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

3. V.Hyperpituitarism A.Cause 1.Increased GH 1.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. 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)

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

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

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

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

11. 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

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! 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. 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

18. Watch for stone formation!! Kidney Stones 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.Potential for injury r/t… 2.Decrease cardiac output D. Tx: IV calcium gluconate

21. 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

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

23. VIII.Adrenals A.Secretes: Cortizol (Most abundant) Aldosterone- Controls NA 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.