| A | B |
|---|
| Pheochromocytoma | (1) may result in malignant hypertension (2) primary surgical treatment is usually adrenalectomy (3) caused by episodic or persistent hypersecretion of catecholamine hormones (4) r/t adrenal hypersecretion |
| Cushing’s Syndrome | (1) involves excessive cortisol levels (2) often caused by chronic use of oral corticosteroids (3) hirsutism and gynecomastia may occur (4) extra potassium may be needed in diet (5) ecchymoses and striae are symptoms (6) symptoms include pendulous abdomen (7) ymptoms include truncal obesity (8) low-calorie diet is recommended (9) moonlike rounding of facial features is common (10) r/t adrenal hypersecretion (11) bffalo hump may be present |
| Addison’s Disease | (1) pts have dark bronze pigment to skin (2) caused by adrenal hyposecretion (3) crisis can arise in relation to severe hypotension and cardiac dysrhythmias |
| Syndrome of Inappropriate Antidiuretic Hormone Secretion (SIADH) | (1) caused by excessive secretion of vasopressin by pituitary gland (2) liguria and weight gain are primary symptoms (3) derebral edema may develop and precipitate seizures |
| Diabetes Insipidus | (1) caused by insufficient secretion of ADH (2) lithium may be a contributing factor (3) dehydration and fever are common |
| Acromegaly | (1) occurs following epiphyseal closure (2) symptoms include somnolence (3) caused by overproduction of growth hormone (4) headaches and vision loss are common (5) enlarged hands and thickened facial features are present |
| Hypopituitarism | (1) replacement of ACTH, TSH, and ADH are required (2) symptoms include loss of axillary and pubic hair (3) headaches and vision loss are common (4) symptoms include growth delay (5) symptoms include cessation of menstruation and infertility |
| Pheochromocytoma | (1) five signs incl (a) N/V (b) nervousness (c) visual disturbances (d) tachycardia (e) palpitations (f) HTN (g) headache (h) hyperhidrosis (i) hypermetabolism (j) hyperglycemia (2) all are symptoms of overactivity of the SNS |
| Malignant HTN | (1) condition in which systolic BP can be over 300 mm Hg w/diastolic BP can be as high as 200 mm Hg (2) caused by constriction of the blood vessels |
| Malignant HTN Assoc w/Pheochromocytoma Interventions | (1) bed rest w/HOB in an elevated position (2) muscle relaxants & antihypertensives (sodium nitroprusside (Nipride)) may be given to immediately & dramatically lower BP |
| Nonpharmacological Interventions Prior to Catecholamine Testing | (1) because physical, mental, or emotional stress of any kind can incr catecholamine levels, it is important to provide a quiet environ before any diagnostic testing (2) bed rest prior to blood & urine analysis (3) teach or encouraged relaxation thru deep-breathing or visualization exercises |
| Catecholamine Testing (Foods To Avoid Prior To) | (1) aspirin, OTC drugs containing stimulants (ephedrine) must be D/C prior to testing (2) foods/beverages to avoid d/t catecholamine production (a) bananas (b) caffeinated drinks (c) chocolate (3) foods that affect urine levels of VMA & sh/not be consumed (a) vanilla (b) alcoholic beverages (c) citrus fruit |
| Adrenal Gland Removal | (1) IV therapy ensures pt is well hydrated (2) inadequate hydration can lead to hypotensive states both during & after surgery |
| Adrenalectomy (Meds Prior To Surgery) | (1) meds (hentolamine (Regitine) and propranolol hydrochloride (Inderal)) to lower & stabilize high BP & correct any cardiac dysrhythmias (2) preop meds may incl alpha & beta adrenergic blocking agents (block or inhibit secretion of catecholamines that could elevate BP to dangerous levels) (3) this often occurs when the adrenal glands are handled during surgery |
| Adrenalectomy (Meds Taken For Life After Bilateral Postsurgery) | (1) corticosteroid therapy for life, generally oral prednisone, to prevent hypoglycemia |
| Pheochromocytoma Diagnostic Tests or Labs | (1) angiography used to detect tumor location (2) glucagon stimulation test used in diagnosis (3) clonidine suppression test used in diagnosis (4) high vanillylmandelic acid (VMA) level in urine |
| Cushing’s Syndrome Diagnostic Tests or Labs | (1) elevated 17-hydrocorticosteroid and 17-ketosteroid levels (2) dexamethasone suppression test used in diagnosis (3) corticotropin stimulation test used in diagnosis (4) |
| Addison’s Disease Diagnostic Tests or Labs | (1) hypoglycemia (2) hyponatremia (3) high WBC (4) decreased serum cortisol (5) hyperkalemia (6) low levels of 17-hydrocorticosteroids and 17-ketosteroids (7) |
| Syndrome of Inappropriate Antidiuretic Hormone Secretion (SIADH) Diagnostic Tests or Labs | (1) hyponatremia (2) specific gravity of urine > 1.030 |
| Diabetes Insipidus Diagnostic Tests or Labs | (1) fluid deprivation test used in diagnosis (2) specific gravity of urine < 1.005 (3) hypernatremia |
| Acromegaly Diagnostic Tests or Labs | (1) high serum GH (2) high serum lipids |
| Hypopituitarism Diagnostic Tests or Labs | (1) low serum GH (2) low serum prolactin |
| Steroid Overdose (Symptoms) | (1) weight gain (2) edema (3) elevated BP (4) euphoria |
| Steroid Dosage Inadequate | (1) weight loss (2) dizziness (3) postural hypotension (4) depression |
| Cushing's Syndrome (3 Polys) | (1) polydipsia, polyuria & polyphagia may occur related to the inhibiting effect of glucocorticoid hormones on insulin (2) frequent infections may occur related to increased susceptibility |
| Cushing's Syndrome (Changing Body Image) | (1) depression & psychosis may occur r/t changing body image & the effect of cortisol on the neurological system |
| Phentolamine (Regitine) | (1) prevents constriction of blood vessels |
| Propranolol Hydrochloride (Inderal) | (1) common antiarrhythmic drug |
| Sodium nitroprusside (Nipride) | (1) used for malignant hypertension |
| Prednisone | (1) often given following bilateral adrenalectomy |
| Metyrapone (Metopirone) | (1) suppresses adrenal secretions |
| Intravenous hydrocortisone (Solu-Cortef) | (1) used in immediate treatment of Addisonian crisis |
| Oral hydrocortisone (Cortef) | (1) given for lifetime management of Addison’s disease |
| Antitussives | (1) given after hypophysectomy to prevent CSF leakage |
| Furosemide (Lasix) | (1) used to treat fluid retention related to SIADH |
| Octreotide | (1) used to treat acromegaly |
| Vasopressin (Pitressin) | (1) antidiuretic hormone given IM to treat diabetes insipidus |
| Pitressin tannate | (1) contraindicated if patient is allergic to peanuts |
| Desmopressin acetate (DDAVP) | (1) comes in a nose spray |
| Addisonian Crisis | (1) imbalanced Na+ & K+ levels result in emotional or physiological stress precipitating an Addisonian crisis (2) symptoms incl back pain, severe dehydration, severe hypotension, tachycardia w/weak pulse, cardiac dysrhythmias, rapid respirations & even circulatory collapse if the aforementioned symptoms are untxed |
| Addisonian Crisis Tx | (1) initial tx is targeted at hypovolemic shock (2) elevate lower extremeties in a shock position (3) IV saline solution sh/be given to restore circulation & raise BP (4) IV dextrose sh/be given to elevate blood sugar (5) corticosteroid therapy will be immediately instituted IV hydrocortisone (Solu-Cortef) |
| Pituitary Surgery Postop Care | (1) (1) afer surgery, cerebrospinal fluid (CSF) can leak into the brain during instances of intracranial pressure (2) activities that incr pressure & sh/be avoided incl sneezing, coughing, & straining w/bowel movement (3) Rx stool softeners & antitussives (4) HOB sh/be elevated 30 deg |
| CSF Leakage S/S | (1) frequent swallowing (2) leakage may be detected by using a reagent strip to check the patient’s nasal drainage for glucose |
| Glucocorticoids | (1) stress hormones |
| Mineralocorticoids | (1) steroid hormones (2) regulate fluid & electrolyte excretion by the kidneys |
| Aldosterone | (1) sodium, water, potassium balance & BP regulatiion |
| Epinephrine & Norepinephrine Effects On Body | (1) bld vessel constriction (2) incr HR & metabolism (3) incr force of heart contractions (4) incr cardiac output (5) dilation of smooth muscles in the bronchioles of lung (6) breakdown of glycogen in the liver & skeletal muscles |
| Thyroid Gland | (1) produces (a) calcitonin (b) triidothyronine (T3) (c) thyroxine (T4) |
| Thyroid Gland & Fetus | (1) adequate amounts of all three (a) calcitonin (b) triidothyronine (T3) (c) thyroxine (T4) essential for normal fetal dev & physical & mental growth thru life |
| Thyroid Hormone | (1) T3 & T4 (2) inv in (a) synthesis of protein (b) speeding of cellular metabolism, which incrs both energy production & body's basal metabolic rate |
| Calcitonin | (1) acts by (a) incr calcium deposition in bones (b)aid in serum calcium regulation (2) important to fetal growth |
| Iodine | (1) important for T3 & T4 synthesis (2) controlled by thyroid stimulating hormone substance secreted by the anterior pituitary gland |
| Parathormone | (2) hormone decrs serum phosphate & K+ levels in blood causing these substances to be excreted in urine (2) regulates amount of serum calcium level in blood w/vitamin D |
| Calcium | (1) essential to proper coagulation of bld & normal neuromuscular function |
| Growth Hormone (Somatotropic Hormone) | (1) stimulates growth thru protein anabolism (2) incrs bld glucose levels (3) breaks down fat in tussues (4) exercise & stress are primary external factors that stimulate GH |
| Catabolism | (1) process of breaking down fat in the tissues |
| Follicle-Stimulating Hormone | (1) stimulates estrogen secretion in women |
| Prolactin | (1) stimulates production of breast milk |
| Luteinizing Hormone | (1) stimulates both estrogen secretion & ovulation in women & testosterone in men |
| Adrenocorticotropic Hormone (ACTH) | (1) stimulates the secretion of cortisol by the adrenal gland |
| Thyroid-Stimulating Hormone | (1) stimulates the secretion of hormones in the thyroid |
| Nephrons | (1) contain the glomeruli that are involved in urine formation |
| Glomerular Filtration | (1) process of urine formation during which urea, creatinine & uric acid are processed into urine |
| Urea | (1) waste product of the metabolism of proteins & amino acids (produced during glomerular filtration) that is processed into urine |
| Uric Acid | (1) product of purine metabolism (produced during glomerular filtration) that is processed into urine |
| Creatinine | (1) a waste product of skeletal muscle metabolism (produced during glomerular filtration) that is processed into urine |
| Endocrine Glands | (1) ductless glands that secrete hormones directly into the bloodstream or lymph system |
| Adrenal Cortex | (1) glucocorticoids (2) mineralocorticoids (3) androgens and estrogens |
| Adrenal Medulla | (1) epinephrine (2) norepinephrine |
| Fight-Or-Flight Response | (1) epinephrine (2) norepinephrine |
| Thyroxine | (1) Increases BMR (2) synthesizes protein |
| Glucocorticoids & Growth hormone | (1) elevates blood glucose levels |
| Mineralocorticoids | (1) aldosterone is an example |
| Corticosteroid Hormone | (1) glucocorticoids (2) mineralocorticoids (3) androgens and estrogens |
| Sex Hormones | (1) androgens and estrogens |
| Growth Hormone | (1) involved in cell growth |
| Glucocorticoids | (1) stress hormones (2) cortisol is an example (3) ecretion is highest in the morning |
| Epinephrine & Norepinephrine | (1) increases cardiac rate and output (2) release is stimulated by the sympathetic nervous system (3) constricts blood vessels |
| Parathormone | (1) d(1) epinephrine (2) norepinephrine |
| Glucocorticoids & Body Rhythm | (1) secretion is related to circadian body rhythms |
| Thyroid-Stimulating Hormone | (1) stimulates secretion of thyroxine |
| Antidiuretic Hormone | (1) low BP prompts secretion (2) constricts blood vessels (3) secreted by the posterior lobe of the pituitary gland |
| Luteinizing Hormone | (1) stimulates testosterone secretion |
| Thyroxine | (1) secretion is controlled by TSH (2) important to fetal growth (3) equires iodine for synthesis (4) excess can precipitate s/s of graves disease |
| Oxytocin | (1) secreted by the posterior lobe of the pituitary gland (2 stimulates milk ejection |
| Nephron | (1) functional unit of the kidney |
