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Hypothalamus
Characteristics
Anterior Pituitary Stimulated Through the Hypophyseal Portal
GHRH
GnRH
TRH
PIF
CRF Released During Stress
Posterior Pituitary Stimulated Through Neural Control
CRF (CRH) acts on Anterior Pituitary Gland to Release ACTH
Cortisol Released
Androgens Released
Adrenal Medulla
Epinephrine & Norepinephrine
2 mins
Adrenal Gland (Advanced)
Characteristics
Adrenal Cortex
Zona Glomerulosa
Aldosterone
Zona Fasciculata
Cortisol
Zona Reticularis
Androgens
Adrenal Medulla
Chromaffin Cells
Epinephrine & Norepinephrine
2 mins
Pancreas
Characteristics
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
3 mins
Peptide Hormones
Characteristics
Fast-Acting and Short-Lived
Bind To Cell Membrane Receptors
Stimulate Secondary Messengers
Amino Acid-Derived
Examples
Insulin
Parathyroid Hormone (PTH)
Vasopressin
Oxytocin
2 mins
Testes
Characteristics
FSH Stimulates Sertoli Cells
Inhibin B Release
LH Stimulates Leydig Cells
Leydig Cells Secrete Testosterone
Testosterone Causes Male Development
2 mins
Steroid Hormones
Characteristics
Nuclear Membrane
Long-Lived and Slow-Acting
Cholesterol-Derived
Intracellular Receptors
DNA Transcription
Examples
Testosterone
Aldosterone
Estrogen
Cortisol
2 mins
Oxytocin (Pitocin)
Mechanism of Action
Increase Uterine Contractions
Indications
Labor Induction
Control Postpartum Hemorrhage
Side Effects
Uterine Rupture
Water Intoxication
Contraindications
Fetal Lung Immaturity
Cervix Not Ripened
Active Genital Herpes Infection
Considerations
Use Lowest Dose
IV Pump
3 mins
Lipid Metabolism and Ketogenesis
Lipid Metabolism
Acetyl-CoA
Biotin Cofactor
Malonyl-CoA
Fatty Acids
Triglycerides
Glycerol
DHAP
Acetoacetyl-CoA
HMG-CoA
HMG-CoA Reductase
Mevalonate
Cholesterol
Ketogenesis
Acetoacetate
Beta-Hydroxybutyrate
4 mins
Blood Glucose Lab Value
70-100 mg/dL
25 secs
Hemoglobin A1c Lab Value
4-6%
1 min
Thyroid Function Screening Tests
If TSH High
If TSH High
Free T4 (FT4)
Free T4 (FT4)
If TSH Low
If TSH Low
Free T4 (FT4) and T3 (Triiodothyronine)
Free T4 (FT4) and T3 (Triiodothyronine)
Consider Serum Total T4 (Thyroxine)
Consider Serum Total T4 (Thyroxine)
Considerations
Considerations
Only Total T4 Increases in Pregnancy
Only Total T4 Increases in Pregnancy
T4 is Converted to T3
T4 is Converted to T3
Avoid for Inpatient Screening
Avoid for Inpatient Screening
2 mins
Thyroid Nodule Assessment
Initial Tests
Thyroid-Stimulating Hormone (TSH)
Ultrasound
Normal / Elevated TSH
Fine Needle Aspiration
Most Accurate Test
Decreased TSH
Radioactive Iodine Uptake (RAIU)
Hot Nodules Rarely Malignant
Free T3 and T4
Considerations
Repeat Ultrasound 6 -18 Months
2 mins
Hypothyroidism Assessment
Assessment
Weight Gain - Edema
Lethargy
Cold Intolerance
Bradycardia
Hypertension
Brittle Nails and Dry Skin
Constipation
Goiter
Prolonged Menses
Slowed Thinking
Diagnostic Tests
Decreased Free T4
Increased TSH
2 mins
Hypothyroidism Intervention
Medications
Levothyroxine (Synthroid)
Liothyronine (Cytomel)
Complication
Myxedema Coma
Nursing Considerations
Lifelong Replacement Hormone
Monitor Vital Signs
Fluids and Fiber
Low Calorie, Low Fat Diet
Medication Education
No Switching Brands
2 mins
Levothyroxine
Indications
Hypothyroidism
Myxedema Coma
Mechanism of Action
Isomer of Thyroid Hormone (T4)
T3 has Higher Potency
Side Effects
Hyperthyroid Symptoms
57 secs
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