The Endocrine System Unit 42

Adonis K. Lomibao, R.N.12/22/11

Objectives

Spell & Define terms Review the location & functions of the

endocrine system 5 Diagnostic tests associated with endocrine

conditions Describe common diseases S&S of hypo/hyperglycemia PCT actions Fingerstick for glucose

Structure & Function

Endocrine glands

-secret hormones that regulate body activities

-control body activities & growth

-distinct glands or clusters of cells

-subject to disease that cause hypo or hypersecretion of hormones

Pituitary Gland

Master gland b/c controls most of the other glands

2 lobes:

-anterior lobe secretes STH,TSH, FSH, ACTH,ICSH, LTH

-posterior secretes ADH & Pitocin

Pineal Body

Small gland located in the skull beneath the brain

Produces:

-glomerulotropin

-serotonin

-melatonin

Adrenal Glands

One located atop each kidney Adrenal medulla(inside)- produces

norepinepherin & epinephrine(stimulate body to produce energy quickly during an emergency

The adrenal cortex(outside)- produces glucocorticoids, mineral corticoids, & gonadocorticoids

Gonads

Male & female sex glands. Females have two ovaries located in the

pelvic cavity...produce estrogen & progesterone.

-Produces ovum Males have 2 testes contained in the

scrotum...produce testosterone.

-produces sperm

Thyroid & Parathyroid glands

Thyroid-2 lobes found in the neck

-secretes thyroxine(iodine important component) & thyrocalcitonin

Parathyroid glands- embedded in posterior thyroid glands.

-manufactures parathormone

-tetany: sever muscle spasms(can lead to death)

Islets of Langerhans

Cells found in pancreas Produce insulin & glucagon Insulin lowers blood sugar Glucagon raises blood sugar

Hyperthyroidism

Overactivity of the thyroid gland S&S:

-irritability & restlessness

-nervousness

-rapid pulse

-increased appetite

-weight loss

-sensitivity

Hyperthyroidism PCT Actions: patience, quiet & cool room, nutritional

needs Treatment: reduce level of thyroxine with

thyroidectomy or radiation Thyroidectomy post-op:

-semi-fowler's position with neck supported

-assist with oxygen

-routine post-op care

-report bleeding, resp. distr,inability to speak, elevated temp or pulse,numbness or tingle of extremities.

Hypothyroidism

Undersecretion of thyroxine Lack of iodine can result in low thyroxine

production Called simple goiter Thyroid gland enlarges Treatment: can be managed with thyroxine

replacement

Common Parathyroid Glands Parathormone regulates level of electrolytes,

calcium, & phosphates Hypersecretion results in:

-hypercalcemia

-renal calculi

-loss of bone calcium Usually caused by tumors---can be removed. Hyposecretion can lead to abnormal muscle-

nerve interaction, severe muscle spasm(tetany) calcium to treat emergency

Conditions of Adrenal Glands

Regulate development & maintenance f sexual characteristics, carb/fat/prot metabolism, fluid balance, sod & K levels

Hypersecretion results in Cushins's syndome:

-weakness

-hyperglycemia

-edema

-hypertension,loss of K and retaining of sodium Masculinity of female Surgical & supportive treatment

Cont.

Hyposecretion results in Addison's Disease characterized by:

-loss of sod & retension of K

-hypoglycemia

-dehydration

-low stress tolerance Treated by hormone replacement &

techniques to combat dehydration

Diabetes Mellitus

Chronic disease that results from a deficiency of insulin or a resistance to effects of insulin

Glucose from food breakdown remains in blood—elevated blood sugar

Affects blood vessels & nerves—person more likely to develop heart attack, stroke, blindness, renal disease, etc.

Risk factors: heredity,obesity, age, diet, lack of exercise

Disease Mechanism

Glucose in blood increases—pancreas secretes more insulin

Glycogen is storage form of energy Diabetes—insufficient insulin for these

functions

Types of Diabetes

Insulin-dependent diabetes mellitus(Type 1)-more common in young & must take daily insulin to live

S&S:

-polyuria

-polydipsia

-polyphagia

-glucosuria

Types Cont.

Non-insulin dependent diabetes mellitus-metabolic disorder that occurs when the body does not make enough insulin, or does not properly use insulin

Most common form 90-95% S&S:

-easy fatigue, skin infections, slow healing, itching,vision changes, obesity, p.736

PCT Care Diabetes

Eat a healthful, well-balanced diet-weight reduction is favored (ADA Diet)

Exercise regularly Check blood sugar regularly Use insulin or antidiabetic agents if ordered

-Insulin

Insulin

Several types of insulin vary in;

-speed of action

-duration

-potency or strength Given by nurse Injection or pump

Complications of Diabetes

Renal disease Circulatory imparements Poor healing Hypertension Cardiovascular problems Diabetic coma Vision problems & blindness

Hypoglycemia

Blood glucose level is below normal

-may occur rapidly

-insulin reaction/shock if insulin OD Can be brought on by: skipping meals,drug

interaction, etc. p.738 S&S: complaints of hunger, weakness,

dizziness, shakiness, skin cold/moist/clammy/pale...p.738

Hyperglycemia

Occurs when there is insufficient insulin for metabolic needs(diabetic coma)

-usually develops slowly May be brought on by: stress, illness,

dehydration, etc. p739 S&S: headache, drowsiness, confusion,fruity

breath, deep breathing, p.738

PCT Roles

Know S&S of insulin shock & insulin coma Know location of assimilated(absorbed)

sources of carbs Do not give extra food without permission Serve proper tray Special attention to feet

-wash daily

-inspect

-p. 739

Blood Glucose Monitoring

Glycated hemoglobin (A1C) -a series of stable minor hemoglobin components formed from hemoglobin & glucose

-measure glucose levels in blood over prolonged period of time.

Fingerstick blood sugar collects sample of capillary blood with a lancet(tiny needle).

Normal fasting range: 65-120 Normal value:70-110

Notify Nurse... If BS Value is outside of range Inadequate food intake Eating food not permitted Refusal of meals,supps, snacks N&V, Diarrhea Inadequate fluid intake Excessive activity Complaints of dizziness, shakiness, racing

heart