Chapter 50: Endocrine Problems
(Nursing Management)
Describe the gender differences in relation to endocrine problems. - correct answer--Ectopic
ACTH production is more common in men.
-Hyper and hypothyroidism as well as Graves disease occurs more commonly in women
than men
The result of excessive growth hormone secretion in adults. The condition is characterized
by a thickening of bones and soft tissue. - correct answer-Acromegaly
An enlarged pituitary gland can exert pressure on surrounding structures within the brain,
leading to... - correct answer-Visual disturbances and headaches
Excessive GH secretion in children results in gigantism. Why? - correct answer-Because the
epiphyseal plate is not closed in children.
Because GH mobilizes stored fat for energy, acromegaly increases free fatty acid levels in
the blood and predisposes to _________. - correct answer-Atherosclerosis
Excessive GH in acromegaly antagonizes the action of insulin leading to _________. -
correct answer-Hyperglycemia
In addition to the history and physical examination, a diagnosis of acromegaly requires
evaluation of: - correct answer--Plasma insulin like growth factor 1 (IGF-1) levels
-IGF binding protein-3 (IGFBP-3)
-The oral glucose tolerance test
What does IGF-1 do? - correct answer-It mediates the peripheral actions of GH
A specific test for acromegaly is: - correct answer-The oral glucose tolerance test.
Because GH is inhibited by ______, measurement of _______ nonsuppressibility is useful in
diagnosis of acromegaly. - correct answer-Glucose
In acromegaly, GH levels do not fall below ____ ng/mL during the oral glucose tolerance
test. - correct answer-3
Patients with larger tumors or those with GH levels greater than _______ ng/mL may require
adjuvant radiation or drug therapy along with a hypophysectomy. - correct answer-45
After hypophysectomy, any clear nasal drainage with a glucose level greater than ______
mg/dL indicates CSF leakage from an open connection in the brain. - correct answer-30
, If there is a CSF leakage from an open connection in the brain the patient is at an increased
risk for _______. - correct answer-Meningitis
If untreated, patients with acromegaly are more likely to succumb to what diseases? - correct
answer-Cardiovascular and respiratory diseases, diabetes mellitus, colon polyps, and
colorectal cancer
The therapeutic goal in acromegaly is to return the patient's GH levels to normal. This is
accomplished by: - correct answer-Surgery, irradiation, drug therapy, or a combination of
these therapies
Hypophysectomy - correct answer-The surgical removal of the pituitary gland
The majority of surgeries done to remove pituitary tumors are done with the ________
approach. - correct answer-Transphenoidal
When the entire pituitary gland is removed during hypophysectomy how does one replace
the pituitary hormones? - correct answer-Rather than replace the pituitary hormones
parenterally, the essential hormones produced by target organs are given orally. Hormone
replacement continues throughout life
_________ therapy is used for acromegaly when surgery has failed to produce complete
remission and for those considered high risk for surgery. - correct answer-Radiation
_________ therapy is used for acromegaly in patients who have had an inadequate
response to or cannot be treated with surgery and/or radiation surgery. - correct
answer-Drug
A rare disorder that involves a decrease in one or more of the pituitary hormones. - correct
answer-Hypopituitarism
A deficiency of only one pituitary hormone. - correct answer-Selective hypopituitariam
Panhypopituitarism - correct answer-Total failure of the pituitary gland that results in
deficiency of all pituitary hormones
The usual cause of pituitary hypofunction is: - correct answer-A pituitary tumor
Overproduction or oversecretion of ADH results in a condition known as: - correct
answer-Syndrome of inappropriate antidiuretic hormone (SIADH)
The most common cause of SIADH is: - correct answer-Malignancy, especially small cell
lung cancer
What are the 4 main causes of SIADH? - correct answer--Malignant tumors
-CNS disorders
-Drug therapy
-Miscellaneous conditions
(Nursing Management)
Describe the gender differences in relation to endocrine problems. - correct answer--Ectopic
ACTH production is more common in men.
-Hyper and hypothyroidism as well as Graves disease occurs more commonly in women
than men
The result of excessive growth hormone secretion in adults. The condition is characterized
by a thickening of bones and soft tissue. - correct answer-Acromegaly
An enlarged pituitary gland can exert pressure on surrounding structures within the brain,
leading to... - correct answer-Visual disturbances and headaches
Excessive GH secretion in children results in gigantism. Why? - correct answer-Because the
epiphyseal plate is not closed in children.
Because GH mobilizes stored fat for energy, acromegaly increases free fatty acid levels in
the blood and predisposes to _________. - correct answer-Atherosclerosis
Excessive GH in acromegaly antagonizes the action of insulin leading to _________. -
correct answer-Hyperglycemia
In addition to the history and physical examination, a diagnosis of acromegaly requires
evaluation of: - correct answer--Plasma insulin like growth factor 1 (IGF-1) levels
-IGF binding protein-3 (IGFBP-3)
-The oral glucose tolerance test
What does IGF-1 do? - correct answer-It mediates the peripheral actions of GH
A specific test for acromegaly is: - correct answer-The oral glucose tolerance test.
Because GH is inhibited by ______, measurement of _______ nonsuppressibility is useful in
diagnosis of acromegaly. - correct answer-Glucose
In acromegaly, GH levels do not fall below ____ ng/mL during the oral glucose tolerance
test. - correct answer-3
Patients with larger tumors or those with GH levels greater than _______ ng/mL may require
adjuvant radiation or drug therapy along with a hypophysectomy. - correct answer-45
After hypophysectomy, any clear nasal drainage with a glucose level greater than ______
mg/dL indicates CSF leakage from an open connection in the brain. - correct answer-30
, If there is a CSF leakage from an open connection in the brain the patient is at an increased
risk for _______. - correct answer-Meningitis
If untreated, patients with acromegaly are more likely to succumb to what diseases? - correct
answer-Cardiovascular and respiratory diseases, diabetes mellitus, colon polyps, and
colorectal cancer
The therapeutic goal in acromegaly is to return the patient's GH levels to normal. This is
accomplished by: - correct answer-Surgery, irradiation, drug therapy, or a combination of
these therapies
Hypophysectomy - correct answer-The surgical removal of the pituitary gland
The majority of surgeries done to remove pituitary tumors are done with the ________
approach. - correct answer-Transphenoidal
When the entire pituitary gland is removed during hypophysectomy how does one replace
the pituitary hormones? - correct answer-Rather than replace the pituitary hormones
parenterally, the essential hormones produced by target organs are given orally. Hormone
replacement continues throughout life
_________ therapy is used for acromegaly when surgery has failed to produce complete
remission and for those considered high risk for surgery. - correct answer-Radiation
_________ therapy is used for acromegaly in patients who have had an inadequate
response to or cannot be treated with surgery and/or radiation surgery. - correct
answer-Drug
A rare disorder that involves a decrease in one or more of the pituitary hormones. - correct
answer-Hypopituitarism
A deficiency of only one pituitary hormone. - correct answer-Selective hypopituitariam
Panhypopituitarism - correct answer-Total failure of the pituitary gland that results in
deficiency of all pituitary hormones
The usual cause of pituitary hypofunction is: - correct answer-A pituitary tumor
Overproduction or oversecretion of ADH results in a condition known as: - correct
answer-Syndrome of inappropriate antidiuretic hormone (SIADH)
The most common cause of SIADH is: - correct answer-Malignancy, especially small cell
lung cancer
What are the 4 main causes of SIADH? - correct answer--Malignant tumors
-CNS disorders
-Drug therapy
-Miscellaneous conditions
