Endocrine Disorders

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Author:
rforgan
ID:
72055
Filename:
Endocrine Disorders
Updated:
2011-03-10 10:58:14
Tags:
Medical Surgical Nursing Mosby Lewis ch48 ch50 thyroid parathyroid adrenal anterior posterior pituitary gland
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Description:
Endocrine Disorders: Thyroid, Parathyroid, Adrenal, Anterior Pituitary, Posterior Pituitary
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  1. Hyperthyroidism & Graves disease.
    • Thyroid gland is excreting too much T4
    • Since elevated T4, anterior pituitary will not release TSH
    • Slightly elevated Ca+
    • Skinny "hyper" disease; rapid speech, movement, body temp, insomnia, tremors, diarrhea, decreased muscle strength
  2. Hypothyroidism & Hashimoto's disease.
    • Thyroid gland not excreting enough T3 or T4
    • Since low T3 & T4, anterior pituitary will release more TSH
    • Ca+ levels normal
    • Fat "hypo" lethargic disease; slow mentation, apathy, decreased HR, cold, weakness, arthralgia, paresthesias, constipation, distention, anorexia, N/V, dry, thick skin, puffy face and eyes
  3. Addison's disease.
    • Adrenal gland not excreting enough glucocorticoids, mineralocorticoids
    • Since decreased glucocorticoids, anterior pituitary releases more ACTH (adrenocorticotrophic hormone)
    • High Ca+, K+
    • Low Na+, Cl-
    • Lethargy, fatigue, muscle weakness, GI disturbance, weight loss, menstrual changes, impotence
    • Hypoglycemia, postural hypotension
    • Skin hyperpigmentation "tan" r/t high ACTH levels
    • John F. Kennedy had Addison's
  4. Cushing's disease.
    • Adrenal gland excreting too much glucocorticoids, mineralocorticoids
    • Anterior pituitary producing too much ACTH, causing increased adrenal gland production
    • Low K+, low/normal Ca+
    • High Na+, Cl-
    • Generalized muscle wasting, weakness
    • Moon face, buffalo hump, truncal obesity, skinny arms/legs, hirsutism (masculine looking females)
    • Hyperglycemia, hypertension
  5. Hyperparathyroid.
    • Pituitary gland excreting too much PTH (parathyroid hormone)
    • High Ca+, Cl- (think hyper parathyroid = hyper calcium)
    • Low phosphorous
    • Weakness, anorexia, constipation, emotional disorders, decreased attention span
    • Osteoporosis, fractures, stones, pancreatitis, renal failure, cardiac changes, psychosis, coma
  6. Hypoparathyroid.
    • Pituitary gland not excreting enough PTH (parathyroid hormone)
    • Low Ca+ (think hypo parathyroid = hypo calcium)
    • Sometimes elevated Cl-
    • High phosphorous
    • Tingling in fingers, hands, feet, lips, tetanus, muscle cramps, difficulty walking, throat constriction, laryngospasm, dyspnea, GI cramping, incontinence, behavioral changes, psychosis, brittle hair/nails, seizure, hyperreflexive deep tendons
    • Chvostek's (cheek tap) & Trousseau's (BP cuff, forearm/hand flexion) signs
  7. Symptoms of Inappropriate Antidiuretic Hormone Hypersecretion (SIADH).
    • Posterior pituitary excreting too much ADH (antidiuretic hormone)
    • Low Na+, Cl-, serum osmolality (think too much water, too dilute)
    • High urine concentration (not enough water leaving body)
    • Commonly found in small cell carcinoma (lungs), pneumonia, brain tumors, head trauma, stroke, meningitis, encephalitis
    • Low (Na+) and wet (water retention)
  8. Diabetes Insipidus.
    • Posterior pituitary not excreting enough ADH (antidiuretic hormone) -or- renal insensitivity to ADH
    • High Na+, serum osmolality (think water leaving too quickly, dehydration)
    • Low urine concentration (water in urine, not body)
    • Polyuria, polydyspia
    • High (Na+) and dry (dehydrated)

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