Stress response - marked increase in levels o Target tissue - all body tissue o Function - promotes metabolism, response to stress, ant inflammatory Aldosterone (Mineralocorticoids) o Secreted through kidneys o Released in response to fluid volume and altered potassium levels o Maintains extracellular fluid volume o Acts at the renal tubule to promote renal reabsorption of sodium and excretion of potassium & Hydrogen ions o Target tissue - kidney o Function - regulates sodium & potassium balance and thus water balance Androgens o Function - promotes masculinization in men; promotes growth & sexual activity in women Pancreas Produces Glucagon and Insulin Glucagon - Alpha cells; stimulates glycogenlysis and gluconeogenesis Insulin - Beta cells; promotes movement of glucose out of blood and into cells o Principle regulator of metabolism and storage of ingested carbohydrates, fats, and proteins o Facilitates glucose transport across cell membranes Disorders Hypopituitary o Decrease in one or more pituitary hormones (anterior or posterior) o One deficiency is “ selective hypopituitarism ” o Total failure of pituitary is “ panhypopituitarism ” o Treatment – replacement therapy, radiation and/or surgery
Pituitary (Anterior) o Growth Hormone Excess Gigantism -excessive secretion before the closure of the epiphyses Acromegaly - excessive secretion after the closure of the epiphyses Clinical Manifestations o Enlargement of tissues, facial features, tongue, o Joint pain o Muscle weaknesses o Visual changes o Hyperglycemia Treatment o Surgery – transsphenoidal hypophysectomy Neuro assessment every 15 min Risk factor: infection>>>meningitis>>>stiff neck pain If drainages on facial bandage is tested positive for glucose>>>cerebral spinal fluid o Radiation o Drug Therapy Pituitary (Posterior) o Antidiuretic Overproduction SIADH (Syndrome of Inappropriate Antidiuretic Hormone) Clinical Manifestations o Fluid retention o Dilutional hyponatremia Hyponatremia o Concentrated urine o Antidiuretic Deficiency DI (Diabetes Insipidus) Clinical Manifestations o Increased urine output o Dilute urine o Dehydration Types of DI o Central (neurogenic) - direct injury to the brain o Nephrogenic - renal, most common is side effect of lithium o Primary - decrease of thirst mechanism in the brain
Adrenal Cortex o Excess Corticosteroids Cushing’s Syndrome Related to cortisol (glucocorticoids) People who take too much steroids can get Cushing’s syndrome o Must teach pt. do NOT abruptly stop steroids Clinical Manifestations o Moon face- face is very round o Slow wound healing (susceptibility to infections) o Weight gain (thin extremities) o Purple striae on abdomen o Increased body and facial hair on women o Thirst (excessive need of water) o Buffalo hump at the base of the neck o Thin skin o Sodium and fluid retention (muscle twitches, presence of edema) o Osteoporosis o Hyperglycemia Collaborative Care o
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- Winter '09
- Endocrine System, Calcium metabolism, collaborative care