Download Med Surg III/Endocrine power point/C. Mackey

Physiologic Integrity and
Therapeutic Nursing
Interventions for Patients With
Endocrine Needs
Black, J.M. & Hawks, J.H. (2005)
Chapters 44, (pp 1154 -1189)
Baptist Health School of Nursing
NSG 4037: Adult Nursing III
Carole Mackey, MNSc,
MNSc, RN, PNP
The Endocrine System
2
The Metabolic System
„ Dependent
on Fuel
„ Anabolic
„ Catabolic
„ Regulation
3
1
Metabolic System Regulation
„ Metabolism
„ Growth
and
Development
„ Plasma Glucose
4
Structure of the Metabolic
System
Endocrine =
within
„ Exocrine =
outside
„ Liver
„ Endocrine Glands
„
5
Endocrine System
„ Endocrine
versus Exocrine
„ Liver
„ Endocrine
Glands
6
2
Liver
„
„
„
„
„
Largest Solid Organ in
body
Largest Gland in body
Synthesis and storage of
glycogen
Synthesis of lipoproteins,
plasma proteins
(including albumin and
clotting factors)
Detoxification of
metabolic waste (drugs,
toxins, alcohols)
7
What Are Hormones?
„
„
Chemicals That Are Released
Into the Bloodstream
Regulators of Specific Body Functions
8
What are Hormones?
„
Hormones – chemical substances secreted
by cells into the extracellular fluids
„ Regulate the metabolic function of other
cells
„ Have lag times ranging from seconds to
hours
„ Tend to have prolonged effects
„ Are classified as amino acid-based
hormones, or steroids
9
3
Types of Hormones
„ Steroids
„ Peptides
„ Amino
Acid
Derivatives
10
Types of Hormones
„ Peptides
„ Oxytocin
„ Insulin
„ Amino
Acid Derivatives
„ Thyroxine
„ Catecholamines
„ Steroids
„ Estrogens
„ Progestins
„ Androgens
11
Major Endocrine Organs
12 16.1
Figure
4
Hypothalmus and Pituitary Gland
13
The Thyroid Gland
Located in the
anterior neck
„ Largest pure
endocrine gland
„ Produces two
hormones
„
Thyroid hormone
(TH, T3 & T4)
„ Calcitonin
„
14
The Parathyroid Gland
Lie on the
posterior
surface of the
thyroid gland
„ Contain two
types of
endocrine cells
„
„
Chief cells –
produce
parathyroid
hormone (PTH)
15
Figure 25.8a
5
Endocrine Pancreas
„
„
The endocrine pancreas
contains Islets of
Langerhans
„
alpha cells: secrete
„
beta cells: secrete
„
delta cells: secrete SS
glucagon
insulin
(somatostatin)
somatostatin)
Pancreatic hormones are
involved in blood glucose
regulation, and problems
with them can lead to
diabetes
16
Adrenal Glands
An adrenal gland is found on top of each kidney.
Each adrenal gland has two regions that carry out
separate functions!
•The adrenal medulla
•The adrenal cortex
17
The Adrenal Cortex
Acts like a regular endocrine
organ
Secretes many hormones, but
most importantly secretes the
following steroids:
„ aldosterone
„ cortisol
„ sex
hormones
18
6
The Adrenal Medulla
Acts very much like a part of the
sympathetic nervous system (fight
or flight)
Secretes two amines:
„ norepinephrine (20%)
„ epinephrine (80%)
19
Negative Feedback Loop
20
Metabolic Substrates
„
„
„
„
Plasma Glucose
Plasma Amino Acids
Plasma Free Fatty Acids
Plasma Calcium
21
7
Effects of Aging
„
„
„
„
„
„
Functions deteriorate
Liver Cells Reduced
Decrease in protein
synthesis
Liver ability diminishes
Pancreas vessels calcify
Decreased absorption of
fat soluble vitamins
22
Assessment of Endocrine
System
„ History
„ Chief
Complaint
„ Symptom
Analysis
23
Integumentary Manifestations
„
„
„
„
„
„
„
„
Appearance
Color
Petechiae
Delayed Healing
Edema
Changes in size of
hands, feet, face
Growth delay
Hair distribution
24
8
Cardiovascular Manifestations
„
„
„
„
„
„
Nosebleeds or bruising
Changes in VS
Edema of limbs
Hypertension
Tachycardia
Kussmaul’s
Respirations
25
Neurologic Manifestations
„
„
„
„
„
„
„
„
Weakness
Depression
Changes in mental
status or mood
Emotional lability
Drowsiness
Pain
Tremors
Loss of sensation
26
Ophthalmic Manifestations
„ Bulging
eyes
(Exophthalmos)
Exophthalmos)
„ Diminished or
blurred vision
„ Visual Loss
27
9
Gastronintestinal Manifestations
„
„
„
„
„
„
„
„
„
Glossitis
Weight Gain or Loss
Change in Appetite
Polydipsia
Abdominal Pain
Anorexia
Fatty Food Intolerance
Heartburn
Bowel Patterns
28
Genitourinary and Reproductive
Manifestations
Urine Color
„ Polyuria
„ Amenorrhea
„ Loss of libido
„ Sexual changes
„ Renal problems
„
29
Other Manifestations
Yellow Sclerae
„ Fever
„ Malaise
„ Fatigue
„ Dehydration
„ Bone or joint pain
„ Muscle cramps
„
30
10
Physical Examination
General
Appearance
„ Vital Signs
„ Integument
„ Head
„ Eyes
„ Nose
„
Mouth
„ Neck
„ Extremities
„ Thorax
„ Abdomen
„ Inspection
„
31
Diagnostic Tests
„ Blood
Glucose Levels
„ Thyroid Function
„ Parathyroid Function
„ Adrenocortical
Function
„ Liver Function
„ Pancreas Function
32
Diagnostic Imaging
„ Radioiodine
Uptake
„ Radiography
„ Computed
Tomography
„ Ultrasound
„ Magnetic Resonance
Imaging
33
11