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Transcript
Chapter 11
Care of the Patient with an Endocrine
Disorder
Mosby, Inc. items and derived items copyright © 2003, 1999, 1995, 1991 Mosby, Inc.
Care of the Patient with an Endocrine
Disorder



Endocrine glands are ductless glands that
release chemicals (hormones) into the blood
stream to regulate body activities
The endocrine glands regulate themselves by
a series of negative feedback messages
The hormones secreted by the endocrine
glands affect tissues of the entire body, and
the imbalance in their levels may contribute
to pathological changes in many different
systems
Mosby, Inc. items and derived items copyright © 2003, 1999, 1995, 1991 Mosby, Inc.
Hormone Effects




Generalized effect on metabolism, growth
and development, and reproduction
The slightest changes in hormonal levels can
upset the metabolic balance of the body
Hormones increases and decreases normal
body processes by exerting their effects on
target organs
Abnormal levels of these hormones cause
diseases and disorders of the endocrine
system
Mosby, Inc. items and derived items copyright © 2003, 1999, 1995, 1991 Mosby, Inc.
Pituitary Gland



Acromegaly and gigantism – growth
changes that my lead to negative effects on
the patient’s self-image and self-esteem
Diabetes insipidus – antidiuretic hormone
deficiency – results in marked polyuria and
intense polydipsia
SIADH – syndrome of inappropriate
secretion of antidiuretic hormone – too much
ADH hormone
Mosby, Inc. items and derived items copyright © 2003, 1999, 1995, 1991 Mosby, Inc.
Thyroid and Parathyroid


Hyperthyroidism – too much thyroid hormone –
patient’s metabolic processes exaggerated
Hypothyroidism – not enough thyroid hormone –
slows the body’s metabolic processes

Goiter – enlarged thyroid

Cancer – relatively rare malignancy


Hyperparathyroidism – too much parathyroidism –
elevated calcium
Hypoparathyroidism – insufficient parathyroidism –
decrease calcium
Mosby, Inc. items and derived items copyright © 2003, 1999, 1995, 1991 Mosby, Inc.
Person with Myxedema
(Figure 11-8)
Mosby, Inc. items and derived items copyright © 2003, 1999, 1995, 1991 Mosby, Inc.
Adrenal Glands



Cushing’s syndrome – elevated
adrenocortical hormones – body’s protective
mechanism fails
Addison's disease – insufficient
adrenocortical hormone – electrolytes and
fluid balance is unstable
Pheochromocytoma – tumor in the adrenal
medulla – causes severe hypertension that
may result in CVA
Mosby, Inc. items and derived items copyright © 2003, 1999, 1995, 1991 Mosby, Inc.
Pancreas

Diabetes mellitus – improper metabolism
of carbohydrates, fats and proteins due to
lack of insulin
– Type 1 (IDDM) – autoimmune beta-cell
destruction – usually in patient under 30 years
of age
– Type 2 (NIDDM) – decrease response to
insulin – more commonly found after age 30
and incidence increases with the aging process
Mosby, Inc. items and derived items copyright © 2003, 1999, 1995, 1991 Mosby, Inc.
Treatment of Diabetes Mellitus

Individualized treatment that depends on:
– Age
– Lifestyle
– Food preferences
– Ability to cook
– Activity levels
Mosby, Inc. items and derived items copyright © 2003, 1999, 1995, 1991 Mosby, Inc.
Nursing Responsibilities Diabetes
Mellitus



Monitor medications effects during peak
action of the medication, and treatment must
be initiated promptly if hypoglycemia
develops
Be familiar with the clinical manifestations of
DKA/HH and hypoglycemic reaction
Frequent assessments necessary because
DKA can result in seizures, brain damage, or
death
Mosby, Inc. items and derived items copyright © 2003, 1999, 1995, 1991 Mosby, Inc.
Sites for Insulin Injections
(Figure 11-13)
Mosby, Inc. items and derived items copyright © 2003, 1999, 1995, 1991 Mosby, Inc.
Nursing Diagnoses




Knowledge, deficient
Self-esteem, risk for
situational low
Sensory perceptions,
disturbed
Fluid volume, risk for
deficient

Infection, risk for

Injury, risk for

Sexual dysfunction

Body image, disturbed

Coping, ineffective




Home maintenance,
impaired
Nutrition: less than
body requirements,
imbalanced
Nutrition: more than
body requirement,
imbalanced
Activity intolerance
Mosby, Inc. items and derived items copyright © 2003, 1999, 1995, 1991 Mosby, Inc.