Podcast
Questions and Answers
What is the primary function of mineralocorticoids, such as aldosterone, secreted by the adrenal cortex?
What is the primary function of mineralocorticoids, such as aldosterone, secreted by the adrenal cortex?
- Controlling sodium and potassium levels to regulate electrolyte and fluid balance. (correct)
- Suppressing the immune response to prevent excessive inflamation.
- Regulating metabolism and reducing inflammation.
- Contributing to female libido and muscle development.
Which of the following is the preferred surgical treatment for pituitary tumors causing Cushing's Disease?
Which of the following is the preferred surgical treatment for pituitary tumors causing Cushing's Disease?
- Transsphenoidal Hypophysectomy (correct)
- Unilateral Adrenalectomy
- Radiation therapy
- Bilateral Adrenalectomy
A patient exhibits muscle weakness, arrhythmias, and fluid retention. Which electrolyte imbalance should the nurse suspect?
A patient exhibits muscle weakness, arrhythmias, and fluid retention. Which electrolyte imbalance should the nurse suspect?
- Hyperkalemia
- Hypokalemia (correct)
- Hypercalcemia
- Hyponatremia
Which dietary modification is most appropriate for a patient with Cushing's Syndrome?
Which dietary modification is most appropriate for a patient with Cushing's Syndrome?
A patient post-adrenalectomy is showing signs of fatigue, hypotension, and electrolyte imbalances. What does this likely indicate?
A patient post-adrenalectomy is showing signs of fatigue, hypotension, and electrolyte imbalances. What does this likely indicate?
Why should patients be educated never to abruptly stop taking corticosteroids?
Why should patients be educated never to abruptly stop taking corticosteroids?
What is the most common cause of Addison's disease?
What is the most common cause of Addison's disease?
Which laboratory findings are indicative of primary adrenal insufficiency (Addison's disease)?
Which laboratory findings are indicative of primary adrenal insufficiency (Addison's disease)?
What dietary recommendation is appropriate for a patient with Addison's disease experiencing gastrointestinal fluid losses?
What dietary recommendation is appropriate for a patient with Addison's disease experiencing gastrointestinal fluid losses?
A patient with Addison's disease is admitted to the hospital. What nursing action should the nurse prioritize?
A patient with Addison's disease is admitted to the hospital. What nursing action should the nurse prioritize?
A patient with Addison's disease is prescribed hydrocortisone. What education should the nurse provide about medication management?
A patient with Addison's disease is prescribed hydrocortisone. What education should the nurse provide about medication management?
Severe hypotension, rapid weak pulse are the signs and symptoms of:
Severe hypotension, rapid weak pulse are the signs and symptoms of:
What is the purpose of administering a high-sodium diet preoperatively for a patient undergoing surgical removal of a pheochromocytoma?
What is the purpose of administering a high-sodium diet preoperatively for a patient undergoing surgical removal of a pheochromocytoma?
Excessive secretion of epinephrine and norepinephrine is a result of:
Excessive secretion of epinephrine and norepinephrine is a result of:
Which of the following is an expected laboratory finding in a patient with primary aldosteronism (Conn's Syndrome)?
Which of the following is an expected laboratory finding in a patient with primary aldosteronism (Conn's Syndrome)?
A patient with hyperaldosteronism is prescribed spironolactone. What electrolyte imbalance should the nurse monitor for?
A patient with hyperaldosteronism is prescribed spironolactone. What electrolyte imbalance should the nurse monitor for?
A client with type 1 diabetes is admitted to the ER with suspected diabetic ketoacidosis (DKA). Which of the following assessment findings would the nurse anticipate?
A client with type 1 diabetes is admitted to the ER with suspected diabetic ketoacidosis (DKA). Which of the following assessment findings would the nurse anticipate?
What is DKA an acute complication of?
What is DKA an acute complication of?
A nurse is caring for a patient with Cushing's syndrome. Which assessment finding should the nurse prioritize?
A nurse is caring for a patient with Cushing's syndrome. Which assessment finding should the nurse prioritize?
What is the primary goal when managing a patient during an Addisonian crisis?
What is the primary goal when managing a patient during an Addisonian crisis?
The nurse is monitoring a patient who is 12 hours post-op following an adrenalectomy. What is priority?
The nurse is monitoring a patient who is 12 hours post-op following an adrenalectomy. What is priority?
The nurse is providing education to patient diagnosed with Addison’s disease. What should she emphasize when educating patient on dietary?
The nurse is providing education to patient diagnosed with Addison’s disease. What should she emphasize when educating patient on dietary?
Which signs and symptoms are caused by Primary aldosteronism?
Which signs and symptoms are caused by Primary aldosteronism?
Nurse found out the adult patient aged 30 , is diagnosed with Primary aldosteronism because one of the causes is:
Nurse found out the adult patient aged 30 , is diagnosed with Primary aldosteronism because one of the causes is:
What is the initial treatment for patient is diagnosed with Pheochromocytoma
What is the initial treatment for patient is diagnosed with Pheochromocytoma
Flashcards
Adrenal Cortex
Adrenal Cortex
The outer region of the adrenal gland that secretes glucocorticoids, mineralocorticoids, and sex hormones.
Adrenal Medulla
Adrenal Medulla
The inner part of the adrenal gland; secretes catecholamines (epinephrine and norepinephrine).
Catecholamines
Catecholamines
Hormones secreted by the adrenal medulla that includes epinephrine and norepinephrine. Functions to prepare the body for fight or flight.
Glucocorticoids (Cortisol)
Glucocorticoids (Cortisol)
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Mineralocorticoids (Aldosterone)
Mineralocorticoids (Aldosterone)
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Sex hormones (Androgens)
Sex hormones (Androgens)
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Cushing's Syndrome
Cushing's Syndrome
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Transsphenoidal Hypophysectomy
Transsphenoidal Hypophysectomy
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Antihypertensives
Antihypertensives
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Potassium Supplements
Potassium Supplements
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Addison's Disease
Addison's Disease
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Addisonian Crisis
Addisonian Crisis
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Pheochromocytoma
Pheochromocytoma
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Preoperative BP Control
Preoperative BP Control
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Spironolactone
Spironolactone
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Hyperaldosteronism
Hyperaldosteronism
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Diabetes Mellitus
Diabetes Mellitus
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Hypoglycemics
Hypoglycemics
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Buildup of Glucose
Buildup of Glucose
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A Deadly Cycle
A Deadly Cycle
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DKA complication
DKA complication
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Study Notes
- Adrenal glands are on top of the kidneys
- Each gland has an outer cortex and inner medulla, both secreting specific hormones
- The adrenal medulla releases catecholamines like epinephrine (90%) and norepinephrine during sympathetic nervous system stimulation
Catecholamines functions
- Prepares the body for fight-or-flight
- Redirects blood flow by decreasing blood flow to the GI tract and increasing blood flow to the heart and skeletal muscles
- Stimulates lipolysis, increasing free fatty acids for energy
- Elevates basal metabolic rate
- Increases blood glucose by promoting glycogen breakdown
Adrenal Cortex
- Plays a role in adapting to stress and produces steroid hormones: glucocorticoids, mineralocorticoids, and sex hormones
Glucocorticoids (Cortisol)
- Regulates metabolism, reduces inflammation, and helps the body respond to stress
- Increases blood glucose levels by promoting gluconeogenesis
- Suppresses the immune response
Mineralocorticoids (Aldosterone)
- Regulates electrolyte and fluid balance by controlling sodium (Na+) and potassium (K+) levels
- Promotes sodium retention and potassium excretion, helping maintain blood pressure and hydration
Sex Hormones (Androgens)
- Primarily male sex hormones that contribute to female libido and muscle development
- Androgens convert into estrogens in females
Importance of the Adrenal Cortex
- Essential for managing stress, maintaining circulation, and metabolic balance
- Adrenal insufficiency can lead to peripheral circulatory failure, circulatory shock, and prostration
Functioning Adrenal Cortex
- Requires nutritional support, electrolyte and fluid replacement, and adrenocortical hormone therapy for survival
Cushing’s Syndrome (Hypercortisolism)
- Definition - A disorder with excessive adrenocortical activity, leading to overproduction of corticosteroids and disrupts hormonal balance (Porth, 2015)
Clinical Manifestations
- Metabolic and physical changes include arrested growth, obesity, and musculoskeletal changes
- Central obesity presents as a "buffalo hump", with a heavy trunk and thin extremities
- Thin, fragile skin leads to easy bruising and striae
- Muscle wasting and osteoporosis lead to kyphosis, back pain, and vertebral compression fractures
- Hypertension and heart failure occur due to sodium and water retention
- Facial and skin changes include a moon face, oily skin, acne, and poor wound healing
- Hormonal effects in women - virilization, and loss of libido in both sexes
- Neurological and psychological symptoms include sleep disturbances, depression, mood swings, emotional distress, and visual disturbances (if tumor-related)
Key Diagnostic Tests
- At least two abnormal results are required for diagnosis of Cushing's Syndrome
- Serum Cortisol Levels are normally highest in the morning (6-8 AM) and lowest in the evening (4-6 PM); Cushing syndrome disrupts this
- The 24-Hour Urinary Cortisol test - three times the upper normal limit indicate Cushing syndrome
- Dexamethasone Suppression Test measures cortisol levels in response to a low dexamethasone dose (1 mg or 8 mg) at night
- Normal response - Cortisol is suppressed to <5 mg/dL; Cushing syndrome - No suppression
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