Endocrine Function

The laboratory test results of a patient show a significant hyponatremia. What hormone imbalance should the nurse consider as the cause? Cortisol Rationale: Cortisol deficiency would result in decreased ability to cope with stress. Aldosterone Rationale: Hyponatremia is the condition in which there is a decrease in the level of sodium in the body. A decreased secretion in adrenocorticotropic hormone results in the decrease of the release of the mineralocorticoids (aldosterone) and glucocorticoids (cortisol) from the adrenal cortex. Aldosterone deficiency leads to hyponatremia. Growth hormone Rationale: Growth hormone deficiency may result in decreased bone density in adults. Follicle-stimulating hormone (FSH) Rationale: Decreased secretion of FSH may alter sexual and reproductive functioning. Test Taking Tips:Low sodium = Low aldosterone.

Aldosterone Rationale: Hyponatremia is the condition in which there is a decrease in the level of sodium in the body. A decreased secretion in adrenocorticotropic hormone results in the decrease of the release of the mineralocorticoids (aldosterone) and glucocorticoids (cortisol) from the adrenal cortex. Aldosterone deficiency leads to hyponatremia.

A patient is placed on intravenous oxytocin. What teaching should the nurse provide before beginning the medication? Oxytocin will increase water reabsorption. Rationale: Vasopressin increases water reabsorption. Oxytocin will stimulate sperm production. Rationale: Follicle-stimulating hormone and luteinizing hormone stimulate the production of sperm in males. Oxytocin will facilitate bone and tissue growth. Rationale: Growth hormone facilitates the growth of bones and tissues through protein synthesis, fat metabolism, and insulin antagonism. Oxytocin will stimulate uterine contractions in labor. Rationale: Oxytocin is secreted by the posterior pituitary gland. It stimulates uterine contractions in labor. It also stimulates milk ejection.

Oxytocin will stimulate uterine contractions in labor. Rationale: Oxytocin is secreted by the posterior pituitary gland. It stimulates uterine contractions in labor. It also stimulates milk ejection.

A patient with osteoporosis and a recent fracture asks the nurse what the provider meant by saying it could be caused by hormone deficiency. How should the nurse reply? "Growth hormone, when low, can decrease bone density." Rationale: Osteoporosis may result with decreased secretion of growth hormone. This causes decreased bone density. "Luteinizing hormone is important in strengthening the bones." Rationale: Decreased secretion of gonadotropins such as LH would result in the alteration of sexual and reproductive functioning. "Follicle-stimulating hormone allows for the stimulation of strong bone formation." Rationale: The decreased secretion of FSH may alter sexual and reproductive functioning. "Adrenocorticotropic hormone acts on the bones, making them stronger." Rationale: The deficiency of ACTH results in decreased release of the mineralocorticoids and glucocorticoids from the adrenal cortex. Test Taking Tips:Consider hormones of hyposecretion.

"Growth hormone, when low, can decrease bone density." Rationale: Osteoporosis may result with decreased secretion of growth hormone. This causes decreased bone density.

A nurse is comparing the hormones of the pituitary gland in preparation for care of a patient undergoing a posterior lobe removal. Which hormone is secreted through the posterior lobe of the pituitary gland? Antidiuretic hormone (ADH) Rationale: The posterior lobe of the pituitary is responsible for the hormonal action of ADH. The hormone controls water retention by the kidneys. It also moderates vasoconstriction. Follicle-stimulating hormone (FSH) Rationale: The anterior lobe of the pituitary is responsible for the hormonal action of FSH. The hormone assists the maturation of the ovaries in females. It also participates in spermatogenesis in males. Growth-stimulating hormone (GSH) Rationale: GSH is secreted through the anterior lobe of pituitary. It affects the stimulation and production of cells. Adrenocorticotropic hormone (ACTH) Rationale: ACTH is secreted from the anterior pituitary lobe. It is involved in the synthesis of corticosteroids. Test Taking Tips:Differentiate between the anterior and posterior pituitary.

Antidiuretic hormone (ADH) Rationale: The posterior lobe of the pituitary is responsible for the hormonal action of ADH. The hormone controls water retention by the kidneys. It also moderates vasoconstriction.

After serum testing, it is determined that a patient has a deficiency of adrenocorticotropic hormone (ACTH)? What concern should the nurse be aware of? Dwarfism Rationale: Dwarfism is associated with the deficiency of growth hormone in children. Osteoporosis Rationale: The decreased secretion of growth hormone in adults may result in decreased bone density. This may lead to osteoporosis. Circulatory collapse Rationale: The decreased secretion of ACTH would result in decreased glucocorticoids and mineralocorticoids. Therefore, the patient would be unable to maintain an adequate fluid volume status. Such a condition may result in circulatory collapse. Ventricular tachyarrhythmias Rationale: Ventricular tachyarrhythmias are associated with hyperaldosteronism. Test Taking Tips:Do not confuse deficiency and excess.

Circulatory collapse Rationale: The decreased secretion of ACTH would result in decreased glucocorticoids and mineralocorticoids. Therefore, the patient would be unable to maintain an adequate fluid volume status. Such a condition may result in circulatory collapse.

A patient with hypercortisolism is hospitalized after experiencing a fall from orthostatic hypotension. Which additional symptom will be present? Decreased bone density Rationale: Decreased secretion of growth hormone would result in decreased bone density. Decreased blood pressure Rationale: Hypotension is associated with decreased aldosterone. Decreased blood glucose level Rationale: Hypoglycemia is related to decreased secretion of adrenocorticotropic hormone. This results in decreased secretion of cortisol. Decreased blood potassium level Rationale: The decrease in blood potassium level could be an indication of the decreased aldosterone level in body. Test Taking Tips:Hypocortisolism means less glucose release.

Decreased blood glucose level Rationale: Hypoglycemia is related to decreased secretion of adrenocorticotropic hormone. This results in decreased secretion of cortisol.

The nurse is caring for a patient who has had this gland removed. What hormone imbalance will be experienced Hypoaldosteronism Rationale: Aldosterone, glucocorticoids, and catecholamines are secreted by the adrenal gland. Hyperthyroidism Rationale: Triiodothyroxine (T3) and thyroxine (T4) are secreted by the thyroid gland, located in the neck. Hypoparathyroidism Rationale: Parathyroid hormone (PTH) is secreted by the parathyroid glands, located by the thyroid gland. Hyperpituitarism Rationale: Several hormones are secreted by the pituitary gland, located in the brain. Test Taking Tips:Pay special attention to the location over the kidneys.

Hypoaldosteronism Rationale: Aldosterone, glucocorticoids, and catecholamines are secreted by the adrenal gland.

The nurse is caring for a patient with adrenocorticotropic hormone (ACTH) deficiency. What should be included in the plan of care? Preventing the risk for injury Rationale: A patient with osteoporosis is more likely to be at risk for injury resulting from falls. Providing a diet rich in calcium Rationale: Maintaining a diet rich in calcium is an important intervention for a patient with osteoporosis. Increasing the intake of vitamin D Rationale: Increasing the intake of vitamin D is an important intervention for a patient with osteoporosis. Maintaining adequate volume of fluid intake Rationale: Fluid volume deficiency is related to decreased glucocorticoid and mineralocorticoid levels, which is related to ACTH deficiency. Maintaining adequate fluid levels in a patient with ACTH deficiency is an important intervention. Test Taking Tips:A deficiency of ACTH is associated with a decrease in the release of the mineralocorticoids and glucocorticoids from the adrenal cortex.

Maintaining adequate volume of fluid intake Rationale: Fluid volume deficiency is related to decreased glucocorticoid and mineralocorticoid levels, which is related to ACTH deficiency. Maintaining adequate fluid levels in a patient with ACTH deficiency is an important intervention.

Which is true regarding the pituitary gland? Select all that apply. The pituitary gland is located in the sella turcica. Rationale: The pituitary gland is located in the sella turcica, a depression of the sphenoid bone. The anterior pituitary gland secretes prolactin. Rationale: The anterior pituitary gland secretes the hormone prolactin, which stimulates the mammary glands for milk production. The posterior pituitary gland synthesizes oxytocin. Rationale: The posterior pituitary gland releases two hormones: the antidiuretic hormone and oxytocin. These hormones are synthesized by the hypothalamus, but stored and released from the posterior pituitary gland. The posterior pituitary gland is responsible for the growth-stimulating hormone (GSH). Rationale: The GSH affects the stimulation and production of cells. It is secreted by the anterior pituitary gland. The anterior lobe of the pituitary is called adenohypophysis. Rationale: The anterior lobe of the pituitary gland is called adenohypophysis while the posterior lobe is called neurohypophysis. Test Taking Tips:Remember there are two lobes of the gland. Question

The pituitary gland is located in the sella turcica. Rationale: The pituitary gland is located in the sella turcica, a depression of the sphenoid bone. The anterior pituitary gland secretes prolactin. Rationale: The anterior pituitary gland secretes the hormone prolactin, which stimulates the mammary glands for milk production. The anterior lobe of the pituitary is called adenohypophysis. Rationale: The anterior lobe of the pituitary gland is called adenohypophysis while the posterior lobe is called neurohypophysis.

A patient is admitted with severe dehydration and hypotension. Which hormone, when delivered, increases water reabsorption? Oxytocin Rationale: Oxytocin is secreted by the posterior pituitary gland. It stimulates uterine contractions in labor. It also stimulates milk ejection. Vasopressin Rationale: Vasopressin increases water reabsorption. Luteinizing hormone Rationale: Follicle-stimulating hormone and luteinizing hormone stimulate the production of sperm in males. Adrenocorticotropic hormone Rationale: Adrenocorticotropic hormone increases the secretion of glucocorticoids and mineralocorticoids. Test Taking Tips:Vasopressin is ADH.

Vasopressin Rationale: Vasopressin increases water reabsorption.