Insert:Pituitary Gland

Secretes:GHACTH- Controls adrenalTSH- Stimulates thyroidFSH- Eggs and SpermLH- Egg release and Test. release

V. HyperpituitarismA. Cause

1. Increased GH

1. S&SGigantismAcromegaly

Test:GTT- Sugar drink followed by numerous

blood draws

Hypophysectomy- (Removal of Pituitary)

No sneezingNo coughingNo inc pressureStrict I&O

I. Hyperthyroidism (Graves Disease)

A. Cause1. Over stimulation of the

thyroidB. S&S

1. Think Increase in Metabolicrate. (Tachycardia, TachypneaIncrease BP, Wt loss, Fatigue)

C. Dx (and Tx)1. Radioactive Iodine Uptake

a. Teaching?2. Labs?

TSH down T4 High

D. Complications1. Thyroid storm/crisis

E. Tx1. Tapazole

2. Thyroidectomy (Partial)a. Pt teaching

1. Deep breathing2. Support head3. Check drainage

behind headb. Chvostek’s sign

Due to hypocalcemia

F. Nursing Stuff1. No straining2. Support head3. Nursing Dx

a. disturbed sleepb. decrease cardiac

output

II. HypothyroidismA. Cause

1. Hyperthyroidism2. Pituitary problems

B. S&S1. Opposite of Hyper2. Plus: Mental slowness,

c/o cold, dry skin,swollen ankles

C. Dx1. Labs

a. TSH upb. T4 down

D. Complications1. Myxedema

2. Infants get cretinism

E. Tx1. Synthroid 4-ever!

2. Salt

F. Nursing Stuff1. Nursing Dx:

a. Imbalanced nutrition:more than……

b. Constipationc. Impaired skin integrity

(use lotions, raise feet)

Insert: Thyroid Cancer

Treatment: Thyroidectomy followedby replacement therapy andRadioactive iodine therapy

III. HyperparathyroidismA. Cause

1. Over production of PTHB. S&S

1. Hypercalcemia- High bloodcalcium level

2. Bone pain….fracturesC. TX

Calcitonin- Stops release from Bone

Watch for stone formation!!Kidney Stones

Monitor urinary output in case stone blockspassage

IV. HypoparathyroidismA. Cause

1. ThyroidectomyB. S&S

1. Hypocalcemia2. Tingling and

Twitching3. Watch for

Tetany!

C. Nursing Dx1. Potential for injury r/t…2. Decrease cardiac output

D. Tx:IV calcium gluconate

VI. Diabetes InsipidusA. Cause

1. Low ADH or not responding to ADH

B. S&S1. Massive Diuresis2. Dehydration3. Hypotension with tachycardia4. Weakness and dizziness

VII. SIADHA. Cause

Increase in ADH

B. S&S1. Fluid overload

VIII. Adrenals

A. Secretes:Cortizol (Most abundant)Aldosterone-

Controls NA and H2Olevels.

B. Addison’s diseaseAdrenal Hypofunction1. Pt’s always susceptible

to hypotension. Becareful when getting up.(Risk for injury)

2. Adrenal Crisis (Addisons)Caused by STRESS

C. Cushing’s Syndrome1. Hyperfunction of adrenals

Excess production ofACTH

2. Cause is often due tolong term treatment withsteroids (Asthma)

S&SExcess adiposeon trunkThin armsMoon face

Have high risk for infection because of highsteroid in body.