Endocrine System NCLEX Review
This week, Brainy Nurses brings you a review of the endocrine system and some key components that will help you to be successful in your NCLEX.
What areas of the endocrine system have provided you the most difficulty during your study? Do you feel comfortable answering the questions that the NCLEX will grade you on, and what steps are you taking to prepare for the NCLEX? Click the link below to receive information like this post in your inbox.
The topics that will be covered during the course of this blog include: the Three S’s, Adrenal and Anti-Adrenal Agents, Cushing’s Syndrome, and Hypoglycemia Assessment. We hope that this review, along with the videos and flashcards, help you to prepare for your examination and career as a Nurse.
The Three S’s
Adrenal medulla secretes catecholamines such as epinephrine and norepinephrine. Pheochromocytoma is the tumor which can occur in the medulla.
The adrenal cortex secretes what you can remember as the three “S’s”
- Sugar (Cortisol)
- Salt (Alsosterone)
- Sex (Estrogen and Testosterone)
For a more detailed explanation of the three S’s, please check out this portion of our online NCLEX Review and hear Cindy discuss this concept.
Adrenal and Anti-Adrenal Agents
Adrenal and Anti-Adrenal Agents are used by the provider to correct abnormalities of the secretion of the adrenal gland. There are numerous lab effects, including and increase in WBC, BS, Na+, and a decrease in K+
Systemic steroids can cause adrenal insufficiency if they are not gradually withdrawn. Some other side effects of steroids include:
- Muscle Weakness
- Abnormal fat distribution
- Growth retardation in children
- Weight gain
- Mood swings such as depression
There are numerous medications that can be administered by the provider. An easy way to quickly identify there steroids is that most end in -zone.
Here are all the potential medications that can be provided to correct these abnormalities:
- Betamethasone (Celestone)
- Dexamethasone (Decadron)
- Cortisone (Cortone)
- Fludrocortisone (Florinef)
- Methylprednisolone (Solu Medrol)
- Prednisolone (Pred Forte)
- Prednisone (Deltasone)
- Triamcinolone (Aristacort)
This section of Endocrine System review will talk about Cushing’s Syndrome. Cushing’s syndrome is caused by too much of the adrenal hormones, especially cortisol. This may be due to the overproduction of hormones or the long term use of steroids.
There are numerous clinical manifestations that will be observed by a patient suffering from Cushing’s Syndrome. They are easier to remember if you group them into the three S categories: Sugar, Salt, and Sex.
Too Much Sugar:
Hypoglycemia, an increase in the risk of infection, fat deposits on the back, personality changes and irritability, osteoporosis, thin skin and extremities, bruises and peterchiae, GI distress and an increase in acid
Too Much Salt:
Hypertension, moon face, Na+ and Fluid Retention, Profound weakness due to hypokalemia,
Too Much Sex:
Purple Striae, Gynecomastia (Males) Amenorrhea and Hirsutism (Females)
To treat Cushing’s Syndrome, the following treatment options are needed for successful NCLEX completion:
- If due to steroid therapy, taper the medication and discontinue if possible.
- Surgical resection if adrenal adenoma or pituitary tumor.
- Medications to inhibit cortisol synthesis such as ketoconazole or metopirone (Metyrapone).
- Mifepristone (Mifeprex) is a glucocorticoid receptor antagonist
Hypoglycemia occurs then the blood sugar is less than 60-70, at which signs and symptoms appear and mental efficiency is impaired. It is caused by not enough food, too much insulin, or too much exercise.
To easily recall hypoglycemia during the NCLEX examination, remember the acronym TIRED.
T = Tachycardia
I = Irritability and Nervous
R = Restless
E = Excessive Hunger
D = Diaphoresis
In general, the patient will appear to be “drunk and in shock”. Other potential clinical manifestations that may be present by a patient experiencing hypoglycemia include:
To treat hypoglycemia, here are three recommendations:
- Simple Sugar, followed by a complex carbohydrate and then a protein. Don’t give chocolate
- Orange juice for adults. Milk for children, which provides sugar, protein, and fat
- Glucagon subcu or IM if unconscious
We hope that you have enjoyed this review of the endocrine system and the potential questions that you may be asked during the course of your NCLEX examination.
Have you struggled to prepare for the NCLEX? Do you find the number of potential review programs to be confusing or too expensive? Have you tried the major programs, but have yet to pass the NCLEX? We would like to invite you to give our NCLEX review a try, which has been successful for thousands or nurses.
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