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