Hormones
What does the hypothalamus do?
Releases and inhibits hormones
Define TSH, target organ and action
Thyroid Stimulating Hormone
Thyroid Gland
Increases the secretion of thyroid hormone, increases the size of the thyroid gland
ADH
Anti-diuretic hormone
Posterior lobe of the pituitary gland
The target organ is the Kidney
Increase water reabsorption (decreases water lost in urine)
To detect Diabetes Insipidus
Fluid deprivation test
NPO, hourly urine output, specific gravity and osmolality, weight , VS
Vasopressin is given subcut
Provide urine containers for hourly output-remind patient to urinate hourly
Excessive amounts of ADH resulting in fluid retention
SIADH- Syndrome of Inappropriate Antidiuretic Hormone
It can be caused by a tumor or malignancy
S/Sx= Confusion, seizures, LOC, weight gain, edema, decreased urine
Hyponatremia <120 can cause muscle cramps and weakness
Diagnosis- 24-hour urine osmolality, Labs decreased BUN, hemoglobin, hematocrit, Cr Cl,
Does the hypothalamus target the anterior or posterior pituitary gland?
Anterior lobe of the pituitary gland
Define FSH, target organ and action
Follicle Stimulating Hormone
Targets ovarian follicles in females, seminiferous tubules in males
Follicle maturation and estrogen secretion in females, spermatogenesis in males
Oxytocin
The target gland is the mammary gland and the uterus
Increase uterine contractions, stimulates the ejection of milk from the mammary gland
Posterior lobe of the pituitary gland
Detect abnormal glucose metabolism, assists with DM diagnosis
Patient fasts 10-12 hours
Patient given a glucose drink (300mls)
Venous blood draws every 30 minutes for 2 hours
Drugs interact: Phentoyin, birth control, diuretics, glucocorticoids'
Teaching Fast for 10-12 hrs before
During the test, the patient cannot eat, drink, or smoke
During the test, the patient needs to report weakness, dizziness, nervousness, and confusion
Hypophysectomy
Surgical removal of the pituitary gland
Semi Fowlers
Vision, mental changes, LOC, Strength - Monitor post op
Nasal drip pad- Expected bloody or mucus-like discharge
Clear watery drainage should be reported (CSF leak)
After surgery=, no teeth brushing, cough, sneeze, blow their nose or bend forward ( can cause CSF leak)
Where are most of the hormones secreted from -anterior or posterior pituitary gland?
Anterior
Define LH and ICSH, target organ and action
Luteinizing hormone female
Interstitial cell-stimulating hormone male
The ovary in females
Testis in males
Ovulation, progesterone production in females
Testosterone in males
Goiter
An overgrowth of the thyroid
Can be prevented by sufficient intake of iodine
Foods rich in Iodine- Seafood and salt
Pheochromocytoma
Rare tumor
The adrenal medulla that secretes catecholamines
Tachy, severe hypertension, profuse diaphoresis, severe headache, palpitations, nausea, weakness, pallor
Diagnosis : Serum catecholamine and 24 hr urine
Treatment: Remove the tumor
Diabetes Mellitus- complications
Result in damage from the large and small blood vessels
7th leading cause of death in the US
Not treated can lead to new blindness, renal failure leading to failure and nontraumatic lower limb amputations
Diabetics are prone to infection **
What 2 hormones are NOT secreted from the anterior pituitary gland?
ADH and Oxytocin
Define Prolactin , target organ and action
Prolactin
The target is the mammary gland
Stimulates milk production
Test used to diagnosis Cushing syndrome
Dexamethasone suppression test
Morning baseline serum cortisol levels
A high dose of Dexamethasone given at night
Nursing- check for any orders for drugs to be held
24 hr urine
If 3 3-day test- Cortisol levels must be drawn at the same time every day
Avoid strenuous activity the day before the test
Production of copious amounts of dilute urine
Decreased production of antidiuretic hormone
Diabetes Insipidus
PVD
Peripheral Vascular Disease
Keep legs elevated when sitting
Gangrene- amputation
Poor circulation in the feet and lower extremities
Early detection and TAKE CARE OF YOUR FEET
Define Growth Hormone, target tissue and action
GH
Most tissues in the body
Stimulates growth by promoting protein synthesis
Define ACTH, target organ and action
Adrenocorticotropic hormone
Adrenal cortex
Increases the secretion of adrenocortical hormones
Glucocorticoids and Cortisol
Test for Addison Disease
ACTH Stimulation Test
Detects ad
renal cortical insufficiency
ACTH is administered via IV
Blood draw at 24 hr
Check with the lab for food restrictions
Avoid strenuous activity the day before
Diabetes Insipidus - S/Sx, nursing priorities and treatment
S/Sx= Profound diuresis 3-20L every 24 hours
Thirst, weakness, fatigue, nocturia, tachy, hypotension, weight loss, constipation, poor skin turgor
Diagnosis: Urine osmolality, specific gravity, Water deprivation
Replace fluids, Desmopressin (DDAVP) Hormone,
Nursing= early detection, fluid and electrolyte balance, VS, Weights, Strict hourly I & O
Nephropathy
Directly from changes in the renal blood circulation
Kidneys filter too much blood with excessive blood glucose, and start failing
Spill protein in the urine
Strict blood glucose control can prevent ESRD