Maryville Exam 3 Nurs 611 QUESTIONS WITH VERIFIED ANSWERS

Maryville Exam 3 Nurs 611 QUESTIONS WITH VERIFIED ANSWERSIron deficiency IDA can arise inadequate dietary intake or excessive blood loss. The most common cause in developed countries is pregnancy and chronic blood loss. Early symptoms are nonspecific and include fatigue, weakness, shortness of breath, and pale earlobes, palms, and conjunctivae Hyperpituitarism: Primary Adenoma are usually benign slow-growing tumors that arise from cells of the anterior pituitary. Local expansion may cause both neurologic and secretory defects. The adenomatous tissue secretes the hormone of the cell type from which it arose, without regard to physiologic needs and without benefit of regulatory feedback mechanisms. 00:32 01:22 Hyperpituitarism: Primary Adenoma the pressure produced by this adenoma is also associated with decreased function of neighboring anterior pituitary cells, which results in hyposecretion of other anterior pituitary hormones Hypersecretion of Prolactin Prolactinoma Hypersecretion of Prolactin Pituitary tumors that secrete prolactin, prolactinomas, are the most common of the hormonally active pituitary adenomas Hypersecretion of Prolactin Other conditions or medications can elevate prolactin level in the absence of a pituitary pathologic condition. For example, renal failure, polycystic ovarian disease, breast stimulation, or even the stress of venipuncture can increase prolactin levels. Hypersecretion of Prolactin Prolactin is under tonic inhibitory hypothalamic control through the secretion of dopamine prolactin inhibitor factor [PIF] Thus medications that block the effects of dopamine can increase prolactin production and stimulate proliferation of prolactin-secreting cells lactotropes. Hypersecretion of Prolactin antipsychotics risperidone, chlorpromazine metoclopramide, tricyclic antidepressants, and methyldopa. Any process that interferes with the delivery of dopamine from the hypothalamus to the lactotropes pituitary stalk tumor, pituitary stalk transection, or compressive pituitary tumor also results in hyperprolactinemia. Because TRH stimulates prolactin secretion, in addition to enhancing TSH release, prolactin concentration may be elevated in individuals with primary hypothyroidism. prolactinoma is sustained increases in serum prolactin concentration. These tumors can be classified as microprolactinomas <1 cm in size or macroprolactinomas >1 cm in size . Central nervous system symptoms may develop because of growth and pressure of the adenoma within the sella turcica. Microprolactinomas are usually encapsulated and noninvasive, Macroprolactinomas commonly expand into the optic chasm, invade local structures, and are more difficult to treat. Because the adenoma can become an increasingly space-occupying lesion, hypopituitarism may occur because of compression of surrounding hormone-secreting cells Central nervous system symptoms may develop because of growth and pressure of the adenoma within the sella turcica. actions of prolactin include breast development during pregnancy, postpartum milk production, and suppression of ovarian function in nursing women 00:02 01:22 Pathologic elevation of prolactin hyper levels inhibits the pulsatile secretion of gonadotropin-releasing hormone, alters the pattern of release of luteinizing hormone and follicle-stimulating hormone, and suppresses gonadal steroidogenesis, thereby resulting in hypogonadotropic hypogonadism in both sexes. This causes amenorrhea, infertility, nonpuerperal milk production galactorrhea, and hirsutism in women. If not detected until after many years, estrogen deficiency may result in osteopenia or osteoporosis. Hyperprolactinemia in men causes erectile dysfunction, infertility, and osteopenia. Symptoms related to the increasing size of the adenoma include headache or visual impairment Hypothyroidism Lower levels of thyroid hormone result in decreased energy metabolism resulting in constipation, bradycardia, and lethargy. In primary hypothyroidism the loss of functional thyroid tissue leads to a decreased production of TH. Causes in adults include autoimmune thyroiditis Hypothyroidism Hashimoto disease, iatrogenic loss of thyroid tissue after surgical or radioactive treatment for hyperthyroidism, head and neck radiation therapy, medications, and endemic iodine deficiency. Hyperthyroid Conditions Graves Disease results from a form of type II hypersensitivity in which there is stimulation of the thyroid by autoantibodies directed against the TSH receptor. Hyperthyroid Conditions These autoantibodies, called thyroid-stimulating immunoglobulins override normal regulatory mechanisms. The TSI stimulation of TSH receptors in the gland results in hyperplasia of the gland goiter and increased synthesis of TH Hyperthyroid Conditions Increased cardiac output and decreased peripheral resistance; tachycardia at rest; supraventricular dysrhythmias Restlessness; short attention span; compulsive movement; fatigue; tremor; insomnia; increased appetite; emotional lability Hyperthyroid Conditions Enlarged thyroid gland goiter; bruit over thyroid; hypercalcemia and decreased PTH secretion Oligomenorrhea or amenorrhea; erectile dysfunction and decreased libido Weight loss; increased peristalsis leading to less formed and more frequent stools Excessive sweating, flushing, and warm skin; heat intolerance; hair fine, soft,; hair loss Hypothyroidism Reduction heart rate causing lowered cardiac output; ECG changes: sinus bradycardia Dyspnea Reduced renal blood flow; reduced production of erythropoietin Constipation, weight gain, and fluid retention; decreased absorption of most nutrients