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What does the endocrine system consist of?
ductless glands that secrete hormones into the bloodstream.
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What are hormones?
- Chemical substances synthesized from amino acids & cholesterol that act on body tissues & organs & affect cellular activity.
- *affect metabolism
- *negative feedback system
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Hormones can be divided into two catagories, what are they?
- Proteins or small peptides
- Steroids
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Where do the steroid hormones come from?
Adrenal glands & gonads
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Which glands are included in the Endocrine system?
- Pituitary
- Thyroid
- Parathyroid
- Adrenals
- Gonads
- Pancreas
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What are the two ways Endocrine medications work?
Mimic or Block the effects of natural hormones
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Why are Endocrine medications needed?
- The body is making to much hormone
- The body is not making enough hormone
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What does the posterior pituitary gland do?
Secretes ADH (vasopressin) & oxytocin
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Where are ADH & Oxytocin manufactured?
Hypothalamus & stored in the posterior pituitary
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What does ADH hormone do?
^reabsorption of water from the renal tubules, returning it to the systemic circulation.
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What does Oxytocin do?
stimulates contraction of the smooth muscle of the uterus & mammary glands
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What hormones are secreted by the Anterior Pituitary Gland?
- Growth hormone (GH)
- Thyroid-stimilating hormone (TSH)
- Adrenocorticotropic hormone (ACTH)
- Gonadotropins (FSH), (LH)
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What does Growth hormone (GH) do?
Stimulates growth in tissue & bone
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What is the actions of Thyroid-stimulating hormone (TSH)?
Acts on thyroid gland
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What does the Adrenocorticotropic hormone (ACTH) do?
Stimulates adrenal glands to release Glucocorticoids (cortisol), Mineralcorticoids (Aldosterone), & Androgen.
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What is the action of Gondadotropins (FSH), (LH)?
Regulate hormone secretion from the ovaries & testes
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Explain how Growth Hormones work.
Act directly on bones. Stimulate tissue & bone growth, mobilize glucose & free fatty acids.
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What can happen if there are alterations in secretion of Growth Hormones?
- Gigantism: excess prior to closure of epiphyseal shafts.
- Acromegaly: excess after closures.
- Dwarfism: deficiency during childhood
- *inadequate secretion of GH
- *or Genetics
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How do replacement Growth hormones effect a body?
Promote growth both skeletal (at epiphyseal plates) & cellular.
Given: SQ or IM
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Name the Growth Hormone drugs.
- Mimic natural hormone that is lacking.
- Somatrem (Protropin)
- Somatropin (Genotropin, Nutropin)
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What are the s/e of Somatrem & Somatropin?
Hyperglycemia, Insuline resistance, Hypothyroidism
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What are the nursing considerations with the GH Somatropin & Somatrem?
- Montior: Growth rate
- Electrolytes
- Blood sugars
- Athletes are advised NOT to take GH
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What is the Tx for excess GH secretion?
- Drugs that inhibit the release of natural GH
- Mimic the effect of somatostatin (stops growth)
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Name the drugs that inhibit the release of GH.
- Bromocriptine (Parlodel)
- Octreotide (Sandostatin) = inhibits GH, Insulin & glucagon
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Drugs that inhibit GH are used for what diagnosis?
- Acromegaly
- Metastatic Carcinoid
- Other Tumors
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What are the s/e of drugs that inhibit GH like Sandostatin or Parlodel?
- N/V
- Diarrhea
- Abdominal pain
- Hypoglycemia
- rare: hyperglycemia
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Sandostantin acts on Exess GH how?
by mimicking the natural hormone somastatin that blocks somatropin
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What is the action of ACTH (Adrenocorticotropic hormone)?
Stimulates adrenal cortex to secrete cortisol (glucocorticoid)
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The hypothalamus releases Corticotropin-releasing Factor, which stimulates the pituitary corticotrophs to secrete what hormone?
Adrenocorticotropic Homone (ACTH)
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The ACTH drug Corticotropin (Acthar) is used for what purpose?
- In diagnosis of adrenal gland disorders.
- Helps differentiates between pituitary & adrenal causes of Adrenocortical insufficiency
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What are the s/e of the ACTH drug Corticotropin (Acthar)?
- Mood swings, ^appetite, edema, water & Na retention, GI distress, hypokalemia, hypocalcemia, petechiae, ecchymosis, menstrual irregularities
- Osteoporosis, muscle atrophy, <wound healing, glaucoma, cataracts, ulcer perforation, sweating, acne
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What are the nursing interventions for the ACTH drug Corticotropin (Acthar)?
- Monitor: G&D in children, weight, edema, electrolytes
- Do NOT stop drug therapy (taper dose)
- Warn client to <salt intake
- s/s that need reporting
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Where is the antidiuretic hormone Vasopressin secreted from & where is it produced?
- Stored & secreted from Posterior Pituitary gland
- Produced in hypothalamus
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What does ADH (antidiuretic hormone) do?
- promotes water reabsorption from the renal tubules to maintain water balance in the body fluids.
- Vasoconstriction of arterioles
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What patients are deficient in ADH?
Diabetes Insipidus
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What are the factors of Diabetes Insipidus?
- Deficiency of ADH
- Urinary excretion of excessive amts of very dilute urine (5-20 liter/day!!)
- Polydipsia: incredible thirst
- General weakness, altered CNS
- ^serum sodium & osmolaity
- Severe FVD: wt loss, poor tissue turgor, hypotention, tachycardia, shock
- Fatigue from nocturia
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Hormone replacement therapy for ADN promotes what?
Water reabsorption from the renal tubules
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What is ADH replacement therapy used to Tx?
- Diabetes Insipidus
- Hemophilia A
- Von Willebrand disease
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What are the drugs used as ADH replacement therapy?
- Desmopressin (DDAVP, Stimate); PO, IV, nasal
- Vasopressin (Pitressin); IM, SQ
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What are the s/e of the ADH replacement drugs Desmpressin & Vasopressin (Pitressin)?
HA, fluid retention, ^BP, nasal congestion, chest pain, MI, abdominal cramps, N/V/D
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What are the nursing implications for ADH replacement meds?
- Monitor: Electrolytes, BP, Vitals, Wt, fluid imbalances, I&O
- Assess ability to utilize nasal sparys & discurss URI's
- Do NOT take OTC meds for colds, cough or allergies (NO decongestants while on vasopressin d/t ^BP)
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