Download Part E – Endocrine

RNSG 2504 – Care of the Patient With Common Health Care Needs
Unit IV– Part E – Endocrine Problems
Behavioral Objectives
1. Apply the terms listed in the
I.
content column appropriate
to the patient situations
involving the endocrine
system.
2.
3.
Content Outline
Application of terms
A. Polydipsia
B. Polyphagia
C. Polyuria
D. Sensorium
E. Kussmal respirations
F. Euglycemia
Clinical Objectives
Learning Opportunities
Readings:
McKinney
Adams
Lewis
TVCC Library – Nursing Education on
Video
http://tvcc.ent.sirsi.net/client/tvcclibraries
Compare and contrast the
normal anatomy and
physiology to the pathophysiology of selected endocrine
system disease processes in
the content column.
II. Anatomy & Physiology of Endocrine
System
A. Developmental considerations
1. Infant
2. Child
3. Adolescent
4. Adult
5. Older adult
B. Pathophysiology of endocrine
system
1. Fluid & electrolyte imbalance
Analyze factors included in
the assessment of the patient
experiencing commonly
occurring endocrine system
problems, including the
developmental and cultural
considerations.
III. Selected commonly occurring endocrine
Problems
A. Interview
1. Chief complaint
2. Precipitating event
3. Medical history
4. Family/ Social/occupational
history
5. Medication history
(prescription/nonprescription)
6. Knowledge of health
maintenance
7. Risk factors
B. Physical exam – pancreatic
endocrine system
1. Skin turgor
2. Buccal mucosa
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Diabetes in Clinical Practice
RNSG 2504 – Care of the Patient With Common Health Care Needs
Unit IV– Part E – Endocrine Problems
Behavioral Objectives
Content Outline
C.
4.
Differentiate between the
etiology, pathophysiology,
and clinical manifestations
of selected commonly
occurring endocrine disease
processes.
Clinical Objectives
3. Intake & output
4. Level of consciousness
5. Feet
Diagnostic tests
1. Laboratory studies
a. Electrolytes
b. Glycosylated hemoglobin
c. Blood glucose
d. Urine
(1) Ketones
(2) Specific gravity
2. Other
a. Cultural influences
b. Hereditary
c. Environmental
d. Health beliefs/practices
e. Developmental
(1) Age specific assessment
data
(a) Vital signs
(b) Fluid /electrolytes
(c) Nutritional
(d) Behavioral/emotional
response to health
care providers
IV. Commonly Occurring Endocrine
Problems
A. Pancreatic endocrine
1. Diabetes Mellitus
a. Insulin Dependent Diabetes
Mellitus (IDDM) (Type 1)
b. Non-Insulin Dependent
Diabetes Mellitus (NIDDM)
(Type 2)
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Learning Opportunities
RNSG 2504 – Care of the Patient With Common Health Care Needs
Unit IV– Part E – Endocrine Problems
Behavioral Objectives
5.
Discuss analysis, planning,
implementation, and
evaluation for the nursing
management of patients with
commonly occurring
selected endocrine disease
processes.
Content Outline
Clinical Objectives
V. Selected Nursing Diagnoses /
Implementation / Evaluation
A. Fluid / Electrolyte Imbalance
1. Independent interventions
a. Age related hydration status
b. Monitor pertinent diagnostic
tests
c. Maintain skin integrity
d. Intake and output
e. Weight
f. Vital signs
g. Sensorium
h. Adhere to standard
precautions
2. Collaborative interventions
a. Administer replacement
fluids
(1) Oral replacement
solutions
(2) Intravenous fluids
(3) Electrolytes
b. Administer medications and
monitor for
desired/side/adverse effects
(1) Insulin preparations
(2) Oral antidiabetic agents
3. Recognition of complications
a. Hypoglycemia
b. Hyperglycemia
c. Long term complications of
diabetes
(1) Microvascular
(2) Macrovascular
(3) Neuropathic
(4) Infection/sepsis
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Learning Opportunities
RNSG 2504 – Care of the Patient With Common Health Care Needs
Unit IV– Part E – Endocrine Problems
Behavioral Objectives
Content Outline
Clinical Objectives
4.
Evaluation of Outcomes: The
patient will have improved
fluid and electrolyte balance as
evidenced by:
a. Hydration status
b. Improved laboratory studies
c. Intake and output
d. Bowel/urinary elimination
e. Vital signs
B. Altered health maintenance:
Knowledge deficit regarding
diabetes
1. Patient teaching
a. Assess readiness to learn,
ability, and knowledge
level
b. Reportable signs /
symptoms
(1) Hypoglycemia
(2) Hyperglycemia
c. Medication
(1) Insulin injection
techniques
(2) Oral agents
d. Exercise
e. Foot care
f. Sick day management.
rules/
g. Dental care
h. Blood glucose monitoring
i.
American Dietary
Association
(meal planning)
j. Safety precautions
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Learning Opportunities
RNSG 2504 – Care of the Patient With Common Health Care Needs
Unit IV– Part E – Endocrine Problems
Behavioral Objectives
Content Outline
2.
3.
Clinical Objectives
Learning Opportunities
Community Resources
a. American Diabetes
Association
b. Podiatrist
c. Home Health
d. Diabetes Educator
Evaluation of Outcomes: The
patient will have improved
health maintenance as
evidenced by:
a. Identifying reportable
signs and symptoms
(1) Hypoglycemia
(2) Hyperglycemia
b. Describing the purpose,
correct administration and
side effects of medications
c. Demonstrate insulin
injection administration
d. Demonstrate use of blood
glucose monitor
e. Demonstrate proper foot
care
f. Adheres to prescribed diet
g. Utilizes appropriate
members of health care
team
h. Participates in prescribed
exercise program
i. Utilizes community
resources
N:\ADN \Unit IV Part E - Endocrine
Revised 11/12
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