1. Endo

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

3. Hyperpituitarism
Cause
Increased GH
S&S
Gigantism
Acromegaly

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

6. 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)

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

8. D. Complications
1. Thyroid storm/crisis
- Increased HR, Res, BP
- Feeling hot and scared
E. Tx
1. Tapazole

9. 2. Thyroidectomy (Partial)
a. Pt teaching
1. Deep breathing
2. Support head during
position changes
b. Chvostek’s sign
Due to hypocalcemia
c. Watch for Tetany**
Treat with Ca Gluconate
d. Watch for hoarseness
could be laryngeal spasm
Seek help

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

11. 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
3. Goiter

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

13. 2. Infants get cretinism

14. E. Tx
1. Synthroid 4-ever!
and first thing in the
morning.
2. Salt

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

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

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

18. Kidney Stones (Urinary Calculi) Monitor urinary output in case stone
Watch for stone formation!!
Kidney Stones (Urinary Calculi)
Monitor urinary output in case stone
blocks
passage

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

20. C. Nursing Dx
1. Decrease cardiac output
D. Tx:
IV calcium gluconate

21. Diabetes Insipidus
Cause
Low ADH or not responding to
ADH
B. S&S
1. Massive Diuresis
2. Dehydration
3. Hypotension with tachycardia
4. Weakness and dizziness
5. Polydipsia
C. Tx
DDAVP medicine

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

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

24. 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

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

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

27. The
End