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Endocrine System

Endocrine System. Lecture 11 Medical Surgical Nursing P10B Chapter 34-35. Endocrine System. Primary function Regulate internal environment Homeostasis. Endocrine System. Structure Glands Hormones. Major Endocrine Glands. Hypothalamus Pituitary gland Thyroid gland

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Endocrine System

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  1. Endocrine System Lecture 11 Medical Surgical Nursing P10B Chapter 34-35

  2. Endocrine System • Primary function • Regulate internal environment • Homeostasis

  3. Endocrine System • Structure • Glands • Hormones

  4. Major Endocrine Glands • Hypothalamus • Pituitary gland • Thyroid gland • Parathyroid glands • Thymus • Adrenal glands • Pancreas • Gonads • Ovaries • Testis

  5. Hormones • Chemical messengers of the body • Act on specific target cells  • Increase or decrease in body function

  6. Hormone Regulation • “Negative Feedback” • When target cells release too much hormone  send back a message to reduce the hormone release. • When too little hormone is released  the target cell sends back a message to increase the normal level

  7. Negative feedback • i temperature  • Unit (gland)  • Heating unit turns on and generates heat (hormone)  • h temperature  • (Heating unit turns off)

  8. Hypothalamus • Location • Brain • Attached to the pituitary gland • Function • Controls the anterior pituitary • Temperature • Fluid volume • growth

  9. Pituitary Gland • AKA: hypophysis • AKA: “Master gland” • Location • In the skull • Below the hypothalamus

  10. Parts of the Pituitary Gland • Anterior lobe • 6 hormones • GH • PRL • FSH • LH • TSH • ACTH • Posterior lobe • 2 hormones • Oxytocin • ADH

  11. Anterior Pituitary Gland • Growth hormone (GH)  • Bones & muscles • Function • Stimulate growth • h blood glucose levels

  12. Anterior Pituitary Gland • Prolactin (PRL)  • Mammary glands • Function • Stimulate breast development during pg • Milk secretion p\ delivery

  13. Anterior Pituitary Gland • Follicle-Stimhorm. (FSH) • Luteinizing Horm. (LH)  • Testes or ovaries • FSH  • Sperm production • Estrogen secretion • LH  • Ovulation • Testosterone secretion

  14. Anterior Pituitary Gland • Thyroid Stimulating Hormone (TSH)  • Thyroid • Function • Stim. thyroid growth • Stim. secretion of thyroid hormones

  15. Anterior Pituitary Gland • Adrenocorticotropic hormone (ACTH)  • Adrenal Cortex • Function • Stim. adrenal cortex growth • Stim. secretion of glucocorticoids

  16. Posterior Pituitary Hormones • Anti-diuretic Hormone (ADH) • Oxytocin

  17. Posterior Pituitary Gland • Antidiuretic Hormone (ADH)  • Kidney • Function • Stim. H2O retention  • i urine output  • h H2O in serum/body

  18. Posterior Pituitary Gland • Oxytocin • Uterus • Mammary glands • Function: • Uterine contractions during labor • “let-down” hormone • Milk secretion

  19. Thyroid Gland • Shape • Butterfly • Two lobes • Isthmus • Location • Straddles the trachea

  20. Thyroid Hormones • Hormones (3) • Thyroid Hormone • Thyroxine (T4)  • Triiodothyronine (T3) • Necessary ingredient • Iodine • Calcitonin  • i Ca+ levels in the blood. • h Metabolism

  21. Parathyroid Glands • Location • Embedded on the posterior lobes of the thyroid gland • Number • @4-6 • Hormone • Parathyroid Hormone (PTH) • Necessary ingredient • Vitamin D

  22. Parathyroid Hormone • i Serum Ca+ levels  • PTH released  • Bone (target cell)  • Releases Ca+ into plasma  • h Serum Ca+ levels

  23. Adrenal Gland • Location • On top of each kidney • Two parts • Adrenal Cortex • Adrenal Medulla

  24. Adrenal Cortex • Corticosteroids • Glucocorticoids • cortisol • Mineralocorticoids • Aldosterone • Androgens

  25. Glucocorticoids • Cortisol • Primary Action • ___ blood glucose levels • h • Secondary action • Anti-inflammatory • Primary purpose • Handle stress

  26. Mineralocorticoids • Aldosterone • Function: • Salt & water balance • Target cells • Kidney

  27. Mineralocorticoids • i blood volume / blood pressure  • Adrenal Cortex  • Aldosterone  • Kidney  • Retains Na+ and H2O  • h blood volume / blood pressure

  28. Adrenal Medulla • Epinephrine • Adrenaline • Norepinephrine • Action • h heart rate • h Force of heart contraction • Constrict blood vessels • Purpose: • Physical Stress Response • Fight or Flight!

  29. Stress  • Fight or Flight response  • Adrenal Medulla  • Epi/norepinephrine  • Heart  h heart rate/contraction • Blood Vessels  constriction • Handle Stress

  30. Small Group Questions • What is negative feedback? • What is the “Master Gland”? Why is it called that? • What are the target cells of GH? • What hormone targets the mammary glands? • What hormones target the gonads? • What are the targets cells of ACTH? • What is the action of the thyroid hormones? • What is the action of PTH • What is the purpose and action of Glucocorticoids? • What is the action of Epinephrine? What response does it elicit?

  31. Endocrine System Assessment • Hormone affect all body systems • Health Hx • Energy • Wt • Cold/ heat • Nervousness • Hydration

  32. Endocrine System Physical Assessment • General appearance • Skin • Color • Temp • Moisture • Hair& Nails • Exophthalmos • Visual acuity • Palpate thyroid

  33. Diabetes Insipidus • Hormone imbalance • ADH insufficiency

  34. What endocrine glad secretes ADH? • Thyroid • Anterior Pituitary • Posterior Pituitary • Adrenal Cortex • Adrenal Medulla

  35. What is the function / action of ADH? • Stimulates H2O retention leading to i urine output • Increased blood glucose levels • Decreases blood calcium levels • Increases blood calcium levels • Increases metabolism, increased heart rate and blood pressure

  36. What effect would insufficient ADH have? • Edema • Decreased urinary output • Increased urinary output • Decreased blood calcium levels • Increased blood calcium levels

  37. S&S of DI • Polyuria (5-15 L/day) • Thirst • Urine specific gravity • i • Urine color • Pale • Dehydration • Pulse • Tachy • Poor skin turgor • Dry mucous membranes

  38. On your own QUIZ • What would be the priority nursing diagnosis for a client with a medical diagnosis of diabetes Insipidus? • Fluid Volume Deficit

  39. Nursing Interventions • Monitor • I&O • Specific gravity of urine • Vital signs • Skin turgor • Neuro function • Daily weights • Provide adequate fluids • Administer meds per order • Monitor for S/E

  40. Syndrome of Inappropriate ADH secretion • AKA: SIADH • Hormone Imbalance: • Excess production of ADH

  41. What endocrine gland secretes ADH? • Adrenal Medulla • Thyroid • Anterior Pituitary • Adrenal Cortex • Posterior Pituitary

  42. What is the function / action of ADH? • Decreases blood calcium levels • Increases blood calcium levels • Increased urine output • Decrease urine output • Increased blood glucose levels

  43. What effect would excess ADH secretion have? • Decreased urinary output • Increased urinary output • Decreased blood calcium levels • Increased blood calcium levels • Dehydration

  44. S&S of SIADH • Decreased urine output • Concentrated urine • Specific Gravity • h • Hyponatremia • i sodium levels • No edema • H/A • Weight gain • Anorexia

  45. On your own QUIZ • What would be the priority nursing diagnosis for a client with a medical diagnosis of SIADH? • Fluid Volume Excess

  46. Nursing Interventions • Monitor • I&O • V/S • LOC • Serum Na+ levels • Daily weights • Auscultate lungs • Fluid • Restriction • Provide mouth care • Administer meds per MD order • Diuretics • Lasix • Monitor for S/E • Hypokalemia • Seizure precaution

  47. What is a normal Serum Na+ level? • 3.5 – 5.3 mEq/L • 135-140 mEq/L • 12-18 g/dL • 4,500 – 10,000 /mm3 • 36 – 54%

  48. Which of the following is a S&S of hyponatremia? • Thirst • Postural hypotension • Positive Chvostek’s sign • Convulsions • Dysrhythmias

  49. What is a normal Serum K+ level? • 3.5 – 5.3 mEq/L • 135-140 mEq/L • 12-18 g/dL • 4,500 – 10,000 /mm3 • 36 – 54%

  50. Which of the following is a S&S of hypokalemia? • Thirst • Postural hypotension • Positive Chvostek’s sign • Convulsions • Dysrhythmias

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