy ▪ Treatments
Nursing Interventions
▪ provide a calm environment
▪ keep patients room cool
▪ assess pain
▪ prepare patient for surgery
▪ post-operative care
▪ maintain a patent airway
-------- same as hypothyroidism ---------
▪ provide periods of rest
▪ continuous cardiac monitoring
▪ monitor vital signs
▪ daily weight
▪ monitor I&O
▪ monitor laboratory tests
▪ apply antiembolism stockings to prevent DVT
▪ provide skin care
pituitary gland _________ is considered to be the "master gland" as it secretes hormones that
control other parts of the endocrine system.
▪ ACTH Anterior HYPOpituitarism
▪ TSH
▪ Deficiencies of which two hormones are the most life threatening?
▪ are the most life threatening because they cause a
decrease in the secretion of vital hormones from the
adrenal and thyroid glands.
Bloodwork (all are DECREASED) Anterior HYPOpituitarism
▪ T3
▪ T4 ▪ Laboratory & Diagnostic Tests
▪ Prolactin
▪ Testosterone
▪ Estradiol
Scans (you'll always draw blood work first for diagnostics
though)
▪ CT/MRI - detect bone or soft tissue lesions
▪ Skull X-ray - detect enlargement, erosions, and
calcification of the sella turcica
, Rasmussen NUR 2392 MDC II Final Exam
TRUE! We have very small amounts of testosterone or T/F: do both men and women have testosterone and estradiol?
estradiol no matter if we are men or women.
INCREASED: Anterior HYPERpituitarism
▪ Prolactin - this might be the answer to the Q
▪ Cortisol (SATA Q?)
▪ TSH
▪ LH (men) ▪ Laboratory Tests
▪ FSH (men)
▪ Glucose
DECREASED:
▪ Gonadotropin
▪ Prevent infection because they are immunosuppressed HYPERcortisolism (aka Cushing's Disease)
▪ handwashing
Priority Intervention
diabetes insipidus ▪ Deficiency of ADH resulting in large volumes of dilute urine
▪ A disorder of the posterior pituitary gland
They are losing a lot of water: Posterior Pituitary Gland: Diabetes Insipidus:
• polyuria ▪ What will the patient present with?/Key Symptoms
• polydipsia
• dehydration
• fluid/electrolyte imbalance
• dilute, low urine specific gravity (<1.005)
• high plasma osmolarity
• output does not decrease when fluid intake decreases
remember! your s/s are going to look like
dehydration
• tachycardia
• hypotension
• poor turgor
• dry mucous membranes
• decreased cognition
• ataxia
• irritability
▪ desmopressin acetate (a synthetic form Posterior Pituitary Gland: Diabetes Insipidus:
of vasopressin)
▪ can be PO, SL, or intranasal ▪ Drug Therapy
Addison's disease What is adrenal gland hypofunction?
, Rasmussen NUR 2392 MDC II Final Exam
▪ If the patient remains alert and oriented x 3 Addison's Disease
▪ How do you know the therapy is working?
▪ Glucocorticoid drugs MUST be withdrawn slowly so Addison's Disease
you don't wind up with Addison's or adrenal
insufficiency ▪ How do you discontinue glucocorticoid therapy to avoid secondary adrenal
insufficiency?
▪ This allows for pituitary protection of ACTH and
activation of the adrenal cortex to produce cortisol
▪ Muscle weakness Addison's Disease
▪ Muscle/joint pain
▪ Fatigue ▪ Neuromuscular S/S
▪ Hypertension Cushing's Disease aka hypercortisolism
▪ Dependent edema
▪ Bruising ▪ Cardiovascular S/S
▪ Petechiae
INCREASED Cushing's Disease aka hypercortisolism
• blood glucose level
• sodium level ▪ Laboratory Tests
• late-night salivary cortisol
*• urine cortisol*
DECREASED
• lymphocyte count
• calcium level
INCREASED Addison's Disease
▪ potassium (K)
▪ calcium (Ca) ▪ Laboratory Tests
▪ BUN
DECREASED
▪ serum cortisol
▪ salivary cortisol
▪ fasting blood glucose
▪ sodium (Na)
Sodium increases In hyperaldosteronism what happens with potassium and sodium?
Potassium decreases (Remember...it's the opposite of Addison's disease)
Heat intolerance - they are sweaty! Hyperthyroidism aka Grave's disease
▪ Hallmark assessment
PT PAP HOT What are the glands of the endocrine system? (SATA Q?)
▪ Pituitary
▪ Thyroid
▪ Pancreas
▪ Adrenals
▪ Parathyroid
▪ Hypothalamus
▪ Ovaries
▪ Testes
Grave's disease an autoimmune disorder that is caused by hyperthyroidism and is characterized
by goiter and/or exophthalmos
Treatments HYPERthyroidism aka Grave's disease
▪ Rx: methimazole, atenolol, and iodine-131
▪ radiation therapy ▪ Treatments
Nursing Interventions
▪ provide a calm environment
▪ keep patients room cool
▪ assess pain
▪ prepare patient for surgery
▪ post-operative care
▪ maintain a patent airway
-------- same as hypothyroidism ---------
▪ provide periods of rest
▪ continuous cardiac monitoring
▪ monitor vital signs
▪ daily weight
▪ monitor I&O
▪ monitor laboratory tests
▪ apply antiembolism stockings to prevent DVT
▪ provide skin care
pituitary gland _________ is considered to be the "master gland" as it secretes hormones that
control other parts of the endocrine system.
▪ ACTH Anterior HYPOpituitarism
▪ TSH
▪ Deficiencies of which two hormones are the most life threatening?
▪ are the most life threatening because they cause a
decrease in the secretion of vital hormones from the
adrenal and thyroid glands.
Bloodwork (all are DECREASED) Anterior HYPOpituitarism
▪ T3
▪ T4 ▪ Laboratory & Diagnostic Tests
▪ Prolactin
▪ Testosterone
▪ Estradiol
Scans (you'll always draw blood work first for diagnostics
though)
▪ CT/MRI - detect bone or soft tissue lesions
▪ Skull X-ray - detect enlargement, erosions, and
calcification of the sella turcica
, Rasmussen NUR 2392 MDC II Final Exam
TRUE! We have very small amounts of testosterone or T/F: do both men and women have testosterone and estradiol?
estradiol no matter if we are men or women.
INCREASED: Anterior HYPERpituitarism
▪ Prolactin - this might be the answer to the Q
▪ Cortisol (SATA Q?)
▪ TSH
▪ LH (men) ▪ Laboratory Tests
▪ FSH (men)
▪ Glucose
DECREASED:
▪ Gonadotropin
▪ Prevent infection because they are immunosuppressed HYPERcortisolism (aka Cushing's Disease)
▪ handwashing
Priority Intervention
diabetes insipidus ▪ Deficiency of ADH resulting in large volumes of dilute urine
▪ A disorder of the posterior pituitary gland
They are losing a lot of water: Posterior Pituitary Gland: Diabetes Insipidus:
• polyuria ▪ What will the patient present with?/Key Symptoms
• polydipsia
• dehydration
• fluid/electrolyte imbalance
• dilute, low urine specific gravity (<1.005)
• high plasma osmolarity
• output does not decrease when fluid intake decreases
remember! your s/s are going to look like
dehydration
• tachycardia
• hypotension
• poor turgor
• dry mucous membranes
• decreased cognition
• ataxia
• irritability
▪ desmopressin acetate (a synthetic form Posterior Pituitary Gland: Diabetes Insipidus:
of vasopressin)
▪ can be PO, SL, or intranasal ▪ Drug Therapy
Addison's disease What is adrenal gland hypofunction?
, Rasmussen NUR 2392 MDC II Final Exam
▪ If the patient remains alert and oriented x 3 Addison's Disease
▪ How do you know the therapy is working?
▪ Glucocorticoid drugs MUST be withdrawn slowly so Addison's Disease
you don't wind up with Addison's or adrenal
insufficiency ▪ How do you discontinue glucocorticoid therapy to avoid secondary adrenal
insufficiency?
▪ This allows for pituitary protection of ACTH and
activation of the adrenal cortex to produce cortisol
▪ Muscle weakness Addison's Disease
▪ Muscle/joint pain
▪ Fatigue ▪ Neuromuscular S/S
▪ Hypertension Cushing's Disease aka hypercortisolism
▪ Dependent edema
▪ Bruising ▪ Cardiovascular S/S
▪ Petechiae
INCREASED Cushing's Disease aka hypercortisolism
• blood glucose level
• sodium level ▪ Laboratory Tests
• late-night salivary cortisol
*• urine cortisol*
DECREASED
• lymphocyte count
• calcium level
INCREASED Addison's Disease
▪ potassium (K)
▪ calcium (Ca) ▪ Laboratory Tests
▪ BUN
DECREASED
▪ serum cortisol
▪ salivary cortisol
▪ fasting blood glucose
▪ sodium (Na)
Sodium increases In hyperaldosteronism what happens with potassium and sodium?
Potassium decreases (Remember...it's the opposite of Addison's disease)
Heat intolerance - they are sweaty! Hyperthyroidism aka Grave's disease
▪ Hallmark assessment
