RNSG 2432 Endocrine Critical Care 2023/2024 TEST BANK RN Rated A+ Guaranteed
Success
If a patient is diagnosed with pheochromocytoma, what S&S would you expect to see? What is
the hallmark sign? - (ANSWERS)Deep breathing
Pounding heart 很高兴见到你
Headache
Moist cool hands & feet
Visual disturbances
@#$%^%$#@
*Hallmark sign = EXTREMELY high HR & BP*
Primary goal/ Primary treatment: Pheochromocytoma
- Preop meds/ concerns? - (ANSWERS)Primary goal = decrease blood pressure
Primary treatment = tumor removal
Pre - op:
Calcium channel blockers (Cardene)
Sympathetic blocking agents (Minipress): watch for orthostatic hypotension, teach to change
positions slowly
Beta blocking agent (Inderal)
Discuss the intra and post operative risks for a patient undergoing surgery to treat a
pheochromocytoma? - (ANSWERS)During surgery: give REGITINE & NIPRIDE to prevent
hypertensive crisis
Postop: BP may be increased initially, BUT CAN BOTTOM OUT
Can give Volume expanders & Vasopressors
Hourly I/ O
Observe for hemorrhage (very vascular)
Describe the anterior pituitary and the 6 hormones it secretes (know alternate hormone
names!) - (ANSWERS)Regulated by the hypothalamus through releasing & inhibiting hormones.
Secretes:
1) ACTH (Adrenocorticotropic hormone) -aka *Corticotropin* --- know this!!
- Stimulates the adrenal cortex to secrete cortisol
2) TSH - aka *Thyrotropin*: Stimulates thyroid to secrete thyroid hormones (T3 & T4)
3) FSH : Stimulates growth of ovarian follicles & spermatogenesis in males
4) LH (Leutenizing hormone): Regulates growth of gonads & reproductive activities
5) GH (Growth hormone) aka *Somatotropin*- Affects all tissues in the body: --- know this!!
- G&D of skeletal muscles and long bones (which affects a persons size/ height)
- plays a role in protein, fat, cholesterol metabolism
- glucose regulation & metabolism
6) Prolactin aka luteotropin/mammotropin: Promotes mammary gland growth and milk
secretion
, RNSG 2432 Endocrine Critical Care 2023/2024 TEST BANK RN Rated A+ Guaranteed
Success
Briefly describe the 3 disorders due to HYPER-secretion of the anterior pituitary hormones
(Prolactin, LH, GH) - (ANSWERS)1) Prolactin = Increased prolactin secretion = Galactorrhea
- spontaneous flow of milk from the breast, unassoc with childbirth or nursing) 很高兴见到你
2) LH = Increased LH secretion = stimulates the growth of the gonads
3) GH = Increased GH secretion = *Gigantism or Acromegaly*
- Over production of GH is usually caused by a benign tumor, which leads to overgrowth of
@#$%^%$#@
bones and soft tissues
Patho/ S&S: Acromegaly - (ANSWERS)*Excessive secretion of GH in ADULTS* (A is for Adult)
- The problem develops after epiphyseal closure in adults, & the bones are unable to grow
longer
S&S: enlargement of hands/ feet, joint pain, thickening of bones (become wide, brittle),
*prognathism (protruding of the mandible)*, HTN, weight gain, HA, visual disturbances, DM,
*enlargement liver & heart*, & potentially other organs
Prognosis: If tumor is removed/problem fixed, they can live about 60-70 years old (typically will
die from CV issues d/t organ enlargement)
Describe Pre & Postop concerns for a Transsphenoidal Hypophysectomy. - (ANSWERS)Most
common to remove pituitary tumors. Incision is made thru the flow of the nose into the sella
turcica.
(Pre-op) Patient may feel anxious related to: body changes, fear of the unknown, brain
involvement, chronic condition with life long care (d/t hormone replacement).
- If the entire gland is removed, then hormone replacement will be life long. If part of the gland
is removed, they will have to see what happens after surgery to determine how much
replacement will be necessary)
(Post-op) : *FREQUENT NEURO CHECKS IS MOST IMPORTANT!*
- Sensory-perceptual alteration: diplopia (very common d/t pressure on optic nerve)
- Alteration in comfort: HA (very common; r/t tumor growth & post op edema), Periocular
edema/ ecchymosis
If packing comes out of pt's nose, DO NOT re-pack, call Dr; will no longer be sterile & could
increase risk of infection
What if rhinorrhea is discovered on your pt who is post op Transsphenoidal Hypophysectomy?
(what do you do first??) - (ANSWERS)Call Dr. FIRST!!!!!
Test later for halo sign, raise HOB to 30 degrees, have pt remain on bed rest. Concern with
rhinorrhea is increased risk of meningitis if CSF.
Success
If a patient is diagnosed with pheochromocytoma, what S&S would you expect to see? What is
the hallmark sign? - (ANSWERS)Deep breathing
Pounding heart 很高兴见到你
Headache
Moist cool hands & feet
Visual disturbances
@#$%^%$#@
*Hallmark sign = EXTREMELY high HR & BP*
Primary goal/ Primary treatment: Pheochromocytoma
- Preop meds/ concerns? - (ANSWERS)Primary goal = decrease blood pressure
Primary treatment = tumor removal
Pre - op:
Calcium channel blockers (Cardene)
Sympathetic blocking agents (Minipress): watch for orthostatic hypotension, teach to change
positions slowly
Beta blocking agent (Inderal)
Discuss the intra and post operative risks for a patient undergoing surgery to treat a
pheochromocytoma? - (ANSWERS)During surgery: give REGITINE & NIPRIDE to prevent
hypertensive crisis
Postop: BP may be increased initially, BUT CAN BOTTOM OUT
Can give Volume expanders & Vasopressors
Hourly I/ O
Observe for hemorrhage (very vascular)
Describe the anterior pituitary and the 6 hormones it secretes (know alternate hormone
names!) - (ANSWERS)Regulated by the hypothalamus through releasing & inhibiting hormones.
Secretes:
1) ACTH (Adrenocorticotropic hormone) -aka *Corticotropin* --- know this!!
- Stimulates the adrenal cortex to secrete cortisol
2) TSH - aka *Thyrotropin*: Stimulates thyroid to secrete thyroid hormones (T3 & T4)
3) FSH : Stimulates growth of ovarian follicles & spermatogenesis in males
4) LH (Leutenizing hormone): Regulates growth of gonads & reproductive activities
5) GH (Growth hormone) aka *Somatotropin*- Affects all tissues in the body: --- know this!!
- G&D of skeletal muscles and long bones (which affects a persons size/ height)
- plays a role in protein, fat, cholesterol metabolism
- glucose regulation & metabolism
6) Prolactin aka luteotropin/mammotropin: Promotes mammary gland growth and milk
secretion
, RNSG 2432 Endocrine Critical Care 2023/2024 TEST BANK RN Rated A+ Guaranteed
Success
Briefly describe the 3 disorders due to HYPER-secretion of the anterior pituitary hormones
(Prolactin, LH, GH) - (ANSWERS)1) Prolactin = Increased prolactin secretion = Galactorrhea
- spontaneous flow of milk from the breast, unassoc with childbirth or nursing) 很高兴见到你
2) LH = Increased LH secretion = stimulates the growth of the gonads
3) GH = Increased GH secretion = *Gigantism or Acromegaly*
- Over production of GH is usually caused by a benign tumor, which leads to overgrowth of
@#$%^%$#@
bones and soft tissues
Patho/ S&S: Acromegaly - (ANSWERS)*Excessive secretion of GH in ADULTS* (A is for Adult)
- The problem develops after epiphyseal closure in adults, & the bones are unable to grow
longer
S&S: enlargement of hands/ feet, joint pain, thickening of bones (become wide, brittle),
*prognathism (protruding of the mandible)*, HTN, weight gain, HA, visual disturbances, DM,
*enlargement liver & heart*, & potentially other organs
Prognosis: If tumor is removed/problem fixed, they can live about 60-70 years old (typically will
die from CV issues d/t organ enlargement)
Describe Pre & Postop concerns for a Transsphenoidal Hypophysectomy. - (ANSWERS)Most
common to remove pituitary tumors. Incision is made thru the flow of the nose into the sella
turcica.
(Pre-op) Patient may feel anxious related to: body changes, fear of the unknown, brain
involvement, chronic condition with life long care (d/t hormone replacement).
- If the entire gland is removed, then hormone replacement will be life long. If part of the gland
is removed, they will have to see what happens after surgery to determine how much
replacement will be necessary)
(Post-op) : *FREQUENT NEURO CHECKS IS MOST IMPORTANT!*
- Sensory-perceptual alteration: diplopia (very common d/t pressure on optic nerve)
- Alteration in comfort: HA (very common; r/t tumor growth & post op edema), Periocular
edema/ ecchymosis
If packing comes out of pt's nose, DO NOT re-pack, call Dr; will no longer be sterile & could
increase risk of infection
What if rhinorrhea is discovered on your pt who is post op Transsphenoidal Hypophysectomy?
(what do you do first??) - (ANSWERS)Call Dr. FIRST!!!!!
Test later for halo sign, raise HOB to 30 degrees, have pt remain on bed rest. Concern with
rhinorrhea is increased risk of meningitis if CSF.
