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2. Pituitary Disorders. Pituitary gland is responsible for the hormonal regulation of several body processes, including water retention, breast milk synthesis and release, human growth, and thyroid gland secretions. A. Anterior pituitary various cells release the following hormones: 1. Gona
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1. 1 Chapter 8 Nursing Care of Patient With Endocrine Disorders
2. 2 Pituitary Disorders Pituitary gland is responsible for the hormonal regulation of several body processes, including water retention, breast milk synthesis and release, human growth, and thyroid gland secretions.
A. Anterior pituitary various cells release the following
hormones:
1. Gonadotrophs release luteinizing hormone (LH) and
follicle-stimulating hormone (FSH).
2. Lactotrophs release prolactin (PRL).
3. Corticotrophs release adrenocorticotropic hormone (ACTH).
4. Somatotrophs release growth hormone (GH).
5. Thyrotrophs release thyroid-stimulating hormone (TSH).
3. 3 Pituitary Disorders (cont’d) Posterior pituitary releases oxytocin and antidiuretic hormone (ADH, or vasopressin).
Common Disorders:
A. Hypopituitarism (pituitary dwarfism)
Clinical Manifestations:
1. Weight loss.
2. Atrophy of all endocrine glands and organs.
3. Hair loss.
4. Impotence.
5. Amenorrhea.
6. Hypoglycemia.
Treatment:
- Replacement of missing hormone (as GH)
4. 4 Pituitary Disorders (cont’d) B. Hyperpituitarism (acromegaly)
Clinical Manifestations (excessive GH secretion)
1. Coarse features( e.g., broad skull, protruding
jaw/hands/feet)
2. Thickened heel pads.
3. Thick tongue.
4. Change in ring and shoe size.
Clinical Manifestations (excessive PRL secretion)
1. Decreased libido.
2. Amenorrhea.
3. Impotence.
5. 5 Pituitary Disorders (cont’d) c. Diabetes insipidus.
caused by under secretion of ADH.
Clinical Manifestations:
1. Profound increased urine output.
2. Nocturia.
3. Extreme thirst.
4. Weight loss.
5. Tachycardia, hypotension.
Treatment:
- Administer ADH (vasopressin)
6. 6 Thyroid Glands Disorders Thyroid gland secretes hormones that are involved in human development, growth, and metabolism (T4 and T3)
It also secretes calcitonin when there is a high concentration of calcium in the blood stream. The function of calcitonin is to inhibit the amount of reabsorption of calcium from the bone and to regulate the amount of calcium in the blood stream.
Common Disorders
A. Iodine deficiency or excess
Dietary intake of iodine is necessary for the normal synthesis of T3 and T4. A deficiency or excess consumption of iodine can result in a deficiency in these hormones (hypothyroidism) or an excess of these hormones (hyperthyroidism). Disorders which lead to a deficiency of iodide in the thyroid can also cause hypothyroidism.
7. 7 Thyroid Glands Disorders (cont’d) B. Hypothyroidism
Results in deficient production of T4/T3 by the thyroid.
Clinical Manifestations:
1. Goiter.
2. Fatigue.
3. Constipation.
4. Weight gain.
5. Memory and mental impairment and decreased
concentration.
6. Depression.
7. Menstrual irregularities and loss of libido.
8. Coarseness or loss of hair.
9. Dry skin and cold intolerance.
8. 8 Thyroid Glands Disorders (cont’d) 10. Irregular or heavy menses.
11. Infertility.
12. Hoarseness.
13. Myalgias.
14. Hyperlipidemia.
15. Reflex delay.
16. Bradycardia, elevated diastolic BP.
17. Hypothermia.
18. Ataxia.
19. Decreased serum T4,T3 levels.
Treatment:
- Hormones replacement therapy.
9. 9 Thyroid Glands Disorders (cont’d) C. Hyperthyroidism
Results from an excess amount of T4 and T3 in the blood.
Clinical Manifestations:
1. Heat intolerance.
2. Palpitations, elevated systolic BP.
3. Weight changes.
4. Menstrual irregularities and decreased libido.
5. Increased serum T4, T3.
6. Exophthalmos (bulging eyes)
7. Goiter.
8. Insomnia.
9. Muscle weakness.
10. Heat intolerance.
11. Diarrhea.
10. 10 Thyroid Glands Disorders (cont’d) Treatment:
1. Administer medications such as thionamides, which inhibit synthesis of T4 and T3, and beta blockers which block the action of thyroid hormones on peripheral cells.
2. Radioiodine destruction of the thyroid .
3. Surgical removal of the thyroid (thyroidectomy)
11. 11 Thyroid Glands Disorders (cont’d) D. GRAVES' DISEASE.
- It is the most common cause of hyperthyroidism, an over production of thyroid hormone, which causes enlargement of the thyroid and other symptoms such as Exophthalmos, heat intolerance and anxiety.
12. 12 Diabetes Mellitus DM is a chronic disease that results from a deficiency of insulin or a resistance to the effects of insulin.
Predisposing Factors:
1. Heredity.
2. Obesity.
3. Age.
4. Diet.
5. Lack of exercise.
Types of DM:
1. IDDM (type 1)
2. NIDDM (type 2)
13. 13 Diabetes Mellitus (cont’d) - IDDM:
Clinical Manifestations:
1. Polyuria.
2. Polydipsia.
3. Polyphagia.
4. Glucosuria.
- NIDDM:
Clinical Manifestations:
1. Easy fatigue.
2. Skin infections, slow healing, Itching.
3. Vision changes.
4. burning on urination.
14. 14 Diabetes Mellitus (cont’d) Nursing Care of DM:
1. Encourage eat healthful well balanced diet.
2. Encourage exercise.
3. Check the blood sugar regularly.
4. Use insulin or oral antidiabetic agents correctly if ordered
by the physician.
Complications:
1. Vision problems.
2. Cardiovascular diseases.
3. Renal diseases.
4. Poor healing.
5. Diabetic coma.
15. 15 Hyperglycaemia (diabetic coma) Clinical Manifestations:
1. Early headache, drowsiness, or confusion.
2. Sweat, fruity odor to the breath.
3. Deep breathing, labored respirations.
4. Full, bounding pulse, low BP.
5. Nausea, vomiting.
6. Flushed, dry hot skin.
7. Weakness.
8. Glucosuria, hyperglycaemia.
9. Unconsciousness.
16. 16 Hyperglycaemia (cont’d) Treatment:
- Administer insulin, as well as fluids and electrolytes.
Occurs slowly.
17. 17 Hypoglycemia Clinical Manifestations:
1. Complaints of hunger, weakness, dizziness.
2. Skin cold, moist clammy pale.
3. Rapid shallow respirations.
4. Nervousness.
5. Rapid pulse.
6. Unconsciousness.
7. No sugar in urine.
8. Low serum glucose level.
Occurs rapidly
