Chapter 61 Endocrine system

LH (luteinizing hormone) function

sexual function/production for both male & females

hypothalamus function

shares a small closed circulatory system w/*anterior pituitary glands when it releases hormones

A nurse prepares to palpate a clients thyroid gland. Which action should the nurse take when performing this assessment? a. Stand in front of the client instead of behind the client. b. Ask the client to swallow after palpating the thyroid. c. Palpate the right lobe with the nurses left hand. d. Place the client in a sitting position with the chin tucked down.

sitting position with the chin tucked down

pituitary gland is controlled by

hypothalamus

Melanocyte-inhibiting hormone (MIH)

hypothalamus skin color, pigmentation

adrenal medulla

epinephrine and norepinephrine (catecholamines) sympathetic response increases peripheral vascular resistance

Hormones from pituitary gland for water and ion balance

ADH---- kidneys---> mineralocorticoids(aldosterone)

lock and key model

only correct hormones (key) can bind & activate receptor site (lock)

Corticotropin-releasing hormone- (CRH)

Pituitary gland Promotes secretion of *adrenocorticotropic hormone* P(ACTH) adrenal gland ----> --> glucocorticoids (cortisol) -*metabolism* mineralocortocoids (aldosterone) *Ion and water balance*

Thyrotropin-releasing hormone (TRH)

Pituitary gland thyroid gland thyroid stimulating hormones *metabolism*

Gonadotropin-releasing hormone (*Gn*-RH)

Pituitary gland releases estrogen, progesterone, and sexual characteristics. FSH & LH released A hormone secreted by the hypothalamus that stimulates the pituitary to release gametes production and sexual characteristics. *reproduction*

adrenal glands location

a pair of endocrine glands just above the kidneys.

pituitary gland location

a small structure just below brain attached to hypothalamus 2 lobes: anterior/posterior

anterior lobe of pituitary gland

Also called adenohypophysis Hormones "turn on" endocrine glands or support other organs

anterior pituitary gland secretes

Breast fluid and milk production are induced by the presence of prolactin,

anterior pituitary hormones

FSH, LH, TSH, GH, ACTH, MSH and prolactin

Hormones from pituitary gland for metabolism

GH-RH---> GH LIVER & MANY TISSUES GH-IH---> GH- LIVER & MANY TISSUES TRH---> TSH THYROID GLAND CRH---> ACTH ADRENAL GLAND

A nurse cares for clients with hormone disorders. Which are common key features of hormones? (Select all that apply.) a. Hormones may travel long distances to get to their target tissues. b. Continued hormone activity requires continued production and secretion. c. Control of hormone activity is caused by negative feedback mechanisms. d. Most hormones are stored in the target tissues for use later. e. Most hormones cause target tissues to change activities by changing gene activity.

Hormones may travel long distances to get to their target tissues. Continued hormone activity requires continued production and secretion. Control of hormone activity is caused by negative feedback mechanisms

What is the link b/t nervous and endocrine systems ?

Hypothalamus

parathyroid hormone

PTH

A nurse cares for a client who is prescribed a serum catecholamine test. Which action should the nurse take when obtaining the sample? a. Discard the first sample and then begin the collection. b. Draw the blood sample after the client eats breakfast. c. Place the sample on ice and send to the laboratory immediately. d. Add preservatives before sending the sample to the laboratory.

Place the sample on ice and send to the laboratory immediately.

Oxytocin

Posterior pituitary gland stimulates uterine contractions, delivery & mammary glands

Thyroid gland hormones

T3, T4, calcitonin

A nurse cares for a client with a hypofunctioning anterior pituitary gland. Which hormones should the nurse expect to be affected by this condition? (Select all that apply.) a. Thyroid-stimulating hormone b. Vasopressin c. Follicle-stimulating hormone d. Calcitonin e. Growth hormone

Thyroid-stimulating hormone (TSH) Follicle-stimulating hormone (FSH) Growth hormone

Hormones secreted by the anterior pituitary gland

Thyroid-stimulating hormone, follicle-stimulating hormone, and growth hormone

Adrenal gland 2 parts

adrenal cortex and adrenal medulla

salt craving

adrenal hypofunction

adrenal cortex hormones

aldosterone (mineralcortcoid) cortisol (glucocorticoid)

Islet cells of Pancreas 3 types

alpha cells beta cells delta cells

FSH (follicle stimulating hormone)

anterior pituitary stimulates gametes production by gonads

GH growth hormones

anterior pituitary gland; target bones and muscles; stimulate growth

MSH (melanocyte stimulating hormone)

anterior pituitary that regulates the activity of pigment-containing cells in the skin melanin

parathyroid function

calcium regulation absorbs calcium

Cortisol (glucocorticoid)

carb, fat and protein metabolism maintains blood glucose levels response to stress (fight or flight) help w/emotional stability immune function

Cortisol (glucocorticoid) function

controls metabolism helps with BP & blood sugars

Endocrine function

controls rate of metabolism maintains homeostasis ( fluids, electrolytes & pH) *growth/development roles in reproduction* (main roles)

overies and testes (gonads)

ovaries (estrogen & testosterone) testes (Testosterone)

posterior pituitary gland

oxytocin and ADH

blood sample for catecholamine must be

placed on ice and taken to the laboratory immediately

FSH & LH

regulate processes in the gonads and the production of sex hormones

alpha cells of pancreas

secrete glucagon

normal age-related endocrine change is

decreased antidiuretic hormone (ADH) production. This results in a more diluted urine output, which can lead to dehydration.

Somatostatin

decreases blood sugar by interfering with the release of glucagon and growth hormones

Catecholamines

dopamine, norepinephrine, epinephrine are responsible for the fight-or-flight can be correlated with tachycardia.

most endocrine disorders are ?

either Hypo/Hyper secretion of hormones

Hirsutism, or excessive hair growth on the face and body, can result from

endocrine disorders. This may cause a disruption in body image, especially for female clients.

negative feedback loop

final response to stimulate production of cortisol-> final response to decrease stimulation of cortisol.

Testosterone

gametes production& sex characteristics

Growth hormone -*inhibiting*hormone (GH-IH)

growth hormone inhibits production of growth hormones in liver and other tissues *metabolism*

Hormone activity can

increase or decrease according to the bodys needs, and continued hormone activity requires continued production and secretion.

A nurse collaborates with an unlicensed assistive personnel (UAP) to provide care for a client who is prescribed a 24-hour urine specimen collection. Which statement should the nurse include when delegating this activity to the UAP? a. Note the time of the clients first void and collect urine for 24 hours. b. Add the preservative to the container at the end of the test. c. Start the collection by saving the first urine of the morning. d. It is okay if one urine sample during the 24 hours is not collected.

time of the clients first void and collect urine for 24 hours.

Hypothalamus

water balance/bp/temp *regulation*/hunger/thirst/sex. secretes release hormones secretes inhibiting hormones link b/t nervous & endocrine systems

Hormone control is maintained via

negative feedback. are not stored for later use, and they do not alter genetic activity.

beta cells of pancreas

secrete insulin

delta cells of pancreas

secrete somatostatin

T3 (triodothyronine)

70-205 ng/dL

Hormones from pituitary gland for reproduction

Oxytocin prolactin FSH & LH testosterone

Growth hormone- *releasing* hormone (GH-RH)

Increases the release of GH from the anterior pituitary Growth hormone to stimulate liver(somatomedin) many other tissues *metabolism*

negative feedback

a mechanism of response in which a stimulus initiates reactions that reduce the stimulus

A nurse evaluates laboratory results for a male client who reports fluid secretion from his breasts. Which hormone value should the nurse assess first? a. Posterior pituitary hormones b. Adrenal medulla hormones c. Anterior pituitary hormones d. Parathyroid hormone

Anterior pituitary hormones

hypothalamus and anterior pituitary- Hormones released

Corticotropin-releasing hormone- (CRH) Thyrotropin-releasing hormone (TRH) Gonadotropin-releasing hormone (*Gn*-RH) Growth hormone -*inhibiting*hormone (GH-IH) Growth hormone- *releasing* hormone (GH-RH) Prolactin-inhibiting hormone (PIH) Melanocyte-inhibiting hormone (MIH)

A nurse cares for a client who is prescribed a drug that blocks a hormones receptor site. Which therapeutic effect should the nurse expect? a. Greater hormone metabolism b. Decreased hormone activity c. Increased hormone activity d. Unchanged hormone response

Decreased hormone activity Hormones cause activity in the target tissues by binding with their specific cellular receptor sites, thereby changing the activity of the cell.

A nurse assesses a client diagnosed with adrenal hypofunction. Which client statement should the nurse correlate with this diagnosis? a. I have a terrible craving for potato chips. b. I cannot seem to drink enough water. c. I no longer have an appetite for anything. d. I get hungry even after eating a meal.

I have a terrible craving for potato chips.

Thyrocalcitonin (calcitonin)

thyroid; accelerates absorption of calcium by the bones and lowers blood calcium level

thyroid gland

endocrine gland that surrounds the trachea in the neck, butterfly shaped

Hormones are secreted by

endocrine glands and travel through the body to reach their target tissues.

T4 (thyroxine)

increases metabolism and basal metabolic rate (BMR) RR & HR

Prolactin-inhibiting hormone (PIH)

inhibits secretion of prolactin mammary gland- breast milk production *hypothalamus- reproduction*

Islet cells of pancreas location

islet of Langerhans

Endocrine system definition

made up of *glands* that regulate overall body functions works in conjunction with the *nervous* system

Aldosterone,

major mineralocorticoid, maintains extracellular fluid volume. promotes sodium and water reabsorption and potassium excretion in the kidney tubules. deficiency will have increased urine output

Purpose of endocrine glands?

secretion of hormones

parathyroid glands

small pea-like organs that regulate calcium and phosphate balance in blood, bones, and other tissues

aldosterone (mineralcortcoid)

sodium reabsorption & potassium excretion regulates renin/angiotensin systems

Prolactin

stimulates milk production anterior pituitary gland

ACTH (adrenocorticotropic hormone)

stimulates secretion of hormones by adrenal cortex glucocorticoid (cortisol) raises glucose levels in blood

A nurse teaches a client who has been prescribed a 24-hour urine collection to measure excreted hormones. The client asks, Why do I need to collect urine for 24 hours instead of providing a random specimen? How should the nurse respond? a. This test will assess for a hormone secreted on a circadian rhythm. b. The hormone is diluted in urine; therefore, we need a large volume. c. We are assessing when the hormone is secreted in large amounts. d. To collect the correct hormone, you need to urinate multiple times.

test will assess for a hormone secreted on a circadian rhythm.

pituitary gland definition

the "master gland" of the body's hormone-producing system, which releases hormones that direct the functions of many other glands in the body

adrenal glands function

the adrenals secrete the hormones epinephrine (adrenaline) and norepinephrine (noradrenaline), which help to arouse the body in times of stress.

Parafollicular cells produce

thyrocalcitonin (calcitonin), which regulates serum calcium levels.

endocrine system glands

1. Hypothalamus 2. pituitary gland 3. Thyroid gland 4. parathyroid gland 5. Adrenal gland 6. Islet cells of pancreas 7. gonads (ovaries & testes)

Calcitonin

Lowers blood calcium levels

A nurse teaches an older adult with a decreased production of estrogen. Which statement should the nurse include in this clients teaching to decrease injury? a. Drink at least 2 liters of fluids each day. b. Walk around the neighborhood for daily exercise. c. Bathe your perineal area twice a day. d. You should check your blood glucose before meals.

Walk for daily exercise.

LH (luteinizing hormone)

a hormone that causes the secretion of sex hormones by the testes and ovaries

A nurse cares for a client who is prescribed a 24-hour urine collection. The unlicensed assistive personnel (UAP) reports that, while pouring urine into the collection container, some urine splashed his hand. Which action should the nurse take next? a. Ask the UAP if he washed his hands afterward. b. Have the UAP fill out an incident report. c. Ask the laboratory if the container has preservative in it. d. Send the UAP to Employee Health right away.

Ask the UAP if he washed his hands afterward. safety, the nurse should find out if the UAP washed his or her hands.

A nurse cares for a client with excessive production of thyrocalcitonin (calcitonin). For which electrolyte imbalance should the nurse assess? a. Potassium b. Sodium c. Calcium d. Magnesium

Calcium

A nurse assesses clients who have endocrine disorders. Which assessment findings are paired correctly with the endocrine disorder? (Select all that apply.) a. Excessive thyroid-stimulating hormone Increased bone formation b. Excessive melanocyte-stimulating hormone Darkening of the skin c. Excessive parathyroid hormone Synthesis and release of corticosteroids d. Excessive antidiuretic hormone Increased urinary output e. Excessive adrenocorticotropic hormone Increased bone resorption

Excessive thyroid-stimulating hormone = Increased bone formation Excessive melanocyte-stimulating hormone= Darkening of the skin

A nurse assesses a client who is prescribed a medication that stimulates beta1 receptors. Which assessment finding should alert the nurse to urgently contact the health care provider? a. Heart rate of 50 beats/min b. Respiratory rate of 18 breaths/min c. Oxygenation saturation of 92% d. Blood pressure of 144/69 mm Hg

Heart rate of 50 beats/min Stimulation of beta1 receptor sites in the heart has positive chronotropic and inotropic actions. The nurse expects an increase in heart rate and increased cardiac output

A nurse assesses a female client who presents with hirsutism. Which question should the nurse ask when assessing this client? a. How do you plan to pay for your treatments? b. How do you feel about yourself? c. What medications are you prescribed? d. What are you doing to prevent this from happening?

How do you feel about yourself?

A nurse cares for a client with a deficiency of aldosterone. Which assessment finding should the nurse correlate with this deficiency? a. Increased urine output b. Vasoconstriction c. Blood glucose of 98 mg/dL d. Serum sodium of 144 mEq/L

Increased urine output

A nurse plans care for an older adult who is admitted to the hospital for pneumonia. The client has no known drug allergies and no significant health history. Which action should the nurse include in this clients plan of care? a. Initiate Airborne Precautions. b. Offer fluids every hour or two. c. Place an indwelling urinary catheter. d. Palpate the clients thyroid gland.

Offer fluids every hour or two.

Key features of the endocrine system

hormone travels through blood exert their action on *specific* targets a.k.a. *lock and key*

TSH-thyroid gland-thyroid hormones

thyroid hormones metabolic rate

A nurse cares for a client who has excessive catecholamine release. Which assessment finding should the nurse correlate with this condition? a. Decreased blood pressure b. Increased pulse c. Decreased respiratory rate d. Increased urine output

Increased pulse

ADH (antidiuretic hormone/vasopressin)

antidiuretic hormone (vasopressin) mineralocorticoids(aldosterone) posterior pituitary gland reabsorption of water in kidney tubules