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Altered Hormonal and Metabolic Regulation - Coggle Diagram

- - - - heat intolerance
      - restlessness
      - weight loss
      - palpitations
      - tremors
      - enlarged thyroid gland
    - - serum-free thyroxine measurement
      - serum TSH levels
      - T3 and T4 levels
    - - gland destruction
      - medication to block thyroid hormone production
  - - - thyroid autoantibodies
      - FT4, total T4, and T3 uptake
      - TSH assay
    - - Levothyroxine
    - - cold intolerance
      - weight gain
      - fatigue
      - dry skin
      - constipation
      - goiter
- - - - hypotonicity
      - hypotnatremia
      - decreased urine volume
      - concentrated urine with high sodium
      - absence of renal, adrenal, or thyroid abnormalities
    - - water restriction
      - medication to block effects of ADH
      - remove cause
    - - nausea
      - anorexia
      - decreased/concentrated urine output
      - muscle cramps
      - disorientation
- - - - 24 hr urine collection in which elevations in cortisol are noted
      - imaging studies to locate tumors
    - - remove cause
      - surgery or radiation for tumors
      - corticosteroids
    - - obesity of trunk, face, and upper back
      - muscle wasting
      - behavioral changes
      - immune suppression
      - glucose intolerance
  - - - weakness, fatigue, weight loss, nausea
      - hyperpigmentation of skin and mucous membranes
      - hyperkalemia, hyponatremia, hypotension
    - - lab analysis of electrolyte levels demonstrating hyponatremia and hyperkalemia
      - Measurement of serum corticosteroid levels
    - - isotonic IV fluid replacement
      - lifelong oral replacement of glucocorticoid and mineralocorticoid
      - increase of salt intake in hot weather
  - - - polyuria
      - excessive thirst
      - highly dilute urine with low specific gravity
      - dehydration
    - - review of patient history
      - serum solute concentrations
      - ADH levels
      - urine-specific gravity
    - - hydration
      - IV hydration with hypotonic solution
      - pharmacological use of desmopressin