Unit 3: Pharm: Chapter 36

Question 1

Adrenal Glands

Answer 1

flattened bodies that sit on top of each kidney. Each gland is made up of an inner core called the adrenal medulla and an outer shell called the adrenal cortex.

Question 2

Adrenal Medulla

Answer 2

actually part of the sympathetic nervous system (SNS).
It is a ganglion of neurons that releases the neurotransmitters norepinephrine and epinephrine into circulation when the SNS is stimulated.
The secretion of these neurotransmitters directly into the bloodstream allows them to act as hormones, traveling from the adrenal medulla to react with specific receptor sites throughout the body.

Question 3

Adrenal Cortex

Answer 3

Surrounds the medulla and consists of three layers of cells, each of which synthesizes chemically different types of steroid hormones that exert physiological effects throughout the body.
Produces hormones called corticosteroids.

Question 4

Diurnal Rhythm

Answer 4

The adrenal cortex responds to adrenocorticotropic hormone (ACTH) released from the anterior pituitary. ACTH in turn responds to corticotropin-releasing hormone (CRH) released from the hypothalamus.

The secretion of CRH, ACTH, and cortisol are high in the morning (those who have a regular cycle of wakefulness during the day and sleep during the night).
In such people, the peak level of cortisol usually comes between 6 and 8 a.m. The level then falls off slowly (with periodic spurts) and reaches a low in the late evening, with the lowest level around midnight.

Question 5

Stress Reaction

Answer 5

Activation of the stress reaction through the SNS bypasses the usual diurnal rhythm and causes release of ACTH and secretion of the adrenocortical hormones—an important aspect of the stress (“fight or flight”) response.

Question 6

Stress Response

Answer 6

is activated with cellular injury or when a person perceives fear or feels anxious. These hormones have many actions, including the following:
•Increasing the blood volume (aldosterone effect)
•Causing the release of glucose for energy
•Slowing the rate of protein production in most cells and increasing protein breakdown
•Mobilizing fatty acids into plasma
•Decreasing the activities of the inflammatory and immune systems (which preserves energy)

Question 7

ACTH

Answer 7

This stimulation is necessary for aldosterone release from the adrenal cortex.

Question 8

Adrenal Insufficiency

Answer 8

Due to a shortage of adrenocortical hormones

occur when a patient does not produce enough ACTH, when the adrenal glands are not able to respond to ACTH, when an adrenal gland is damaged and cannot produce enough hormones (as in Addison’s disease), or secondary to surgical removal of the glands.

Question 9

Glucocorticoids

Answer 9

named because they stimulate an increase in glucose levels for energy.
Increase the rate of protein breakdown and decrease the rate of protein formation in most cells.
cause increased mobilization of fatty acids to be used as energy. With high levels, they are able to suppress the inflammatory response and immune response.

Question 10

Corticosteroids in children

Answer 10

Same as adults

dose for children is determined by the severity of the condition being treated and the response to the drug—not on a weight or age formula.
Monitor for growth ands development

Question 11

Corticosteroids: Adults

Answer 11

Important to take in the morning
Caution with pregnancy

Question 12

Corticosteroids: Older Adults

Answer 12

more likely to have hepatic and/or renal impairment, which could lead to accumulation of drug and resultant toxic effects.
They are also more likely to have medical conditions that could be imbalanced by changes in fluid and electrolytes, metabolism changes, and other drug effects.

Question 13

Nursing Considerations: Glucocorticoids

Answer 13

Assess weight; temperature; orientation and affect; grip strength; eye examination; blood pressure, pulse, peripheral perfusion, and vessel evaluation; respiration and adventitious breath sounds; and glucose tolerance, renal function, serum electrolytes, and endocrine function tests

Question 14

Mineralocorticoids

Answer 14

affect electrolyte levels and homeostasis. These steroid hormones directly affect the levels of electrolytes in the system.
secreted by the adrenal gland is aldosterone.

Question 15

Fludrocortisone

Answer 15

Primary and secondary adrenocortical insufficient in Addison disease
Treatment of salt losing adrenogentail syndrome

Question 16

Hydrocortisone

Answer 16

Replacement therapy
Treatment of allergic and inflammatory disorders

Question 17

Methlyprednisolone

Answer 17

Treatmetn of allergic and inflammatory disporders
Treatment of adrenal insufficiency
Palliative treatment of leukemia and lymphoma