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Understanding Medical Surgical Nursing Ch 37

Terms

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Insufficient hormone activity may be the result of 1_____ of an endocrine gland or 2_____ of the target tissue to its hormone.
1 hypofunction
2 insensitivity
ectopic hormone production
hyperactive gland caused by self-administration of too much replacement hormone
antidiuretic hormone (ADH)
AKA vasopressin

synthesized in hypothalamus

stored & secreted by posterior pituitary

decrease = diabetes insipidus

increase = syndrome of inappropriate antidiuretic hormone (SIADH)
nephrogenic diabetes
sufficient ADH exists but kidneys do not respond to it
osmolality
ionic concentration of dissolved substances per unit of solvent
diabetes insipidus
caused by ADH deficiency usually due to tumors/trauma to pituitary gland

occasionally caused by pt drinking large amounts of water in absence of true disease

S/S: polyuria - nocturia - high serum osmolality - low urine osmolality - decreased urine specific gravity - polydipsia
psychogenic
of mental origin
polyuria
excessive urination
nocturia
excessive urination at night
polydipsia
extreme thirst
hypovolemic
low volume of blood in circulatory system
hypophysectomy
surgical removal of pituitary gland

check postop pt for DI & CSF leakage (contains glucose unlike surgical discharge)
When doing a nursing assessment of a pt w/DI, place special attention on 1_____ balance. 2_____ 2_____ are the most reliable method for monitoring the amount of fluid that is being 3_____.
1 fluid
2 daily weights
3 lost
syndrome of inappropriate antidiuretic hormone (SIADH)
results from too much ADH in body causing excess water to be reabsorbed by kideny tubules & collecting ducts

results in decreased urine output & fluid overload

certain cancers, several drugs, and head trauma or surgery can cause SIADH

S/S: weight gain - serum osmolality less than 275 mOsm/kg - concentrated urine - muscle cramps & weakness - lethargy - seizures - coma
1_____ mL of ice chips equal approximately 2_____ mL of water.
1 100
2 50
growth hormone (GH)
AKA somatotropin

responsible for normal growth of bones, cartilage, & soft tissue

synthesized & secreted by anterior pituitary

excess = acromegaly

deficit = dwarfism
dwarfism
AKA short stature

occurs when GH is deficient in childhood

may be due to pituitary tumor/failure to develop, infection, trauma, & extreme stress

S/S CHILDREN: growth may reach 3-4 feet max w/norm body proportions - sexual maturation slowed - sometimes accompanied by mental retardation

S/S ADULTS: weakness - hypoglycemia - sexual dysfunction - skin changes - headaches - mental slowness - visual disturbances
acromegaly
excess of GH that affects adults (usually in 30s or 40s)

if GH excess occurs as child, result is gigantism

caused by oversecretion of GH

S/S: nose/jaw/brow/hands/feet enlarge - teeth may be displaced - tongue thickens - kyphosis due to vertebral changes - headaches - diabetes mellitus - osteoporosis & arthritis may occur
hyperplasia
abnormal increase in number of cells in tissue/organ

is NOT a tumor
amenorrhea
absence /cessation of menstruation
Triiodothyronine (1____) and thyroxine (2_____) are secreted by the 3_____ gland. These hormones may be collectively referred to as 4_____ 4_____ (TH). Deficient secretion of these hormones results in 5_____; excess TH results in 6_____.
1 T3
2 T4
3 thyroid
4 thyroid hormone
5 hypothyroidism
6 hyperthyroidism
cretinism
hypothyroidism occuring in infancy
myxedema
hypothyroidism that develops in an adult
hypothyroidism
occurs when thyroid gland fails to produce enough TH despite enough TSH being secreted

cause can be due to congenital defect, inflammation, iodine deficiency, autoimmune dx, postpartum pituitary necrosis

S/S: reduced metabolism - fatigue - weight gain - bradycardia - constipation - mental dullness - feeling cold - SOB - dry skin & hair - water retention
hyperthyroidism
excessive amounts of circulating thyroid hormone

increases metabolism, number of beta-adrenergic receptor sites & activity of NE resulting in 'fight-or-flight' response

S/S: heat intolerance - increased appetite w/weight loss - increased bowel movements - nervousness - tremor - tachycardia
thyrotoxic crisis
AKA thyroid storm

severe hyperthyroid state that can occur in hyperthyroid pts who are untreated or who are experienceing another illness or stressor

can result in death in as little as 2 hrs if untreated
euthyroid
having normal thyroid gland function
goiter
enlargement of thyroid gland

may be due to increased TSH levels, iodine deficiency, enviornmental factors, or food/medications

S/S: thyroid gland enlarged - interference w/swallowing or breathing - s/s of hypo or hyperthyroidism may be present
goitrogens
foods/medications that block body's use of iodine & result in goiter
cancer of the thyroid gland
rare but the most common cancer of endocrine system

possible causes include thyroid hyperplasia, radiation exposure, iodine deficiency, & prolonged exposure to goitrogens

S/S: hard, painless nodule on thyroid gland - difficulty breathing or swallowing - voice may change

** many pts have NORMAL TH levels
hypoparathyroidism
decreased PTH activity

most common causes are heredity & accidental removal during thyroidectomy

S/S: hypocalcemia - numbness/tingling of fingers - muscle spasms/twitching - +Chvostek's sign - +Trousseau's sign - lethargy
Chvostek's sign
method for assessing pt for hypocalcemia

tap on pt's facial nerve just in front of ear - spasm of face = + hypocalcemia
Trousseau's sign
method for assessing pt for hypocalcemia

place sphygmomanometer on pt's arm & pump to above pt's systolic pressure - spasm of thumb & fingers occurs w/i 3 min if pt has hypocalcemia
hyperparathyroidism
overactivity of one or more parathyroid glands causing increase in PTH

usually result of hyperplasia, benign tumor, heredity, or cancer

S/S: hypercalcemia - fatigue - depression - confusion - polyuria - anorexia - N/V - peptic ulcers - joint pain - pathological fractures

Deck Info

34

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