Hypothalamus
- Anterior Pituitary Stimulated Through the Hypophyseal Portal
- GHRH
- GnRH
- TRH
- PIF
- CRF Released During Stress
- Posterior Pituitary Stimulated Through Neural Control
Adrenal Gland (Basic)
- Adrenal Cortex
- RAAS Stimulates Aldosterone
- CRF (CRH) acts on Anterior Pituitary Gland to Release ACTH
- Cortisol Released
- Androgens Released
- Adrenal Medulla
- Epinephrine & Norepinephrine
Adrenal Gland (Advanced)
- Adrenal Cortex
- Zona Glomerulosa
- Aldosterone
- Zona Fasciculata
- Cortisol
- Zona Reticularis
- Androgens
- Adrenal Medulla
- Chromaffin Cells
- Epinephrine & Norepinephrine
Thyroid Gland
- TSH Stimulates T3 and T4 Release
- Metabolism Regulation
- Blood Calcium Sensor
- Calcitonin Release
- Blood Calcium Decreases
- Bone Building
Parathyroid Gland
- Blood Calcium Sensor
- Parathyroid Hormone
- Bone Resorption
- Blood Calcium Increases
- Vitamin D Activation
- Calcium Absorption From The Small Intestine
Pancreas
- Acinar Cells Release Digestive Enzymes
- Ductal Epithelial Cells Release Bicarbonate
- Islets of Langerhans
- Beta Cells Release Insulin
- Alpha Cells Release Glucagon
- Delta Cells Release Somatostatin
- Somatostatin Inhibits Alpha and Beta Cells
Prednisone (Glucocorticoids)
- Glucocorticoid
- Inflammatory Conditions
- Organ Transplant Rejection
- Cataracts and Glaucoma
- Cushing's Syndrome
- Osteoporosis
- Immunosuppression
- Hyperglycemia
- Ulcers
- Adrenal Insufficiency
- Taper Gradually
Hyperthyroidism Assessment
- Heat Intolerance
- Exophthalmos
- Warm, Moist Skin and Silky Hair
- Tremors
- Goiter
- Diarrhea
- Weight Loss
- Tachycardia
- Hypertension
- Amenorrhea
- Decreased TSH with Elevated Free T4
- Radioactive Iodine Uptake (RAIU)
Hyperthyroidism Interventions
- Propylthiouracil (PTU)
- Methimazole (Tapazole)
- Iodine
- Beta Blockers
- Radioiodine Ablation
- Thyroidectomy
- Thyrotoxicosis
- Post-Surgery Hypocalcemia
Hypothyroidism Assessment
- Weight Gain - Edema
- Lethargy
- Cold Intolerance
- Bradycardia
- Hypertension
- Brittle Nails and Dry Skin
- Constipation
- Goiter
- Prolonged Menses
- Slowed Thinking
- Decreased Free T4
- Increased TSH
Hypothyroidism Intervention
- Levothyroxine (Synthroid)
- Liothyronine (Cytomel)
- Myxedema Coma
- Lifelong Replacement Hormone
- Monitor Vital Signs
- Fluids and Fiber
- Low Calorie, Low Fat Diet
- Medication Education
- No Switching Brands
Posterior Pituitary
- Neuroendocrine Reflex Stimulation (By Hypothalamus)
- Vasopressin
- Increased Water Retention (In Kidneys)
- Oxytocin
- Increased Uterine Contraction
- Mammary Glands Contraction
Anterior Pituitary
- Hypothalamic Control
- FLAT PeG Mnemonic
- Follicle-Stimulating Hormone (FSH)
- Lutenizing Hormone (LH)
- Adrenocorticotropic Hormone (ACTH)
- Thyroid-Stimulating Hormone (TSH)
- Prolactin (PRL)
- Growth Hormone (GH)
Diabetes Insipidus Assessment
- Polyuria
- Nocturia
- Low Specific Gravity (USG)
- Polydipsia
- Dehydration
- Hypotension
- Tachycardia
- Confusion
Syndrome Of Inappropriate Antidiuretic Hormone (SIADH)
- Hypersecretion of ADH
- Increased Sensitivity to ADH
- Serum Hypoosmolality
- Coma and Seizure
- Dilutional Hyponatremia
- Cramps and Tremors
- Euvolemia
- Change in LOC
Syndrome of Inappropriate Antidiuretic Hormone (SIADH) Nonpharmacologic Interventions
- Monitor Serum and Urine Osmolality
- IandOs with Daily Weights
- Restrict Fluid Intake
- Monitor Cardiovascular and Neurological Status
- Seizure Precautions
Syndrome of Inappropriate Antidiuretic Hormone (SIADH) Pharmacologic Interventions
- Diuretics
- Hypertonic IV Fluids
- Demeclocycline
- Tolvaptan and Conivaptan
Acromegaly Assessment
- Excess Growth Hormone (GH)
- Protruding Jaw
- Large Lips and Nose
- Hearing Loss
- Enlargement of Hands and Feet
- Vision Changes and Headache
- Joint Pain
- Peripheral Neuropathy
- Hyperglycemia
Addison's Disease Assessment
- Deficiency of Cortisol and Aldosterone
- Irritability
- Hyperkalemia
- Muscle Weakness
- Skin Hyperpigmentation
- Hyponatremia
- Hypotension
- Hypoglycemia
- Addisonian Crisis
Addison's Disease Intervention
- Hydrocortisone
- 2/3 Dose in Morning
- 1/3 Dose in Late Afternoon
- Fludrocortisone
- Androgen Replacement Therapy
- Salt Additives
- Increase Dosage During Stress and Infection
- Medic Alert Bracelet
- Lifelong Hormone Therapy
Primary Hyperaldosteronism
- Increased Aldosterone Secretion
- Adrenal Adenoma
- Bilateral Adrenal Hyperplasia
- Hypertension
- Hypokalemic Metabolic Alkalosis
- No Significant Edema
- Increased Aldosterone
- Decreased Renin
- Abdominal CT Scan
- Aldosterone Antagonists
- Surgery
Cushing's Syndrome Assessment
- Increased Cortisol Levels
- Truncal Obesity
- Purple Abdominal Striae
- Buffalo Hump
- Decreased Bone Density
- Moon Face
- Thinning Skin
- Hyperglycemia
- Hypertension
- Long Term Glucocorticoid Use
- Immunosuppression
Pheochromocytoma
- Adrenal Medulla Tumor
- Increased Catecholamines
- Episodic Hypertension
- Diaphoresis
- Abdominal or Chest Pain
- Surgery
- Antihypertensives
- Phenoxybenzamine
- Metyrosine (Demser)
- Do Not Palpate Abdomen
Addisonian Crisis
- Severe Symptoms
- Shock
- High-Dose Hydrocortisone
- Large Volumes of IV Fluid
- Insulin with Dextrose
- Kayexalate
- Loop or Thiazide Diuretics
Hypoparathyroidism
- Hypocalcemia
- Lethargy
- Tetany
- Arrhythmias
- Decreased Calcium and Increased Phosphorus
- IV Calcium Chloride
- Rebreather Mask
- Lifelong Medications
- Oral Calcium Supplements with Vitamin D
Primary Hyperparathyroidism
- Hypercalcemia
- Kidney Stones
- Osteoporosis
- Arrhythmias
- Increased Calcium and Decreased Phosphorus
- Prevent Injury
- Medication Education
- Surgery
Diabetes Assessment
- Juvenile Onset
- Absent Insulin Production
- Ketosis Prone
- Adult Onset
- Insulin Resistance
- Obesity
- Onset During Pregnancy
- Glucose Intolerance
- Retinopathy
- Peripheral Vascular Disease
- Nephropathy
- Neuropathy
Diabetes Interventions
- Early Diagnosis
- Insulin
- Oral Hypoglycemics
- Glucose Monitoring
- Routine Exercise
- Diabetic Diet
- Monitor for Complications
- Insulin Therapy
- Diabetic Ketoacidosis (DKA)
Insulin
- Rapid Acting
- Insulin Lispro (Humalog)
- Insulin Aspart (Novolog)
- Insulin Glulisine (Apidra)
- Short Acting
- Regular Insulin (Humulin R)
- Intermediate Acting
- Isophane NPH (Humulin N)
- Long Acting
- Detemir (Levemir)
- Glargine (Lantus)
Mixing NPH and Regular Insulin for Injection
- Verify Order
- Roll NPH Insulin
- Alcohol to Multiuse Vials
- Inject Air into NPH Insulin (Cloudy)
- Inject Air into Regular Insulin (Clear)
- Withdraw Regular Insulin Units
- Withdraw NPH Units
- Verify with 2nd Nurse
- Discard if Error
Dawn Phenomenon
- Increased Hormone Production
- Hyperglycemia Upon Awakening
- Long-Acting Evening Insulin
- Change Administration Times
- Insulin Pump
- Closely Monitor Glucose Levels
- Between 2-6AM
- Limit Carbohydrates Before Bedtime
Hypoglycemia Assessment
- Too much insulin
- Decreased glucose
- < 70 mg/dL
- Change in LOC
- Lethargic
- Confusion and Irritability
- Tremors
- Diaphoresis
- Tachycardia
- Vision Changes
- Weakness
- Seizures
Hypoglycemia Intervention
- Mild to Moderate Hypoglycemia
- Simple Carbohydrate (Oral Dextrose, Fruit Juice, Candies)
- Complex Carbohydrate (Whole Grains, Vegetables)
- Severe Hypoglycemia or Unconscious
- 50% Dextrose
- Glucagon
- Monitor Blood Glucose Q 10-15 Minutes
- Give Small Meal After Intervention
- Hypoglycemia Prevention
- Encourage Self-Monitoring