Chapter 17 Endocrine Disorder Chart PDF

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Pathophysiology Endocrine Notes...

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NURS 3120 Endocrine Disorders

HEALTH ALTERATION Diabetes insipidus (DI)

RISK FACTORS         

Polycystic Kidney Disease Genetics Pituitary Disorders Hypothalamic Injury Hypercalcemia Head Tremors Males Pregnancy Family History of Nephrogenic DI

PATHOPHYSIOLOGY 

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Disorder of the posterior lobe of the pituitary gland Deficiency of ADH When ADH is absent, urine output increases and the body loses water

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Syndrome of inappropriate antidiuretic hormone (SIADH)

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Cancer – Many tumours. Most common is small cell cancer of the lung. Brain – Meningitis, cerebral abscess, head injury, tumour. Lung – Pneumonia, tuberculosis, lung abscess. Metabolic – Porphyria, alcohol

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Excessive ADH secretion from the pituitary or ectopic site that also secretes ADH which inhibits patients from excreting a dilute urine Patients retain fluids and develop a sodium deficiency

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NURSING CONSIDERATIONS (What to look for, do)  Fluid Volume Gradual or  Vital Signs Sudden onset  Skin Turgor If Hereditary then  Daily Weights Symptoms Begin  Urine Specific Gravity at Birth  Strict I & O Large Amount of  Encourage patient and family Daily Output of undergoing tests for cranial Very Dilute Urine lesions Specific Gravity  Education about follow up care 1.001-1.005  Advise patient to wear medic Extreme Thirstalert bracelet and to always Drink 4-40 L a Day carry medication info. Craving of Cold Water Poor Skin Turgor, Weight Loss, Anorexia Nausea or  Mild asymptomatic cases need vomiting. no treatment other than that Cramps or of the underlying cause. tremors.  Symptomatic cases – options: Depressed  Water restriction (500-1000ml mood,memory in 24 hours) impairment.  Dimethylchlorotetracycline – Irritability. inhibits the action of Personality vasopressin on the kidney and changes, such as may be useful if water combativeness, restriction is poorly tolerated confusion, and or ineffective. hallucinations.  For severe cases: Hypertonic

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Hyperthyroidism (Thyrotoxicosis)

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withdrawal. Drugs – Opiates, chlorpropramide, carbamezapine, vincristine Females Over the Age of 60 Recent Pregnancy Having an Autoimmune Disease Family History of Thyroid Disease Person History of Thyroid Issues

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Hyperthyroidism may result from increased synthesis and secretion of thyroid hormones (thyroxine [T4] and triiodothyronine [T3]) from the thyroid, caused by thyroid stimulators in the blood or by autonomous thyroid hyperfunction. It can also result from excessive release of thyroid hormone from the thyroid without increased synthesis

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Seizures. Stupor or coma.

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Can lead to Graves Disease & Thyroid Tremors

saline IV slowly – with frusemide to prevent circulatory overload.

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Administer antithyroid medications (propylthiouracil [PTU]) that block thyroid synthesis, as prescribed. Administer iodine preparations that inhibit the release of thyroid hormone as prescribed. Prepare the client for radioactive iodine therapy, as prescribed, to destroy thyroid cells

Hypothyroidism

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Hyperparathyroidism

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Females Over the Age of 50 Family History of Thyroid Disease Type I Diabetes or Rheumatoid Arthritis Someone Taking Anti-Thyroid Medication Someone with Previous Thyroid Surgery Someone Exposed to Radiation to Neck

Women who have Been Through Menopause Prolonged Severe Calcium or Vitamin D Deficiency Rare Inherited Disorder (Multiple Endocrine Neoplasia, Type I Have had Radiation Treatment for Cancer Exposing Neck Have taken LithiumA Drug Used to Treat Bipolar Disorder

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Poorly functioning thyroid gland Low secretion of TSH by pituitary Most common type in US caused by autoimmune thyroiditis

In primary hyperparathyroidism, an enlargement of one or more of the parathyroid glands causes overproduction of the hormone, resulting in high levels of calcium in the blood (hypercalcemia), which can cause a variety of health problems. Surgery is the most common treatment for primary hyperparathyroidism

Can Lead to Hashimotos Thyroiditis and Thyroidectomy  MyexedemaGeneral Weakness, Muscle Cramps, Dry Skin  Slurred Speech, Bradycardia, Weight Gain, Decreased Sense of Taste and Smell  Intolerance to Cold Environments • Fragile bones that easily fracture (osteoporosis) • Kidney stones. • Excessive urination. • Abdominal pain. • Tiring easily or weakness. • Depression or forgetfulness. • Bone and joint pain. Frequent complaints of illness with no apparent cause 

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Various ways of nursing intervention for hypothyroidism disease are described in the following: Monitor vital signs carefully( blood pressure, pulse, and body temperature). Administer of correct prescribed antithyroid medication timely. ... Monitor T3, T4, and TSH levels

Obtain baseline serum potassium, calcium, phosphate, and magnesium levels before treatment. Provide atleast 3 liters of fluid per day, including cranberry or prune juice, to increase urine acidity and help prevent calculus formation. Take safety precaution to minimize the risk for injury from fal

Hypoparathyroidism

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Recent Neck Surgery (Thyroid) Family History Certain Autoimmune or Endocrine Conditions (Addison’s Disease)

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Hypoparathyroidism is an uncommon condition in which your body secretes abnormally low levels of parathyroid hormone (PTH). PTH plays a key role in regulating and maintaining a balance of your body's levels of two minerals — calcium and phosphorus. The low production of PTH in hypoparathyroidism leads to abnormally low ionized calcium levels in your blood and bones and to an increase of serum phosphorus.

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Tingling or Burning in Fingertips, Toes, and Lips Muscle Aches or Cramps Affecting Legs, Feet, Abdomen, or Face Twitching Spasms of Muscles Fatigue or Weakness Painful Menstruation Patchy Hair Loss Dry Coarse Skin, Brittle Nails, Headaches Depression & Memory Problems

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As the nurse taking care of the patient with hypoparathyroidism it is important you understand the: signs and symptoms, pathophysiology, causes, nursing interventions, medical treatments...