Post on 28-Dec-2015
transcript
Insert:Pituitary Gland
Secretes:GHACTH- Controls adrenalTSH- Stimulates thyroidFSH- Eggs and SpermLH- Egg release and Test. release
V. HyperpituitarismA. Cause
1. Increased GH
1. S&SGigantismAcromegaly
Test:GTT- Sugar drink followed by numerous
blood draws
Hypophysectomy- (Removal of Pituitary)
No sneezingNo coughingNo inc pressureStrict I&O
I. Hyperthyroidism (Graves Disease)
A. Cause1. Over stimulation of the
thyroidB. S&S
1. Think Increase in Metabolicrate. (Tachycardia, TachypneaIncrease BP, Wt loss, Fatigue)
C. Dx (and Tx)1. Radioactive Iodine Uptake
a. Teaching?2. Labs?
TSH down T4 High
D. Complications1. Thyroid storm/crisis
E. Tx1. Tapazole
2. Thyroidectomy (Partial)a. Pt teaching
1. Deep breathing2. Support head3. Check drainage
behind headb. Chvostek’s sign
Due to hypocalcemia
F. Nursing Stuff1. No straining2. Support head3. Nursing Dx
a. disturbed sleepb. decrease cardiac
output
II. HypothyroidismA. Cause
1. Hyperthyroidism2. Pituitary problems
B. S&S1. Opposite of Hyper2. Plus: Mental slowness,
c/o cold, dry skin,swollen ankles
C. Dx1. Labs
a. TSH upb. T4 down
D. Complications1. Myxedema
E. Tx1. Synthroid 4-ever!
2. Salt
F. Nursing Stuff1. Nursing Dx:
a. Imbalanced nutrition:more than……
b. Constipationc. Impaired skin integrity
(use lotions, raise feet)
Insert: Thyroid Cancer
Treatment: Thyroidectomy followedby replacement therapy andRadioactive iodine therapy
III. HyperparathyroidismA. Cause
1. Over production of PTHB. S&S
1. Hypercalcemia- High bloodcalcium level
2. Bone pain….fracturesC. TX
Calcitonin- Stops release from Bone
Watch for stone formation!!Kidney Stones
Monitor urinary output in case stone blockspassage
IV. HypoparathyroidismA. Cause
1. ThyroidectomyB. S&S
1. Hypocalcemia2. Tingling and
Twitching3. Watch for
Tetany!
C. Nursing Dx1. Potential for injury r/t…2. Decrease cardiac output
D. Tx:IV calcium gluconate
VI. Diabetes InsipidusA. Cause
1. Low ADH or not responding to ADH
B. S&S1. Massive Diuresis2. Dehydration3. Hypotension with tachycardia4. Weakness and dizziness
VII. SIADHA. Cause
Increase in ADH
B. S&S1. Fluid overload
VIII. Adrenals
A. Secretes:Cortizol (Most abundant)Aldosterone-
Controls NA and H2Olevels.
B. Addison’s diseaseAdrenal Hypofunction1. Pt’s always susceptible
to hypotension. Becareful when getting up.(Risk for injury)
2. Adrenal Crisis (Addisons)Caused by STRESS
C. Cushing’s Syndrome1. Hyperfunction of adrenals
Excess production ofACTH
2. Cause is often due tolong term treatment withsteroids (Asthma)
S&SExcess adiposeon trunkThin armsMoon face
Have high risk for infection because of highsteroid in body.