Ch 35 Endocrine SPP

Chapter 35: The Endocrine System

Lesson 35.1 Objectives

• Theory Objectives:

  • Identify the location of each endocrine gland.

  • Diagram the principal actions and target tissues for hormones of the hypothalamus and pituitary, parathyroid, adrenal, and pancreas glands.

  • Summarize the effects of thyroid hormones.

  • Compare care for common diagnostic tests for the endocrine system.

• Clinical Practice Objectives:

  • Assess for specific age-related changes in the endocrine system in older adults.

  • Educate patients about diagnostic tests for endocrine disorder symptoms.

  • Perform a focused assessment on potentially endocrine-disordered patients.

  • Distinguish appropriate nursing diagnoses and interventions for common endocrine disorder issues.

Organs and Structures of the Endocrine System

• Endocrine Glands:

  • Pituitary gland (anterior and posterior)

  • Thyroid gland

  • Parathyroid glands

  • Adrenal glands

  • Pancreas (beta cells)

  • Ovaries and testes

  • Pineal gland

  • Thymus gland

  • Heart

Functions of the Endocrine System

• Major Functions:

  • Alter chemical reactions and control rates of activities within cells.

  • Change cell membrane permeability and select substances transported across membranes.

  • Activate cellular mechanisms like growth and reproduction control.

Pituitary Gland

• Effects of Pituitary Hormones:

  • Posterior pituitary: stores and releases oxytocin and ADH (produced in hypothalamus).

  • Anterior pituitary: secretes hormones into bloodstream based on releasing hormones from hypothalamus.

Thyroid Gland

• Effects of Thyroid Hormones:

  • Secretes thyroxine (T4), triiodothyronine (T3), and thyrocalcitonin.

  • Thyroid hormones stimulate:

    • Cellular heat production

    • Protein and lipid synthesis, mobilization, and degradation

    • Manufacture of coenzymes from vitamins

  • Regulate carbohydrate metabolism and tissue response to epinephrine and norepinephrine.

Parathyroid Glands

• Functions:

  • Produce and secrete parathormone (parathyroid hormone).

  • Calcitonin (from thyroid) balances parathormone.

  • Key role in regulating plasma calcium levels.

Adrenal Glands

• Functions:

  • Adrenal medulla secretes epinephrine and norepinephrine (catecholamines) as a response from the sympathetic nervous system.

  • Adrenal cortex secretes adrenal corticosteroids including mineralocorticoids and glucocorticoids.

Aging Effects on the Endocrine System

• Indicators include:

  • Smaller pituitary gland

  • Nodular/lumpy thyroid

  • Hormone levels may increase or decrease

  • Blood glucose levels rise

  • Decreased thyroid hormone levels

Pancreas Hormonal Functions

• Endocrine Functions:

  • Produces hormones: insulin (from beta cells) and glucagon (from alpha cells).

  • Insulin allows body cells to use glucose as fuel.

  • Glucagon stimulates glycogen conversion to glucose in the liver.

Endocrine System Disorders

• Types of Dysfunction:

  • Primary dysfunction (hypersecretion/hyposecretion, tumors, inflammation, infection, autoimmune response).

  • Secondary dysfunction (medications, trauma, hormone therapy, temporary or permanent).

Preventing Goiter

• Prevention Strategy:

  • Sufficient iodine intake helps prevent goiter (thyroid overgrowth).

• Diagnosis:

  • Thyroid panel; parathyroid function via serum calcium and phosphate; adrenal gland function through electrolyte panels, glucose levels, hormone levels, ECG.

Diagnosis of Diabetes Mellitus

• Criteria:

  • Symptoms and either:

    • Random blood glucose ≥ 200 mg/dL

    • Fasting glucose ≥ 126 mg/dL

    • Glucose tolerance test ≥ 200 mg/dL

• Additional Tests:

  • Glucose tolerance test

  • Hemoglobin A1c (goal to increase adult diabetes screenings).

  • Fructosamine assay.

Nursing Management of Endocrine Disorders

• Focus Areas:

  • Conduct thorough focused assessments.

  • Develop nursing diagnosis.

  • Set care goals and evaluate them.

  • Engage in community care.