The Metabolic System. Physiologic Integrity and Therapeutic Nursing Interventions for Patients With Endocrine Needs. The Endocrine System

Transcription

1 Physiologic Integrity and Therapeutic Nursing Interventions for Patients With Endocrine Needs Black, J.M. & Hawks, J.H. (2005) Chapters 44, (pp ) Baptist Health School of Nursing NSG 4037: Adult Nursing III Carole Mackey, MNSc,, RN, PNP The Endocrine System 2 The Metabolic System Dependent on Fuel Anabolic Catabolic Regulation 3 1

2 Metabolic System Regulation Metabolism Growth and Development Plasma Glucose 4 Structure of the Metabolic System Endocrine = within Exocrine = outside Liver Endocrine Glands 5 Endocrine System Endocrine versus Exocrine Liver Endocrine Glands 6 2

3 Liver Largest Solid Organ in body Largest Gland in body Synthesis and storage of glycogen Synthesis of lipoproteins, plasma proteins (including albumin and clotting factors) Detoxification of metabolic waste (drugs, toxins, alcohols) 7 What Are Hormones? Chemicals That Are Released Into the Bloodstream Regulators of Specific Body Functions 8 What are Hormones? Hormones chemical substances secreted by cells into the extracellular fluids Regulate the metabolic function of other cells Have lag times ranging from seconds to hours Tend to have prolonged effects Are classified as amino acid-based hormones, or steroids 9 3

4 Types of Hormones Steroids Peptides Amino Acid Derivatives 10 Peptides Oxytocin Insulin Types of Hormones Amino Acid Derivatives Thyroxine Catecholamines Steroids Estrogens Progestins Androgens 11 Major Endocrine Organs Figure

5 Hypothalmus and Pituitary Gland 13 Located in the anterior neck Largest pure endocrine gland Produces two hormones Thyroid hormone (TH, T 3 & T 4 ) Calcitonin The Thyroid Gland 14 The Parathyroid Gland Lie on the posterior surface of the thyroid gland Contain two types of endocrine cells Chief cells produce parathyroid 15 hormone (PTH) Figure 25.8a 5

6 Endocrine Pancreas The endocrine pancreas contains Islets of Langerhans alpha cells: : secrete glucagon beta cells: : secrete insulin delta cells: : secrete SS (somatostatin) Pancreatic hormones are involved in blood glucose regulation, and problems with them can lead to diabetes 16 Adrenal Glands An adrenal gland is found on top of each kidney. Each adrenal gland has two regions that carry out separate functions! The adrenal medulla The adrenal cortex 17 The Adrenal Cortex Acts like a regular endocrine organ Secretes many hormones, but most importantly secretes the following steroids: aldosterone cortisol sex hormones 18 6

7 The Adrenal Medulla Acts very much like a part of the sympathetic nervous system (fight or flight) Secretes two amines: norepinephrine (20%) epinephrine (80%) 19 Negative Feedback Loop 20 Metabolic Substrates Plasma Glucose Plasma Amino Acids Plasma Free Fatty Acids Plasma Calcium 21 7

8 Effects of Aging Functions deteriorate Liver Cells Reduced Decrease in protein synthesis Liver ability diminishes Pancreas vessels calcify Decreased absorption of fat soluble vitamins 22 Assessment of Endocrine System History Chief Complaint Symptom Analysis 23 Integumentary Manifestations Appearance Color Petechiae Delayed Healing Edema Changes in size of hands, feet, face Growth delay Hair distribution 24 8

9 Cardiovascular Manifestations Nosebleeds or bruising Changes in VS Edema of limbs Hypertension Tachycardia Kussmaul s Respirations 25 Neurologic Manifestations Weakness Depression Changes in mental status or mood Emotional lability Drowsiness Pain Tremors Loss of sensation 26 Ophthalmic Manifestations Bulging eyes (Exophthalmos) Diminished or blurred vision Visual Loss 27 9

10 Gastronintestinal Manifestations Glossitis Weight Gain or Loss Change in Appetite Polydipsia Abdominal Pain Anorexia Fatty Food Intolerance Heartburn Bowel Patterns 28 Genitourinary and Reproductive Manifestations Urine Color Polyuria Amenorrhea Loss of libido Sexual changes Renal problems 29 Other Manifestations Yellow Sclerae Fever Malaise Fatigue Dehydration Bone or joint pain Muscle cramps 30 10

11 Physical Examination General Appearance Vital Signs Integument Head Eyes Nose Mouth Neck Extremities Thorax Abdomen Inspection 31 Diagnostic Tests Blood Glucose Levels Thyroid Function Parathyroid Function Adrenocortical Function Liver Function Pancreas Function 32 Diagnostic Imaging Radioiodine Uptake Radiography Computed Tomography Ultrasound Magnetic Resonance Imaging 33 11