Management of Patients with Endocrine Disorders (Part 1)

Management of Patients with Endocrine Disorders (Part 1)

• The nervous and endocrine systems work together to control bodily functions.
• Endocrine system disorders affect all organ systems.
• Endocrine glands secrete hormones directly into the bloodstream.
• Exocrine glands secrete their products through ducts (e.g., digestive tract, sweat glands).
• The hypothalamus links the endocrine and nervous systems.
• The hypothalamus regulates hormone production.
• Hormones influence the nervous system; examples include norepinephrine and epinephrine.
• The immune system interacts with the endocrine system, responding to foreign agents and regulated by adrenal cortex hormones.
• Endocrine glands are anatomically separated in the body.
• Hormones regulate the internal environment and affect all aspects of life.

Endocrine Organs

• Pineal gland
• Hypothalamus
• Pituitary gland
• Thyroid gland
• Parathyroid glands
• Thymus
• Adrenal glands
• Pancreas
• Ovary (female)
• Testis (male)

Cardiac Hormones

• Atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP) are synthesized and secreted by cardiac muscle cells in the atria of the heart.
• These cells contain volume receptors.
• Volume receptors respond to increased stretching of the atrial wall due to increased atrial blood volume

Hormone Regulation

• Hormone concentration in the bloodstream is mostly maintained at a constant level.
• When hormone concentration increases, its production is inhibited.
• When hormone concentration decreases, its production increases.
• This mechanism (negative feedback) maintains homeostasis.

Negative Feedback Example (Calcium Regulation)

• Increased calcium causes a decreased secretion of parathyroid hormone (PTH).
• Decreased calcium causes an increased secretion of PTH.
• This feedback loop maintains calcium homeostasis.

Nursing Assessment

• Health History: Fatigue, energy changes, heat/cold tolerance; changes in weight, sexual function, mood/memory/sleep; family history of endocrine disorders.
• Physical Examination. Height/weight, vital signs (especially blood pressure); skin texture, eye changes (e.g., exophthalmos), facial appearance changes, and extremities.
• Palpation: Thyroid gland palpation, noting size, shape, presence of thrills or nodules.
• Inspection: Assess for changes in appearance.

Diagnostic Tests

• Blood tests: Indicate hormone levels (e.g., T3, T4, calcium, glucose).
• Urine tests: Measure hormone excretion in 24 hours.
• Nuclear Scanning: Identifying tumors or nodules or functioning abnormalities.
• Radiographic tests (CT or MRI): locating tumors or hypertrophy.
• Ultrasound: Identifying masses in thyroid or parathyroid.
• Biopsy: Obtain tissue for examination.

Nursing Interventions Before Thyroid Tests

• Take a thorough patient history.
• Discontinue thyroid medications 7–10 days before the test.
• Avoid iodine-containing medications, excessive iodine intake, and iodine-related tests.
• Inform the patient that no radiation precautions are necessary.

Causes of Endocrine Problems

• Insufficient Hormone Activity: Gland hypo function, lack of tropic or stimulating hormone, target tissue insensitivity to hormone.
• Excess Hormone Activity: Gland hyper function, excess tropic hormone production, excessive replacement medication.

Thyroid Gland Disorder

• Thyroid hormone affects metabolic activity throughout the body.
• See how thyroid hormones are secreted

Hypothyroidism/Hyperthyroidism

• Definitions and characteristics of both conditions
• Etiology
• Signs and symptoms (cardiovascular, neurologic, pulmonary, integumentary, gastrointestinal, reproductive).
• Diagnostic tests
• Therapeutic measures
• Nursing diagnoses Specific to hypothyroidism and hyperthyroidism

Common Goiters

• Endemic (nutritional Iodine deficiency).
• Sporadic (ingestion of goitrogenic foods or goitrogenic drugs).

Thyroid Storm/Thyrotoxic Crisis

• Management objectives, especially considering body temperature and heart rate reduction.
• Specific interventions to treat the crisis

Myxedema

• Characteristics/features of Myxedema, important complications

Thyroid Surgery (Thyroidectomy)

• Methods (traditional vs. minimally invasive)
• Types (total vs. subtotal).
• Circumstances that dictate surgical treatment.
• Preoperative care, including euthyroid status and iodine use.
• Postoperative care including monitoring vital signs, drain care ,prevent hemorrhage.
• Possible complications, including tetany (assessment and interventions)
• Teaching for the patient/caregivers.

Nutritional Therapy for Hyperthyroidism and Hypothyroidism

• High-calorie diet (for hyperthyroidism), 6 full meals + snacks
• Emphasize low-calorie diet or other nutritional strategies (for hyperthyroidism).

Common Nursing Diagnoses for Patient Conditions

• Common nursing diagnoses for patients with hyperthyroidism and hypothyroidism, including those related to nutrition, breathing, activity, knowledge, and body temperature.

Maintaining Normal Body Temperature

• Patients with hyperthyroidism experience increased body temperatures and need a cool environment.

Patient and Caregiver Teaching Guides (for both conditions)

• Importance of thyroid hormone therapy, lifestyle interventions, medication considerations, follow-up care.

Disorders of the Parathyroid Glands

• Overview of parathyroid glands and their role in regulating calcium balance
• Hypoparathyroidism and hyperparathyroidism pathophysiology, symptoms, diagnostic tests, therapeutic measures and nursing interventions

Explore the essential concepts of the endocrine system and its disorders in this quiz. Learn about the roles of various glands, hormone regulation, and the interaction between the endocrine and nervous systems. This quiz is designed to enhance your understanding of the complexities of endocrine disorders and their management.