Insert: Pituitary Gland Secretes: GH ACTH- Controls adrenal TSH- Stimulates thyroid FSH- Eggs and Sperm LH- Egg release and Test. release

V.Hyperpituitarism A.Cause 1.Increased GH 1.S&S Gigantism Acromegaly

Test: GTT- Sugar drink followed by numerous blood draws Hypophysectomy- (Removal of Pituitary) No sneezing No coughing No inc pressure Strict I&O

I.Hyperthyroidism (Graves Disease) A.Cause 1.Over stimulation of the thyroid B. S&S 1.Think Increase in Metabolic rate. (Tachycardia, Tachypnea Increase BP, Wt loss, Fatigue)

C.Dx (and Tx) 1.Radioactive Iodine Uptake a.Teaching? 2.Labs? TSH down T4 High

D.Complications 1.Thyroid storm/crisis E.Tx 1.Tapazole

2.Thyroidectomy (Partial) a. Pt teaching 1.Deep breathing 2.Support head 3. Check drainage behind head b. Chvostek’s sign Due to hypocalcemia

F.Nursing Stuff 1.No straining 2.Support head 3.Nursing Dx a.disturbed sleep b.decrease cardiac output

II.Hypothyroidism A.Cause 1.Hyperthyroidism 2.Pituitary problems B. S&S 1.Opposite of Hyper 2.Plus: Mental slowness, c/o cold, dry skin, swollen ankles

C.Dx 1. Labs a. TSH up b. T4 down D. Complications 1.Myxedema

2.Infants get cretinism

E.Tx 1.Synthroid 4-ever! 2.Salt

F.Nursing Stuff 1. Nursing Dx: a.Imbalanced nutrition: more than…… b. Constipation c.Impaired skin integrity (use lotions, raise feet)

Insert:Thyroid Cancer Treatment: Thyroidectomy followed by replacement therapy and Radioactive iodine therapy

III.Hyperparathyroidism A. Cause 1. Over production of PTH B. S&S 1. Hypercalcemia- High blood calcium level 2. Bone pain….fractures C. TX Calcitonin- Stops release from Bone

Watch for stone formation!! Kidney Stones Monitor urinary output in case stone blocks passage

IV.Hypoparathyroidism A. Cause 1.Thyroidectomy B. S&S 1. Hypocalcemia 2.Tingling and Twitching 3. Watch for Tetany!

C.Nursing Dx 1.Potential for injury r/t… 2.Decrease cardiac output D. Tx: IV calcium gluconate

VI.Diabetes Insipidus A.Cause 1.Low ADH or not responding to ADH B. S&S 1. Massive Diuresis 2.Dehydration 3.Hypotension with tachycardia 4.Weakness and dizziness

VII.SIADH A.Cause Increase in ADH B. S&S 1.Fluid overload

VIII.Adrenals A.Secretes: Cortizol (Most abundant) Aldosterone- Controls NA and H2O levels.

B.Addison’s disease Adrenal Hypofunction 1.Pt’s always susceptible to hypotension. Be careful when getting up. (Risk for injury) 2.Adrenal Crisis (Addisons) Caused by STRESS

C.Cushing’s Syndrome 1.Hyperfunction of adrenals Excess production of ACTH 2.Cause is often due to long term treatment with steroids (Asthma)

S&S Excess adipose on trunk Thin arms Moon face Have high risk for infection because of high steroid in body.