The document discusses disorders of the endocrine system, focusing on the pancreas and disorders related to insulin and glucagon production. It describes the key functions of the pancreatic islets of Langerhans, including the alpha, beta, and delta cells that produce glucagon, insulin, and somatostatin respectively. It then summarizes diabetes mellitus, distinguishing between type 1 caused by beta cell destruction and type 2 related to insulin resistance. The diagnosis and management of diabetes is also briefly outlined.
The endocrine system is made up of glands that produce hormones and regulate bodily functions. The major glands include the hypothalamus, pituitary gland, thyroid gland, parathyroid glands, adrenal glands, pineal gland, ovaries and testes. Hormones produced by these glands influence growth, metabolism, sexual development, and other processes. Diseases can arise if the glands produce too much or too little of certain hormones, leading to conditions such as diabetes, hyperthyroidism, hypothyroidism, and Cushing syndrome.
The document discusses endocrine disorders and their causes, including hypofunction and hyperfunction of endocrine glands. It describes the four main types of hormones and provides examples. Signs and symptoms of endocrine disorders are widespread and can include changes in energy, weight, sexual function, mood and sleep. The pituitary gland and its role in controlling other endocrine glands is explained. Common pituitary gland disorders like Cushing's syndrome, acromegaly, and gigantism are summarized. The causes, signs, and treatments of hypopituitarism are covered at a high level. Diabetes insipidus and SIADH, disorders of the posterior pituitary, are defined and their pathophysiology, risks, diagnostic
This document provides an overview of the endocrine system and its major hormones. It discusses the pituitary gland and its control of other endocrine glands like the thyroid and adrenals. It describes important hormones produced by these glands like thyroid hormones, cortisol, insulin, and others. It also discusses diseases that can result from endocrine disorders, such as hypothyroidism, Cushing's syndrome, diabetes, and osteoporosis. The roles of calcium regulating hormones PTH and calcitonin are also covered.
The document provides an overview of the endocrine system, including:
- The endocrine system uses hormones to regulate bodily functions through slower chemical signaling compared to the nervous system.
- Major endocrine glands include the pituitary, thyroid, parathyroid, adrenal, pancreas, ovaries/testes, thymus, placenta, and pineal glands.
- Hormone secretion is regulated by negative and positive feedback loops to maintain homeostasis. Endocrine disorders can result from too much or too little hormone production.
The document provides an overview of endocrinology, summarizing the major endocrine glands and their hormones. It discusses the pituitary gland, thyroid gland, parathyroid glands, adrenal glands, and pancreas. It also covers some common endocrine disorders like hyperthyroidism, hypothyroidism, Cushing's disease, Addison's disease, diabetes mellitus, and discusses some relevant laboratory tests.
This document discusses the assessment and management of patients with endocrine disorders. It begins by outlining learning objectives which are to describe endocrine gland functions and hormones, identify diagnostic tests for endocrine disorders, and compare manifestations and management of thyroid, parathyroid, and diabetes disorders. It then provides details on the endocrine system, hormones, endocrine organs, comparisons to the nervous system, and specific glands. The majority of the document focuses on diabetes, covering types, risk factors, pathophysiology, clinical manifestations, diagnostic criteria, management including nutrition, exercise, monitoring and medications, and complications.
This document discusses the pathogenesis and etiology of metabolic disorders, including disorders of carbohydrate and lipid metabolism. It covers several key points:
1. Metabolic disorders can be caused by genetic factors like enzymopathies, damage to membranes/receptors, endocrine dysfunction, and neural impairment.
2. Dietary and digestive issues as well as other organ dysfunction can also contribute to metabolic disorders.
3. Glucose regulation is maintained through a balance of insulin and counter-regulatory hormones like glucagon, with disorders resulting in hyperglycemia or hypoglycemia.
4. The two primary types of diabetes mellitus - type 1 and type 2 - differ in etiology and pathogenesis
The document discusses disorders of the endocrine system, focusing on disorders of the pancreas and diabetes mellitus. It describes the key functions of the pancreas in regulating blood sugar levels through the hormones insulin and glucagon. It then characterizes the various types of diabetes mellitus, including type 1, type 2, and gestational diabetes. The diagnostic criteria and management approaches for diabetes are also summarized, including nutritional management, exercise, and pharmacologic therapy such as insulin.
The endocrine system is made up of glands that produce hormones and regulate bodily functions. The major glands include the hypothalamus, pituitary gland, thyroid gland, parathyroid glands, adrenal glands, pineal gland, ovaries and testes. Hormones produced by these glands influence growth, metabolism, sexual development, and other processes. Diseases can arise if the glands produce too much or too little of certain hormones, leading to conditions such as diabetes, hyperthyroidism, hypothyroidism, and Cushing syndrome.
The document discusses endocrine disorders and their causes, including hypofunction and hyperfunction of endocrine glands. It describes the four main types of hormones and provides examples. Signs and symptoms of endocrine disorders are widespread and can include changes in energy, weight, sexual function, mood and sleep. The pituitary gland and its role in controlling other endocrine glands is explained. Common pituitary gland disorders like Cushing's syndrome, acromegaly, and gigantism are summarized. The causes, signs, and treatments of hypopituitarism are covered at a high level. Diabetes insipidus and SIADH, disorders of the posterior pituitary, are defined and their pathophysiology, risks, diagnostic
This document provides an overview of the endocrine system and its major hormones. It discusses the pituitary gland and its control of other endocrine glands like the thyroid and adrenals. It describes important hormones produced by these glands like thyroid hormones, cortisol, insulin, and others. It also discusses diseases that can result from endocrine disorders, such as hypothyroidism, Cushing's syndrome, diabetes, and osteoporosis. The roles of calcium regulating hormones PTH and calcitonin are also covered.
The document provides an overview of the endocrine system, including:
- The endocrine system uses hormones to regulate bodily functions through slower chemical signaling compared to the nervous system.
- Major endocrine glands include the pituitary, thyroid, parathyroid, adrenal, pancreas, ovaries/testes, thymus, placenta, and pineal glands.
- Hormone secretion is regulated by negative and positive feedback loops to maintain homeostasis. Endocrine disorders can result from too much or too little hormone production.
The document provides an overview of endocrinology, summarizing the major endocrine glands and their hormones. It discusses the pituitary gland, thyroid gland, parathyroid glands, adrenal glands, and pancreas. It also covers some common endocrine disorders like hyperthyroidism, hypothyroidism, Cushing's disease, Addison's disease, diabetes mellitus, and discusses some relevant laboratory tests.
This document discusses the assessment and management of patients with endocrine disorders. It begins by outlining learning objectives which are to describe endocrine gland functions and hormones, identify diagnostic tests for endocrine disorders, and compare manifestations and management of thyroid, parathyroid, and diabetes disorders. It then provides details on the endocrine system, hormones, endocrine organs, comparisons to the nervous system, and specific glands. The majority of the document focuses on diabetes, covering types, risk factors, pathophysiology, clinical manifestations, diagnostic criteria, management including nutrition, exercise, monitoring and medications, and complications.
This document discusses the pathogenesis and etiology of metabolic disorders, including disorders of carbohydrate and lipid metabolism. It covers several key points:
1. Metabolic disorders can be caused by genetic factors like enzymopathies, damage to membranes/receptors, endocrine dysfunction, and neural impairment.
2. Dietary and digestive issues as well as other organ dysfunction can also contribute to metabolic disorders.
3. Glucose regulation is maintained through a balance of insulin and counter-regulatory hormones like glucagon, with disorders resulting in hyperglycemia or hypoglycemia.
4. The two primary types of diabetes mellitus - type 1 and type 2 - differ in etiology and pathogenesis
The document discusses disorders of the endocrine system, focusing on disorders of the pancreas and diabetes mellitus. It describes the key functions of the pancreas in regulating blood sugar levels through the hormones insulin and glucagon. It then characterizes the various types of diabetes mellitus, including type 1, type 2, and gestational diabetes. The diagnostic criteria and management approaches for diabetes are also summarized, including nutritional management, exercise, and pharmacologic therapy such as insulin.
Includes Information about Pharmacotherapeutic of Diabetes Mellitus, all details about etiology, Pathophysiology, pharmacology, treatment, current clinical trials on DM etc.
Hypoglycemic agent and Thyroid hormone lecture notes-Dr.Jibachha SahDr. Jibachha Sah
Hypoglycemic agent and Thyroid hormone,lecturer notes,Dr.Jibachha Sah,M.V.Sc(Veterinary Pharmacology)Lecture ,College of veterinary Science ,Nepal Poly-technique,Bharatpur,Chitwan,Nepal lecturer notes on ,AUTONOMIC AND SYSTEMIC PHARMACOLOGY SIXTH SEMESTER.This lecture notes also useful for other veterinary college students.Please send me your comments & suggestion.jibachhashah@gmail.com,Mob.00977-9845024121
The endocrine system uses glands and hormones to regulate processes in the body through chemical messages released into the bloodstream. Major glands include the pituitary, thyroid, parathyroid, adrenal, pancreas, gonads and reproductive organs. Endocrine disorders occur when glands under-produce or over-produce hormones, or grow abnormally, and can cause issues like hypothyroidism, polycystic ovary syndrome, or non-toxic goiter.
Health 1 2nd grading by. joanne a. saldanaUsths Pehealth
1) Adolescence involves physical, emotional, intellectual, and social changes caused by hormonal changes in the body. These changes lead to feelings of awkwardness but are perfectly normal.
2) The endocrine system and hormones like estrogen, progesterone, testosterone, insulin, and glucagon cause the changes of adolescence by stimulating growth, sexual development, and other bodily functions.
3) Glands like the hypothalamus, pituitary, thyroid, adrenals, pancreas, and gonads work together to regulate hormones and control development, metabolism, and fertility during puberty.
The endocrine system includes glands that secrete hormones directly into the bloodstream to regulate distant target tissues and organs. The major glands are the pituitary, thyroid, parathyroid, adrenal, pancreas, gonads, thymus, and pineal. The pituitary gland regulates other endocrine glands by secreting hormones like growth hormone, TSH, and ACTH. The thyroid regulates metabolism and produces thyroxine and triiodothyronine. Disorders include hypothyroidism and hyperthyroidism. The pancreas produces insulin to regulate blood sugar levels, and diabetes occurs when there is insufficient insulin. Sex glands like the ovaries and testes produce hormones like estrogen, progesterone and test
- Plasma hormone concentrations and the number of receptors on target cells determine the target cell's response. Feedback mechanisms precisely control hormone levels through negative feedback loops. Disorders can result from hypo- or hyper-secretion and impact hormone concentrations and receptor levels, leading to pathophysiological effects. Common examples are Grave's disease causing hyperthyroidism and Addison's disease resulting in adrenal insufficiency.
This document provides an overview of diabetes mellitus (DM), including:
1) It defines DM as a metabolic disorder characterized by chronic hyperglycemia resulting from defects in insulin secretion or action.
2) It classifies the main types of DM as type 1, type 2, and gestational diabetes and discusses their characteristics.
3) It discusses the etiology, pathophysiology, clinical manifestations, diagnosis, and management of type 1 and type 2 DM.
Endocrine system and related disorders.pptxsumathy ys
The document summarizes the key endocrine glands and hormones. It describes the pituitary gland and its hormones that control other endocrine glands. It then discusses each major endocrine gland - thyroid, parathyroid, adrenal, pancreas, ovaries/testes, thymus and pineal gland. It outlines some disorders associated with over and underproduction of hormones. The document concludes by discussing endocrine disruptors - chemicals that can interfere with hormone function - and the research scope around understanding and preventing their health effects.
The endocrine system controls the body through chemical messengers called hormones. Glands such as the pituitary, thyroid, pancreas and ovaries secrete hormones that travel through the bloodstream and trigger responses in target cells. Hormones can be proteins that bind to cell surface receptors or lipids that pass into cells to regulate gene expression. Conditions like Cushing's syndrome and Addison's disease occur when the endocrine system produces too much or too little cortisol and other hormones.
This document provides information about endocrine disorders and diabetes. It begins with a review of anatomy and physiology of the endocrine system, identifying the major endocrine glands and hormones they secrete. It then discusses each endocrine gland in more detail, including their location, hormones produced, and related disorders. The document also covers diabetes, differentiating between type 1 and type 2 diabetes, risk factors, pathophysiology, classification, and management strategies. Physical assessment techniques for the thyroid gland are also outlined.
ENDOCRINE PHYSIOLOGY LECTURE FOR 300L MBBS-BSc 2019-2020-1.pptOlaniyiEmmanuel5
This document provides an overview of a lecture on endocrine physiology. It begins with an introduction to the endocrine system and hormones. It then covers the classification, properties, and mechanisms of action of hormones. The document outlines the major endocrine glands and hormones, including the pituitary gland and hormones of the anterior and posterior pituitary. It discusses disorders of growth hormone and thyroid hormones, including dwarfism, gigantism, acromegaly, cretinism, and myxedema. It concludes with an overview of hyperthyroidism.
The document discusses various endocrine glands and hormones, including the thyroid gland which produces hormones that regulate metabolism, and the adrenal glands which produce cortisol to help the body cope with stress and aldosterone to regulate sodium levels. It also covers conditions that can arise from too much or too little of these hormones, such as hypothyroidism, hyperthyroidism, Cushing's syndrome, and adrenal insufficiency.
The endocrine system helps regulate the body's functions through glands that release hormones directly into the bloodstream. Major glands include the pituitary, thyroid, parathyroid, adrenal, pancreas, and gonads. The pituitary gland is called the "master gland" and controls other glands by producing tropic hormones. Hormones regulate critical functions like growth, metabolism, fluid balance, mood, and reproduction. Disorders can result from too much or too little hormone production and impact one's health, development, and quality of life.
The endocrine system helps regulate the body's functions through glands that release hormones directly into the bloodstream. Major glands include the pituitary gland, which controls other glands; the thyroid gland, which regulates metabolism; and the adrenal and gonadal glands, which regulate other processes like stress response and reproduction. Disorders can result from too much or too little hormone production and can affect growth, metabolism, and other bodily functions.
The document discusses the human endocrine system. It provides definitions of hormones and describes the major endocrine glands and their roles. The endocrine glands include the hypothalamus, pituitary gland, thyroid gland, parathyroid gland, adrenal glands, pancreas, ovaries, and testes. The hypothalamus and pituitary gland control the other endocrine glands by producing releasing and inhibiting hormones. The endocrine glands secrete hormones like insulin, estrogen and testosterone to regulate processes throughout the body, including growth and development, metabolism, and reproduction.
Hyperthyroidism refers to overactivity of the thyroid gland resulting in excessive secretion of thyroid hormones throughout the body. Some common causes include Graves' disease, toxic adenomas, and thyroiditis. Symptoms include nervousness, palpitations, heat intolerance, tremor, and weight loss. Diagnosis involves tests of thyroid and pituitary hormones. Treatment options are radioactive iodine to destroy the thyroid gland, anti-thyroid medications, beta-blockers to control symptoms, or surgery to remove part or all of the thyroid. Nursing care focuses on managing nutrition, activity tolerance, risk of injury from eye involvement, and hyperthermia due to the increased metabolic rate.
This document summarizes benign prostatic hyperplasia (BPH). It discusses the pathology and pathogenesis of BPH, including that it affects glandular epithelium, stromal cells, and causes increased growth. It also covers the symptomatology, evaluation, and various treatment options for BPH including watchful waiting, medical therapy, and prostatectomies. Surgical treatments discussed are transurethral resection of the prostate (TURP), retropubic prostatectomy (RPP), and transvesical prostatectomy (TVP).
This document provides an introduction to pathology. It defines pathology as the study of disease through scientific methods and examines the mechanisms of disease from etiology to clinical manifestation. The key points are:
1. Pathology studies the etiology, pathogenesis, morphologic changes, and functional derangements that result from disease processes.
2. Diseases are examined through diagnostic techniques including histopathology, cytopathology, and biochemical/immunological testing to identify structural and molecular alterations.
3. The natural course of a disease involves stages from initial exposure through biological onset, clinical onset, potential resolution or death.
Includes Information about Pharmacotherapeutic of Diabetes Mellitus, all details about etiology, Pathophysiology, pharmacology, treatment, current clinical trials on DM etc.
Hypoglycemic agent and Thyroid hormone lecture notes-Dr.Jibachha SahDr. Jibachha Sah
Hypoglycemic agent and Thyroid hormone,lecturer notes,Dr.Jibachha Sah,M.V.Sc(Veterinary Pharmacology)Lecture ,College of veterinary Science ,Nepal Poly-technique,Bharatpur,Chitwan,Nepal lecturer notes on ,AUTONOMIC AND SYSTEMIC PHARMACOLOGY SIXTH SEMESTER.This lecture notes also useful for other veterinary college students.Please send me your comments & suggestion.jibachhashah@gmail.com,Mob.00977-9845024121
The endocrine system uses glands and hormones to regulate processes in the body through chemical messages released into the bloodstream. Major glands include the pituitary, thyroid, parathyroid, adrenal, pancreas, gonads and reproductive organs. Endocrine disorders occur when glands under-produce or over-produce hormones, or grow abnormally, and can cause issues like hypothyroidism, polycystic ovary syndrome, or non-toxic goiter.
Health 1 2nd grading by. joanne a. saldanaUsths Pehealth
1) Adolescence involves physical, emotional, intellectual, and social changes caused by hormonal changes in the body. These changes lead to feelings of awkwardness but are perfectly normal.
2) The endocrine system and hormones like estrogen, progesterone, testosterone, insulin, and glucagon cause the changes of adolescence by stimulating growth, sexual development, and other bodily functions.
3) Glands like the hypothalamus, pituitary, thyroid, adrenals, pancreas, and gonads work together to regulate hormones and control development, metabolism, and fertility during puberty.
The endocrine system includes glands that secrete hormones directly into the bloodstream to regulate distant target tissues and organs. The major glands are the pituitary, thyroid, parathyroid, adrenal, pancreas, gonads, thymus, and pineal. The pituitary gland regulates other endocrine glands by secreting hormones like growth hormone, TSH, and ACTH. The thyroid regulates metabolism and produces thyroxine and triiodothyronine. Disorders include hypothyroidism and hyperthyroidism. The pancreas produces insulin to regulate blood sugar levels, and diabetes occurs when there is insufficient insulin. Sex glands like the ovaries and testes produce hormones like estrogen, progesterone and test
- Plasma hormone concentrations and the number of receptors on target cells determine the target cell's response. Feedback mechanisms precisely control hormone levels through negative feedback loops. Disorders can result from hypo- or hyper-secretion and impact hormone concentrations and receptor levels, leading to pathophysiological effects. Common examples are Grave's disease causing hyperthyroidism and Addison's disease resulting in adrenal insufficiency.
This document provides an overview of diabetes mellitus (DM), including:
1) It defines DM as a metabolic disorder characterized by chronic hyperglycemia resulting from defects in insulin secretion or action.
2) It classifies the main types of DM as type 1, type 2, and gestational diabetes and discusses their characteristics.
3) It discusses the etiology, pathophysiology, clinical manifestations, diagnosis, and management of type 1 and type 2 DM.
Endocrine system and related disorders.pptxsumathy ys
The document summarizes the key endocrine glands and hormones. It describes the pituitary gland and its hormones that control other endocrine glands. It then discusses each major endocrine gland - thyroid, parathyroid, adrenal, pancreas, ovaries/testes, thymus and pineal gland. It outlines some disorders associated with over and underproduction of hormones. The document concludes by discussing endocrine disruptors - chemicals that can interfere with hormone function - and the research scope around understanding and preventing their health effects.
The endocrine system controls the body through chemical messengers called hormones. Glands such as the pituitary, thyroid, pancreas and ovaries secrete hormones that travel through the bloodstream and trigger responses in target cells. Hormones can be proteins that bind to cell surface receptors or lipids that pass into cells to regulate gene expression. Conditions like Cushing's syndrome and Addison's disease occur when the endocrine system produces too much or too little cortisol and other hormones.
This document provides information about endocrine disorders and diabetes. It begins with a review of anatomy and physiology of the endocrine system, identifying the major endocrine glands and hormones they secrete. It then discusses each endocrine gland in more detail, including their location, hormones produced, and related disorders. The document also covers diabetes, differentiating between type 1 and type 2 diabetes, risk factors, pathophysiology, classification, and management strategies. Physical assessment techniques for the thyroid gland are also outlined.
ENDOCRINE PHYSIOLOGY LECTURE FOR 300L MBBS-BSc 2019-2020-1.pptOlaniyiEmmanuel5
This document provides an overview of a lecture on endocrine physiology. It begins with an introduction to the endocrine system and hormones. It then covers the classification, properties, and mechanisms of action of hormones. The document outlines the major endocrine glands and hormones, including the pituitary gland and hormones of the anterior and posterior pituitary. It discusses disorders of growth hormone and thyroid hormones, including dwarfism, gigantism, acromegaly, cretinism, and myxedema. It concludes with an overview of hyperthyroidism.
The document discusses various endocrine glands and hormones, including the thyroid gland which produces hormones that regulate metabolism, and the adrenal glands which produce cortisol to help the body cope with stress and aldosterone to regulate sodium levels. It also covers conditions that can arise from too much or too little of these hormones, such as hypothyroidism, hyperthyroidism, Cushing's syndrome, and adrenal insufficiency.
The endocrine system helps regulate the body's functions through glands that release hormones directly into the bloodstream. Major glands include the pituitary, thyroid, parathyroid, adrenal, pancreas, and gonads. The pituitary gland is called the "master gland" and controls other glands by producing tropic hormones. Hormones regulate critical functions like growth, metabolism, fluid balance, mood, and reproduction. Disorders can result from too much or too little hormone production and impact one's health, development, and quality of life.
The endocrine system helps regulate the body's functions through glands that release hormones directly into the bloodstream. Major glands include the pituitary gland, which controls other glands; the thyroid gland, which regulates metabolism; and the adrenal and gonadal glands, which regulate other processes like stress response and reproduction. Disorders can result from too much or too little hormone production and can affect growth, metabolism, and other bodily functions.
The document discusses the human endocrine system. It provides definitions of hormones and describes the major endocrine glands and their roles. The endocrine glands include the hypothalamus, pituitary gland, thyroid gland, parathyroid gland, adrenal glands, pancreas, ovaries, and testes. The hypothalamus and pituitary gland control the other endocrine glands by producing releasing and inhibiting hormones. The endocrine glands secrete hormones like insulin, estrogen and testosterone to regulate processes throughout the body, including growth and development, metabolism, and reproduction.
Hyperthyroidism refers to overactivity of the thyroid gland resulting in excessive secretion of thyroid hormones throughout the body. Some common causes include Graves' disease, toxic adenomas, and thyroiditis. Symptoms include nervousness, palpitations, heat intolerance, tremor, and weight loss. Diagnosis involves tests of thyroid and pituitary hormones. Treatment options are radioactive iodine to destroy the thyroid gland, anti-thyroid medications, beta-blockers to control symptoms, or surgery to remove part or all of the thyroid. Nursing care focuses on managing nutrition, activity tolerance, risk of injury from eye involvement, and hyperthermia due to the increased metabolic rate.
This document summarizes benign prostatic hyperplasia (BPH). It discusses the pathology and pathogenesis of BPH, including that it affects glandular epithelium, stromal cells, and causes increased growth. It also covers the symptomatology, evaluation, and various treatment options for BPH including watchful waiting, medical therapy, and prostatectomies. Surgical treatments discussed are transurethral resection of the prostate (TURP), retropubic prostatectomy (RPP), and transvesical prostatectomy (TVP).
This document provides an introduction to pathology. It defines pathology as the study of disease through scientific methods and examines the mechanisms of disease from etiology to clinical manifestation. The key points are:
1. Pathology studies the etiology, pathogenesis, morphologic changes, and functional derangements that result from disease processes.
2. Diseases are examined through diagnostic techniques including histopathology, cytopathology, and biochemical/immunological testing to identify structural and molecular alterations.
3. The natural course of a disease involves stages from initial exposure through biological onset, clinical onset, potential resolution or death.
This document provides an overview of preeclampsia and eclampsia. It begins with an introduction and outlines risk factors and classifications. It then describes clinical features such as hypertension and proteinuria. The pathophysiology section explains how abnormal placentation leads to reduced blood flow and imbalance of prostaglandins. Complications are also discussed, including renal failure, pulmonary edema, and intrauterine growth restriction. The document provides information on diagnosis and management of preeclampsia and eclampsia.
This seminar presentation discusses hypersensitivity reactions, which are exaggerated or inappropriate immune responses to benign antigens. It covers the objectives, mechanisms, classification, complications, and references related to hypersensitivity reactions. There are four main types of hypersensitivity reactions: Type I involves IgE antibodies and mast cell degranulation, Type II involves antibody-mediated cell cytotoxicity, Type III involves immune complex formation and deposition, and Type IV involves T-cell mediated reactions. The presentation provides examples and details of each type of hypersensitivity reaction and their clinical implications.
This document discusses inflammation. It defines inflammation as the body's local response to injury or infection aimed at eliminating the cause of injury and initiating repair. The cardinal signs of inflammation are redness, swelling, heat, pain, and loss of function. The early response involves vasodilation and increased permeability, causing swelling. The late response involves neutrophils in acute inflammation and macrophages in chronic cases, which work to destroy pathogens and initiate healing. Understanding inflammation is important for diagnosing conditions like appendicitis and treating diseases.
This document provides an overview of hyaline membrane disease (HMD), also known as respiratory distress syndrome (RDS), for nursing students. It defines RDS as a lack of pulmonary surfactant, outlines its pathophysiology and risk factors. The document discusses the clinical presentation of RDS, including respiratory distress, radiographic findings and laboratory abnormalities. It also covers diagnosis, differential diagnoses, treatment including surfactant replacement and supportive care, complications and prevention of RDS through antenatal corticosteroids.
1. Acute inflammation is rapid in onset and short in duration, characterized by fluid and protein exudation and neutrophil accumulation. Chronic inflammation is slower in onset and longer lasting, characterized by mononuclear cell infiltration, ongoing tissue destruction, and attempts at repair through fibrosis.
2. The key features of acute inflammation are vasodilation, increased vascular permeability, and recruitment of leukocytes from the blood vessels to the site of injury. Chronic inflammation features mononuclear cell infiltration, persistent tissue damage, and attempts to repair through fibrosis and angiogenesis.
3. Granulomatous inflammation is a pattern of chronic inflammation seen with certain infections, featuring focal collections of activated macrophages that develop an epithelial-like appearance known
Cellular injury can result in adaptation, reversible injury, irreversible injury leading to necrosis or apoptosis, or intracellular accumulation. The outcome depends on the injurious agent and cell type. Adaptations include hypertrophy, hyperplasia, atrophy, and metaplasia. Reversible injury includes fatty changes and pigment accumulation. Necrosis is cell death resulting from hypoxia, free radicals, membrane damage, or calcium influx. There are several types of necrosis including coagulative, liquefactive, fat, caseous, and gangrenous. Apoptosis is programmed cell death that does not cause inflammation.
This document discusses pelvic inflammatory disease (PID) and ectopic pregnancy. It defines PID as an infection of the upper female genital tract that spreads to involve the uterus, fallopian tubes, and ovaries. Common causes are Neisseria gonorrhoeae, Chlamydia trachomatis, and bacterial vaginosis. Risk factors include multiple sexual partners and past gynecological procedures. Symptoms can range from mild to severe abdominal pain. Diagnosis involves clinical exams and tests. Complications include infertility and ectopic pregnancy. Ectopic pregnancy is defined as implantation outside the uterus, most commonly in the fallopian tube. Causes may include anatomical obstructions or abnormalities in the fallop
The document discusses acid-base balance and disturbances. It defines the two main buffer systems - metabolic (kidneys) and respiratory (lungs) - that work to maintain blood pH between 7.35-7.45. Five primary acid-base imbalances are described: metabolic acidosis, metabolic alkalosis, respiratory acidosis, respiratory alkalosis, and mixed disturbances. Diagnosis involves blood tests including arterial blood gases and electrolytes to classify the disturbance based on pH, PCO2, and bicarbonate levels. Treatment focuses on addressing the underlying cause rather than just the pH effect.
This document provides an overview of autoimmune diseases. It defines autoimmune diseases as conditions where the immune system mistakenly attacks and destroys healthy body tissue. The causes include genetic factors, environmental triggers like infections, and defects in immunologic tolerance. Some specific autoimmune diseases discussed are rheumatoid arthritis, type 1 diabetes, Hashimoto's thyroiditis, Graves' disease, myasthenia gravis, and systemic sclerosis. The mechanisms, clinical features, pathology, and treatment options are described for each condition.
Patient safety is a fundamental principle of healthcare. Adverse events may result from problems in practice, products, procedures or systems. Improving patient safety demands a complex, system-wide effort involving performance improvement, risk management, infection control, safe clinical practices, and a safe environment of care. Unsafe injections expose millions of people to infections worldwide each year. Ensuring single-use injection devices and safety boxes are available in every healthcare facility can prevent reuse and unsafe waste disposal.
The document discusses integumentary disorders and provides information on the anatomy and functions of the skin. It describes common skin conditions like eczema, acne, and psoriasis. Eczema is characterized by redness, dryness, and itching. Acne presents as inflamed papules and pustules on the face and back. Psoriasis causes thickened red patches covered with silvery scales. The document outlines signs, causes, and management approaches for various dermatological disorders and skin lesions.
A nebulizer converts liquid medication into a mist that can be inhaled directly into the lungs, allowing for rapid onset of medication effects. There are different types of nebulizers that administer medication via mouthpiece or mask. Nebulizers are commonly used to treat conditions involving airflow obstruction like asthma. Proper use involves preparing equipment and medication, positioning the patient, administering the treatment, and monitoring for side effects.
This document provides an overview of the endocrine system, including the major glands and hormones. It describes the hypothalamus and pituitary glands which regulate many other endocrine glands. Other glands covered include the thyroid, parathyroid, adrenal, pancreas, ovaries, testes, thymus, and pineal. The document outlines how to assess endocrine disorders and lists some common laboratory studies. It also provides details on diabetes mellitus, describing the main types of diabetes including type 1, type 2, and gestational diabetes.
This document provides guidance on performing a cardiac and abdominal examination. It outlines the objectives, symptoms, and physical examination techniques for assessing the cardiovascular and abdominal systems. The cardiovascular section covers inspection of the jugular veins, palpation of pulses, auscultation of heart sounds, and measurement of blood pressure. The abdominal section reviews inspection, auscultation, percussion and palpation techniques. Proper examination order and identification of normal versus abnormal findings are emphasized.
This document summarizes several endocrine system disorders including hyperthyroidism, hypothyroidism, hyperparathyroidism, hypoparathyroidism, Cushing's syndrome, Conn's syndrome, Addison's disease, and pituitary adenomas. It provides epidemiological data on certain disorders and describes associated symptoms, diagnostic evaluations, and medical management approaches. Multiple endocrine neoplasia syndromes are also briefly discussed.
This document provides guidance on effectively breaking bad news to patients. It discusses the importance of this communication skill for healthcare professionals. The document outlines best practices for setting, perception checking, invitation, knowledge sharing, exploring the patient's response, and summarizing. Key aspects include ensuring privacy, empathy, clarity, and allowing time for the patient's questions and reactions. The SPIKES protocol is presented as a framework for structuring the discussion. Examples of both best practices and things to avoid are also highlighted.
2 Assessment of patient with respiratory disorder.pptxMohammedAbdela7
This document provides guidelines for performing a physical examination of the thorax and lungs. It begins by outlining the session objectives and general examination guidelines. It then discusses pertinent history data to obtain, such as cough characteristics and sputum type/color. The physical exam involves inspection, palpation, percussion, and auscultation of the chest. Inspection evaluates breathing patterns, respiratory distress signs, and overall appearance. Palpation assesses tracheal position, chest expansion, tactile fremitus, and tenderness. Percussion and auscultation are also performed to evaluate the lungs. Proper equipment, patient positioning, and exam techniques are emphasized throughout.
This document provides an overview of critical thinking, evidence-based medicine, and how to practice evidence-based medicine. It defines critical thinking as the process of conceptualizing and evaluating information to guide beliefs and actions. Evidence-based medicine is defined as integrating the best research evidence with clinical expertise and patient values/circumstances. The history of evidence-based medicine is discussed, from Cochrane's work in the 1970s highlighting gaps between research and practice, to Guyatt coining the term "evidence-based medicine" in 1991 and Sackett explaining the combination of research, expertise, and patient factors in 1996. The five steps to practice evidence-based medicine are described as developing questions, finding evidence, appraising evidence, integrating
5-hydroxytryptamine or 5-HT or Serotonin is a neurotransmitter that serves a range of roles in the human body. It is sometimes referred to as the happy chemical since it promotes overall well-being and happiness.
It is mostly found in the brain, intestines, and blood platelets.
5-HT is utilised to transport messages between nerve cells, is known to be involved in smooth muscle contraction, and adds to overall well-being and pleasure, among other benefits. 5-HT regulates the body's sleep-wake cycles and internal clock by acting as a precursor to melatonin.
It is hypothesised to regulate hunger, emotions, motor, cognitive, and autonomic processes.
Debunking Nutrition Myths: Separating Fact from Fiction"AlexandraDiaz101
In a world overflowing with diet trends and conflicting nutrition advice, it’s easy to get lost in misinformation. This article cuts through the noise to debunk common nutrition myths that may be sabotaging your health goals. From the truth about carbohydrates and fats to the real effects of sugar and artificial sweeteners, we break down what science actually says. Equip yourself with knowledge to make informed decisions about your diet, and learn how to navigate the complexities of modern nutrition with confidence. Say goodbye to food confusion and hello to a healthier you!
Nano-gold for Cancer Therapy chemistry investigatory projectSIVAVINAYAKPK
chemistry investigatory project
The development of nanogold-based cancer therapy could revolutionize oncology by providing a more targeted, less invasive treatment option. This project contributes to the growing body of research aimed at harnessing nanotechnology for medical applications, paving the way for future clinical trials and potential commercial applications.
Cancer remains one of the leading causes of death worldwide, prompting the need for innovative treatment methods. Nanotechnology offers promising new approaches, including the use of gold nanoparticles (nanogold) for targeted cancer therapy. Nanogold particles possess unique physical and chemical properties that make them suitable for drug delivery, imaging, and photothermal therapy.
Nutritional deficiency Disorder are problems in india.
It is very important to learn about Indian child's nutritional parameters as well the Disease related to alteration in their Nutrition.
Travel vaccination in Manchester offers comprehensive immunization services for individuals planning international trips. Expert healthcare providers administer vaccines tailored to your destination, ensuring you stay protected against various diseases. Conveniently located clinics and flexible appointment options make it easy to get the necessary shots before your journey. Stay healthy and travel with confidence by getting vaccinated in Manchester. Visit us: www.nxhealthcare.co.uk
Osvaldo Bernardo Muchanga-GASTROINTESTINAL INFECTIONS AND GASTRITIS-2024.pdfOsvaldo Bernardo Muchanga
GASTROINTESTINAL INFECTIONS AND GASTRITIS
Osvaldo Bernardo Muchanga
Gastrointestinal Infections
GASTROINTESTINAL INFECTIONS result from the ingestion of pathogens that cause infections at the level of this tract, generally being transmitted by food, water and hands contaminated by microorganisms such as E. coli, Salmonella, Shigella, Vibrio cholerae, Campylobacter, Staphylococcus, Rotavirus among others that are generally contained in feces, thus configuring a FECAL-ORAL type of transmission.
Among the factors that lead to the occurrence of gastrointestinal infections are the hygienic and sanitary deficiencies that characterize our markets and other places where raw or cooked food is sold, poor environmental sanitation in communities, deficiencies in water treatment (or in the process of its plumbing), risky hygienic-sanitary habits (not washing hands after major and/or minor needs), among others.
These are generally consequences (signs and symptoms) resulting from gastrointestinal infections: diarrhea, vomiting, fever and malaise, among others.
The treatment consists of replacing lost liquids and electrolytes (drinking drinking water and other recommended liquids, including consumption of juicy fruits such as papayas, apples, pears, among others that contain water in their composition).
To prevent this, it is necessary to promote health education, improve the hygienic-sanitary conditions of markets and communities in general as a way of promoting, preserving and prolonging PUBLIC HEALTH.
Gastritis and Gastric Health
Gastric Health is one of the most relevant concerns in human health, with gastrointestinal infections being among the main illnesses that affect humans.
Among gastric problems, we have GASTRITIS AND GASTRIC ULCERS as the main public health problems. Gastritis and gastric ulcers normally result from inflammation and corrosion of the walls of the stomach (gastric mucosa) and are generally associated (caused) by the bacterium Helicobacter pylor, which, according to the literature, this bacterium settles on these walls (of the stomach) and starts to release urease that ends up altering the normal pH of the stomach (acid), which leads to inflammation and corrosion of the mucous membranes and consequent gastritis or ulcers, respectively.
In addition to bacterial infections, gastritis and gastric ulcers are associated with several factors, with emphasis on prolonged fasting, chemical substances including drugs, alcohol, foods with strong seasonings including chilli, which ends up causing inflammation of the stomach walls and/or corrosion. of the same, resulting in the appearance of wounds and consequent gastritis or ulcers, respectively.
Among patients with gastritis and/or ulcers, one of the dilemmas is associated with the foods to consume in order to minimize the sensation of pain and discomfort.
- Video recording of this lecture in English language: https://youtu.be/Pt1nA32sdHQ
- Video recording of this lecture in Arabic language: https://youtu.be/uFdc9F0rlP0
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Computer in pharmaceutical research and development-Mpharm(Pharmaceutics)MuskanShingari
Statistics- Statistics is the science of collecting, organizing, presenting, analyzing and interpreting numerical data to assist in making more effective decisions.
A statistics is a measure which is used to estimate the population parameter
Parameters-It is used to describe the properties of an entire population.
Examples-Measures of central tendency Dispersion, Variance, Standard Deviation (SD), Absolute Error, Mean Absolute Error (MAE), Eigen Value
Breast cancer: Post menopausal endocrine therapyDr. Sumit KUMAR
Breast cancer in postmenopausal women with hormone receptor-positive (HR+) status is a common and complex condition that necessitates a multifaceted approach to management. HR+ breast cancer means that the cancer cells grow in response to hormones such as estrogen and progesterone. This subtype is prevalent among postmenopausal women and typically exhibits a more indolent course compared to other forms of breast cancer, which allows for a variety of treatment options.
Diagnosis and Staging
The diagnosis of HR+ breast cancer begins with clinical evaluation, imaging, and biopsy. Imaging modalities such as mammography, ultrasound, and MRI help in assessing the extent of the disease. Histopathological examination and immunohistochemical staining of the biopsy sample confirm the diagnosis and hormone receptor status by identifying the presence of estrogen receptors (ER) and progesterone receptors (PR) on the tumor cells.
Staging involves determining the size of the tumor (T), the involvement of regional lymph nodes (N), and the presence of distant metastasis (M). The American Joint Committee on Cancer (AJCC) staging system is commonly used. Accurate staging is critical as it guides treatment decisions.
Treatment Options
Endocrine Therapy
Endocrine therapy is the cornerstone of treatment for HR+ breast cancer in postmenopausal women. The primary goal is to reduce the levels of estrogen or block its effects on cancer cells. Commonly used agents include:
Selective Estrogen Receptor Modulators (SERMs): Tamoxifen is a SERM that binds to estrogen receptors, blocking estrogen from stimulating breast cancer cells. It is effective but may have side effects such as increased risk of endometrial cancer and thromboembolic events.
Aromatase Inhibitors (AIs): These drugs, including anastrozole, letrozole, and exemestane, lower estrogen levels by inhibiting the aromatase enzyme, which converts androgens to estrogen in peripheral tissues. AIs are generally preferred in postmenopausal women due to their efficacy and safety profile compared to tamoxifen.
Selective Estrogen Receptor Downregulators (SERDs): Fulvestrant is a SERD that degrades estrogen receptors and is used in cases where resistance to other endocrine therapies develops.
Combination Therapies
Combining endocrine therapy with other treatments enhances efficacy. Examples include:
Endocrine Therapy with CDK4/6 Inhibitors: Palbociclib, ribociclib, and abemaciclib are CDK4/6 inhibitors that, when combined with endocrine therapy, significantly improve progression-free survival in advanced HR+ breast cancer.
Endocrine Therapy with mTOR Inhibitors: Everolimus, an mTOR inhibitor, can be added to endocrine therapy for patients who have developed resistance to aromatase inhibitors.
Chemotherapy
Chemotherapy is generally reserved for patients with high-risk features, such as large tumor size, high-grade histology, or extensive lymph node involvement. Regimens often include anthracyclines and taxanes.
Summer is a time for fun in the sun, but the heat and humidity can also wreak havoc on your skin. From itchy rashes to unwanted pigmentation, several skin conditions become more prevalent during these warmer months.
“Psychiatry and the Humanities”: An Innovative Course at the University of Mo...Université de Montréal
“Psychiatry and the Humanities”: An Innovative Course at the University of Montreal Expanding the medical model to embrace the humanities. Link: https://www.psychiatrictimes.com/view/-psychiatry-and-the-humanities-an-innovative-course-at-the-university-of-montreal
2. Review Of Anatomy/Physiology Of The Endocrine Glands
The endocrine system is made up of glands and the hormones they secrete.
Although the endocrine glands are the primary hormone producers, the brain, heart, lungs, liver, skin, thymus,
gastrointestinal mucosa, and placenta also produce and release hormones.
3.
4. The primary endocrine glands are the pituitary (the master gland), pineal, thyroid,
parathyroid, islets of Langerhans, adrenals, ovaries in the female and testes in the male.
The function of the endocrine system is the production and regulation of chemical
substances called hormones.
A hormone is a chemical transmitter. It is released in small amounts from glands,
and is transported in the bloodstream to target organs or other cells.
Hormones are chemical messengers, transferring information and instructions
from one set of cells to another.
5. Hormones regulate growth, development, mood, tissue function, metabolism, and sexual function.
Hyposecretion or hypersecretion of any hormone can be harmful to the body.
Controlling the production of hormones can treat many hormonal disorders in the body.
6. The endocrine system and nervous system work together to help maintain homeostasis… balance.
The hypothalamus is a collection of specialized cells located in the brain, and is the primary link between the
two systems.
It produces chemicals that either stimulate or suppress hormone secretions of the pituitary gland.
7. Anterior Pituitary Gland
● Growth Hormone (GH)- affects growth of skeletal muscles
and bones
● Prolactin (PRL)- stimulates milk production after pregnancy
● Gonadotropic- regulates hormone activity of sex organs
● Also effects adrenal cortex and thyroid hormone release
8. Posterior Pituitary
● Oxytocin- helps during pregnancy
● Antidiuretic hormone (ADH)- inhibits urine
production
● Alcohol inhibits ADH causing increased
output of urine
9. Growth Hormone (GH):Essential for the growth and development of bones,
muscles, and other organs. It also enhances protein synthesis, decreases the
use of glucose, and promotes fat destruction.
Over secretion of growth hormone:
Giantism in childhood Acromegaly in adults (with large bones of face,
hands and feet ).
Under secretion of growth hormone:
Dwarfism in childhood
10. Adrenocorticotropin (ACTH): Essential for the growth of the adrenal cortex.
Thyroid-Stimulating Hormone (TSH):Essential for the growth and development of the
thyroid gland.
11. Follicle-Stimulating Hormone (FSH):is a gonadotropic
hormone.
It stimulates the growth ovarian follicles in the female and
the production of sperm in the male.
12. Luteinizing Hormone(LH):is a gonadotropic hormone
stimulating the development of corpus luteum in the female
ovarian follicles and the production of testosterone in the
male.
Prolactin (PRL):stimulates the development and growth of
the mammary glands and milk production during
pregnancy.
14. Antidiuretic Hormone (ADH): stimulates the reabsorption of water by the
renal tubules.
Hyposecretion of this hormone can result in diabetes insipidus.
Oxytocin: stimulates the uterus to contract during labor, delivery, and
parturition.
A synthetic version of this hormone, used to induce labor, is called Pitocin.
It also stimulates the mammary glands to release milk.
15. The islets of Langerhans are small clusters of cells located in the
pancreas.
Langerhans. Alpha cells facilitate the breakdown of glycogen to
glucose. This elevates the blood sugar.
Beta cells secrete the hormone insulin, which is essential for the
maintenance of normal blood sugar levels. Inadequate levels result in
diabetes mellitus.
16. Assessment
24
History
Changes in energy level
T
olerance to heat or cold
Weight
Fat and fluid distribution,
Secondary sexual characteristics
Sexual dysfunction
Memory
Concentration
Sleep patterns
Mood
17. History…
The healthhistoryinformation should include:
1. The severityofthesechanges
2. The lengthoftimethepatienthas experienced
thesechanges
3. The wayinwhichthesechangeshave
affectedthepatient’
s abilityto carryout ALD
4. The effectofthechangeson thepatient’
s self-perception
25
19. Physical Exam …
• Edema
• Thinning of theskin
• Obesity of the trunk
• Thinness of theextremities
• Increasedsize of the feet and hands
• Elevated/Decaresed blood pressure
• Behavioral changes such as agitation, nervousness, a flat affect,
or a lack of concern about personal appearance
21. Disorders of the islets of Langerhans
The pancreatic islets also called “islets of Langerhans” or island
of Langerhans are the regions of the pancreas that contain its
endocrine (i.e., hormone producing) cells.
The most common islet cell the Beta cell. Insulin is the major
hormone in the regulation of carbohydrates, fat, and protein
metabolism.
22. Cont.…
There are three main types of cells in the pancreatic islets.
(alpha) 20 % cells that secrete “glucagon”.
(beta) 75% cells that secrete “insulin”.
(delta) 5% cells that secrete “somatostatin”.
23. INSULIN
A hormone produced in the pancreas by the islets of Langerhans,
which regulates the amount of glucose in the blood.
The lack of insulin causes a form of diabetes mellitus.
The main function of insulin is to lower blood levels of absorbed
nutrients when they rise above normal.
24. GLUCAGON
A hormone formed in the pancreas which promotes the breakdown of glycogen
to glucose in the liver and assist insulin in regulating blood glucose in the
normal range.
1.Gluconeogenesis:The synthesis of glucose from noncarbohydrate
source ( such as amino acids & glycerol)
2.Glycogenolysis:Glycogen breakdown releases glucose when it is
needed.
25. SOMATOSTATIN
SOMATOSTATIN (GHRIH) Also known as growth inhibiting
hormone.
The effect of this hormone, also produced by the hypothalamus, is
to inhibit the secretion of both insulin and glucagon.
26. Diabetes mellitus
Diabetes mellitus is characterized by chronic hyperglycemia due to
inadequate insulin secretion and/or the effectiveness of endogenous
insulin (insulin resistance).
Diabetes mellitus is a contributing factor to development of
cardiovascular disease, hypertension, kidney disease, neuropathy,
retinopathy, peripheral vascular disease and stroke as individuals
age.
27. Cont.…
Type 1 diabetes mellitus is an autoimmune dysfunction
involving the destruction of beta cells, which produce insulin in
the islets of Langerhans of the pancreas.
Immune system cells and antibodies are present in circulation
and may also be started by certain genetic tissue types or viral
infections.
28. Cont…
Type 1 diabetes mellitus usually occurs at a young age, and there
are no successful interventions to prevent the disease.
Type 2 diabetes mellitus is a progressive condition due to
increasing inability of cells to respond to insulin (insulin
resistance) and decreased production of insulin by the beta cells.
It often occurs later in a client’s life due to obesity, inactivity, and
heredity.
29. Risk Factors
Family history of diabetes
Obesity (BMI > 27 k/m2)
Race
Age ≥ 45 years
Previously identifiedimpaired fasting glucose or impaired glucose
tolerance
Hypertension (≥ 140/90mmhg)
HDL cholesterol level≤ 35 mg/dL(0.9mmol/l) and /ortriglyceride levelof
≥ 250mg/dL (2.8 mmol/L)
History of gestational diabetes or delivery ofbabies over 9lbs (4 Kg)
30. DM Classification
1. Type1 diabetes(previouslyreferredto as insulindependent
diabetes(IDD)
2. Type2 diabetes (previouslyreferredto as non-insulindependent
diabetes(NIDD)
3. Gestationaldiabetes
4. Diabetes mellitusassociatedwith other conditions or syndrome
32. Type 2 Diabetes (T2D)
Accountsforapproximately90to95%ofcases
Results from decreased sensitivity of tissues to insulin (called insulin resistance) &
impairedβ-cellfunctioningresultingindecreasedinsulinproduction
MostpeoplewithT2Dareobeseadults>40yrsofage
Obesity appears to play a major role in T2Dby down regulating insulinreceptors in
skeletal muscleandfat cells
Peripheralinsulinresistance
Stimulatesincreasedinsulinproductionasacompensatory response,whichmay
alsopredisposethepatienttoweight gain.
33. Cont.…
The exact mechanisms that lead to insulin resistance and impaired insulin secretion in
T2Dareunknown,althoughgeneticfactorsarethoughttoplayarole
Prevalenceofdiabetesincreaseswithage, withabout half ofcasesinpeopleolderthan55
Despite the impaired insulin secretion that is characteristic of T2D, there is enough
endogenousinsulinpresent, topreventlipolysisandproductionof ketenebodies
Therefore,diabeticketoacidosis(DKA)doesnottypicallyoccurinT2D
34. SIGNS AND SYMPTOM
⚫ Hallmarksymptomsof all typesof DMarethe3Ps:
• Polyuria
• Polydipsia
• Polyphagia
35. SIGNS AND SYMPTOM
Type I:
• Fast onset because no insulin is being produced
• Increased appetite (polyphagia) because cells are starved for energy
• Increased thirst (polydipsia) from the body attempting to rid itself of glucose
• Increased urination (polyuria) from the body attempting to rid itself of glucose
• Weight loss since glucose is unable to enter cells
• Frequent infections as bacteria feeds on the excess glucose
• Delayed healing because elevated glucose levels in the blood hinders healing
process
36. Cont.…
Type II:
Slow onset because some insulin is being produced
Increased thirst (polydipsia) from the body attempting to rid itself of
glucose
Increased urination (polyuria) from the body attempting to rid itself of
glucose
infection as bacteria feeds on the excess glucose
Delayed healing because elevated glucose levels in the blood hinder the
healing process
40. Dx …
B.OralglucoseT
oleranceT
est(OGTT)
◦ Most sensitive test for the of diabetes
◦ Lessconvenient thanFBGtest
◦ Performedinthemorningafter 10-12hourfast
BGL (mg/dL): After 2hrs Indication
139 and below Normal
140 to 199 Pre-diabetic (impaired glucose tolerance)
200 and above Diabetes*
* Confirmed by repeating the test on a different day
42. Criteria for the of DM (especiallyT2D)
I. Symptomsofdiabetespluscasual BGL≥200mg/dL
Theclassicsymptomsofdiabetesincludethe3Ps
II. Fasting plasmaglucose≥126mg/dL(7.0mmol/L)
Fastingisdefinedasnocaloricintakeforatleast 8
hours
III. 2-hourpostloadglucose≥200mg/dL(11.1mmol)duringanoral
glucosetolerancetest.Thetestshouldbeperformedusinga
glucoseloadcontainingtheequivalent of75gglucosedissolvedin
water
43. Diabetes Management
The main goal of diabetes treatment is to
normalize insulin activity and blood
glucose levels to reduce the development
of vascular and neuropathic complications.
There are five components of diabetes
management which are equally important
44.
45. Objective of treatment
Relieve symptoms
Prevent acute hyperglycemic complications
Prevent chronic complications of diabetes
Prevent treatment-related hypoglycemia
Achieve and maintain appropriate glycemic targets
Ensure weight reduction in overweight and obese individuals
47. 1. Nutritional therapy
57
Nutrition, meal planning, and weight control are the foundation of diabetes
management
Thegoals of nutritional managementinclude:
• Providingall theessentialfoodconstituents necessary for optimal
nutrition
• Meeting energy needs
• Achieving and maintaining reasonable weight
• Preventingwidedailyfluctuations inbloodglucose levels
• Decreasing serum lipid levels, if elevated
48. For obese diabetic patients (especially with T2D) weight loss is the key
to treatment
Ingeneral - overweight is considered to be a BMI of 25-29
Obesity is defined as 20%above a BMI equalto or greater than 30
Theuse of fiber diets:
Soluble (legumes, fruits)
Insoluble (whole grain breads and serials) plays a role in lowering
total cholesterol and low density lipoprotein cholesterol in the blood
58
49. 2.Exercises
Exercise is extremely important in managing diabetes because
it lowers the BGL by:
Increasing the up take of glucose by body mussels and
Improving insulin utilization
50. Cont.…
Exerciserecommendations
People with diabetes should exercise at the same time (preferably
whenbloodglucoselevelsareat their peak) andinthesameamount
eachday
Aslow,gradualincreasein theexerciseperiodis encouraged
Formanypatients, walking isasafeand beneficial formof
exercise.
52. Generalprecautionsforexercisein Diabetes
Avoid exercise during periods of poor metabolic control
Inspect feet daily after exercise
Avoid exercise in extreme cold or heat
Use proper foot wear and if appropriate, other protective equipment
53. 3. Monitoring Glucose levels and ketones
Blood glucose monitoring is a cornerstone of diabetes
management, and self-monitoring of blood glucose (SMBG)
levels has dramatically altered diabetes care.
54. 4. Pharmacologic Therapy
Includestreatmentwithinsulinor oral anti-diabeticagents
Decisions in drug treatment should be based primarily on the
typeof diabetes andthegoals for glycoliccontrol.
55. InsulinTherapyandPreparations
⚫ Because the body losses the ability to produce insulin in T1D, exogenous insulin must be
administeredforlife.
⚫ InT2D,insulinmaybenecessary:
Onalongtermbasistocontrolglucoselevelsifdiet andoralagentsfail
ForsomepatientsinwhomT2Disusuallycontrolled bydietaloneorbydietandoral
agentspatientsmay requireinsulintemporaryduring:
Infection
Pregnancy
Surgery, or
Someotherstress-full events.
56. Cont.…
Insulinaction
The main action of insulin is to stimulate carbohydrate metabolism by
increasing the movement of glucose and other monosaccharide in to the cells
of muscle, fat, andliver.
Once insulin binds with receptors on the cell membrane, glucose can move
intothecell,promotingcellularmetabolismandenergyproduction.
60. Insulin regimen in type 1 Diabetes Mellitus
1. Conventional insulin therapy-describes simpler non-
physiologic insulin regimens, such as single daily injections, or
two injections per day (including a combination of regular or
short-acting and NPH insulin)
2. Intensive insulin therapy-describes treatment with three or
more injections per day or with continuous insulin infusion with
an insulin pump.
61. Intensive insulin therapy requires: - Monitoring blood sugar before
breakfast (fasting), before lunch, before dinner & before bed.
Counting and recording carbohydrates.
Adjusting insulin doses in response to given glucose patterns. -
Coordinating diet, exercise, and insulin therapy.
Responding appropriately to hypoglycemia
62. Designing insulin therapy
Total insulin dose per day Initiation, 0.2 to 0.4 units/kg/day
Maintenance – highly variable roughly 0.6 to 0.7 units/kg/day
Regimen options-with NPH and regular insulin (commonly available in
Ethiopian setting)
1. NPH twice daily injection – before breakfast and at bed time and
Regular Insulin twice daily injection-before breakfast and before dinner
2. 70/30 (70% NPH & 30% regular) twice daily injection-before
breakfast and before dinner
3. NPH twice daily injections – before breakfast and before bedtime
65. Complications of InsulinTherapy
77
1. Local allergicreactions
Rx- antihistamine1hourbeforetheinjection
2. Systemicallergicreactions Rx- desensitization
3. Insulinlipdystrophy
LipoatrophyandLipohypertrophy
Mgt-Rotationof injectionsites
66. Complications of InsulinTherapy…
4. InsulinResistance
• Mostcommonlyoccursbecauseof obesity
, whichcanbeovercomebyweight
loss
• Clinicallydefinedasadailyinsulin requirementof200unitsor
more
Rx
• Moreconcentratedinsulinpreparation, suchas U500
• Occasionally
, prednisonetoblocktheproduction of antibodies
67. OralAnti-diabeticAgents
May be effective for patients who have T2D that cannot
be treated by diet and exercise alone
Cannot be used during pregnancy
May also be used with insulin in the management of
some patients withT2D
Use with insulin may decrease the insulin dosage in
some individuals
68. Cont.…
Metformin –
the first line medicine for initiation of therapy
if intolerant to metformin or have a contraindication to it,
sulfonylureas can be the initial treatment medicine.
Metformin, 500mg, P.O.daily with meals. Titrate dose slowly
depending on blood glucose
69. Cont.…
Glibenclamide, 2.5mg-5mg, P.O.daily 30 minutes before
breakfast.
Titrate dose slowly depending on HbA1c and/or fasting
blood glucose levels to 15mg daily.
When 7.5mg per day is needed, divide the total daily
dose into 2, with the larger dose in the morning.
Avoid in the elderly and patients with renal impairment.
70. 5.Patient Education
🢅 Nutrition
🢅 Medication effects and side effects
🢅 Exercise
🢅 Disease progression
🢅 Prevention strategies:blood glucose monitoring
techniques,and medication adjustment
🢅 T
eaching survival skills
Basic definitions of insulin
T
reatment modalities
Recognition,treatment,and prevention of acute complications
🢅 Preventive measures of long term complications
71. Pt educationCont’d…
Teaching patients to self administer insulin
🢅Storing insulin
🢅Selecting syringes
🢅Preparing the injection mixing insulins
🢅With drawing insulin
🢅Selecting and rotating the injection site
🢅Preparing the skin.Alcohol is not recommended for
cleansing
🢅Inserting the needle
🢅Aspiration is generally not recommended
72. Acute Complications of Diabetes
There are three major acute complications of diabetes
related to short-term imbalances in bloodglucose levels:
a. Hypoglycemia
b. Diabeticketoacidosis/ DKA, and
c. Hyperglycemichyperosmolarnon-ketotic syndrome/HHNS,
which is also called hyperglycemic hyperosmolar syndrome
or state
73. 1.Hypoglycemia (Insulin Reactions)
⚫ OccurswhentheBGLsfallsto<50to60mg/dL(2.7to 3.3mmol/L)
Causes
⚫ T
oo much insulin or OHAs
⚫ T
oo little food
⚫ Excessive physical activity
Often occurs before meals, especially if meals are
delayed or snacks are omitted
75. Hypoglycemia C/Ms Cont’d
ii. Moderatehypoglycemia
• DropinBGLdeprives thebraincellsof neededfuel for functioning
• Signsof impairedfunctionof theCNSmayinclude:
Inability toconcentrate
Headache,Light headiness,
Confusion, Memoryloses,
Slurredspeech,
Double vision
Drowsiness,
Numbnessof thelips anN
do
v
e
tm
ob
ne
r
g1
6
u,2
e0
1
5
Adrenergic symptom:
Sweating
Tremor
Tachycardia
Palpitation
Nervousness
+
76. Hypoglycemia C/Ms Cont’d
iii. Sever hypoglycemia
Resultsin:
ImpairedCNSfunctions
Disorientedbehavior
Seizures,
Difficultyarousingfromsleep, and
Lossof consciousness
77. Management
By:Fikadu B.JU 95
A.Immediatetreatmentwithcarbohydrate
Theusual recommendation isfor 15gof afast-acting
concentratedsourceofcarbohydratesuchasthe following,
givenorally:
A. Threeor four commercially prepared glucosetablets
B. 100-150ml of fruit juiceor regular soda
C. 6to10hardcandies
D. 2to3teaspoons of sugar or honey
NursingAlert: To prevent sharp increase in BGL, it is not necessary to
add sugar to juice, even if it is labeled as unsweetened juice: the fruit
sugarin juicecontainsenough carbohydrateto raisethe BGL
78. Management
Immediatetreatmentwithcarbohydrate…
• TheBGLshouldberetested in 15minutesandretreatedif it isless
than70to75mg/dL(3.8 to4mmol/L)
• If thesymptomspersistforlongerthan10to15minutesafterinitial
treatment, thetreatmentis repeated
• Oncethesymptomsresolve,asnackcontainingproteinandstarch
(eg,milk orcheeseandbananas/crackers) isrecommendedunless
thepatientplanstoeataregular meal or snackwithin30to60
minutes
81. C.ProvidingPatientEducation
Consistentpatternofeating,administeringinsulin,and exercising
Between-mealandbedtimesnacksmaybeneededtocounteractthemaximuminsulineffect
Thepatient should cover the time of peakactivity of insulin byeating asnackandbytaking
additionalfoodwhenphysical activityisincreased
Routinebloodglucosetests to anticipate change insulinrequirementsandtoadjust the
dosage
82. T
oprevent unexpected hypoglycemia all patients treated with insulin should
wearanidentification braceletortagstatingthat theyhavediabetes
Symptomsofhypoglycemia
Patientswithdiabetes,especially thosereceiving insulin,learntocarrysomeformof
simplesugarwith themat all times
Advisingtorefrainfromeatinghigh-calorie,high-fat dessert foods(eg,cookies,
cakes, icecream)totreat hypoglycemiabecausetheirhighfatcontentmayslow
theabsorptionoftheglucoseandresolutionofthe hypoglycemicsymptoms
83. Diabetic Ketoacidosis (DKA)
Definition
• DKA is a metabolic derangement in T1D that is
caused by an absence or markedly inadequate
amount of insulin
• Insulin deficiency results in disorders in the
metabolism of carbohydrate,protein, and fat
87. DKA: Diagnosis
BGLs may vary from 250 to 800mg /dL
Serum Bicarbonate 0-15mq/L
PH 6.8-7.3
PaCO2 10-30mmHg – Respiratory
compensation
Increased creatinine
Increased BUN
Increased hematocrite
88. DKA: Prevention
If DKA is related to illness,teach the patient about
“Sick day” rules for managing their diabetes when ill
Assess diabetic self management skills including blood
glucose testing and insulin administration
If insulin dose is intentionally altered, psychological
counseling is recommended for patients and family
members
89. DKA: Medical Management
T
reatment Goals:
1. T
reating hyperglycemia
2.Correcting dehydration
3. Maintaining electrolyte balance
4.Reversing acidosis
90. HHNS
Is ametabolic disorderofT2Dresulting fromarelativeeffective
insulin deficiency (i.e., Insulin resistance) initiatedbyaninter-
currentillness that raises the demandfor insulin,associated with
polyuria andseverdehydration.
Occurs most often in older people (50 to 70 years of age) who
havenoknownhistoryof diabetesor who havetype2diabetes
91. Hyperosmolalityandhyperglycemiaarepredominant
The patient’s persistent hyperglycemia causes osmotic diuresis,
resulting in losses of waterandelectrolytes.
BecauseofwatershiftsfromICFspacetoECFspace thepatientmay
presentwithneurologicabnormalities suchas:
Somnolence, coma,
Seizures,
Hemiparesis, and
Aphasia
92. HHNS: Precipitating factors
i. Acute illness (e.g.pneumonia,stroke)
ii. Medications that exacerbate BGL (e.g.
thiazides)
iii. T
reatments such as dialysis
93. H HNS: Diagnosis
History
Physical Examination
Lab test
BGL 600 to 1200mg/dL
Electrolytes
BUN
CBC- RBCs
Serum osmolality >350 mosm/kg
ABG analysis – PH normal
95. Comparison of DKA and HHNS
Characteristics DKA HHNS
Patients most
commonly
Can occur in type 1 or type 2
diabetes; more common in type 1
diabetes
Can occur in type 1 or type 2
diabetes; more common in type 2
diabetes,
especially elderly patients with
type 2 diabetes
Precipitating event Omission of insulin; physiologic
stress (infection, surgery, CVA, MI)
Physiologic stress (infection,
surgery, CVA, MI)
Onset Rapid (<24 h) Slower (over several days)
Blood glucose levels Usually >250 mg/dL (>13.9 mmol/L) Usually >600 mg/dL (>33.3 mmol/L)
Arterial pH level <7.3 Normal
Serum and urine
ketones
Present Absent
Serum osmolality 300–350 mOsm/L >350 mOsm/L
Plasma bicarbonate
level
<15 mEq/L Normal
BUN and creatinine
levels
Elevated Elevated
Mortality rate <5% 10–40%
99. Disorders of the thyroid gland
It is a butterfly-shaped organ
Located in the lower neck, anterior to the trachea
Consists of two lateral lobes connected by an isthmus
Is about 5 cmlong and 3 cmwide and weighs about 30 g
Hasvery high blood flow:
About 5 mL/min per gram of thyroid tissue (150ml/min)
Approximately five times the blood flow to the liver
Highmetabolic activity of thethyroidgland
100.
101. Synthesis of thyroid hormones (T3 &T4)
T3+T4= Iodine molecule + tyrosine (amino acid)
The major use of iodine in the body is by the thyroid gland, and the
major derangement in iodinedeficiencyis alteration of thyroid function.
102. Function ofThyroid Hormone
A.Theprimary functionof thyroid hormoneisto control cellular
metabolicactivity
T4
Relativelyweak hormone
Maintainsbody metabolisminasteadystate
T3
Is about fivetimes as potent asT4
Has amore rapid metabolicaction
B.Influencecellreplicationandare important inbrain development.
C. Necessary for normal growth.
103. Cont.….
Metabolism
⚫ The complex of physical and chemical processes occurring
within a living cell or organism that are necessary for the
maintenance of life.
⚫ Catabolism is the set of metabolic pathways that
breaks down molecules into smaller units that are either
oxidized to release energy
, or used in other anabolic
reactions
⚫ Anabolism is the set of metabolic pathways that
construct molecules from smaller units
104. Definition of terms
Euthyroid:state of normalthyroid hormoneproduction
Thyroid storm: severe life-threatening hyperthyroidism
precipitated by stress; characterized by high fever,
extreme tachycardia, andalteredmental state
Thyrotoxicosis: condition produced by excessive endogenous or
exogenousthyroid hormone
106. Goiter
A lack of iodine in the patient’s diet (endemic, simple goiter) causes the
thyroid gland to become enlarged.
The thyroid gland can also become enlarged by ingesting large amounts of
goitrogenic drugs or goitrogenic foods that decrease production of
thyroxine, such as strawberries, cabbage, peanuts, peas, peaches, and
spinach.
A simple goiter is not caused by inflammation or neoplasm.
107. SIGNS AND SYMPTOMS
Difficulty in swallowing (dysphagia) due to a large thyroid pressing on
the esophagus
Enlarged thyroid gland
Respiratory distress from the large gland, causing pressure on the trachea
A tight feeling in the throat from a large gland
Coughing
108. TREATMENT
If increased TSH, administer hormone replacement with
levothyroxine (T4), desiccated thyroid, or liothyronine (T3).
If the thyroid gland is overactive, then administer small
doses of Lugol’s solution or potassium iodide solution.
If the simple goiter cannot be reduced through medication,
then a thyroidectomy is performed during which all or part of
the thyroid is removed.
109. NURSING INTERVENTION
Avoid goitrogenic foods or drugs in sporadic goiter since they make thyroid
hormone production.
Use iodized salt to prevent and treat endemic goiter, since the thyroid needs
iodine to make thyroid hormone.
Explain to patient:
The need for life-long thyroid replacement after thyroidectomy and
radioactive iodine.
The need for intermittent lab work to monitor the thyroid.
Visits to the primary care practitioner to monitor size of thyroid gland.
110. Hyperthyroidism
There is an overproduction of T3 and T4 by the thyroid gland that can
be caused by an autoimmune disease where the body’s immune system
attacks the thyroid gland.
Other causes can be a benign tumor (adenomas) resulting in an
enlarged thyroid gland (goiter) or an overproduction of TSH by the
pituitary gland, caused by a pituitary tumor.
111. The thyroid gland produces three hormones: thyroxine (T4),
triiodothyronine (T3), and thyrocalcitonin (calcitonin). Secretion of T3
and T4 is regulated by the anterior pituitary gland through a negative
feedback mechanism.
When serum T3 and T4 levels decrease, thyroid-stimulating hormone
(TSH) is released by the anterior pituitary.
This stimulates the thyroid gland to secrete more hormones until normal
levels are reached.
112. Cont.….
T3 and T4 affect all body systems by regulating overall body metabolism,
energy production, and fluid and electrolyte balance, and controlling
tissue use of fats, proteins, and carbohydrates.
Calcitonin inhibits mobilization of calcium from bone and reduces blood
calcium levels.
Hyperthyroidism is a clinical syndrome caused by excessive circulating
thyroid hormones.
Because thyroid activity affects all body systems, excessive thyroid
hormone exaggerates normal body functions and produces a
hypermetabolic state.
113. Risk Factors
Causes of hyperthyroidism
■ Graves’ disease is the most common cause. Autoimmune
antibodies result in hypersecretion of thyroid hormones.
■ Toxic nodular goiter, a less common form of hyperthyroidism, is
caused by overproduction of thyroid hormone due to the
presence of thyroid nodules.
■ Exogenous hyperthyroidism is caused by excessive dosages of
thyroid hormone.
114. SIGNS AND SYMPTOMS
Enlarged thyroid gland (goiter) caused by tumor
Protrusion of the eyeballs (exophthalmos) due to lymphocytic infiltration
which pushes out the eyeball
Sweating (diaphoresis); excess thyroid hormone raises the metabolic rate
Increased appetite due to increased metabolism
Nervousness due to high levels of thyroid hormone
Weight loss due to increased metabolism
Menstrual changes due to elevated levels of thyroid hormone
115. Laboratory Tests
Serum TSH test – Decreased in the presence of Graves’
disease (may be elevated in secondary or tertiary
hyperthyroidism)
Free thyroxine index (FTI) and T3 – Elevated in the
presence of disease
Thyrotropin-releasing hormone (TRH) stimulation test –
Failure of expected rise in TSH
116. TREATMENT
For mild cases and for young patients, administer antithyroid medication
such as propylthiouracil and methimazole to block synthesis of T3 and T4.
For Graves’ disease and for patients 50 years of age or older, radioactive
iodine therapy is used to decrease production of thyroid hormones.
Administer Lugo's solution, SSKI, or potassium iodide.
For severe cases where the size of the thyroid gland interferes with
swallowing or breathing, the thyroid gland is surgically reduced in size or
removed.
117. Cont.…
Administer beta blockers such as propranolol until hyperthyroidism
diminishes to decrease sympathetic activity and control tachycardia,
tremors, and anxiety.
118. NURSING INTERVENTION
Monitor vital signs.
Provide cool environment.
Protect the patient’s eyes with dark glasses and artificial tears if the
patient has exophthalmos.
Provide a diet high in carbohydrates, protein, calories, vitamins, and
minerals.
Monitor for laryngeal edema following surgery (hoarseness or inability to
clearly speak).
Keep oxygen, suction, and a tracheotomy set near bed in case the neck
swells and breathing is impaired.
119. Keep calcium gluconate near the patient’s bed following surgery.
This is the treatment for tetany and is used to maintain the serum calcium
level in normal range.
Place the patient in a semi-Fowler’s position to decrease tension on the
neck following surgery.
Support the patient’s head and neck with pillows.
Monitor for muscle spasms and tremors (tetany) caused by manipulation of
the parathyroid glands during surgery.
Check drainage and hemorrhage from incision line; red flags are frank
hemorrhage and purulent, foul smelling drainage.
Monitor for signs of hypocalcemia (tingling of hands and fingers).
The treatment is IV calcium, administered quickly.
120. Check for Trousseau’s sign (inflate blood pressure cuff on the arm and
muscles contract).
Check for Chvostek’s sign (tapping of the facial nerve causes twitching
of the facial muscles).
Both this sign and Trousseau’s sign are positive when the parathyroid
glands have been manipulated during thyroid surgery, in which case
they secrete too much phosphorus and not enough calcium.
Since muscles, i.e. the heart, need calcium for work, a low calcium level
may cause muscle spasms which are easily detected by Chvostek’s sign
and Trousseau’s sign.
121. Complication
Hemorrhage at the incision site due to a released surgical tie, excessive
coughing, or movement.
Thyroid Storm/Crisis ;-Thyroid storm/crisis results from a sudden
surge of large amounts of thyroid hormones into the bloodstream,
causing an even greater increase in body metabolism.
Airway Obstruction;-Hemorrhage, tracheal collapse, tracheal mucus
accumulation, laryngeal edema, and vocal cord paralysis can cause
respiratory obstruction, with sudden stridor and restlessness.
Hypocalcemia and Tetany;-Damage to parathyroid gland causes
hypocalcemia and tetany
122. Hypothyroidism
Hypothyroidism is a condition in which there is an inadequate
amount of circulating thyroid hormones triiodothyronine (T3 )
and thyroxine (T4 ), causing a decrease in metabolic rate that
affects all body systems.
123. Classifications of hypothyroidism by etiology
Primary – Primary hypothyroidism stems from dysfunction of the thyroid gland. This is the
most common type of hypothyroidism and is caused by disease (autoimmune thyroiditis –
Hashimoto’s disease) or loss of the thyroid gland (iodine deficiency, radioactive iodine
treatment, surgical removal of the gland).
Secondary – Secondary hypothyroidism is caused by failure of the anterior pituitary gland to
stimulate the thyroid gland or failure of the target tissues to respond to the thyroid hormones
(pituitary tumors).
Tertiary – Tertiary hypothyroidism is caused by failure of the hypothalamus to produce thyroid-
releasing factor.
124. Hypothyroidism is also classified by age of onset
Cretinism – Cretinism is a state of severe hypothyroidism found in infants.
Juvenile hypothyroidism – Juvenile hypothyroidism is most often caused
by chronic autoimmune thyroiditis and affects the growth and sexual
maturation of the child.
Adult hypothyroidism;-Because older adult clients who have
hypothyroidism may have manifestations that mimic the aging
process, hypothyroidism is often undiagnosed in older adult clients,
which can lead to potentially serious adverse effects from
medications (sedatives, opiates, anesthetics).
125. Risk Factors
The disorder is most prevalent in women, with the incidence rising
significantly in people who are 30 to 60 years of age.
Many individuals who have mild hypothyroidism are frequently undiagnosed,
but(intraoperative hypotension, cardiac complications following surgery).
Use of medications (lithium [Lithobid], amiodarone [Cordarone])
Inadequate intake of iodine
126. SIGNS AND SYMPTOMS
Fatigue due to slow metabolism
Hypothermia due to slow metabolism
Brittle nails due to low levels of thyroid hormone, which helps
growth and development
Thick dry hair from lack of thyroid hormone
Dry skin from lack of thyroid hormone
Menstruation changes due to diminished levels of thyroid hormone
Slow cognitive function due to slow metabolism
Weight gain, low levels of thyroid hormone causes fatigue,
sluggishness
127.
128. Diagnostic Procedures
Skull x-ray, computed tomography scan, and magnetic resonance
imaging
☐ These procedures can locate pituitary or hypothalamic lesions that
may be the underlying cause of hypothyroidism.
ECG
☐ Sinus bradycardia, flat or inverted T waves, and ST deviations
129. TREATMENT
Replacement hormone; levothyroxine is the treatment of
choice.
Serum measurements of T3 and T4 will need to be performed
after 6 to 8 weeks to determine if the patient is taking the
correct dose.
The patient needs to be aware that this is a lifetime
replacement.
130. NURSING INTERVENTION
Monitor vital signs.
Provide a warm environment.
Low-calorie diet.
Increase fluids and fiber to prevent constipation.
Take thyroid replacement hormone each morning to avoid insomnia.
Monitor for signs of thyrotoxicosis (an increase in T3): nausea, vomiting,
diarrhea, sweating, tachycardia.
Explain to the patient:
Side effects of thyroid hormone replacement.
Review the signs of hyperthyroidism and hypothyroidism.
Have patient contact health care provider if signs change.
131. Complications
Myxedema;-
Myxedema is a life-threatening condition that occurs when hypothyroidism is
untreated or when a stressor (such as infection, heart failure, stroke, or
surgery) affects an individual who has hypothyroidism.
Clients who have been taking levothyroxine and suddenly stop the medication
are also at risk.
133. Nursing Actions
Maintain airway patency with ventilatory support if
necessary.
Provide continuous ECG monitoring.
Monitor ABGs to detect hypoxia, hypercapnia, respiratory
acidosis.
Warm the client with blankets.
Monitor the client’s body temperature until stable
134. Replace thyroid hormone by administering large doses of levothyroxine
(Synthroid) IV bolus.
Monitor vital signs because rapid correction of hypothyroidism can
cause adverse cardiac effects.
Monitor intake and output, and daily weights. With treatment, urine
output should increase, and body weight should decrease; failure to do
so should be reported to the provider.
Treat hypoglycemia with glucose.
Administer corticosteroids.
Check for possible sources of infection (blood, sputum, urine) that may
have precipitated the coma. Treat any underlying illness.
136. Hypoparathyroidism
Hypoparathyroidism is diminished functioning of the parathyroid glands
leading to low levels of PTH, which causes hypocalcemia.
The primary cause of hypoparathyroidism is destruction of the glands by
an autoimmune cause.
Occasionally the gland(s) may be accidentally removed during
thyroidectomy
137. SIGNS AND SYMPTOMS
Tetany (muscle irritability) due to abnormal levels of calcium
Tingling of periorbital area, hands, and feet from abnormal
calcium levels
Lethargy due to low levels of parathyroid hormone
Cataract development
Convulsions due to acute low calcium levels
138. INTERPRETING TEST RESULTS
Decreased serum calcium due to low levels of PTH.
Increased serum phosphate due to low levels of PTH.
Decreased serum PTH from diminished secretion from the
parathyroid glands.
Decreased urinary calcium from diminished PTH.
Positive Chvostek’s sign due to decreased calcium levels.
Positive Trousseau’s sign due to decreased calcium levels.
139. TREATMENT
Administer calcium gluconate by slow IV drip for acute hypocalcemia
Oral calcium—calcium gluconate, lactate, carbonate (Os-Cal).
Large doses of vitamin D (calciferol) to help absorption of calcium.
Aluminum hydroxide gel (Amphogel) or aluminum carbonate gel; basic
(Basaljel) to decrease phosphate levels.
Keep tracheostomy set and injectable calcium gluconate at bedside for
impaired respiration from swelling as well as for emergency
administration of calcium.
140. NURSING INTERVENTION
Monitor patients condition
If the parathyroids were damaged during thyroid surgery:
• Administer calcium to maintain the serum levels in a low normal range.
• Testing should be done every 3 months.
141. Hyperparathyroidism
Overactivity of the parathyroid glands caused by a tumor
produces too much PTH, resulting in hypercalcemia and
hypophosphatemia.
Excess calcium is reabsorbed by the kidneys and may result in
kidney stones; however, malfunction in the feedback mechanism
prevents detection of excessive calcium levels in the blood,
thereby failing to adjust the secretion of PTH.
Parathyroid tumors are usually benign.
142. SIGNS AND SYMPTOMS
Asymptomatic
Increased serum calcium level
Bone pain or fracture as a result of excreting calcium from bone
Kidney stones
Frequent urination as a result of increased calcium in the urine
(hypercalciuria)
143. INTERPRETING TEST RESULTS
Increased serum calcium.
Increased serum PTH.
Decreased serum phosphate.
Increased urine calcium.
Presence of parathyroid tumor shows on ultrasound.
Fine needle biopsy of the parathyroid tumor.
144. TREATMENT
Surgical removal of the parathyroid tumor.
Administer bisphosphonates to lower serum calcium by
increasing calcium absorption in the bone.
IV normal saline to dilute serum calcium.
Diuretic such as furosemide to excrete excess calcium in
the urine.
145. NURSING INTERVENTION
Monitor intake and output.
Monitor for fluid overload.
Monitor electrolyte balance.
Give the patient acid-ash juices such as cranberry juice.
Strain urine for kidney stones.
Place the patient on a low-calcium and high-phosphorus diet.
Explain to patient:
Avoid over-the-counter calcium supplements.
Maintain daily activities.
147. HYPOPITUTARISM
Hypopituitarism is an underactive pituitary gland
that results in deficiency of one or more pituitary
hormones.
This may result from disorders involving the
pituitary gland, hypothalamus or surrounding
structures.
If there is decreased secretion of most pituitary
hormones, the term panhypopituitarism is used.
148. ETIOLOGY
Disease of the pituitary gland itself, such as
pituitary tumors (adenomas)
Destruction of the pituitary gland by trauma
or vascular lesion or brain surgery.
Radiation therapy to the head and neck area.
149. Contd…
Infections: cerebral-bscess, meningitis, encephalitis,
Ischaemia and infarction
Autoimmune inflammation (hypophysitis)
Congenital malformations of the pituitary gland
150. CLINICAL FEATURES
• The clinical features depends upon type of hormone
deficiency.
Type of
hormone
Symptoms
LowACTH Decrease production of cortisol by the
adrenal glands which causes symptoms
related to adrenal insufficiency.
Low growth
hormone
Failure of growth in children causing
short height (dwarfism) and undue
tiredness and weakness in adults.
151. Type of
hormone
Symptoms
Low LH &
FSH
In Men: decrease in libido, impotence &
impaired fertility due to a decreased ability
to produce testosterone.
In Female: irregular or absent menstrual
periods leading to infertility.
Low thyroid
hormone
Undue tiredness, weight gain,
constipation, dry skin and feeling
colder than usual.
152. Types of hormone Symptoms
Lack ofADH From the posterior part of
the pituitary gland results in
the passing of uncontrolled
large amounts of urine and
causes severe thirst.
Prolactin deficiency Low levels can lead to a
woman inability to produce
breast milk after childbirth.
153. DIAGNOSTIC EVALUATION
Health history and clinical manifestation
Change in physical appearance
Blood test
Radioimmunoassay
158. DWARFISIM
• Dwarfism is when an individual is short in stature
resulting from a medical condition caused by problems
that arise in the pituitary gland in which the growth of the
individual is very slowed or delayed.
159. CAUSES
The most common causes are achondroplasia
is a bone-growth disorder
Turner syndrome
Growth hormone deficiency and
Poor nutrition.
160. SIGN & SYMPTOMS
Short stature
Delayed puberty
Symptomatic hypoglycemia in 10% cases
Delayed eruption of secondary teeth in
children
161. TREATMENT
Hormone therapy
• Growth hormone deficiency is treated with injections of a
synthetic version of the hormone.
Surgical treatment:
• Inserting metal staples into ends of long bones where growth
occurs (growth plates) in order to correct the direction in which
bones are growing.
163. DIABETES INSIPIDUS
It is a disorder of the posterior lobe of the
pituitary gland characterized by a deficiency of
antidiuretic hormone (ADH), or vasopressin.
Great thirst (polydipsia) and large volumes of
dilute urine characterize the disorder.
164. CAUSES
Head trauma
Brain tumor
Surgical ablation or irradiation of the pituitary
gland
Infections of the central nervous system
Failure of the renal tubules to respond to ADH
165. CLINICAL FEATURES
Excessive thirst
• May be intense or uncontrollable
• Involves craving for water
Excessive urine volume
167. TREATMENT
The objectives of therapy are:
To replace ADH (which is usually a long-term
therapeutic program).
To ensure adequate fluid replacement.
To identify and correct the underlying
intracranial pathology.
168. Contd…
1. Fluid replacement
2. Central diabetes insipidus may be controlled
with vasopressin (desmopressin, DDAVP). It
can be taken as either an injection, a nasal
spray, or tablets.
170. Syndrome of inappropriate antidiuretic hormone
(SIADH)
SIADH is caused by too much ADH being secreted by the
posterior pituitary gland.
ADH is responsible for controlling the amount of water
reabsorbed by the kidney; it prevents the loss of too much fluid.
When too much water is detected, ADH production or secretion
is halted.
171. SIADH may be caused by damage to the hypothalamus or
pituitary, inflammation of the brain, some medications
such as selective serotonin receptor inhibitors (SSRIs),
carbamazepine, cyclophosphamides, and chlorpropamide.
Certain cancers, especially lung, may produce ADH.
172. SIGNS AND SYMPTOMS
Headaches due to hyponatremia
Nausea and vomiting due to hyponatremia
Confusion due to hyponatremia
Personality changes due to hyponatremia
173. INTERPRETING TEST RESULTS
Hyponatremia (low serum sodium) due to the
dilution
Treatment
Administer saline IV to replenish sodium.
Treat underlying cause.
174. NURSING INTERVENTION
Monitor electrolytes to determine sodium levels.
Restrict fluid because excess fluid dilutes sodium levels.
Weigh the patient daily using the same scale, at same
time of day with similar clothing.
Monitor intake and output.
175. HYPERPITUTARISM
Hyperpituitarism is the primary
hypersecretion of pituitary hormones.
It typically results from a pituitary adenoma.
There are usually three hormones that are
over secreted due to pituitary adenoma are
prolactin, adrenocorticotropic
hormone (ACTH) and growth hormone (GH).
176. Contd…
Some of the common disorders as a result of
hypersecretion of piutitary glands are as
follows:
Excess prolactin: Prolactinoma.
Excess ACTH: Cushing’s disease.
Excess GH: Gigantism and Acromegaly.
178. CLINICAL FEATURES
Headache
Visual field loss
or Double vision
Excessive sweating
Hoarseness
Milk secretion
from breast
Sleep apnea
Joint pain and limitation
of motion
Muscle weakness
179. Difference between Gigantism & Acromegaly
179
Gigantism
Start in infancy and growth is
continuous.
Onset before puberty.
Excessive growth 8-
9feet,enlargement of organs
heart, liver, spleen.
Acromegaly
Starts at age 20-50yrs and
growth is slow.
Onset after puberty.
Increase in size of hands, feet,
lower jaw, skin becomes thick
and coarse.
181. TREATMENT
Medication:
Drugs may be used to shrink large tumors before
surgery or in cases where surgery is not an option.
Medication to reduce prolactin levels is usually the
preferred treatment for patients with a prolactinoma.
182. Cond…
Bromocriptine and Cabergoline are
dopamine agonists (drugs that behave like
dopamine) and can shrink prolactinomas and return
secretions of prolactin to normal levels.
Acromegaly may be treated with Somastatin analogs
(octreotide) to lower growth hormone levels and
shrink tumors.
183. Contd…
Radiation:
Used to treat patients who cannot undergo
after
surgery or for residual tumor tissue
surgery and do not respond to medication.
There are two approaches to radiation:
Conventional
Stereotactic therapies
184. Contd…
Conventional radiation therapy
• It is administered in small doses over a period
of 4 to 6 weeks.
• One drawback is that radiation treatments can
damage normal tissue surrounding the tumor.
185. Contd…
Stereotactic therapy
• It provides a high-dose beam of radiation
targeted at the tumor.
• It may be completed in one session, resulting
in less damage to surrounding tissue.
186. Note
• Most patients that undergo radiation treatment require
hormone replacement therapy due to a gradual decline in
the secretion of other pituitary hormones.
188. Nursing Intervention
Help to accept altered body image that is irreversible.
Assist family to understand what client is experiencing.
Help to recognize that the need for medical supervision will be life-
long.
Help to understand the basis for the change in sexual functioning.
189. Contd…
Provide psychological and emotional support.
Perform range of motion exercise to assure joint mobility.
Monitor for hyperglycemia and cardiovascular problems
(hypertension, angina, CHF) and modify care accordingly
190. Contd…
Teach self-care after a hypophysectomy.
Encourage to follow the established medical regimen, particularly
hormone replacement
Limit stressful situations.
Protect self from infection.