Term
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Definition
| Metabolism is defined as the physical and chemical processes the body uses to maintain itself through anabolism and catabolism |
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Term
| What is the primary function of the endocrine system? |
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Definition
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Term
| How does the endocrine system adapt to changes in the environment of the body's metabolism? |
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Definition
| by using chemical substances called hormones |
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Term
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Definition
chemical messengers that will exert action on a specific target cell.
They are always present but can be in greater or lesser amounts depending on individual needs |
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Term
| How does hormonal action occur? |
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Definition
| by interaction with high affinity receptors located on surface or inside target cell |
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Term
| What is the mechanism for regulating hormone production called? |
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Definition
| Negative feedback control mechanisms |
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Term
| what are negative feedback control mechanisms? |
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Definition
| when hormone concentration decreases, the rate of hormone production increases in response |
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Term
| What do excesses or deficiencies of hormone levels cause? |
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Definition
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Term
| What glands are in the endocrine system? |
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Definition
| the pituitary gland, the thyroid gland, parathyroid glands, adrenal glands, pancreatic islets, ovaries, and testes |
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Term
| Where is the pituitary gland located? |
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Definition
| in the skull behind the hypothalamus of the brain |
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Term
| What 2 parts are included in the pituitary gland? |
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Definition
anterior pituitary
posterior pituitary |
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Term
| What hormones are included in the anterior pituitary gland? |
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Definition
| growth hormone (GH), prolactin, thyroid stimulating hormone (TSH), adrenocorticotropic hormone (ACTH), gonadotropic hormones: (follicle stimulating hormone (FSH) and luteinizing hormone(LH) |
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Term
| what is the posterior pituitary gland made of and what is its function? |
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Definition
made mostly of nervous tissue (an extension of the hypothalamus)
FX: to store and release ADH and oxytocin which are produced in the hypothalamus |
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Term
| What hormomes are produced in the posterior pituitary? |
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Definition
antidiuretic hormone (ADH)-also called vasopressin
oxytocin |
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Term
| What does the thyroid gland do? |
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Definition
| -secrete thyroid hormones which increase metabolism |
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Term
| What stimulates secretion of thyroid hormone(TH)? |
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Definition
the release of TSH in pituitary gland
(requires iodine in the diet) |
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Term
| what hormones are made in the thyroid? |
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Definition
calcitonin (decreases calcium in the blood; slows calcium releasing activity of the bones; believed to mediate the inflammatory response and can indicate sepsis)
T4-thyroxine
T3 triiodothyronine |
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Term
| Where are parathyroid glands and what do they make? |
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Definition
embedded in posterior of thyroid gland
they secrete parathyroid hormone (PTH) |
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Term
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Definition
| increase calcium levels and controls phosphate metabolism. |
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Term
| what is required for parathyroid hormone to work? |
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Definition
| normal levels of vitamin D |
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Term
| What is the pancreas made of? |
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Definition
| approx 1 million small glands called islets of Langerhans or the Pancreatic Islets |
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Term
| What are pancreatic islets used for? |
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Definition
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Term
| what hormones are secreted by the endocrine portion of the pancreas? |
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Definition
alpha cells (glucagon)
beta cells (insulin)
delta cells (somatostatin) |
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Term
| What is diabetes caused by? |
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Definition
| disruption in the normal metabolism of the pancreatic hormones of glucagon and insulin |
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Term
| What are the adrenal glands and what are they composed of? |
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Definition
a pair of very vascular glands located on top of each kidney
-cortex (outer 2/3 of gland)
-medulla (middle 1/3 of gland, has independent hormone functions)
-capsule (tough connective tissue that surrounds entire gland) |
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Term
| what are the hormones synthesized and secreted by the adrenal cortex? |
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Definition
| adrenal steroids or cortico-steroids |
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Term
| Why is adrenal cortex important? |
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Definition
| it is essential for survival because these hormones are needed to maintain homeostasis |
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Term
| What are the 3 layers of the adrenal cortex? |
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Definition
-Zona glomerulosa (produces mineralcorticoids)
-Zona fasciculate (produces glucocorticoids, androgens)
-Zona reticularis (involved in secretion of same hormones as fasciculate--the 2 inner zona function as a unit) |
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Term
| What is the primary glucocorticoid secreted by the adrenal cortex? |
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Definition
| cortisol (hydrocortisone) |
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Term
| what are the functions of cortisol? |
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Definition
-affects carbohydrate metabolism (anti-insulin effect), affects protein catabolism and fat metabolism
-regulates the body's production of glucose (involved in gluconeogenesis)
-has a role in stress response
-maintains emotional stability
-decreases inflammation, antibodies and WBCs
-suppresses overall immune response
-related to the anterior pituitary hormone ACTH |
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Term
| What mineralcorticoid is made by the adrenal gland? What is it used for? |
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Definition
aldosterone
essential in metabolism of electrolytes (sodium and potassium); electrolyte metabolism maintains normal blood pressure and cardiac output |
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Term
| What do deficiencies of aldosterone cause? |
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Definition
hypotension and hyperkalemia
**decreased cardiac output and shock |
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Term
| What does excess aldosterone cause? |
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Definition
| hypertension and hypokalemia |
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Term
How is aldosterone secretion stimulated?
What does it act on? |
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Definition
-renin-angiotensin system in kidney
-acts on kidney in loop of Henle to reabsorb sodium and excrete potassium |
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Term
| What is a precursor of testosterone and estrogen? |
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Definition
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Term
| where is androgen secreted? |
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Definition
adrenal cortex zona fasciculate, gonads (ovaries and testes)
"Adrenals are a major source of androgens in women" |
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Term
| when the sympathetic nervous system (SNS) is stimulated the medulla releases what? |
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Definition
hormones called catecholamines
(norephinephrine and epinephrine) |
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Term
| When doing a nursing assessment about family history, what are you looking for? |
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Definition
obesity
growth & development anomalies
diabetes mellitus
thyroid disorders
infertility
changes in secondary sex characteristics |
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Term
| When doing a nursing assessment about personal history, what do you look for? |
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Definition
changes in weight
changes in diet-fluid intake, increased salt intake, cravings
previous endocrine problems
activity changes-increased restlessness
medications (current, past, OTC) |
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Term
| Hormones involved in metabolism can effect: |
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Definition
growth and development
regulation of sex hormone levels
fluid and electrolyte balance
body's utilization of nutrients
Keep in mind that an endocrine problem can change physical features |
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Term
| What physical assessments should you perform? |
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Definition
palpate the thyroid gland(only gland that can be palpated)
inspect skin, hair, facial appearance, musculoskeletal system |
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Term
| What does age have to do with metabolism disorders? |
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Definition
| over 50 years=more metabolic disorders |
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Term
| What does gender have to do with metabolism disorders? |
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Definition
| female: more with Diabetes mellitus, gestational diabetes=increased risk of DM later in life, hypothyroidism is more common in women ages 30-60; Cushings sydrome (hyperfunction of adrenal gland) 5x more common in women |
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Term
| What does heredity have to do with metabolism disorders? |
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Definition
Diabetes Mellitus-strong family correlation that is exacerbated by environmental factors, 100% correlation between twins
Thyroid disorders-frequent family correlation |
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Term
| What does weight change have to do with metabolism disorders? |
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Definition
obesity=increased incidence and severity of type 2 DM, obesity around the abdomen in Cushing's syndrome
decreased weight can indicate DM1 or hyperthyroid |
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Term
| What does environmental exposures have to do with metabolism disorders? |
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Definition
| radiation exposure can result in hyperthyroidism or hypofunction of the pituitary gland |
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Term
| What does autoimmunce disruption have to do with metabolism disorders? |
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Definition
graves' disease=autoimmunce form of hyperthyroidism
lupus and hyperthyroid correlated |
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Term
| What does race/ethnicity have to do with metabolism disorders? |
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Definition
| specific to metabolic disorder: diabetes=high incidence among African American women |
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Term
| What happens to the thyroid gland with age? |
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Definition
function decreases with advancing age;
atrophy, fibrosis, and increased nodules resulting in gradual hypothyroidism |
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Term
| What are signs & symptoms of decreased thyroid function? |
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Definition
hair thins
facial skin sags
bones become more prominent
nails thickened/ yellow and brittle
increasing lethargy
constipation
dry skin
sometimes increased mental deterioration |
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Term
| What happens to the female gonads with age? |
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Definition
produce less estrogen
females have increasing signs of estrogen deficiency
require increased calcium intake and increased exercise to promote bone health and to compensate for reduced estrogen |
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Term
| what happens to the male gonads with age? |
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Definition
produce lower levels of testosterone
results in gradual increase in size of prostate which then causes: urinary frequency, retention and nocturia
"This will require intervention if patient has symptomatic benign prostatic hypertrphy (BPH) |
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Term
| What happens to pancreatic islet cells with age? |
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Definition
| patients over 50 have decreased pancreatic endocrine functions which: cause decreased glucose metabolism |
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Term
| What would you monitor in patients over 50 with decreased glucose metabolism? |
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Definition
s/s of hyperglycemia: polyuria, frequent infections, increased thirst
increased weight or increased BMI |
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Term
Changes in the Endocrine System in Children and Adolescents
Endocrine system is responsible for? |
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Definition
| sexual differentiation during fetal development and for promoting growth and development |
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Term
Changes in the Endocrine System in Children and Adolescents:
Disturbances in endocrine system can result in: |
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Definition
| metabolic alterations in growth, development and behavior |
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Term
Changes in the Endocrine System in Children and Adolescents:
What happens if not diagnosed early? |
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Definition
| can result in delays in growth and development, mental retardation, and sometimes death |
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Term
Changes in the Endocrine System in Children and Adolescents:
What does treatment involve? |
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Definition
| hormone replacement, frequent monitoring of hormone levels, and dietary measures for children |
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Term
Changes in the Endocrine System in Children and Adolescents:
Are metabolic disorders of the parathyroid and adrenal glands normalin children? |
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Definition
| NO, they are unusual and are typically the result of a tumor |
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Term
| What happens during puberty? |
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Definition
young people acquire their reproductive capability (gonads secrete increased amounts of sex hormones estrogen and testosterone)
hypothalamus produces more gonadotrpin-releasing hormone |
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Term
| How are primary and secondary sex characteristics developed? |
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Definition
| gonadotrpin-releasing hormone stimulates the anterior pituitary to produce more LH and more (FSH) which then causes gonads to secrete more sex hormones which develops the primary and secondary sex characteristics |
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Term
| What is precocious puberty |
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Definition
| a metabolic anomaly that occurs with the appearance of secondary sexual characteristics before 8 in girls and 9 in boys as a result of early secretion of LH and FSH |
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Term
| Characteristics of precocious puberty |
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Definition
advanced bone age
initially appear unusually tall for their age
growth ceases prematurely as the hormones stimulate the early closure of the epiphyseal plates
results in short stature |
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Term
| What is hyperpituitarism? |
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Definition
disorder where there is oversecretion of growth hormone;
results in abnormal skeletal growth patterns in children (gigantism-abnormally large growth, acromegaly-too much growth hormone and tissues enlarge) |
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Term
| What does hyperpituitarism do? |
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Definition
anterior pituitary gland called the "master gland";
affects a significant # of bodily fluids
growth hormone deficiency results in short statue, growth retardation, and delayed bone maturation in childhood and infancy |
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Term
| What do you need to know about hypothyroidism and hyperthyroidism in children and adolescents? |
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Definition
both can occur in infants/children as result of congenital anomalies or chemical exposures
congenital hypothyroidism is usually due to rare gene mutation
hyperthyroidism is rare and almost always due to Graves' disease |
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Term
| What is the most common metabolic disorder in children? |
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Definition
Diabetes Mellitis-most common chronic disease in school age children(mostly Type 1)
Increasingly large # children and adolescents are being identified with Type 2 (associated with obesity-80% of children with type 2 are overweight) |
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Term
| What is the impact of culture and religion on nutrition? |
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Definition
Food choices and compliance with recommended meal plans can be impacted by spiritual and religious parameters.
Culture and religious practices often determine many food choices and food prohibitions.
Vegetarianism is observed by many people by choice and by both Hindu and Buddhist faiths.
Vegetarian diets can be healthy and well balanced but they can be higher in carbohydrates.
May require more individualized meal planning instruction
Closer observation of metabolic responses to dietary changes |
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Term
| How is diabetes related to culture? |
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Definition
more common in: Native Americans, African Americans, Hispanic Americans
mortality rates due to complications of diabetes are higher among minority groups
food preferences, socio-economic status, and access to health care can significantly impact outcomes for any individual with diabetes |
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Term
| Where does corticotropin-releasing hormone (CRH) come from and what does it affect? |
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Definition
| hypothalamus, affects release of pituitary hormones |
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Term
Patient learning needs
Nursing diagnoses: Knowledge deficit: |
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Definition
disease and risk factors
labs and diagnostic tests
dietary implications of endocrine disorders (include family members who help with food prep)
prescribed medications
medical interventions |
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