Transcript Assessment and Management of Patients With Endocrine Disorders

Assessment
Patients
and
Management of
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 Objectives
On 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 Hormone
Calcitonin
Assessment and Diagnostic Findings
Specific Disorders of the Thyroid Gland
Causes of Hypothyroidism
Clinical Manifestation
Medical Management
Medication Interaction
Nursing Management
Hyperthyroidism
Hyperthyroidism
Clinical 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 Tumors
Tumors 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
Management
Many 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.
Prevention
Providing children in iodine-poor region with iodine
compounds.
Use of iodized salt.
Nodular Goiter
Thyroid Cancer
Causes
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.
Hyperparathyroidism
Primary Hyperparathyroidism.
Secondary Hyperparathyroidism.
Clinical Manifestation
Assessment and Diagnostic Findings
Medical Management
Nursing Management
Complications
Hypercalcemic Crisis
Hypoparathyroidism
Pathophysiology
Clinical Manifestation
Assessment and Diagnostic Findings
Medical Management
Nursing Management
Reference
Brunner, L. and Suddarath, D. (2010). Text Book of
Medical Surgical Nursing. 12th Edition. J.B.
Lippincott Williams & Wilikins, Library of Congress
Catalging-in-Publication Data.]
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Thank you