MED-SURG Exam 3 Study Guide - A comprehensive review of the material covered for Prof. Martinez Medical (Primary concepts of adult nursing)
ENDOCRINE
... [Show More] DISORDERS (CH 52)
ADRENAL + PITUITARY DISORDERS
PITUITARY GLAND
-Abnormalities of the anterior and posterior portion of the gland may occur independently -Hypofunction of the pituitary gland (hypopituitarism) can result from disease of the pituitary gland itself or of the hypothalamus (result is essentially the same)
-hypopituitarism can result from radiation therapy to the head + neck
-Total destruction of pituitary gland (ex. by trauma or tumor) removes all stimuli that are
normally received by thyroid, gonads, and adrenal glands. Result is extreme weight loss, emaciation, atrophy of all endocrine glands + organs, hair loss, impotence, amenorrhea, hypometabolism, and hypoglycemia...Coma + death occur if missing hormones are not replaced
ANTERIOR PITUITARY
-TSH, ACTH, FSH, and LH release hormones from other endocrine glands -Prolactin acts on the breast to stimulate milk production
-GH protein hormone that increases protein synthesis in many tissues, increases the breakdown of fatty acids in adipose tissue, and increases the glucose level in the blood (these actions of GH are essential for normal growth)
Oversecretion:
• ACTH (Cushing’s)
• “Cushing’s syndrome – elevated cortisol level; blood sugar may be high”
• Basophilic tumors giv
• rise to Cushing syndrome with features highly attributable to hyperadrenalism, including masculinization and amenorrhea in females, truncal obesity, HTN, osteoporosis, and polycythemia
• GH (acromegaly)
• Acromegaly = excess of GH in adults, results in enlargement of peripheral body parts without an increase in height
• Oversecretion of GH in children results in gigantism, person may grow up to 7 or 8 feet tall
• “Acromegaly – hypersecretion of GH; everything will be overdeveloped
– a lot of cardiac complications *
– sometimes they cannot see properly
– enlarged extremities, forehead
– female – might have issues with periods, anuria, or unable to have babies”
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• Eosinophilic tumors that develop early in life result in gigantism – person may be over 7 ft. tall + large in all
proportions, but so weak + lethargic that can barely stand. If the disorder begins during adult life, the excessive skeletal growth occurs only in the feet, hands, superciliary ridge, molar eminences, nose, chin, giving rise to ACROMEGALY.
Insufficient secretion:
– GH (dwarfism)
• Dwarfism = insufficient secretion of GH during childhood results in generalized limited growth
• “Dwarfism – undersecretion of GH; other glands will be underdeveloped”
– Panhypopituitarism undersecretion commonly involving all of the anterior pituitary hormones
• Atrophy (shrining) of the thyroid gland, adrenal cortex, & gonads (b/c of loss of the
tropicstimulating hormones)
• “everything is going to be decreased/diminished as a result”
POSTERIOR PITUITARY
- vasopressin (ADH) + oxytocin = hormones secreted by posterior lobe of pituitary gland; stored in the post. pit. but synthesized in the hypothalamus
- ADH = controls excretion of water by the kidney; ADH secretion is stimulated by: an increase in osmolality of the blood or be a decrease in BP
- Oxytocin – secretion is stimulated during pregnancy + childbirth; facilitates milk ejection during lactation & increases contractions during labor + delivery
Diabetes Insipidus (DI) LOW ADH
• “DI = posterior pituitary is not producing enough ADH (vasopressin); patient will be eliminating a lot
of diluted urine (about 250 mL of urine an hour) so you need to give the
vasopressin” • too little ADH = will eliminate a lot of fluid
Syndrome of Inappropriate Antidiuretic Hormone (SIADH) secretion HIGH ADH
• “a lot of fluid accumulation”
• too much ADH = will retain a lot of fluid
DIABETES INSIPIDUS [Show Less]