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NCLEX Review of Endocrine Medications

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NCLEX Review Notes:

A quick NCLEX Review on Pituitary Gland Disorders

Pituitary Gland Disorders

HYPOPITUITARISM

Insuffecient quantities of anterior pituitary gland hormones.

ASSESSMENT

  • Lethargy
  • Hypothermia
  • Weight loss
  • Amenorrhea
  • Dry Skin
  • Hypotension

– Monitor the patient’s risk for infection.

Treatment

Surgery: if hypopituitarism is caused by a tumor.

Hormone therapy

  • Corticosteroids (cortisol)
  • Growth hormone
  • Sex hormones (testosterone for men and estrogen for women)
  • Thyroid hormone

HYPERPITUITARISM

Also called Acromegaly and Cushings’s Disease

ACROMEGALY
Often a result of a benign tumor

ASSESMENT

  • – large hands and feet
  • – protruding jaw and forehead

TREATMENT

  • Hypophysectomy
  • Corticosteroids
  • Elevate head at least 30 degrees.
  • Glucocoritcoids
  • Hormones
  • * Surgery ( Transsphenoidal Pituitary Surgery) to remove the pituitary tumor might be the best treatment.
Meds. used to control increased GH:
  • Octreotide (Sandostatin)
  • bromocriptine (Parlodel)

DISORDER OF THE POSTERIOR PITUITARY GLAND.

♣ DIABETES INSIPIDUS


– Hyposecretion of the ADH hormone.
Assessment:

  • POLYURIA (4-24 L/DAY)
  • POLYDIPSIA
  • DEHYDRATION
  • LOW URINE SPECIFIC GRAVITY 1.006 OR LOWER
  • FATIGUE
  • HYPOTENSION
  • TACHYCARDIA

– * Fluid Deficit is a priority

Medication:

  • VASOPRESSIN (PITRESSIN) *used as an antidiuretic hormone

Examples of Antidiuretic Hormones:

  • Desmopressin acetate
  • Vasopressin (Pitressin)

Side Effects (Antidiuretic Hormones)

  • Headache
  • Nausea & Vomiting
  • Water Intoxication
  • Hypertension
Vasopressin
  • it’s an antidiuretic hormone
  • prevent the loss of water from the body by reducing urine output and reabsorbing water in the body
  • (Increases BP)= by constricting (narrowing) blood vessels
Side Effects (VASOPRESSIN)
  • throbbing headache
  • stomach pain, bloating
  • dizziness, nausea
  • blanching of the skin
♦ Due to increase urine output -> pt. is in risk of HYPOVOLEMIC SHOCK.

♠ SIADH

♠ Syndrome of Inappropriate Antidiuretic Hormone (SIADH)

– excess ADH is being released

Assessment:

  • FLUID OVERLOAD
  • WEIGHT GAIN
  • HYPERTENSION
  • TACHYCARDIA
  • HYPONATREMIA

Interventions:

  • – Monitor fluid & electrolyte imbalance
  • – Fluid restriction.
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NCLEX Review Cirrhosis

So what is cirrhosis and why is it very important to review for the the NCLEX ?

Cirrhosis is basically scarring of the liver.  It occurs when there is severe hepatic inflammation or necrosis.

Common causes of cirrhosis:

  • Alcohol
  • Hepatits C
  • Hepatitis B

Complications of Cirrhosis:

(It is very important to understand these complications for the NCLEX.)

Portal Hypertension

An increase in the pressure in the portal vein.  It is usually due to an obstruction of blood flow within the portal vein.

Ascites

– an accumulation of fluid within the peritoneal cavity.

– there will be retention of water and sodium in the body.

Esophageal Varices

– occurs when thin walled esophageal veins become distended from an increase in pressure.

Jaundice

– is caused by hepatic cirrhosis.  Develops because the liver cells cannot effectively excrete bilirubin.

Portal-Systemic Encephalopathy

– a manifestation by neurological symptoms

Physical Assessment

in patients with Cirrhosis:

  • Fatigue
  • Abdominal pain
  • Weight Loss
  • Asterixis

Laboratary Assessment:

There will be an increase in serum levels of (AST)/ Aspartate aminotransferase, (ALT) / Alanine aminotransferase and (LDH) / Lactate Dehydrogenase.

♣ Interventions:

– depends on the SYMPTOM and the COMPLICATION.

FOR ASCITES

  • Intervention for ascities includes *PARACENTESIS – if diet and drug management fails.

♠ PARACENTESIS

– The procedure is performed in the bedside.

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