Nursing 160 W10D1

Hormonal Regulation

• Hormonal regulation refers to the control of hormones and metabolism by the endocrine system.

• Hormones act as chemical messengers influencing various body functions, affecting target tissues specifically designed to respond to them.

Mechanism of Hormone Action

• Receptor Sites:

  • Hormones attach to specific receptor sites on target cells.

  • The presence of these sites determines how effectively a hormone can influence a cell's actions.

• Cellular sensitivity to hormones can change based on receptor availability:

  • Increased hormone concentration leads to fewer available receptors.

  • Decreased hormone concentration can stimulate more receptor production on cells.

Feedback Systems in Hormonal Regulation

• Four Main Feedback Systems:

  • Negative Feedback:

    • Common mechanism where hormone levels respond inversely to changes in the body.

    • Example: Insulin release based on blood glucose levels. Higher glucose leads to more insulin; lower glucose leads to reduced insulin.

  • Positive Feedback:

    • A rising hormone level triggers more hormone production.

    • Example: Luteinizing hormone (LH) surge during the menstrual cycle.

  • Biological Rhythms:

    • Hormone secretion can follow circadian rhythms, e.g., cortisol levels highest in the morning and lowest at night.

  • Central Nervous System Control:

    • Hormones can be influenced by stress responses (e.g., adrenaline release during fight-or-flight situations).

Factors Affecting Hormonal Balance

• Age, autoimmune conditions, medical issues, family history, hormone supplementation (e.g., estrogen therapy), obesity, sedentary lifestyle, stress, and trauma are significant factors affecting hormone levels.

Addison's Disease

• Overview: Adrenal insufficiency due to insufficient secretion of adrenal hormones (cortisol and aldosterone).

• Causes: Dysfunction of the pituitary gland or damage to adrenal glands.

• Symptoms: Fatigue, weight loss, hypotension, hyperpigmentation, and electrolyte imbalances (e.g., hyponatremia, hyperkalemia).

• Addisonian Crisis: A life-threatening condition triggered by stress, resulting in severe weakness, abdominal pain, and shock.

• Management: Requires hormone replacement therapy, monitoring electrolytes, and managing stresses.

Cushing's Disease

• Overview: Chronic excess of cortisol from adrenal glands, often caused by tumors or chronic steroid use.

• Symptoms: Weight gain, muscle thinning, high blood sugar (hyperglycemia), and mood disturbances.

• Physiological Changes: Proteins in urine, hypertension, fragile skin, and purple abdominal striae.

• Treatment: Address underlying cause (e.g., surgery for tumors) and manage symptoms. Medications may be prescribed long-term.

Diabetes Mellitus

• Overview: Metabolic disorders characterized by insulin deficiency or resistance.

• Types:

  • Type 1 Diabetes: Autoimmune destruction of beta cells; requires lifelong insulin therapy.

  • Type 2 Diabetes: Insulin resistance prevalent in older populations, often associated with lifestyle factors; may be managed with oral medications.

• Complications: Hyperglycemia, diabetic ketoacidosis (DKA), infections, neuropathy, nephropathy, and retinopathy.

• Management: Includes monitoring blood glucose levels, meal planning, and regular check-ups to manage complications.

Diagnostic Tests for Diabetes

• Fasting Glucose Test: Measures glucose after 8 hours without food. Fasting glucose of >125 mg/dL indicates diabetes.

• A1C Test: Average blood glucose over 3 months; A1C >6.4% indicates poor blood sugar control.

• Urinalysis: Can show ketones as byproducts of fat metabolism.

Care for Diabetic Patients

• Foot Care: Emphasizes the importance of monitoring feet for injuries, regular check-ups with foot specialists, and proper footwear.

• Eye Care: Regular eye exams to check for diabetic retinopathy.

• Education: It is crucial for diabetic patients to understand their condition and how to manage their medication and lifestyle to prevent complications.