Chapter 35 and 36 review.

Endocrine System Overview

• The endocrine system is a collection of glands that regulate various bodily functions through hormone secretion.

• Hormones are important for metabolism, growth, development, sexual function, and reproduction.

Key Concepts

Beta Cells

• Function: Beta cells found in the Islets of Langerhans within the pancreas are responsible for releasing insulin, which helps lower blood sugar levels.

• Important Note: While the pancreas is the organ containing islets, the beta cells specifically are the ones releasing insulin, not the pancreas itself.

Diabetes Overview

• Types of Diabetes:

  • Type 1 Diabetes: Insulin-dependent condition due to autoimmune destruction of pancreatic beta cells, leading to little to no insulin production. Patients require lifelong insulin therapy.

  • Management: Emphasis on healthy diet, regular exercise, and maintaining a healthy weight even for Type 1 diabetics.

Clinical Case: Jose

• Patient Profile: 53-year-old male with a history of type 1 diabetes admitted for diverticulitis.

• Clinical Monitoring: Nurse Charlotte monitors vital signs and analyzes cues such as trembling hands and diaphoresis suggesting hypoglycemia.

• Blood Glucose Management: After checking blood glucose at 60 mg/dL, actions taken included discontinuing NPO status and administering orange juice to raise blood sugar levels.

• Outcomes: After intervention, blood glucose rose to 78 mg/dL, confirming successful management of the hypoglycemic episode.

Important Terms and Hormones

Hormones Related to Metabolism

• Thyroid Hormones: Require iodine and protein for adequate function, commonly obtained from iodized salt.

• Parathyroid Hormone: Regulates calcium levels in the blood by mobilizing calcium from bones.

• Cortisol: Stress hormone produced by the adrenal cortex, plays a role in anti-inflammatory responses and metabolism. Reduced cortisol levels in older adults increase infection risks.

Hormonal Functions and Aging

• As individuals age, there is a decrease in the production of several hormones including:

  • Cortisol: Leads to increased susceptibility to stress.

  • Insulin: Contributes to blood sugar management difficulties.

  • Thyroid Hormone: Alters metabolic functions.

  • Epinephrine: Reduces the body's ability to respond to stress.

Testing and Diagnoses

Diabetes Management Tests

• Glucose Tolerance Test: Patients on medications like birth control or aspirin need to discontinue these before testing to avoid false readings.

• 17-Ketosteroid (17-KS) Test: A 24-hour urine collection requiring refrigeration to maintain sample integrity.

• Glycosylated Hemoglobin (HbA1c): Preferred test for diabetes management in older adults; less affected by age-related physiological changes.

Treatment Protocols

Medications for Diabetes Types

• For diabetes insipidus, desmopressin is commonly prescribed.

• Hormonal replacement therapy for thyroid conditions (e.g., Levothyroxine) must be taken consistently at the same time each day, preferably in the morning before food.

Patient Care Considerations

Post-Surgical Protocols

• After thyroid surgery (thyroidectomy), monitor for respiratory distress and maintain airway safety.

• Keep emergency equipment accessible, including a tracheostomy kit.

• Position patients in Fowler's position to promote breathing and minimize swelling.

Precautions for Patients on Radioactive Therapy

• All bodily fluids may be radioactive, necessitating strict precautions during care.

• Proper handling of waste and close monitoring of contamination potential are essential.

Conclusion

• Understanding hormonal functions, diabetes management, and the physiological changes due to aging is crucial for effective patient care and treatment management in an endocrine-related context.