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Endocrine System Handout I. General a. Primary function i. Regulate _____________________environment ii. _______________________ b. Structure: __________________ & _____________________ c. Major Glands i. Hypothalamus v. Thymus ii. Pituitary gland vi. Adrenal glands iii. Thyroid gland vii. Pancreas iv. Parathyroid glands viii. ____________________: Ovaries & Testis d. Hormones i. Chemical _____________________ of the body ii. Act on specific _________________ cells iii. ______________ or ______________in body function e. Hormone Regulation i. “____________________ Feedback” ii. When target cells release too much hormone send back a message to __________________ the hormone release. iii. When too little hormone is released the target cell sends back a message to _________________ the normal level II. Hypothalamus a. Location: ______________________________________ i. Attached to the __________________ gland b. Function i. Controls the ______________ _______________ ii. __________________ iii. __________________ iv. __________________ III. Pituitary Gland: AKA_____________________ AKA ___________________ Document1 5/2/2017 1 a. Location i. In the _________________ ii. Below the _______________________ b. Anterior lobe: ____________________ hormones i. ________________hormone (GH) _________& ____________ 1. Function a. Stimulate ______________________ b. _________ blood ________________levels ii. _________________ (PRL) ____________________glands 1. Function a. Stimulate _______________ development during _______ b. ________________________________________ delivery iii. _____________-Stimulating horm. (FSH) __________ or ____ 1. Function a. _____________ production b. _____________ secretion iv. ________________Horm. (LH) ____________ or _________ 1. Function a. ____________________ b. ____________________ secretion v. ________________ Stimulating Hormone (TSH) ___________ 1. Function a. Stim. ____________________________ b. Stim. secretion of ___________________________ vi. Adrenocorticotropic hormone (ACTH) ___________________ 1. Function a. Stim. adrenal ______________________________ b. Stim. secretion of __________________________ c. Posterior lobe: ____________________ hormones i. Anti-__________________ Hormone (ADH) ______________ 1. Function Document1 5/2/2017 2 a. Stim. H2O _______________ _______urine output ___________H2O in serum/body ii. Oxytocin _______________ & __________________ glands 1. Function: a. Uterine _____________________ during labor b. __________________ secretion IV. Thyroid Gland a. Shape: _____________________ i. ___________ lobes connected by an ___________________ b. Location i. Straddles the _____________________ c. Hormones i. _______________ Hormone: Thyroxine (________) 1. Function: _______________________________________ 2. Necessary ingredient: _______________ ii. Triiodothyronine (_________) 1. Function: _______________________________________ 2. Necessary ingredient: _______________ iii. Calcitonin ____________ ______ levels in the__________ V. Parathyroid Gland a. Location: ______________on the ___________lobes of the ___________ b. Number: ______________ c. Hormone: ________________________ Hormone (_________) i. Necessary ingredient: ____________________________ ii. _________ Serum ___________levels _______ released ____________ (target cell) Releases _______into plasma _____________ Serum ____________levels VI. Adrenal Gland a. Location: _____________ of each ________________ b. Adrenal _____________________ i. ________________ steroids 1. ______________corticoids: _______________ a. Primary Action: ________ blood glucose level Document1 5/2/2017 3 b. Secondary Action: ______________________ c. Primary Purpose: _______________________ 2. ______________corticoids: _______________ a. Function: ________ & _________ balance b. Target cells: _________________ c. __________ blood volume / blood __________ Adrenal _____________ _____________ ___________ ____________ Na+ and H2O _________blood _________/ blood ________________ ii. Androgens c. Adrenal _____________________ i. Epinephrine AKA: ________________________ ii. Norepinephrine 1. Action: a. ___________ Heart rate b. ____________ Force of heart contraction c. _____________ blood vessels 2. Purpose:______________________ Response a. ____________or_______________! 3. ____________ __________ or ____________ response Adrenal _____________ Epi/norepinephrine a. ________ _________ rate/contraction b. ___________Vessels ____________________ c. Handle ___________________ Small Group Questions: 1. What is negative feedback? 2. What is the “Master Gland”? Why is it called that? 3. What are the target cells of GH? 4. What hormone targets the mammary glands? 5. What hormones target the gonads? 6. What are the targets cells of ACTH? 7. What is the action of the thyroid hormones? Document1 5/2/2017 4 8. What is the action of PTH 9. What is the purpose and action of Glucocorticoids? 10. What is the action of Epinephrine? What response does it elicit? VII. Assessment a. Hormone affect ______________________________ b. Health Hx i. ____________________ ii. ____________________ iii. ____________________ iv. ____________________ v. ____________________ vi. ____________________ c. Physical Assessment i. General appearance ii. Skin : _________________________________ iii. ___________ & _____________________ iv. Exophthalmos: ____________________________ v. Visual ________________________ vi. Palpate _______________________ VIII. Diabetes Insipidus a. Hormone Imbalance: ________________________________ b. Gland: ________________________ c. S&S i. _________________________ ii. _________________________ iii. Urine specific gravity: _______________ iv. Urine color: ____________________ v. _______________________ vi. Pulse: ________________________ vii. Skin turgor: __________________ viii. Mucous membranes: ____________________ d. Priority Nursing Dx: _________________________________________ Document1 5/2/2017 5 e. Nursing Interventions i. Monitor: 1. ____________________ 2. __________________________ of urine 3. _____________ 4. _____________ 5. __________________ function ii. Daily ____________________ iii. Provide adequate _____________________ iv. Administer ___________________per order: Monitor for __________ IX. Syndrome of Inappropriate Anti-diuretic Hormone secretion (______________) a. Hormone Imbalance: ______________________________ b. Gland: __________________________ c. S&S i. ___________ urine output ii. _________________ urine 1. Specific Gravity _____________________ iii. ________________ natremia iv. No _________________ v. ____________________ vi. Weight ______________ vii. ____________________ d. Priority nursing diagnosis: _____________________________________ e. Nursing Interventions i. Monitor 1. _________________ 2. _________________ 3. _________________ 4. Serum ___________ levels ii. Daily _________________ iii. Auscultate _____________ iv. Fluid__________________ Document1 5/2/2017 6 v. Provide ______________________ care vi. Administer _______________per MD order 1. ___________________________________ 2. Monitor for S/E: ___________________& __________ precaution Small Group Questions: 1. What hormonal imbalance is assoc. with DI? 2. What are the characteristic S&S of DI? 3. What is the primary nursing diagnosis for DI? 4. Identify 5 nursing interventions for a client with DI (give rationales) 5. What hormonal imbalance is assoc. with SIADH? 6. What are the characteristic S&S of SIADH? 7. What is the primary nursing diagnosis for SIADH? 8. Identify 5 nursing interventions for a client with SIADH (give rationales) X. Hyperthyroidism a. Hormonal imbalance: ___________________________ b. Gland: __________________________ c. S&S: Think ______________________ i. Neuro: _____________________________________________________ ii. C/V: ______________________________________________________ iii. G/I: _______________________________________________________ iv. Integumentary: ______________________________________________ v. Endocrine: __________________________________________________ vi. Sensory: ___________________________________________________ d. Medical Management i. Goal: _________________production of ______________ ii. Meds: Anti- ________________ drugs: 1. Action: _____________ thyroid hormone production iii. Meds: _______________-Adrenergic Blockers 1. Action: ____________________________________ e. Priority Nursing Diagnosis Document1 5/2/2017 7 i. Alt. ______________________________function ii. Imbalanced _________________________ iii. _____________________ iv. _____________________ deficits v. ____________________ disturbance f. Nursing Interventions i. Monitor 1. _________________ 2. _________________ sounds 3. _________________ 4. _________________ intake ii. Diet 1. __________ calorie 2. __________ protein 3. __________ fiber 4. __________ meals iii. Teach __________________ iv. Provide _________________ periods v. _______________ showers vi. Protect __________: __________ glasses & __________________ tears vii. Enc. to express ________________________ viii. Enc to ______________ question XI. Hypothyroidism a. Hormonal imbalance: ______________________________________ b. Gland: _______________________________________ c. S&S: Think _________________________ i. Neuro: _______________________________________________ ii. C/V: _______________________________________________ iii. G/I: _______________________________________________ iv. Integumentary: ________________________________________ v. Endocrine: _______________________________________________ vi. Sensory: _______________________________________________ Document1 5/2/2017 8 d. Medical Management i. Goal: ______________________________ ii. ______________________ preparations 1. Levothyroxine sodium (Synthroid, Levothroid) 2. Action: ____________________________ 3. Nursing Implications a. Give _________________________ b. Check ____________________a\ admin c. Monitor S/E: _____________________________ d. Rx for __________________________________ e. Priority Nursing Diagnosis i. Decreased ___________________________ ii. Imbalances________________: ___________than body requirements iii. _______________________ iv. _______________________ intolerance f. Nursing Interventions i. Monitor : _______________________________________________ ii. Provide __________________ iii. ________________________ room temp iv. Monitor _________________________ status v. Monitor _____________________ vi. Diet 1. ____________ calorie 2. ____________ fiber 3. ____________ fluid _______________________ vii. Enc ______________________ at tolerated viii. ________________________ periods ix. Assist with __________________ x. Administer ______________________________ per MD order xi. Administer meds per MD order: Monitor for S/E Small Group Questions: 1. What hormonal imbalance is assoc. with hyper & hypo thyroidism? Document1 5/2/2017 9 2. What are the distinguishing characteristic of hyperthyroidism? 3. What is the medical treatment for hyperthyroidism 4. What are the primary nursing diagnosis for hyperthyroidism? 5. What are 5 nursing interventions for a client with hyperthyroidism (give rationales)? 6. What are the distinguishing characteristic of hypothyroidism? 7. What is the medical treatment for hypothyroidism 8. What are the primary nursing diagnosis for hypothyroidism? 9. What are 5 nursing interventions for a client with hypothyroidism (give rationales)? XII. Cushing’s Syndrome a. Hormonal imbalance: ________________________________ b. Gland ____________________________________________ c. S&S i. ______________face & ___________________hump ii. Easy ____________________ iii. Slow ____________________healing iv. Hirsutism: Excessive _________________________________ d. Medical Management i. Goal: _______________________________________________ e. Priority Nursing Diagnosis: i. Fluid Volume _______________________ ii. Risk for _____________________ iii. Risk for ___________________________ iv. Disturbed _________________________ f. Nursing Interventions i. Monitor: ____________________________________________________ ii. _____________________________environment iii. _____________________________devices iv. Provide _____________________periods v. ___________________room/limit ________________________ vi. Assess ________________________ vii. ______________________________ tech with procedure Document1 5/2/2017 10 XIII. Addison’s Disease a. Hormonal imbalance: ________________________________________________ b. Gland:_______________________________________________________ c. S&S i. Skin: ____________________________________________________ ii. C/V: ____________________________________________________ iii. CNS: ____________________________________________________ iv. G/I: ____________________________________________________ d. Medical Management: i. Goal ______________________ corticosteroids and Mineralocorticoids 1. _______________________ (cortone) 2. Nursing implications a. Give ______________________________ 3. S/E a. _____________B/P b. _____________ c. Weight ____________ d. __________________ e. Poor ________________ healing e. Priority Nursing Diagnosis i. Fluid volume ______________________ ii. _______________________ intolerance iii. Imbalanced____________________ : __________than body requirements f. Nursing Interventions i. Monitor 1. ______________________ 2. S&S of ____________________ 3. ___________________________B/P ii. ________________ fluids iii. ________________ slowly increase ______________________ iv. Diet 1. _______________calorie Document1 5/2/2017 11 2. _______________ meals Small Group Questions: 1. What is the hormonal imbalance assoc. with Cushing’s disease? 2. What are the distinguishing and important S&S of Cushing’s disease? 3. What is the medical management for a client with Cushing's disease? 4. What are the primary nursing diagnoses of a client with Cushing’s disease? 5. What are 5 nursing interventions for a client with Cushing’s disease? Prioritize you interventions and give a rational 6. What is the hormonal imbalance assoc. with Addison’s disease? 7. What are the distinguishing and important S&S of Addison’s disease? 8. What is the medical management for a client with Addison’s disease? 9. What are the primary nursing diagnoses of a client with Addison’s disease? Prioritize your diagnoses. 10. What are 5 nursing interventions for a client with Addison’s disease and give a rational for each? Document1 5/2/2017 12