NURS 251 Portage Study Guide 1

Where in the body is the pituitary gland located? - The pituitary gland is located in the brain near the hypothalamus. What is the primary substance released from the pituitary gland? - Its primary role is to release hormones into the body that control other glands within the endocrine system. What are the two lobes of the pituitary gland called - Anterior Pituitary Gland & Posterior Pituitary Gland Hormones associated with the anterior pituitary gland - -Adrenocorticotropic Hormone (ACTH) -Follicle Stimulating Hormone (FSH) -Growth Hormone (GH) -Luteinizing Hormone (LH) -Prolactin (PH) -Thyroid Stimulating Hormone (TSH), Hormones associated with the posterior pituitary gland - -Antidiuretic Hormone (ADH) -Oxytocin Uses of somatropin - used in children who are deficient in Growth Hormone to promote linear growth Uses of octreotide - Used in the treatment of severe watery diarrhea caused by a slow growing tumor Uses of vasopressin - used in emergency situations when blood pressure is dropping too low Uses of desmopressin - used to treat certain blood disorders Two common disorders associated with the thyroid gland - Hypothyroidism & Hyperthyroidism Hypothyroidism symptoms - cold intolerance, unintentional weight gain, depression, dry brittle hair and nails, and fatigue Hyperthyroidism symptoms - diarrhea, flushing, increased appetite, muscle weakness, fatigue, palpitations, irritability, nervousness, heat intolerance and altered menstrual flow What is levothyroxine? - a synthetic thyroid hormone used in hypothyroidism Levothyroxine mechanism of action and special use instructions - Essentially levothyroxine works in the same manner as the endogenous hormone, Thyroxine or T4. By taking levothyroxine, the deficiency is corrected. However, it can be impacted by food or drugs and so it is recommended to take on an empty stomach 30-60 minutes prior to breakfast. Hyperthyroidism drugs (and how they work) - methimazole and propylthiouracil (PTU) are two antithyroid drugs available that work by inhibiting the formation of the thyroid hormones. Two conditions that can occur when there is a deficiency or excess of glucocorticoids released from the adrenal cortex. - Addison's disease- deficiency Cushing's syndrome- excess Describe how glucocorticoids exert their anti-inflammatory effect. - The glucocorticoids work at the cellular level to bind to receptors that either activate the production of anti-inflammatory proteins or prevent proinflammatory protein production. Describe the risks associated with long term use of glucocorticoids. - Symptoms similar to Cushing's disease such as, abnormal fat deposits causing a rounded "moon face" or "buffalo hump" on their shoulders. Steroid psychosis is associated with long term use. Prolonged use will result in increased gluconeogenesis which can lead to obesity or diabetes. It will also lead to increased protein catabolism which will show up as muscle weakness and wasting, thinning of skin, osteoporosis, decreased growth in children, decreased wound healing, increased infections. Explain the basic mechanism of action around contraceptive medications. - By taking an oral contraceptive, the women is introducing exogenous estrogen and progesterone into their body that would not normally be there. This is enough of a change to signal the inhibition of FSH and LH resulting in no ovulation as well as changes to the endometrium that prevent implantation. Describe the basic pathophysiology of diabetes, specifically in the pancreas. - Diabetes is when the pancreas no longer produces insulin or the cells in the body stop responding to insulin or some combination of the two. Hyperglycemia - higher than normal glucose level in the blood; fasting blood glucose greater than 126mg/dl Hypoglycemia - lower than normal range of glucose levels in the blood. Typically defines as less than 70mg/dl accompanied with symptoms in patients with diabetes. Insulin - Insulin is the hormone secreted by the beta cells of the pancreas in response to a rise in glucose levels in the blood Type 1 diabetes - An autoimmune disorder in which autoantibodies are produced against the beta cells in the pancreas that secrete insulin. Type 2 diabetes - Far more common accounting for at least 90% of all patients with diabetes. Type 2 is caused by both an insulin resistance and an insulin deficiency. Meaning there is overall less insulin and that the insulin that is there is not working efficiently. This insulin deficiency results from a loss of the normal responsiveness of the beta cells. In addition, there is a reduction in the number of insulin receptors on the cells and the receptors present are less sensitive. Obesity is a contributing factor in type 2 diabetes. List long term consequences of diabetes, both micro and macro vascular. - Macrovascular - primarily diseases of the coronary arteries (increased risk or stroke,