Endocrine System Lecture Slides PDF

HCAP 1210  The endocrine system is made up of glands called the endocrine glands. Endocrine The endocrine glands secrete chemical substances called System hormones into the bloodstream. Hormones regulate the activities...

HCAP 1210  The endocrine system is made up of glands called the endocrine glands. Endocrine The endocrine glands secrete chemical substances called System hormones into the bloodstream. Hormones regulate the activities of other organs and glands in the body. Endocrine System  The pituitary gland is called the master gland  Located at the base of the brain, behind the eyes  The anterior pituitary lobe secretes:  Growth hormone (GH)  Thyroid-stimulating hormone (TSH)  Adrenocorticotropic hormone (ACTH)  Hormones that regulate growth, development, and function of the male and female reproductive systems  The posterior pituitary lobe secretes:  Antidiuretic hormone (ADH)  Oxytocin Endocrine System  The thyroid gland is in the neck, in front of the larynx  It plays a major role in the metabolism, growth and development of the human body. It helps to regulate many body functions by constantly releasing a steady amount of thyroid hormones into the bloodstream. For example it regulates body temperature, heart rate, blood pressure and metabolism.  Secretes thyroid hormone (T3-thyroxine, T4- triiodothyronine) and calcitonin Hypothyroidism  Caused by an underactive thyroid gland, resulting in decreased production of thyroid hormone  With decreased hormone production, all of the body processes are slowed down  Treatment consists of thyroid supplements Hyperthyroidism  Caused by an overactive thyroid gland, resulting in too much thyroid hormone being produced  All of the body’s processes are regulated by the thyroid hormone, so they all speed up due to excess hormone  Treatment consists of surgical removal of some or all of the thyroid gland or administration of one dose of radioactive iodine to destroy some of the thyroid cells Endocrine System  There are two adrenal glands.  An adrenal gland is on the top of each kidney.  The adrenal medulla secretes  epinephrine  Norepinephrine.  The adrenal cortex secretes three groups of hormones needed for life:  Glucocorticoids  Mineralocorticoids  Small amounts of male and female sex hormones Endocrine System Endocrine System  The gonads are the glands of human reproduction.  Male sex glands (testes) secrete testosterone.  Female sex glands (ovaries) secrete estrogen and progesterone.  The endocrine system  The endocrine system is made up of glands Endocrine  The endocrine glands secrete hormones that affect other organs and glands Disorders  Diabetes is the most common endocrine disorder Diabetes  “Diabetes is a chronic, metabolic disease characterized by elevated levels of blood glucose (or blood sugar), which leads over time to serious damage to the heart, blood vessels, eyes, kidneys, and nerves”. (WHO)  Over 9 million Canadians live with diabetes  Risk factors:  A family history of the disease  Obesity  Risk increases after age 40  Canadians of Aboriginal descent are more likely than others to have diabetes The Pancreas Pancreas is 6” long, sits across the back of the abdomen, behind the stomach   Insulin is a hormone that is secreted by the Pancreas.  Insulin is needed for glucose (sugar) to move from the blood into the cells. Acts a key!  When we eat foods or drink liquids that contain carbohydrates, this breaks down into glucose (sugar) in our bodies, which enters the bloodstream What is Insulin?  Insulin acts as a “key”, binds to the receptors of the cells, opens up the “doorway” so glucose can move from the bloodstream into the cells where it is used for energy.  The cells need glucose (sugar) for energy to thrive!!!  Without enough insulin, sugar builds up in the blood = dangerous!!!  Diabetes = Disorder in which the body cannot produce or use insulin properly  When cells do not have glucose (sugar) for energy, they cannot perform their function. Think of how you feel when you do not have enough energy? Diabetes and  If there is not enough insulin being released or produced from the pancreas, sugar will build up in Insulin the blood (Hyperglycemia) and this will lead to many complications. RECAP! 1. Your body is made up of millions of cells. To make energy, these cells need food in a very simple form = Glucose (sugar) 2. When you eat or drink, much of your food is broken down into a simple sugar called "glucose." 3. Glucose is transported through the bloodstream to the cells of your body where it can be used to provide some of the energy your body needs for daily activities. 4. The amount of glucose in your bloodstream is tightly regulated by the hormone insulin. Insulin is always being released in small amounts by the pancreas. 5. When the amount of glucose in your blood rises to a certain level, the pancreas will release more insulin to push more glucose into the cells. This causes the glucose levels/blood sugar levels in your blood to drop. 6. HOWEVER… when your pancreas either does not make insulin OR our cells have become resistant to insulin then we have high levels of sugar circulating our blood, called simply high blood sugar = severe complications. This in result is diabetes. What is Diabetes?  There are three types of diabetes:  Type 1 occurs most often in children, teenagers, and young adults  The pancreas produces little or no insulin  Type 2 can occur at any age  The pancreas secretes insulin. The body cannot use it well, receptors have lost sensitivity Types of  Persons over 40 years of age are at risk Diabetes  Being overweight, not exercising regularly, and having hypertension are risk factors  Gestational diabetes develops during pregnancy  It usually goes away after the baby is born  The mother is at risk for type 2 diabetes later in life  Pancreas doesn't produce ANY insulin thus leads to severe hyperglycemia Type 1 Clients develop symptoms early in Diabetes disease & need treatment of daily insulin injections & blood sugar checks (IDDM) Sometimes also referred to as insulin dependent diabetes mellitus (IDDM) Type 2 Diabetes (NIDDM) ❖ Usually develops in adulthood but can occur in children as well ❖ Seeing trends of this occurring more now as children eat more fast food and high sugar diets ❖ Most common type of diabetes ❖ Either pancreas produces too little insulin or body doesn’t effectively use the produced insulin (also commonly referred to as insulin resistance) ❖ 80% of Canadians come from populations that are at high risk for diabetes: Indigenous Hispanic Asians South Asians African descent ❖ Hyperglycemia often mild enough that may not notice symptoms ❖ Referred to as non-insulin dependent diabetes mellitus (NIDDM)   Treatment  No cure  Type 1 treated with daily insulin therapy, healthy eating, and exercise  Type 2 is treated with healthy eating and exercise  Many persons with type 2 take oral drugs; some need insulin Treatment for  Overweight persons need to lose weight Diabetes ❖ All clients with diabetes must follow a careful diet, & overweight clients need to lose weight ❖ Exercise is also included in the treatment plan. Regular exercise helps low blood sugar levels and promotes weight loss. ❖ Exact type of insulin & dose is ordered by physician to prevent complications   Blood glucose is monitored daily or 3 or 4 times a day for:  Hypoglycemia (low sugar in the blood) Treatment for   Hyperglycemia (high sugar in the blood) Table 37-1 (p. 875): Signs of hypoglycemia and Diabetes hyperglycemia  Blood glucose monitoring is a delegated act that you may be trained to do Blood Glucose Levels Normal Range  Normal blood sugar levels should be as following:  Fasting and before meals: 4.0 to 7.0 millimoles per liter (mmol/L)  After meals: 5.0 – 10.0 millimoles per liter (mmol/L) Blood Sugar Levels Hypoglycemia  Hypoglycemic blood sugar levels are as follows:  Less then 4.0mmol/L  Signs and symptoms noted in chart Blood Sugar Levels Hyperglycemia  Hypoglycemic blood sugar levels are as follows:  Greater than 10.0mmol/L  Signs and symptoms noted in chart  ❖ Good foot care is needed!!! ❖ Foot & leg wounds have profound complications in diabetics leading to infection & gangrene and possibility of amputation ❖ Regular & proper foot & nail care needed provided by professional foot care nurse or podiatrist Corns, blisters, calluses on feet can lead to infection & may lead to amputation  Diabetes must be controlled to prevent the following complications: Diabetes  Blindness Kidney disease Complications   Nerve damage  Sexual dysfunction  Circulatory disorders (which can lead to stroke, heart attack, slow wound healing)  If too much insulin is taken this leads to hypoglycemia aka low blood sugar. If not corrected can lead to coma & death. You will see nurses always asking for what is called a “double- check” from another nurse to ensure correct dosing.  Types 1 and 2 involve controlling blood pressure, blood cholesterol, and the risk factors that may lead to a diagnosis of coronary artery disease Diabetic Ketoacidosis Diabetes Complications Diabetic Ketoacidosis It usually happens because Diabetic ketoacidosis (DKA) is It could be life-threatening, your body doesn't have a buildup of acids in but it usually takes many enough insulin. Your cells your blood. It can happen hours to become that can't use the sugar in when your blood sugar is too serious. You can treat it and your blood for energy, so high for too long. prevent it, too. they use fat for fuel instead. Biggest symptom to note of Burning fat makes acids this condition People with type 1 called ketones and, if the FRUITY SMELLING BREATH!! diabetes are at risk for process goes on for a while, ketoacidosis, since their they could build up in your bodies don't make any insulin blood. Critical Thinking!  What are considered normal ranges for blood sugar levels?  Why is it essential the HCW inform the nurse that the patient/resident is ready for their blood sugars to be checked before meals are given?  What are some ways to maintain a healthy diet for diabetes disease management?  Some people believe they can eat what they want as long as they take their diabetic medication. Why is nutrition important if medication is available to manage diabetes?  With proper diet and exercise, can a person eventually not need to take diabetes medication?  How can you help your patient prepare for eating when going to a restaurant? Diabetes & the Importance of Foot Care  Diabetes can cause nerve damage (also known as diabetes peripheral neuropathy) and poor blood flow or circulation to the legs and feet  As a result, people with diabetes are less likely to feel a foot injury, such as a blister or cut.  Diabetes can make these injuries more difficult to heal. Unnoticed and untreated, even small foot injuries can quickly become infected, potentially leading to serious complications. Daily Foot Care  Wash your residents feet in warm (not hot) water, using a mild soap. Don’t soak the feet, as this can dry your skin.  Dry your residents feet carefully, especially between your toes.  Thoroughly check your residents feet and between your toes to make sure there are no cuts, cracks, ingrown toenails, blisters, etc.  Apply a good lotion to your heels and soles. Wipe off excess lotion that is not absorbed. Don’t put lotion between your toes, as the excessive moisture can promote infection  Wear fresh clean socks and well-fitting shoes every day. Whenever possible, wear white socks – if you have a cut or sore, the drainage will be easy to see.  Elevate your feet when you are sitting.  Wiggle your toes and move your ankles around for a few minutes several times a day to improve blood flow in your feet and legs. Your Role as the Health Care Worker  Client’s feet should be inspected daily & any cuts, lesions or nonintact skin surfaces should be reported immediately  Ensuring you know which of your clients has IDDM or NIDDM. Most often than none during meal times your client will request sugar with their tea or coffee. YOU need to know if they can or cannot have it, or if Splenda is the better alternative option. ❖ As a support worker, you may prepare meals for adults with diabetes ❖ Diet is very important in managing. Follow diet plan & serve meals/snacks on time ❖ You need to record the amount of food client consumes at every meals & snack. This is your responsibility!!! ❖ Calories not consumed at a meal/snack need to be replaced in the day so client doesn’t experience hypoglycemia. Most often a meal replacement is provided for missed meals (ex. Boost or Ensure), or cookies/crackers & juice for a missed snack. ❖ There are meal replacement drinks available that have a lower sugar content to be mindful of patients who have diabetes. ❖ Immediately report signs and symptoms of hypoglycemia or hyperglycemia to supervisor