Assessment and Management of Patients With Endocrine Disorders

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Assessment and Management of
Patients With Endocrine Disorders

• Prepared by Dr. Iman Abdalla

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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

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Out line

• Endemic (Iodine-Deficient) Goiter
• Management
• prevention
• Nodular Goiter
• Thyroid Cancer
• The Parathyroid Glands
• Pathophysiology
• Hyperparathyroidism
• Hypoparathyroidism

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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.

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Glands of the Endocrine System
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Classification and Action of Hormones

• Hormones are classified as
• Steroid hormones ( hydrocortisone )
• Peptide or protein hormones ( insulin )
• Amine hormones ( epinephrine )
• Fatty acids derivatives ( retinoids )

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The Thyroid Gland

• The thyroid gland produces three
• hormones
• 1- Thyroxin (T4), 2- Calcitonine.
• 3- Triiodthyronine(T3),

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Regulation of Thyroid Hormone
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Function of Thyroid Hormone

• Calcitonin
• Assessment and Diagnostic Findings

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Specific Disorders of the Thyroid Gland

• Causes of Hypothyroidism
• Clinical Manifestation
• Medical Management
• Medication Interaction
• Nursing Management

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Hyperthyroidism
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Hyperthyroidism

• Clinical Manifestation
• Medical Management
• Pharmacotherapy
• Surgical Management
• Nursing Process The Patient With Hyperthyroidism

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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

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Thyroiditis

• Thyroiditis, inflammation of the thyroid gland,
  can be
• acute,
• subacute,
• or chronic.

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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

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Endemic (Iodine-Deficient) Goiter
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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.

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Nodular Goiter
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Thyroid Cancer

• Causes
• Types
• Assessment and Diagnostic Findings
• Medical Management
• Nursing Management

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The Parathyroid Glands
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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.

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Hyperparathyroidism

• Primary Hyperparathyroidism.
• Secondary Hyperparathyroidism.
• Clinical Manifestation
• Assessment and Diagnostic Findings
• Medical Management
• Nursing Management
• Complications
• Hypercalcemic Crisis

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Hypoparathyroidism

• Pathophysiology
• Clinical Manifestation
• Assessment and Diagnostic Findings
• Medical Management
• Nursing Management

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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