Lab Name:

Thyroid Stimulating Hormone

What is the Labs Abbreviation for Thyroid Stimulating Hormone?

TSH

What is Thyroid Stimulating Hormone (TSH) in terms of Nursing Labs?

Thyroid Stimulating Hormone (TSH) is released from the pituitary in response to low levels of
thyroid hormone. TSH communicates to the thyroid gland to release the thyroid hormones:
Triiodothyronine (T3) and Thyroxine (T4). Thyroid hormones regulate metabolism. T3 and T4
have and inverse relationship with TSH.

What is the Normal Range for Thyroid Stimulating Hormone?

2-10 mU/L

What are the Indications for Thyroid Stimulating Hormone?

Diagnose:
o Hyperthyroidism
o Hypothyroidism
Monitor thyroid replacement therapy

What would cause increased levels of Thyroid Stimulating Hormone?

Hypothyroidism
Thyroidectomy
Thyroid dysfunction
Thyroiditis
Thyroid Agenesis
Large doses of iodine
Pituitary TSH-secreting tumor

What would cause decreased levels of Thyroid Stimulating Hormone?

Pituitary hypofunction
Hyperthyroidism

What are the two parts of the pituitary gland?

o anterior and posterior
Name the 8 major endocrine glands:
o pituitary, thyroid, parathyroid, adrenal, pancreas, thymus, pineal, gonads
What regulates the release of anterior pituitary hormones?
o hypothalamus
Name the 6 major hormones produced by the pituitary gland:
o GH (growth hormone), TSH (thyroid stimulating hormone), ACTH
9adrenocorticotropic hormone), FSH, LH, Prolactin
 What hormones are produced and released by the thyroid?
o T3, T4, Thyrocalcitonin
What is the purpose of T3 and T4?
o regulate metabolism
What role does the pituitary play in metabolism?
o production and release of TSH when stimulated by the hypothalamus.
What does thyrocalcitonon do?
o lowers blood calcium by inhibiting bone resorption
What does the parathyroid do?
o produce PTH (parathyroid hormone) which raises blood Ca levels
Where are the adrenal glands located?
o on top of the kidneys
What are the two endocrine tissues within the adrenal glands?
o adrenal medula and adrenal cortex
Name the two major hormones secreted by the adrenal medula and their functions:
o The adrenal medula secretes two catecholamines: epinephrine, and
norepinephrine. Epinephrine prepares the body for the fight or flight response by
converting glycogen to glucose and increasing HR. Norepinephrine produces
extensive vasoconstriction.
What stimulates the adrenal cortex?
o ACTH adrenocorticotropic hormone from the anterior pituitary gland
What does ACTH stimulate the adrenal cortex to produce?
o corticosteroids
Name the 3 types of corticosteroids:
o mineralcorticoids: aldersteron
o glucocorticoids: cortisol
o adrenal sex hormones: androgens & estrogen
What does cortisol do and how?
o increase blood glucose by stimulating gluconeogensis, decrease inflammatory
response, decrease immune response
Name 3 types of cells in the pancreas/where are they located?
o Alpha, Beta, Delta . . . islets of Langerhans
What does each cell type secrete and what is the purpose?
o Alpha . . . glucagon . . . increase glucose via gluconeogensis
o Beta . . . insulin . . . regulate protein, fat, and carbohydrate metabolism
o Delta . . . somatostatin . . . inhibitory hormone
What hormones will be affected with anterior pituitary dysfunction?
o ACTH, GH, LH, FSH, PRL, TSH
What assessment findings are common in anterior hypopituitarism?
o mainly affects thyroid, adrenal, and gonadal function. Atrophy of all endocrine
glands, hair loss, impotence, amenorrhea, hypoglycemia
Anterior hyperpituitarism often results in altered ACTH or GH secretion; what
assessment findings will you see with hyper secretion of these hormones?
o coarse features, thick heel pads, thick tongue, decreased libido, amenhorrhea,
impotence, acromegaly
What hormone is undersecreted with Diabetes Insipidus? What gland is affected?
 o ADH (vasopressin) from the posterior pituitary
Why does diabetes insipidus result in excess urine production?
o ADH promotes resorption of fluid in distal tubules. Without resorption massive
amounts of urine are excreted.
With SIADH what is the result of over secretion of ADH?
o excessive water conservation
SIADH and diabetes insipidus are the result of a malfunction of what endocrine
gland?
o posterior pituitary
Hyperthyroidism is also known as?
o Graves Disease
What is the main function of the thyroid?
o metabolism
What are the clinical manifestations of hyperthyroidism (Graves)
o responsiveness to catecholimes
o increase metabolism
o increased heat
o weight change
o increased appetite
o insomnia
o nervousness
o bruit heard over thyroid
o warm, sweaty skin
o exopthalmus
o goiter
o increase systolic BP
o tremor

What can cause thyroid storm?

o uncontrolled hyperthyroid, surgery, infection
Name 2 immediate interventions for a client experiencing thyroid storm:
o admin Tylenol, provide cooling blanket
Why should you NEVER admin aspirin to a client in thyroid storm?
o in can increase thyroid hormone levels
What will be the effect of Ca levels with hyperthyroidism?
o hypocalcemia
What will be the effect of Ca levels with hypothyroidism?
o hypercalcemia due to a decrease in Thyrocalcitonin
What are the common assessment finding with hypothyroidism?
o lethargy, weakness, muscle aches, CHF, dry skin, Brady, constipation, weight
gain
What is the cause of myxedema coma?
o persistently low thyroid production
What assessment findings would you see with myxedema coma?
 o hypotension, hypotermia, hypoglycemia, brady
What will be the effect on serum Ca levels in hyperparathyroid?
o increased Ca and bone demineralization
What are common assessment findings of hyperparathyroidism?
o fatigue, wt loss, fractures, HTN, joint pain, polyuria, renal calculi . . . think
increased Ca
What two tests will be positive with hypoparathyroidism?
o chvotsek and Trousseaus
What is a KEY sign of hypoparathyroidism and why?
o carpopedal spams indicate neuromuscular irritability sign of decreased Ca levels
What are the classic signs of adrenal hyperfunction?
o buffalo hump, moon face, fatigue, muscle weakness, hyperglycemia
What is the cause of hyperglycemia in adrenal hyperfunction?
o adrenal cortex secrets cortisol which increases blood glucose by stimulating
gluconeogensis
What is adrenal hyperfunction called?
o Cushings Syndrome
What is adrenal hypofunction called?
o Addisons Disease
Name the symptoms of Addisons disease:
o hypoglycemia, hyponatremia, GI disturbances, hyperpigmentation due to
decreased secretion of cortisol

Selected Resource:

Hargrove-Huttel, R. (2000). Lippincotts review series: Medical-surgical nursing . (3rd ed.).

Philadelphia: Lippincott.