HomeCh 35 Endocrine Key Points • The principal endocrine glands include the pituitary, thyroid, parathyroid, adrenal, pineal, thymus. • The endocrine system alters chemical reactions and controls the rate at which chemical activities take place within cells. • Any type of dysfunction of the pituitary gland will affect one or more of the hormones and their target organs. • The thyroid gland secretes the hormones thyroxine (T4), triiodothyronine (T3), and thyrocalcitonin. • Parathormone is a hormone produced and secreted by the parathyroid glands that acts on the renal tubules to increase the excretion of phosphorus in the urine and to stimulate the reabsorption of calcium; it also stimulates the production of the active form of vitamin D, which enhances calcium absorption in the small intestine and acts on bone, causing the release of calcium from the bone into the bloodstream. • The adrenal medulla (middle portion) secretes two hormones—epinephrine and norepinephrine (called catecholamines)—in response to stimulation from the sympathetic nervous system. • T he two major types of hormones secreted by the adrenal cortex are the mineralocorticoids (aldosterone) and the glucocorticoids (cortisol). • The beta cells are responsible for producing and secreting insulin, while the alpha cells release glucagon. • Age-related changes in the endocrine system include the pituitary gland becoming smaller, the thyroid becoming more lumpy or nodular, increases and decreases in different hormones, and increases in blood glucose levels. • The endocrine system regulates metabolism, growth and development, sexual function, reproductive processes. • The secretion of a particular hormone normally depends on the need. • Endocrine disorders are caused by an imbalance in the production of hormone or by an alteration in the body’s ability to use the hormones produced. • Goiter, an overgrowth of the thyroid, may be prevented by sufficient intake of iodine. • Tests of the endocrine system are performed on blood samples; on urine samples; or by scans, ultrasounds, radiographs, or magnetic resonance imaging (MRI). • According to the 2020 American Diabetes Association guidelines, diagnosis of diabetes mellitus is based on one of four abnormalities: (1) Symptoms of diabetes mellitus plus a random glucose level greater than or equal to 200 mg/dL; (2) a fasting glucose level greater than or equal to 126 mg/dL; (3) a hemoglobin A1c level greater than 6.5%; and (4) a glucose tolerance test revealing a postprandial glucose greater than or equal to 200 mg/dL, 2 hours after 75 g of glucose is administered. • A full physical assessment and history are needed to evaluate a patient who is possibly experiencing an endocrine disorder. • An example of a problem statement for someone with an endocrine disorder is as follows: Altered fluid volume caused by increased urine output (DI, Hyperthyroidism, AD). An example of an expected outcome would be as follows: Patient will display a balance between intake and output. • Planning care for a patient with an endocrine disorder will depend on the type of disorder the patient has. Stress has a direct effect on endocrine function. Therefore, measures to help the patient decrease stress should be planned. • Evaluation is accomplished by determining whether symptoms are resolving and by laboratory testing to determine whether treatment of the endocrine problem is effective