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ENDOCRINE NURSING

ENDOCRINE NURSING. PN 142. OBJECTIVES. Be able to define key terms relating to the system Be able to identify the anatomy of the system Be able to explain negative feedback and understand how hormones are triggered and their affect on organs or tissue

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ENDOCRINE NURSING

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  1. ENDOCRINE NURSING PN 142

  2. OBJECTIVES • Be able to define key terms relating to the system • Be able to identify the anatomy of the system • Be able to explain negative feedback and understand how hormones are triggered and their affect on organs or tissue • Begin to become familiar with some common diagnostic tests and their nursing implications

  3. KEY TERMS • Chvostek’s sign: abnormal spasm of the facial muscles in response to a light tapping of the facial nerve. • Cretinism: congenital lack of thyroid hormones causing defective physical development and mental retardation.

  4. Key Terms • Dawn phenomenon: abrupt increases in fasting levels of plasma glucose concentrations at 5-9 am morning glucose elevation in patients receiving insulin. • Endocrine: group of cells secreting substances directly into the blood or lymph circulation and affecting another part of the body. • Exophthalmos: marked protrusion resulting from increased orbital fluid behind the eyeballs. • Glucagon: hormone secreted by the alpha cells of the pancreas which stimulate the release of glucose from the liver.

  5. KEY TERMS • Glycosuria: excess glucose in the urine. • Goiter: enlargement of the thyroid gland. • Gynecomastia: abnormal enlargement of one or both breasts in males. • Hirsutism: excessive body hair in a masculine distribution. • Hormone: substance that initiates or regulates activity of another organ, system or gland in another part of the body.

  6. KEY TERMS • Hyperglycemia: condition where the blood glucose level becomes too high as a result of the absence of insulin. • Hypoglycemia: condition where the blood glucose level is exceedingly low. • Hypovolemia: abnormally low circulatory blood volume. • Iatrogenic: caused by treatment or diagnostic procedures.

  7. KEY TERMS • Insulin: pancreatic hormone that aids in the diffusion of glucose into the liver and muscle cells • Ketonuria: presence of ketones in the urine. • Myxedema: severe hypothyroidism in adults. • Paroxysmal: descriptor for a symptom that begins and ends abruptly

  8. KEY TERMS • Polydipsia: excessive thirst. • Polyphasia: increased hunger. • Polyuria: increased urination. • Somogyi“ phenomenon” or “ effect “: in response to hypoglycemia, the release of glucose elevating hormones (epinephrine, cortisol, glucose) produces a hyperglycemic state.

  9. KEY TERMS • Tetany: sharp flexion of the wrist and ankle joints, involving muscle twitching or cramps. • Trousseau’s sign: carpal spasm caused by inflating a blood pressure cuff above the client’s systolic pressure and leaving it in place for three minutes.

  10. ANATOMY AND PHYSIOLOGY • Endocrine system: group of glands that produces regulatory chemicals called hormones. • Endocrine system and Nervous system work together to control and coordinate all other systems of the body. • Nervous system controls rapid actions like muscle movement and intestinal activity by means of chemical and electrical stimuli.

  11. Anatomy & Physiology • Endocrine Glands • Ductless • Release secretions directly into bloodstream • Secretions have a regulatory function • HORMONES – chemical messengers that travel though the bloodstream  target organ  metabolic change occurs

  12. Anatomy & Physiology • HORMONES • Function of: (What do they do?) • Maintenance and regulation of vital functions • Response to stress and injury • Growth and development • Energy metabolism • Reproduction • Fluid and electrolyte balance; acid-base balance

  13. Anatomy & Physiology • Negative Feedback system: • Information is constantly being exchanged between the target organ and pituitary gland via the bloodstream regarding the effect of the hormone on the target organ • Controls the amount of hormone released  decrease in function of the target organ in response to stimuli

  14. Anatomy & Physiology • Negative Feedback System cont. • The glands within the endocrine system that stimulate the release of a hormone (eg. pituitary gland) from another gland (eg. thyroid gland) are eventually “shut off”, in a sense, so that too much hormone is not produced and a hormone imbalance is avoided.

  15. An Example • Negative Feedback System cont. • The hypothalamus secretes TRH (thyrotropin-releasing hormone)  causes the pituitary to release TSH  causes the thyroid gland to secrete T4 (thyroid hormone). • When the body has enough thyroid hormone in the blood, T4 “feeds back” to the hypothalamus and pituitary, and causes decrease in secretion of TRH and TSH. • This pattern is true of ovaries, testes, and adrenal glands

  16. Anatomy & Physiology • PITUITARY GLAND (HYPOPHYSIS) • “Master Gland” • Through negative feedback system, it controls the other endocrine glands • Works closely with hypothalamus • Located in sphenoid bone • Divided into 2 segments: • Anterior • Posterior

  17. Anatomy & Physiology • PITUITARY GLAND (cont.) • The hypothalamus produces the hormones of the posterior pituitary gland and stores them in the posterior lobe of the pituitary gland • ANTERIOR PITUITARY LOBE: • 6 major hormones secreted • 5 “tropic” hormones – responsible for the stimulation of other endocrine glands • The 6th – Prolactin – acts on the mammary glands to produce milk

  18. Anatomy & Physiology • PITUITARY GLAND (cont.) • POSTERIOR PITUITARY LOBE • 2 hormones: Oxytocin and Antidiurectic Hormone • Oxytocin – promotes release of milk and stimulates uterine contractions during labor • AntiDiurectic Hormone (ADH) – “vasopressin” – causes kidneys to conserve water  decreased urine production • Also, can increase BP d/t increased arterial constriction

  19. Anatomy & Physiology • ADRENAL GLANDS • Adrenal Cortex • 3 layers; each secretes a particular hormone called a “steroid” • Mineralocorticoids: • Affects water and electrolyte balance • Indirectly manages BP – eg. Aldosterone regulates Na+, K+

  20. Anatomy & Physiology • ADRENAL GLANDS (cont.) • Adrenal Cortex, 3 layers (cont.) • Glucocorticoids – Cortisol • Glucose metabolism • Reserve energy in times of stress • Antiinflammatory • Sex Hormones • Male: Androgen • Female: Estrogen

  21. Anatomy & Physiology • ADRENAL GLANDS (cont.) • Adrenal Medulla • During times of stress  releases epinephrine (adrenaline) and norepinephrine  ↑HR, ↑BP, ↑ vasocontriction; liver releases reserve glucose • System prepares for flight/fight

  22. Anatomy and Physiology • Thyroid gland: • located in anterior part of the neck; “butterfly” shape • Adequate oral intake of iodine is needed for the formation of thyroid hormones • Thyroid hormones: 3 main functions: • Growth and development • Metabolism • Activation of the Nervous System

  23. Anatomy and Physiology • Thyroid Gland (cont.) • Thyroid Hormones (cont.) • Their function is controlled by the release of Thyroid Stimulating Hormone (TSH) from the pituitary gland • Hormones: • Thyroxine • Triiodothryronine • (thyro)calcitonin

  24. Anatomy and Physiology • Thyroid Gland (cont.) • Thyroid Hormones (cont.) • Calcitonin : reduces blood Ca++ by storing Ca++ in bones

  25. Anatomy and Physiology • PARATHYROID GLANDS: • Located on the posterior surface of the thyroid gland • Controls the rate of body metabolism and growth • Controls Ca++ and phosphate metabolism • Indirectly influences fat and protein metabolism • Produces parathyroid hormone ( PTH )

  26. Anatomy and Physiology • Parathyroid Hormone (PTH) • Antagonist to calcium from the thyroid hormone • Increases the concentration of calcium in the blood • Regulates the amount of phosphorus in the blood

  27. Anatomy and Physiology • PARATHYROID GLANDS (cont.) • Parathyroid Hormone (cont.) • Note: when serum Ca++ is too low, nerve cells become excited  muscles receive too many impulses  spasms (tetany). • Note: when serum Ca++ is too high  impaired heart function  death

  28. Anatomy and Physiology • PANCREAS: • Located posterior to the stomach • Influences carbohydrate metabolism • Produces insulin and glucagon Composed of: endocrine and exocrine tissue Endocrine: > 1 mil. tiny clusters of cells (Islets of Langerhans) • Secrete 2 major hormones: Insulin and glucagon

  29. Anatomy and Physiology • PANCREAS (cont.) • Insulin: secreted in response to ↑ levels of serum glucose • Glucagon: secreted in response to ↓ levels of serum glucose

  30. Anatomy and Physiology • OVARIES • Located in the pelvic cavity • At puberty, produce estrogen and progesterone • Estrogen: responsible for development of secondary sex characteristics and maturation of reproductive organs • Progesterone: continues the preparation of the reproductive organs

  31. Anatomy & Physiology • OVARIES (cont.) • Placenta: a “temporary” endocrine gland that forms and functions during pregnancy TESTES • located in the scrotum • Produces testosterone • Testosterone is responsible for the development of secondary sexual characteristics, maturation of reproductive organs, deepening of voice, development of bone and muscle mass; and sperm formation

  32. Anatomy & Physiology • THYMUS GLAND • Located in the upper thorax, posterior to the sternum • Produces Thymosin which plays an active role in immune system • Programs information into T-lymphocytes in utero and infancy  carrying out immune reactions to certain antigens

  33. Anatomy & Physiology • PINEAL GLAND/PINEAL BODY • Small, cone-shaped • Located on the roof of the 3rd ventricle in the brain • Secrete Melatonin: • Inhibits gonadotrophic hormones  inhibit reproductive activity • Also, induces sleep, affects mood, and has an impact on mentrual cycle

  34. Making the Connections

  35. Anatomy & Physiology • Endocrine system changes occur more slowly and over a longer period; involve chemical stimuli, and these chemical messengers have widespread effects over the body. • Activity of pituitary controlled by the brain’s hypothalamus. • This connection helps the endocrine function to adjust to the body’s changing environment • Homeostasis: a relative constancy in the internal environment of the body, naturally maintained by adaptive responses that promote healthy survival.

  36. HORMONES AND STRESS • The body’s response to stress involves nervous and endocrine systems, and hormones • Fight or flight response mediated by brain: hypothalamus, sympathetic nervous system • Hormones help body meet stressful situations; can be harmful if unchecked • Unmanaged stress can be harmful; many diseases can be caused by immunosuppresseddisorder; stress management techniques help maintain overall health. Stress relieving methods include • Meditation, prayer, self-talk, exercise, yoga, pilates, therapy, play, vacation.

  37. Aging

  38. AGING AND THE ENDOCRINE SYSTEM • Aging-associated changes linked with endocrine changes include: • loss of muscle and bone tissue; decreased bone mass-osteoporosis • continue with exercise in any form • Main clinical conditions associated with endocrine system involve pancreas, thyroid • Adult-onset diabetes • Decline in sex hormones in males and females • Hypothyroidism increases with age, esp. women at peri-menopause or menopause

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