GN-RH, GHRH, SOMATSTATIN GHIH, PROLACTIN-INHIBITING HORMONE, AND TRH

NUR 254 TEST 3

• Hypothalamus

Answer brain region controlling the pituitary gland. Secrets CRH,

GN-RH, GHRH, SOMATSTATIN GHIH, PROLACTIN-INHIBITING HORMONE, AND TRH

• pituitary gland

Answer The endocrine system's most influential gland. Under the in- fluence of the hypothalamus, the pituitary regulates growth and controls other endocrine glands.

• adrenal cortex

Answer outer section of each adrenal gland; secretes (gluticocorticoids) cortisol, (mineralcortocoids) aldosterone, and sex hormones

• adrenal medulla

Answer secretes (catecholamines) epinephrine and norepinephrine

• Anterior pituitary gland

Answer Secretes tropic hormones such as thyroid stimulating hormone (TSH), ACTH, growth hormone (somatotropic hormone), and the gonadotropins, prolactin, melanocyte stimulating hormone

• Posterior pituitary gland

Answer (Vasopressin)ADH and oxytocin

• parathyroid glands 1 / 4

Answer small pea-like organs that secretes parathyroid hormone (PTH) to regulate calcium and phosphate balance in blood, bones, and other tissues

• Posterior pituitary disorders

Answer diabetes insipidus SIADH

• Posterior pituitary disorders

Answer Hormone

ADH (Antidiuretic hormone) Target

Distal tubules and collecting ducts of kidneys

Action

Increases water reabsorption

• diabetes insipidus

Answer Decreased secretion of antidiuretic hormone (ADH, vasopressin) from posterior pituitary

Secondary to

Brain tumors Neuorsurgery Head trauma

• Clinical Manifestations Of Diabetes Insipidus

Answer 2 / 4

Polyuria - Enormous output of "water-like urine" w/ urine specific gravity < 1.005 (normally

1.010-1.030).

nocturia. Polydipsia - Intense thirst

Hemoconcentration - Elevated serum sodium (>145 mEq/L) and hematocrit (>50%) Volume deficit - hypotension, tachycardia, tenting turgor, fatigue, prolonged capillary refill

• Diagnostics of diabetes insipidus?

Answer Urine-Decreased urine osmolality (<200 mOsm/kg) and urine specific gravity <1.005

Serum -Hypernatremia (Na >145 mEq/L) Hematocrit increased (Hct >50%) Osmolality increased (>300 mOsm/kg)

Water (fluid) deprivation test-All water withheld Measure urine osmolality and body weight hourly Normally urine osmolality increases to 2 to 4 times the serum. With DI the urine osmolality doesn't increase and the serum osmolality continues to increase

CT or MRI to assess for cause (if not apparent)

• Management of Diabetes Insipidus

Answer Replace Fluids

Answer

P.O. water Hypotonic IV fluids if unable to take p.o. (D5W) Monitor for hyperglycemia, volume overload and slowly decreasing the serum sodi- um Replace ADH

Desmopressin (DDAVP) or Vasopressin (Pitressin) - synthetic ADH (SQ, IN, or oral). Monitor U/O, serum electrolytes, fluid status (skin turgor, cap refill, daily weight) 3 / 4

• Complications of diabetes insipidus

Answer Dehydration/hypovolemia/circulatory collapse

Hypernatremia w/CNS dysfunction (seizures, confusion, coma, etc.)

• Nursing Diagnosis Diabetes Insipidus

Answer FVD, Risk for ineff therap regimen

• Nursing Interventions Diabetes Insipidus

Answer Assess

VS, weight, I&O, Visual acuity, Serum Na/osmolality/Urine specific gravity Do

Administer DDAVP, IVFs, p.o. fluids, mouth care Teach

Daily weights, Manifestations, FVE, Medications

• The functioning of the endocrine system works on what type of system?

Negative feedback system Positive feedback system

Alternating negative and positive feedback system Closed loop system

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