Care of the Patient with an Endocrine Disorder

1. Care of the Patient with an Endocrine Disorder Unit 8 Med-Surg 2

2. Care of Endocrine Disorders • Work on your terms! • Review of A and P Med-Surg 2

3. Care of Endocrine Disorders • Thyroid Gland • Parathyroid Gland • Adrenal or Suprarenal Glands • Pituitary • Gonads • Islets of Langerhans Med-Surg 2

4. Care of Endocrine Disorders • Thyroid Disorders • Simple (endemic) goiter-thyroid enlargement due to deficiency of iodine in the diet • Hyperthyroidism- Grave’s disease, toxic goiter or thyrotoxicosis, excess thyroxine • Thyroidectomy- total or subtotal. • Thyroid Crisis or Thyroid Storm- life threatening emergency Med-Surg 2

5. Care of Endocrine Disorders • Thyroid Disorders • Hypothyroidism-inadequate amounts of thyroxine. • Myxedema- occurs in adults, with gradual onset • Juvenile Myxedema- varies in degree of severity • Cretinism- little or no thyroid hormone present during fetal life, or infancy • Tumors of the Thyroid- benign or malignant, uncommon and rarely fatal Med-Surg 2

6. Care of Endocrine Disorders • Medications • Antithyroid Drugs • Thionamides • propylthiouracil • methimazole (Tapazol) • Iodides • Thyroid Hormone Replacement • levothyroxine (Synthroid) • liothyronine (Cytomel) Med-Surg 2

7. Care of Endocrine Disorders • Parathyroid Disorders • Hyperparathyroidism- excessive secretion of parathormone • Hypoparathyroidism- diminished secretion of parathormone Med-Surg 2

8. Care of Endocrine Disorders • Disorders of the Pancreas • Diabetes Mellitus- most common endocrine disorder, abnormal CHO metabolism • Type I (IDDM) • Type II (NIDDM) • Gestational • Pathophysiology • Symptoms- differ in the adult and the child • Diagnostics Med-Surg 2

9. Care of Endocrine Disorders • Treatment of Diabetes • Diet • Exercise • Hygiene • Drug Therapy • Insulin • Oral Anti-Hyperglycemics • Education Med-Surg 2

10. Care of Endocrine Disorders • Diabetic Ketoacidosis- considered an emergency, hyperglycemia • Hypoglycemia (Insulin Shock, Insulin Reaction)- blood sugar less than 60 Med-Surg 2

11. Care of Endocrine Disorders • The Adrenal Glands • Cortex • Glucocorticoids- cortisol and hydrocortisone • Mineralocorticoids- aldosterone • Androgenic Hormones- estrogen and progesterone • Medulla • Norepinephrine- alpha adrenergic stimulation • Epinephrine- beta adrenergic stimulation Med-Surg 2

12. Care of Endocrine Disorders • Disorders of the Adrenal Glands • Addison’s Disease (hypoadrenalism)- deficiency of cortisol and aldosterone • Cushing’s Syndrome (hyperadrenalism)-excess amounts of cortisol • Pheochromocytoma- tumor of the adrenal medulla Med-Surg 2

13. Care of Endocrine Disorders • Disorders of the Adrenal Glands • Surgery (adrenalectomy)- removal of the adrenal glands • Medication- corticosteroids • Adrenal Crisis- life threatening emergency Med-Surg 2

14. Care of Endocrine Disorders • The Pituitary Gland • Anterior Pituitary • Growth Hormone • Adrenocorticotropic Hormone • Thyroid Stimulating Hormone • Follicle Stimulating Hormone • Leutinizing Hormone • Prolactin • Melanocyte Stimulating Hormone • Posterior Pituitary • Antidiuretic Hormone • Oxytocin Med-Surg 2

15. Care of Endocrine Disorders • Disorders of the Pituitary Gland • Hypopituitarism • Dwarfism- undersecretion of GH • Hyperpituitarism- excess of one or more of the anterior pituitary hormones • Gigantism- rare, occurs in early childhood • Acromegaly- rare, occurs in the fourth or fifth decade of life Med-Surg 2

16. Care of Endocrine Disorders • Disorders of the Pituitary Gland • Diabetes Insipidus- decreased production of ADH, causing excessive urine output • SIADH(syndrome of inappropriate antidiuretic hormone)- caused by an increase in synthesis or secretion, or both Med-Surg 2 End of Unit