Assessment and Management of Patients With Endocrine Disorders

Prepared by Dr. Iman Abdalla

Out line Glands of the Endocrine System Classification and Action of Hormones The Thyroid Gland Regulation of Thyroid Hormone Function of Thyroid Hormone Assessment and Diagnostic Findings Hypothyroidism Hyperthyroidism Thyroid Storm (Thyrotoxic Crisis) Thyroiditis Thyroid Tumors

Out line Endemic (Iodine-Deficient) Goiter Management prevention Nodular Goiter Thyroid Cancer The Parathyroid Glands Pathophysiology Hyperparathyroidism Hypoparathyroidism

Learning ObjectivesOn completion of this lecture, the student will be able to:

Describe the functions of each of the endocrine glands and their hormones.

Compare hypothyroidism and hyperthyroidism: their causes, clinical manifestations, management, and nursing interventions.

Develop a plan of nursing care for the patient undergoing thyroidectomy.

compare hyperparathyroidism and hypoparathyroidism: their causes, clinical manifestations, management, and nursing interventions.

Glands of the Endocrine System

Classification and Action of Hormones Hormones are classified as:

Steroid hormones ( hydrocortisone )

Peptide or protein hormones ( insulin )

Amine hormones ( epinephrine )

Fatty acids derivatives ( retinoids )

The Thyroid Gland

The thyroid gland produces three hormones:

1- Thyroxin (T4), 2- Calcitonine.

3- Triiodthyronine(T3),

Regulation of Thyroid Hormone

Function of Thyroid HormoneCalcitonin

Assessment and Diagnostic Findings

Specific Disorders of the Thyroid GlandCauses of Hypothyroidism

Clinical Manifestation

Medical Management

Medication Interaction

Nursing Management

Hyperthyroidism

HyperthyroidismClinical Manifestation

Medical Management

Pharmacotherapy

Surgical Management

Nursing Process The Patient With Hyperthyroidism

Thyroid Storm (Thyrotoxic Crisis)

Causes :It is precipitated by stress, injury, infection, thyroidectomy, tooth extraction, insulin reaction, diabetic ketoacidosis, pregnancy, abrupt withdrawal of antithyroid medications

Clinical manifestations

Management

Thyroiditis Thyroiditis, inflammation of the thyroid gland, can be:

acute,

subacute,

or chronic.

Thyroid TumorsTumors of the thyroid gland are classified on the basis of being benign or malignant.

If the enlargement is sufficient to cause a visible swelling in the neck, the tumor is referred to as goiter.

All grades of goiter are encountered, from those, that are barely visible to those producing disfigurement.

Goiter either symmetrical and diffuse or nodular.

It might accompanied by hyperthyroidism (toxin); others are non toxic goiters

Endemic (Iodine-Deficient) Goiter

ManagementMany goiters of this type decreased after correction of iodine insufficiency.

When surgery is recommended, post operative complications can be minimized by pre operative iodide administration to reduce the size & vascularity of goiter.

PreventionProviding children in iodine-poor region with iodine compounds.

Use of iodized salt.

Nodular Goiter

Thyroid CancerCauses

Types

Assessment and Diagnostic Findings

Medical Management

Nursing Management

The Parathyroid Glands

Pathophysiology Excess parathormone can result in markedly increased levels of serum calcium, a potentially life- threatening situation.

When the product of serum calcium and serum phosphorus (calcium x phosphorus) rises, calcium phosphorus may precipitate in various organs of the body (kidneys) and cause tissue calcification.

HyperparathyroidismPrimary Hyperparathyroidism.Secondary Hyperparathyroidism.Clinical ManifestationAssessment and Diagnostic FindingsMedical ManagementNursing ManagementComplicationsHypercalcemic Crisis

HypoparathyroidismPathophysiology

Clinical Manifestation

Assessment and Diagnostic Findings

Medical Management

Nursing Management

ReferenceBrunner, L. and Suddarath, D. (2010). Text Book of Medical Surgical Nursing. 12th Edition. J.B. Lippincott Williams & Wilikins, Library of Congress

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