Adrenal Disorders
These hormones are released from the adrenal medulla.
What are epinephrine and norepinephrine?
Excessive release of these catecholamines may cause an increase in heart rate, blood pressure, palpitations, sweating, and headache.
This disorder is characterized by fluid overload and resultant hyponatremia due to hemodilution
What is Syndrome of Inappropriate Antidiuretic Hormone (SIADH) ?
Be sure to monitor fluid intake and restrict as necessary pending doctor's orders.
Interventions for THIS include: semi-Fowler's position, head and neck support, oxygen, monitor for s/s of tetany, and be ready to administer IV calcium gluconate.
What is... Postoperative interventions for thyroidectomy?
Also monitor respiratory status. Prepare for intubation with symptoms ineffective airway maintenance such as stridor.
This disorder is characterized by excessive growth hormone and can result in enlarged bones in adults.
What is... acromegaly?
The drug of choice to treat Diabetes Insipidus (DI).
What is... synthetic vasopressin (Desmopressin).
It is used to replace a natural hormone called antidiuretic hormone, or ADH.
Teach patients to monitor for changes in weight and s/s of hyponatremia.
True or False
Excessive production of aldosterone leads to hypertension.
True.
Aldosterone, produced by the adrenal glands is responsible for maintaining fluid and electrolyte volume. Excessive production may lead to sodium and water retention, and hypertension.
Clinical manifestations for THIS include: high urine output; low SG ; high serum osmolality ; HYPERnatremia; hypotension; tachycardia; poor skin turgor; dry mucous membranes, and dehydration.
What is Diabetes Insipidus (DI)?
Be sure to monitor clients closely for complications.
List nursing considerations for a client with signs and symptoms of hypothyroidism.
What is ... if they are cold = warm environment/blanket. if they are constipated = stool softeners, high bulk, low cal diet. give thyroid replacement hormones. Increase activity gradually and allow for rest.
Ensure levothyroxine is given as prescribed to prevent symptoms such as BRADYCARDIA and FATIGE.
Nursing interventions for THIS include: monitoring for renal stones, monitor vital signs and EKG, and ensure patient safety with transfers and ambulation.
What is... hyperparathyroidism?
Hyperparathyroidism causes increased reabsorption of calcium from the bones, causing increased fracture risk and increased r/f kidney stones. Assess urine, cardiac status, and promote patient safety during ambulation AND POSITION CHANGES IN THE BED.
This medication can be given to clients with syndrome of inappropriate antidiuretic hormone (SIADH).
What is... tolvaptan?
Tolvaptan is a vasopressin V2 receptor antagonists. It works by increasing the amount of water released from the body as urine. Monitor for hypernatremia.
Adrenal insufficiency reduces the amount of aldosterone the body produces, leading to the retention of this electrolyte.
What is potassium?
A decrease in aldosterone causes increased excretion of sodium, and retention of potassium. Ensure this client is on telemetry and perform a cardiac assessment, due to cardiac risk with hyperkalemia.
These are important teachings for a client diagnosed with Diabetes Insipidus (DI).
The client should report fluctuations to the MD appropriately.
What is... hyperthyroidism?
Ensure cardiac monitoring, assess apical pulse, heart rate, anxiety, weight loss, and heat intolerance.
This condition results from an overproduction of cortisol and can cause symptoms like weight gain and high blood pressure.
What is... Cushing's syndrome?
A patient, newly diagnosed with hypothyroidism, is anxious to begin her drug regimen. What should the nurse’s instructions relative to hormone replacement include?
What is... Take the medication before breakfast every day and know the s/s of hyperthyroidism?
Tell your doctor if you have chest pain, irregular heart beat, anxiety, difficulty sleeping, difficulty breathing, or excessive sweating.
A test, most commonly known as an "ACTH stimulation test," where a synthetic version of the hormone ACTH is injected into a client to stimulate the adrenal glands and assess their ability to produce cortisol.
What is provocative testing?
This test can help diagnose adrenal insufficiency disorders if the cortisol response is inadequate.
This is the treatment of SIADH.
What is... What is ...Diuretics, Lithium, hypertonic saline, fluid restriction.
Hyperthermia, HTN, delirium, vomiting, ab pain, hyperglycemia, and tachydysrhythmias are associated with this diagnosis.
What is... thyroid storm.
A patient with Addison’s disease is being discharged after an Adrenal Crisis. Which instruction is most important for the nurse to reinforce?
What is... The importance of taking their steroid replacement medications as prescribed.
Addison's disease, also known as primary adrenal insufficiency, is a rare disorder that occurs when the adrenal glands are damaged and can't produce enough cortisol and aldosterone.
This is a treatment for Cushing syndrome.
What is... Taper and discontinue corticosteroid medications to treat this condition
Clinical manifestations of this include muscle weakness, hypotension, hyponatremia, hyperkalemia, bronze skin, confusion, hypoglycemia.
What is Addison Disease?
Treatment to prevent Addisonian crisis includes corticosteroids.
Common etiologies of DI
What is... head trauma, lithium?
Related to the decrease or absence of ADH
Hyperthyroidism is often associated with this autoimmune disorder.
What is... Graves' disease?
Most common cause of hypoparathyroidism.
What is... thyroidectomy?
Nursing considerations for medication administration with hypothyroidism.
What is... analgesic, sedative, and anesthetic agent effects are prolonged?