Chapter 18, Mechanisms of Hormonal Regulation

A client has a dysfunctional gland that synthesizes and releases adrenocorticotropic hormone (ACTH). Which gland is affected?

Anterior pituitary ACTH is synthesized and released by the anterior pituitary gland in response to stimulation by corticotropin-releasing hormone (CRH) from the hypothalamus. ACTH is not synthesized and released by the adrenal cortex (aldosterone, glucocorticoids), adrenal medulla (catecholamines), or posterior pituitary (oxytocin, antidiuretic hormone).

A client has a deficiency of calcitonin. Which cells that secrete calcitonin are not functioning properly? Select all that apply.

C cells, Parafollicular cells C cells, or parafollicular cells, secrete calcitonin. The follicular cells synthesize and secrete the thyroid hormones. The pars tuberalis is a thin layer of cells on the anterior and lateral portions of the pituitary stalk. Chromophobes are nonsecretory cells located in the anterior pituitary. https://eaq.elsevier.com/Libraries/EAQ_Huether_Patho6e/QB-pw0i/Q-qnw1-2s126imi/8ccz/Huether_Table18-6.png

If the adrenal medulla is dysfunctional, the client would experience a decrease in which hormones? Select all that apply.

Epinephrine, Noradrenaline The adrenal medulla secretes the catecholamines epinephrine (adrenaline) and norepinephrine (noradrenaline). The adrenal cortex produces aldosterone and the glucocorticoids cortisol, cortisone, and corticosterone. Minimal amounts of estrogen are secreted from the adrenal cortex.

A client has pathologically high levels of glucocorticoids. Which areas should the nurse check to monitor for fat deposits? Select all that apply.

Face, Neck

A nurse is teaching about gonadotropin-releasing hormone. What happens when this hormone stimulates the client's anterior pituitary? Select all that apply.

It releases luteinizing hormone. It releases follicle-stimulating hormone. Gonadotropin-releasing hormone causes the anterior pituitary to release follicle-stimulating hormone and luteinizing hormone. Growth hormone-releasing hormone stimulates the anterior pituitary to release growth hormone. Thyrotropin-releasing hormone stimulates the anterior pituitary to release thyroid-stimulating hormone. Prolactin-releasing factor causes the anterior pituitary to secrete prolactin. https://eaq.elsevier.com/Libraries/EAQ_Huether_Patho6e/QB-pw0i/Q-ocqn-o8126imi/r12e/Huether_Table18-5.png

A nurse is teaching a coworker about the endocrine system. Which information from a coworker will cause the nurse to intervene?

Pancreatic somatostatin inhibits growth hormone. Pancreatic somatostatin is not the same thing as hypothalamic somatostatin, which inhibits the release of growth hormone. Pancreatic somatostatin inhibits secretion of insulin, glucagon, and pancreatic polypeptide. Therefore the nurse would need to correct this misinformation. All the rest are correct and do not require the nurse to intervene. Amylin does have a satiety effect. Glucagon increases blood glucose by stimulating lipolysis and glycogenolysis. Ghrelin does play a role in the regulation of insulin sensitivity. https://eaq.elsevier.com/Libraries/EAQ_Huether_Patho6e/QB-pw0i/Q-gdl7-deo16imi/5z3q/Huether_Table18-4.png

A nurse is teaching about the functions of melatonin. Which functions should the nurse include in the teaching session? Select all that apply.

Regulates immune system, Regulates circadian rhythms, Increases nitric oxide release Melatonin regulates circadian rhythms and reproductive systems, including the secretion of the gonadotropin-releasing hormones and the onset of puberty. It also plays an important role in immune regulation and is postulated to affect the aging process. Further effects of melatonin include increasing nitric oxide release from blood vessels, removing toxic oxygen free radicals, and decreasing insulin secretion.

A nurse is teaching about the effects of aging on the endocrine system. Which information from the staff indicates successful teaching? Select all that apply.

Secretion of cortisol decreases. Secretion of growth hormone declines. Secretion of antidiuretic hormone is reduced. Secretion of antidiuretic hormone, growth hormone, and cortisol decreases. Insulin and aldosterone are also decreased. https://eaq.elsevier.com/Libraries/EAQ_Huether_Patho6e/QB-pw0i/Q-ai87-mqn16imi/tbwp/Huether_GeriatricConsiderations_Aging%26ItsEffectsonSpecificEndocrineGlands.png

A nurse is describing the components of the posterior pituitary. Which structures should the nurse include? Select all that apply.

Stalk, Pars nervosa, Median eminence The embryonic posterior pituitary (neurohypophysis) is derived from the hypothalamus and comprises three parts: (1) the median eminence, located at the base of the hypothalamus; (2) the pituitary stalk; and (3) the pars nervosa or neural lobe. The pars distalis is part of the anterior pituitary; the isthmus is found in the thyroid gland.

Which information indicates a nurse has an accurate understanding of the thyroid-stimulating hormone (TSH)?

TSH secretion is regulated by thyrotropin-releasing hormone. Thyroid-stimulating hormone (TSH) secretion from the anterior pituitary is stimulated by thyrotropin-releasing hormone (TRH) from the hypothalamus and by decreased serum levels of the thyroid hormones thyroxine (T4) and triiodothyronine (T3). Secretion of TSH stimulates the synthesis and secretion of thyroid hormones. Increasing levels of T4 and T3 then generate negative feedback on the pituitary and hypothalamus to inhibit TRH and TSH synthesis.

A nurse is teaching about the parathyroid glands. Which information should the nurse include in the teaching session? Select all that apply.

They influence the serum phosphate level. They secrete the most important factor in calcium regulation. Parathyroid hormone (PTH) is the single most important regulator of serum calcium. The overall effect of PTH secretion is to increase serum calcium concentration and decrease serum phosphate level. Although there are usually two pairs of parathyroid glands present, there may be two to six. Thyroid hormone is produced by the thyroid gland and is unaffected by the parathyroid glands. The parathyroid glands are small and are located behind the thyroid gland.