Chapter 13

Altered Hormone function can be caused by impairment of endocrine gland, lack of/excessive hormone synthesis, impaired receptor binding, impaired feedback mechanism, impaired cell response to hormones

Negative Feedback loop: The mechanism of negative feedback is like an internal thermostat. When the temperature gets too hot, the thermostat shuts down the heat source; when the temperature is too cool, the furnace is activated to release heat. The hypothalamus and pituitary act as sensors that are constantly gauging hormone levels in the body. When levels rise above the expected range, the stimulation, production, or secretion of hormone is decreased. When levels fall, stimulation, production, or secretion of hormone is increased.

What is the function of the hypothalamic-pituitary axis?

Which type of feedback loop is characterized by the hormone stimulating increased production of the same hormone?

What is the name of the hormone involved in positive feedback loop?

____________ refers to the neurologic or hormonal response.

___________ is a condition of excessive production and release of ADH despite changes in serum osmolality and blood volume.

What is the result of SIADH in terms of urine output?

What is the likely diagnosis of a patient with a rapid onset of anorexia, nausea, vomiting, headache, irritability, disorientation, muscle cramps, and weakness?

What is the primary cause of Diabetes Insipidus?

What is the most common cause of hyperthyroidism?

Primary treatment for SIADH is ________

What is the purpose of using hypertonic IV solutions in SIADH treatment?

What is the synthetic vasopressin analog used to treat Diabetes Insipidus?

Clinical manifestations of SIADH are related to hypotonic hyponatremia (low sodium concentration in blood) and include a decreased and concentrated urine output.

A patient presents to the ER with a rapid onset of anorexia, nausea, vomiting, headache, irritability, disorientation, muscle cramps, and weakness. The doctor checks for hyponatremia (decreased sodium levels) and see’s the patient is below 110 mEq/L. As the results come back from the lab the patient starts exhibiting psychosis, gait disturbances, and seizures. What does the nurse suspect?

Patient presents to the ER with Polyuria, polydipsia/Excessive Thirst, Dehydration, highly diluted urine with low specific gravity, and shock. What does the nurse suspect?

Hormonal response to ______ involves Corticotropin-releasing hormone, ACTH, Cortisol, and Catecholamines (Epinephrine, Norepinephrine, and Dopamine).

Neurologic response to stress involves the Autonomic System, Cerebral Cortex, Limbic System, Thalamus, Hypothalamus , and Reticular Activating System.

The ________contains neurons that synthesize prolactin, inhibiting hormones, and releasing hormones to act on the anterior pituitary gland.

What are the three stages of General Adaptation Syndrome?

What are the general manifestations of Altered Hormone Function?

In Graves disease, what causes excessive thyroid hormone secretion?

What is a common cause of altered hormone function?

A patient presents to the ER with Goiter, Exophthalmos (Eye bulging), Weight loss, agitation, restlessness, sweating, heat intolerance, diarrhea, tachycardia, heart palpitations, tremors, fine hair, oily skin, and patient states she has had an irregular period. What can the nurse suspect?

Common causes of acquired hypothyroidism include autoimmunity, iodine deficiency, surgical removal of or radiation therapy to the thyroid gland, medications that destroy the thyroid gland, and genetic defects that affect the thyroid hormones.

Patient presents to the ER with fatigue, cold intolerance, weight gain, dry skin, course hair, constipation, impaired memory, loss of lateral eyebrows, pallow, deep voice, can’t sweat, large tongue, cardiomegaly, swelling of the skin/underlying tissues (myxedema), boggy/nonpitting edema of the face; hands; mucous membranes; and feet. What can the nurse suspect?

Patient comes to the ER with thinning scalp hair, round face, increased facial hair, osteoporosis, protruding abdomen with abdominal striae, thin extremities and a buffalo hump. Patient states they have taken steroids for years. Patient’s husband states she has behavior ranging from euphoric to psychosis. What can the nurse suspect?

Treatment for ________ includes Fluid replacement along with hydrocortisone (sodium succinate or sodium phosphate), followed by oral glucocorticoid and mineralocorticoid replacement. Dietary change, increased sodium intake due to excess sodium losses (sweating).

__________ Deficiency in patients with Addison disease present with Hypoglycemia, weakness, poor stress response, anorexia, nausea, vomiting, weight loss, fatigue, and personality changes.

___________ deficiency in patient with Addison disease present with sparse axillary and pubic hair.

__________ deficiency in patients with Addison disease present with hypotension, weakness, fatigue, shock, dehydration, hyponatremia, and hyperkalemia.

In Addison disease, _______ in ACTH levels result in darkening of the skin and mucous membranes.

What is the treatment for hypothyroidism?

What is the cause of Addison disease?

What is the treatment for Cushing syndrome?

Which condition affects females up to 10 times more frequently than males?

What is the result of excess glucocorticoids in Cushing syndrome?

What is the pathophysiology of Hashimoto thyroiditis?

Treatment for hyperthyroidism includes medications that block TH production, oral TH replacement therapy, destruction of gland with radioactive iodine, possible ablation of the thyroid gland.

Acquired hypothyroidism can result from (1) deficient thyroid hormone synthesis; (2) destruction of the thyroid gland; or (3) impaired TSH or TRH secretion.

The pathophysiology of ________ includes Autoimmune destruction of the adrenal cortex. Adrenal gland cannot produce glucocorticoids, mineralocorticoids, or androgens. ACTH levels increase to stimulate secretion of hormones from adrenal glands.