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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
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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 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.
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),
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 • 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
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.
Thyroid Cancer • Causes • Types • Assessment and Diagnostic Findings • Medical Management • Nursing Management
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 (calciumxphosphorus) 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.] .