Endocrine NSG 219- Endocrine Disorders, Diabetes Insipidus, and Diabetes Mellitus Questions and Answers
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Course
NURS 219
Institution
NURS 219
What is the job of the hypothalamus? to stimulate or inhibit the release of hormones from the pituitary gland
The pituitary gland is the target tissue of the hypothalamus
What hormones are secreted by the anterior pituitary? ACTH-stimulate corticosteroids
GH-growth
TSH-metabolism
FSH/LH-sexual...
Endocrine NSG 219- Endocrine
Disorders, Diabetes Insipidus, and
Diabetes Mellitus Questions and
Answers
What is the job of the hypothalamus? ✅to stimulate or inhibit the release of hormones
from the pituitary gland
The pituitary gland is the target tissue of the hypothalamus
What hormones are secreted by the anterior pituitary? ✅ACTH-stimulate
corticosteroids
GH-growth
TSH-metabolism
FSH/LH-sexual development
What hormones are secreted by the posterior pituitary? ✅ADH-maintain fluid and
electrolyte balance
Vasopressin-maintain fluid and electrolyte balance
Oxytocin
What is hypopituitarism?
How is it treated? ✅deficiency of one or more pituitary hormones
It is treated by HORMONE REPLACEMENT THERAPY-giving the hormones that
patient is lacking
Should HORMONE REPLACEMENT THERAPY be stopped for any reason?
✅NEVER, because it places a patients at risk in the future
What is hyperpituitarism?
What is the cause? ✅over secretion of hormones
Caused typically by benign tumors or adenomas
,What is Acromegaly? ✅over production of GH after puberty typically caused by a
benign tumor (anterior pituitary adenoma)
What are some physical assessment findings of acromegaly? ✅enlarged hands and
feet, protruding lower jaw, increased head shape
Hypertension, hyperglycemia, and SEVERE HEADACHE (increased ICP), visual
disturbances, joint pain
What lab/diagnostic tests do you expect do you anticipate for a patient with
acromegaly? ✅1. IGF-1 (insulin-like growth factor) and GH response to an OGTT (oral
glucose tolerance test)
2. Growth Hormone Suppression Test (high or climbing GH at risk)
3. CT or MRI of brain and head
What medication would you expect to give to a patient with acromegaly?
✅OCTREOTIDE, lanreotide (somatostatin analogs) -to reduce GH levels to normal
What interventions (surgical and treatment interventions) do you use for a patient with
acromegaly? ✅surgical-transphenoidal hypophysectomy (removal of pituitary gland)
Treatment-
Radiation to shrink
Life-long HRT
What surgical nursing considerations should you consider after a patient has had a
hypophysectomy? ✅-no bending at the waist, blowing nose, keep high-fowlers
Monitor:
-MONITOR URINE OUTPUT (concern with DI)
-check CSF for glucose (tell doctor)
-neuro and vision changes
What is the client education a nurse should give following a hypophysectomy? ✅-
report nasal drip and excessive swallowing
-do not brush teeth, but perform oral care q4h and rinse mouth regularly
-avoid activities that increase ICP
-consume diet high in fiber to avoid straining during defecation
-drip pad "mustache" under nose should stay in place 2-3 days
, Excess ACTH from acromegaly can lead to what other diseases? ✅diabetes mellitus.
Cushing's disease, and Cardiovascular disease
What are two disease processes that occur from the posterior pituitary independently
from problems from the anterior pituitary? ✅Diabetes insipidus
SIADH (syndrome of inappropriate antidiuretic hormone)
What is the cause of Diabetes Insipidus (DI) of the posterior pituitary? ✅deficiency
of/or response to ADH...
Over secreted ADH=kidney tubules and collecting ducts not absorbing water =>
increased volume of urine output => dehydration
Increased risk from brain injury, tumor, lesion, etc
What are assessment findings you should expect in a patient with DI? ✅"DI-Dry Inside"
-excessive thirst
-excessive urine output (2-20 L of dilute urine a day)
-dehydration causing tachycardia, hypotension, loss of skin turgor, dry mucous
membranes, weak P pulses
What are some lab findings you should expect in a patient with Diabetes insipidus? ✅-
hyperkalemia (^ K+)
-hypernatremia (^ Na+)
-low urine specific gravity ( <1.005)
-excessive urine output (2-20 L of dilute urine a day) (dilute)
What are some nursing interventions you should expect to perform for a patient with
Diabetes Insipidus? ✅-PLACE ON TELEMETRY (MONITOR FOR PEAK T-WAVES)
-DAILY WEIGHTS
-urine I's and o's
-avoid caffeine
-IV and oral hydration
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