2. This project was funded $3,000,000 (100% of its total cost) from a grant awarded under the Trade Adjustment Assistance
Community CollegeandCareerTraining Grants, as implementedby the U.S. Department of Labor’s Employment and
Training Administration. Rogue Community Collegeis an equal opportunity employer/program. Auxiliary aids and
services, alternate form and language services are available to individuals with disabilities andlimitedEnglish proficiency
free of cost upon request.
This work is licensed under a Creative Commons Attribution 4.0 International License.
3. System of Glands
Function:
◦ Body Metabolism
◦ Growth
◦ Reproduction
4 Major Glands
◦ Pituitary
◦ Thyroid
◦ Pancreas
◦ Adrenals
4. Master Gland
◦ Makes Hormones
for other glands
Regulates
◦ Growth
◦ Reproduction
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5. Sit on kidneys
Secrete Epinephrine
Flight or Fight
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6. Cortisol Exposure for Too Long
#1 Cause: Excessive Steroid Use
◦ Chronic Breathing
◦ Chronic Inflammation
14. Monitor:
◦ VS
◦ Accurate I&O
◦ Weight
◦ Activity
Limit Fatigue
Cluster activities
Plan rest periods
◦ Report Abnormals
Medical Id bracelet
Refer questions/concerns to nurse
16. Three Types
◦ Type 1
Onset early in life
Pancreas not producing enough insulin
Insulin injections
◦ Type 2
Adults
Body doesn’t use insulin well
Diet/exercise/PO meds
◦ Gestational (GDM)
During pregnancy
Generally goes away after birth
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28. This project was funded $3,000,000 (100% of its total cost) from a grant awarded under the Trade Adjustment Assistance
Community CollegeandCareerTraining Grants, as implementedby the U.S. Department of Labor’s Employment and
Training Administration. Rogue Community Collegeis an equal opportunity employer/program. Auxiliary aids and
services, alternate form and language services are available to individuals with disabilities andlimitedEnglish proficiency
free of cost upon request.
This work is licensed under a Creative Commons Attribution 4.0 International License.
Editor's Notes
System of glands that secrete directly into bloodstream
• Function: controls body metabolism, growth and reproduction
• 4 Major glands are:
Pituitary- “master gland” regulates growth and reproduction
Thyroid- regulates metabolism
Pancreas- regulates blood glucose and insulin
Adrenals- sit on top of each kidneys- secrete epinephrine (which stimulates the body to
produce energy during an emergency)
Cushing’s Syndrome
• Cushing’s syndrome occurs when the body’s tissues are exposed to high levels of cortisol for
too long
• One cause is- excessive use of steroids (usually prescribed for breathing, or other
inflammatory diseases)
Definition
Cushing's syndrome is a relatively rare endocrine (hormonal) disorder resulting from excessive exposure to the hormone cortisol. The disorder, which leads to a variety of symptoms and physical abnormalities, is most commonly caused by taking medications containing the hormone over a long period of time. Chronic breathing or inflammation. A more rare form of the disorder occurs when the body itself produces an excessive amount of cortisol.
Cushing's syndrome, also called hypercortisolism, has an adverse effect on all of the processes described above. The syndrome occurs in approximately 10 to 15 out of every one million people per year, usually striking adults between the ages of 20 and 50.
Causes and symptoms
The most common cause of Cushing's syndrome is the long-term use of glucocorticoid hormones in medications. Medications such as prednisone are used in a number of inflammatory conditions. Such conditions include rheumatoid arthritis, asthma, vasculitis, lupus, and a variety of other autoimmune disorders in which the body's immune cells accidentally attack some part of the body itself. In these disorders, the glucocorticoids are used to dampen the immune response, thereby decreasing damage to the body.
Muscular weakness
Thinning of hair
Weight gain
Depression
Thinning of skin
Hyperthyroidism
• Hyperthyroidism is a condition in which the thyroid gland makes too much thyroid hormone.
The condition is often referred to as an "overactive thyroid.”
• • Causes:
Graves' Disease (autoimmune disorder; the thyroid is extremely active)
Excessive intake of thyroid hormones
Abnormal secretion of TSH (thyroid stimulating hormone)
Thyroiditis (inflammation of the thyroid gland)
Excessive iodine intake
Can significantly accelerate the body's metabolism
• Can cause sudden weight loss, a rapid or irregular heartbeat, sweating, and nervousness or
irritability
• Hypothyroidism is a condition in which the thyroid gland does not make enough thyroid
hormone.
• Causes:
Severe lack of iodine
Pituitary or hypothalamic disease
Thyroid destruction (from radioactive iodine or surgery)
Advanced age (thyroid function can decrease as we age)
Observation & Reporting: Slow Metabolism Down ask what they think
Tiredness, Weakness, Fatigue
Social withdrawal & depression
Wt. gain and hoarseness
Cold intolerance and Raynaud’s phenomenon
Decreased sweating
Thick, course, hair
Facial myxedema
Loss of lateral third of the eyebrows
Cold dry, thickened skin
Constipation
Endocrine cells in the pancreas form clusters called the Islets of Langerhans after a German scientist named Paul Langerhans who discovered them. Each islet contains two types of endocrine cells: alpha cells and beta cells. These cells produce two very important hormones: alpha cells produce glucagon and beta cells produce insulin. These two hormones regulate blood glucose levels. When blood glucose levels rise higher the beta cells release insulin. When blood glucose levels fall lower the alpha cells release glucagon.
Diabetes mellitus is a disease in which the body either doesn't produce enough insulin—type 1 diabetes—or has decreased sensitivity to insulin—type 2 diabetes. This results in elevated levels of blood glucose which, without treatment, can lead to serious complications including coma and death.
Diabetes Mellitus: A chronic disorder marked by hyperglycemia. Results from either failure of the pancreas to produce insulin (type 1)or from insulin resistance, with inadequate insulin secretion to sustain normal metabolism (Type 2)
• Three types:
Type 1: Also called “Insulin Dependent” or IDDM
Occurs most in children and young adults
Pancreas produces little or no insulin. Insulin lowers blood glucose
Need to use insulin therefore is a less stable form of this disease
Type 2: Also called Non-Insulin Dependent or NIDDM
Occurs in adults
Body cannot use body’s supply of insulin well
Can be managed with diet, exercise and oral meds (occasionally insulin)
Gestational or GDM:
Usually goes away after delivery of baby
One of the crucial tasks for a clinical nurse is to stay alert for signs and risk factors. If you work in a general practice office, you may be the first person to notice signs or complaints of developing diabetes, such as:
Increased thirst
Polyuria
Unexplained weight loss
Blurred vision
Non-healing lesions or rashes
Frequent vaginal yeast infections
These should be brought to the attention of the physician. Gastrointestinal, genitourinary and cardiovascular symptoms are also common. Adults with diabetes have a heart disease death rate 2 to 4 times greater than persons without diabetes, and are 2 to 4 times at greater risk for a stroke. Hypertension comorbidity is seen in 73 percent of adult diabetes patients.
Complications
For many patients, the required lifestyle changes of diet, exercise and self-care can be quite difficult to adjust to. Without your active assistance and encouragement, and your testing to supplement their self-monitoring, diabetes patients risk serious long-term consequences.
Common long-term complications can include retinopathy and loss of vision. Diabetes is the leading cause of blindness in persons 20 to 74 years old. There is also a risk of renal failure, and peripheral neuropathy that can lead to foot ulcers and even amputations. Sixty to 70 percent of those with diabetes will have mild to severe nervous system damage. In addition, poorly controlled diabetes before conception and into the first trimester can cause major birth defects in 5 to 10 percent of pregnancies, and is responsible for 15 to 20 percent of spontaneous abortions.
Hypoglycemia- (Low Blood Sugar- below 60)
Most common cause is skipping a meal
Signs and Symptoms:
• Irritability • Headache • Rapid, shallow breathing • Convulsions
• Hunger • Dizziness • Confusion • Unconsciousness
• Weakness • Faintness • Difficulty thinking
• Trembling • Rapid Pulse • Changes in vision
• Sweating • Low Blood Pressure
• Cold, clammy skin
Report abnormal s/s to nurse- Hypoglycemia protocol
Ensure patient gets correct diet
Report dietary intake less than 75% to nurse
Provide for skin integrity (skin in extremities may be fragile or compromised)
Provide emotional support
Diabetic Ketoacidosis (DKA)
Is a dangerous complication of diabetes mellitus in which the chemical balance of the
body becomes far too acidic
Ketones are poisonous acidic chemicals produced by the body when fat instead of
glucose is burned for energy
Normal UOP: 1000-3000 ml/day
Excessive urination caused either by inadequate amts of circulating vasopressin (antidiuretic hormone) in the body, or by failure of the kidney to respond to antidiuretic hormones. UOP if often massive (5-15L/day), which may result in dehydration.in patients who cannot drink enough liquid to replace urinary losses (impaired consciousness. The urine is dilute( spc gravity > 1.005. Pt.s serum sodium and osmolality rise as free water is eliminated as urine.
