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Hormones - what do they do
- regulate metabolism
- growth and development
- sexual and reproductive processes
Diabetes insipidus - Etiology
- Characterized by the production of copious amounts of Urine ( usually moer that 2.5L/day) of dilute urine.
- Occurs as a result of decreased ADH (antidirectic hormone)
- Centeral DI - brain tumors,head injury, neurosugery, CNS infections
- Nephrogenic DI - drug therapy or kidney disease
- Dispogenic DI - exessive water intake (sometimes associated w/schizophrenia.
Dibetes insipidus - S/S
- profound diuresis (production of large amts. of urine)
- 15 - 20 L in 24 hrs
- thirst, weakness, fatigue - from nocturia.
- deficient fluid volume: tachycardia, hypotension, weight loss, constipation, poor skin turgor
Diebetes insipidus - diagnoses
Lab test...urine adn plasma osmolality urine specific gravity (a water deprivation test)
Diabetes insipidus - Treatment
- Fluide and Electrolyte replacement
- hormone therapy
- v/s - to establish baselien
caused by atrophy or traumatic injury to parathyroid glands
S/S mild tingling, numbness, muscle cramps, mental changes such as irritabilty. tetany (a muscular twitchin and spasm - serious)
treated by measures to raise serum calcium levels to normal...oral parenteral admin of calcium salts
chronic: vidamin d
Cause postmenopausal women...excessive synthesis of parathoromne...high calcium
S/S: mild or severe: dehydration, confusion, lethargy, anorexia, nausea, vomiting, weight loss, consitipation, thirst, frequent urination, hypertension.
treatment: infusion of isotonic sodium chloried and admin of diuretic agents, phosphate therapy, milthramycin. surgical removal of thyroid...thyroidectomy
Post-op for Thyroidectomy
- Fowlers position
- head may be supported with sandbags torelieve tension on sutures
- V/S continuously progressing to hourly once pt is stable
- watch for signs of bleeding and swelling at site
- rise in temp, pulse, r/r - sould report immediately as may indicate a high level thyroxine in bloodstream.
Thyroid Storm - throid crisis
- complicaiton following a thyroidectomy.
- or od of levothyroxine
- Sudden andextreme elevation of all body processes temp may rise to 106
- pulse 200 beats
- respiration rapid - marked apprehension/restlellness
- pt cna quicky go from delirum,, coma, dealth from heartfailure.
- Treatment must be immediate, reduce temp, cardiac drugs, sedatives
Transsphenoidal - surigical approach for hypophysectomy
hypophsectomy...removal of the pituitary gland
transsphenoidal - via the nose
- Expected findings during assessment:
- Generlized malaise, muscle weakness, muscle pain, orthostatic hypotension adn dysrhthmias.
Cortisol - hydrocortisone (glucocorticoid)
- acts to increase glucose levels in the blood...helps counteract inflammatory response
- helps the body respond to stress
- rare tumor of the adrenal gland causes too much epinephrine/norepinephrine
- treatment: removal of the tumor
- low level of thyroid...can result in coma
- hypotension, hpyothermia, respiratory failure, hyponatremia, hypoglycemia
Inspection: tall, huge facial features, enlared ft, hands, thichened skin, fatigure, weakness, enlarged heart, and organs chest size
remove turmor - transsphenoidal