Endocrine Problems PDF

Care of Patients with Endocrine Problems By Dr. Angela D. Banks, RN, PhD Hyperthyroidism  Overview of Thyroid Hormones Thyroid Releasing Hormone (TRH) Thyroid Stimulating Hormone (TSH) T3 & T4 Thyroid Hormones  Pathophysiology...

Care of Patients with Endocrine Problems By Dr. Angela D. Banks, RN, PhD Hyperthyroidism  Overview of Thyroid Hormones Thyroid Releasing Hormone (TRH) Thyroid Stimulating Hormone (TSH) T3 & T4 Thyroid Hormones  Pathophysiology of Hyperthyroidism Primary Secondary Tertiary Exophthalmos (Thyroid Eye Disease) Patients may complain of: Blurred vision Diplopia- Double vision Eye pain Photophobia-Sensitivity to light Pharmacological Management Surgical Treatment for Hyperthyroidism Hypothyroidism Goiter Clinical Symptoms of Hypothyroidism Cold intolerance Extreme fatigue Constipation Bradycardia Weight gain Pharmacological Treatment of Hypothyroidism Levothyroxine (Synthroid) Side effects Decreases the ability of insulin or anti-diabetic meds to function in a person with diabetics Dosages of insulin or antidiabetic drugs may need to be adjusted Hypothalamus and Anterior Pituitary Disorders of Anterior Pituitary Gland Primary pituitary dysfunction Secondary pituitary dysfunction Pituitary hypofunction Pituitary hyperfunction Cause of Hypopituitarism Benign or malignant tumors Anorexia nervosa Shock or severe hypotension Sheehan’s syndrome postpartum hemorrhage Patient Assessment  Management of Hypopituitarism Replacement of deficient hormones Androgen (Testosterone) Most preferred route is Testosterone gels Once therapy begins it is lifelong Acromegaly Growth hormone hypersecretion after puberty Most common cause is pituitary adenoma No change in height Increase in size of bones in hands and feet Hypertrophy of skin Gigantism  Pharmacological Treatment Brimocriptine (Parlodel) Stimulate dopamine Carbergoline (Dostinex) receptors Pergolide Mexylate Inhibit the release of many (Permax) pituitary hormones Growth hormone Prolactin Transsphenoidal Adenomectomy  Postoperative Care Monitor neurologic response Assess for postnasal drip HOB elevated Assess nasal drainage Avoid bending Avoid strain at stool Diabetes Insipidus (Dry Inside) Pharmacological Treatment Desmopressin acetate (DDAVP) It works by replacing vasopressin, a hormone that is normally produced in the body to help balance the amount of water and salt.  Syndrome of Inappropriate Antidiuretic Hormone Secretion (SIADH) (Soaked Inside) Vasopressin is secreted even when plasma osmolarity is low or normal. Feedback mechanisms do not function properly Water is retained, resulting in hyponatremia  Medical Problems & SIADH Recent head trauma Cerebrovascular disease Tuberculosis or other pulmonary disease Cancer (e.g. Lung Cancer) All past and current drug use Nursing Interventions Fluid restriction Diuretics Furosemide Hypertonic saline 3% Normal Saline Demeclocycline (Declomycin) Neurologic assessment