The document discusses the endocrine system and various endocrine disorders. It provides an overview of the pituitary gland and hormones it secretes including ACTH, TSH, growth hormone, and others. Specific endocrine disorders covered include Cushing's syndrome, acromegaly, gigantism, hypopituitarism, diabetes insipidus, and syndrome of inappropriate antidiuretic hormone secretion. Treatment options are discussed for each condition along with nursing considerations.
When too much growth hormone is secreted that augments the growth of muscle, bones, and connective tissue in childhood or adolescence before the end of puberty, the condition is called Gigantism.
1. What comprises the Endocrine system
2. Mechanisms of Hormonal alterations
3. Pituitary Gland- Anterior pituitary gland, posterior pituitary gland and their disorders
4. Thyroid gland and its disorders
5. Diabetes
6. Parathyroid Gland disorders
7. Adrenal Gland and its disorders
8. Thank you
Hyperthyroidism (overactive thyroid) occurs when your thyroid gland produces too much of the hormone thyroxine. Hyperthyroidism can accelerate your body's metabolism, causing unintentional weight loss and a rapid or irregular heartbeat
Hypothyroidism (underactive thyroid) is a condition in which your thyroid gland doesn't produce enough of certain crucial hormones.
When too much growth hormone is secreted that augments the growth of muscle, bones, and connective tissue in childhood or adolescence before the end of puberty, the condition is called Gigantism.
1. What comprises the Endocrine system
2. Mechanisms of Hormonal alterations
3. Pituitary Gland- Anterior pituitary gland, posterior pituitary gland and their disorders
4. Thyroid gland and its disorders
5. Diabetes
6. Parathyroid Gland disorders
7. Adrenal Gland and its disorders
8. Thank you
Hyperthyroidism (overactive thyroid) occurs when your thyroid gland produces too much of the hormone thyroxine. Hyperthyroidism can accelerate your body's metabolism, causing unintentional weight loss and a rapid or irregular heartbeat
Hypothyroidism (underactive thyroid) is a condition in which your thyroid gland doesn't produce enough of certain crucial hormones.
Pituitary gland disorders include acromegaly, Cushing's syndrome, diabetes insipidus, empty sella syndrome, hypopituitarism and pituitary tumors. Pituitary problems can be caused by pituitary tumors, most of which are benign.
Pathology of Endocrine system
Endocrine pathology is the subspecialty of diagnostic pathology which deals with the diagnosis and characterisation of neoplastic and non-neoplastic diseases of the endocrine system
When the pituitary Gland it' s function is increased whether the cause are?
Both anterior and Posterior gland secretions are increased the most causes are ADENOMAS
We understand the unique challenges pickleball players face and are committed to helping you stay healthy and active. In this presentation, we’ll explore the three most common pickleball injuries and provide strategies for prevention and treatment.
The dimensions of healthcare quality refer to various attributes or aspects that define the standard of healthcare services. These dimensions are used to evaluate, measure, and improve the quality of care provided to patients. A comprehensive understanding of these dimensions ensures that healthcare systems can address various aspects of patient care effectively and holistically. Dimensions of Healthcare Quality and Performance of care include the following; Appropriateness, Availability, Competence, Continuity, Effectiveness, Efficiency, Efficacy, Prevention, Respect and Care, Safety as well as Timeliness.
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Defecation
Normal defecation begins with movement in the left colon, moving stool toward the anus. When stool reaches the rectum, the distention causes relaxation of the internal sphincter and an awareness of the need to defecate. At the time of defecation, the external sphincter relaxes, and abdominal muscles contract, increasing intrarectal pressure and forcing the stool out
The Valsalva maneuver exerts pressure to expel faeces through a voluntary contraction of the abdominal muscles while maintaining forced expiration against a closed airway. Patients with cardiovascular disease, glaucoma, increased intracranial pressure, or a new surgical wound are at greater risk for cardiac dysrhythmias and elevated blood pressure with the Valsalva maneuver and need to avoid straining to pass the stool.
Normal defecation is painless, resulting in passage of soft, formed stool
CONSTIPATION
Constipation is a symptom, not a disease. Improper diet, reduced fluid intake, lack of exercise, and certain medications can cause constipation. For example, patients receiving opiates for pain after surgery often require a stool softener or laxative to prevent constipation. The signs of constipation include infrequent bowel movements (less than every 3 days), difficulty passing stools, excessive straining, inability to defecate at will, and hard feaces
IMPACTION
Fecal impaction results from unrelieved constipation. It is a collection of hardened feces wedged in the rectum that a person cannot expel. In cases of severe impaction the mass extends up into the sigmoid colon.
DIARRHEA
Diarrhea is an increase in the number of stools and the passage of liquid, unformed feces. It is associated with disorders affecting digestion, absorption, and secretion in the GI tract. Intestinal contents pass through the small and large intestine too quickly to allow for the usual absorption of fluid and nutrients. Irritation within the colon results in increased mucus secretion. As a result, feces become watery, and the patient is unable to control the urge to defecate. Normally an anal bag is safe and effective in long-term treatment of patients with fecal incontinence at home, in hospice, or in the hospital. Fecal incontinence is expensive and a potentially dangerous condition in terms of contamination and risk of skin ulceration
HEMORRHOIDS
Hemorrhoids are dilated, engorged veins in the lining of the rectum. They are either external or internal.
FLATULENCE
As gas accumulates in the lumen of the intestines, the bowel wall stretches and distends (flatulence). It is a common cause of abdominal fullness, pain, and cramping. Normally intestinal gas escapes through the mouth (belching) or the anus (passing of flatus)
FECAL INCONTINENCE
Fecal incontinence is the inability to control passage of feces and gas from the anus. Incontinence harms a patient’s body image
PREPARATION AND GIVING OF LAXATIVESACCORDING TO POTTER AND PERRY,
An enema is the instillation of a solution into the rectum and sig
CHAPTER 1 SEMESTER V - ROLE OF PEADIATRIC NURSE.pdfSachin Sharma
Pediatric nurses play a vital role in the health and well-being of children. Their responsibilities are wide-ranging, and their objectives can be categorized into several key areas:
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This includes tasks like:
Monitoring vital signs and physical condition.
Administering medications and treatments.
Performing procedures as directed by doctors.
Assisting with daily living activities (bathing, feeding).
Providing emotional support and pain management.
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Administering vaccinations.
Providing education on nutrition, hygiene, and development.
Offering breastfeeding and childbirth support.
Counseling families on safety and injury prevention.
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Educating families about their child's condition and treatment options.
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Objective: Contribute to improving the quality of care for children by participating in research initiatives.
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Attending workshops and conferences on pediatric nursing.
Participating in clinical trials related to child health.
Implementing evidence-based practices into their daily routines.
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There is a movement towards home-based care for the elderly, next generation scanning and MRI devices, wearable technology, artificial intelligence incorporation, and online connectivity. Experts also see a focus on predictive, preventive, personalized, participatory, and precision medicine, with rising levels of integration of home care and technological innovation.
The average cost of treatment has been rising across the board, creating additional financial burdens to governments, healthcare providers and insurance companies. According to MCG, cost-per-inpatient-stay in the United States alone rose on average annually by over 13% between 2014 to 2021, leading MedTech to focus research efforts on optimized medical equipment at lower price points, whilst emphasizing portability and ease of use. Namely, 46% of the 1,008 medical technology companies in the 2021 MedTech Innovator (“MTI”) database are focusing on prevention, wellness, detection, or diagnosis, signaling a clear push for preventive care to also tackle costs.
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QA Paediatric dentistry department, Hospital Melaka 2020Azreen Aj
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1. Prepared By:
Mr. Prakash makasare; M.Sc. Nursing
Mrs. Nutan Makasare; M.Sc. Nursing
College of Nursing ; G.M.C. Nagpur
2. The nervous system and the interconnected network of
glands known as the endocrine system control body
systems.
Endocrine disorders are the consequences of hypo
function and hyper function of each endocrine gland.
3.
4. The chemical substances secreted by the endocrine glands
are called hormones.
The endocrine glands are composed of secretory cells
arranged in minute clusters known as acini.
Glands are ductless with a rich blood supply, so the
hormones they produce enter the bloodstream rapidly.
Hormone concentration in the bloodstream is maintained at
a relatively constant level.
When the hormone concentration increases, further
production of that hormone is inhibited & vice versa.
Negative feedback.
6. Widespread effects on the body and a wide variety of
signs and symptoms
Changes in energy level and fatigue
Tolerance of heat and cold as well as recent changes in
weight:
Changes in sexual function and secondary sex
characteristics
Changes in mood, memory, and ability to concentrate
and altered sleep patterns
7. Changes in skin texture with both hypo function and
hyper-function
Eye changes, such as exophthalmos,
Changes in physical appearance (e.g., appearance of facial
hair in women, "moon face," "buffalo hump," thinning of
the skin, obesity of the trunk and thinness of the
extremities, increased size of the feet and hands, edema)
Vital signs Elevated B.P. may occur with hyper function of
the adrenal cortex or tumor of the adrenal medulla and
Decreased blood pressure may occur with hypo function of
the adrenal cortex.
8. Anatomic and Physiologic Overview
The pituitary gland, or hypophysis, about 1.27 cm in
diameter located on the inferior aspect of the brain.
Commonly referred to as the master gland.
Control the secretion of hormones by other endocrine
glands.
The pituitary itself is controlled by the hypothalamus.
The pituitary gland is divided into the anterior and
posterior lobes.
9. The major hormones
Follicle-stimulating hormone (FSH),
Luteinizing hormone (LH),
Prolactin, ACTH,
TSH,
Growth hormone (somatotropin).
Other hormones include melanocyte-stimulating
hormone and beta-lipotropin.
10. The important hormones
Vasopressin, also called antidiuretic hormone or ADH,
Oxytocin. (Oxytocin secretion is stimulated during
pregnancy and at childbirth. )
11.
12. disease of the pituitary gland itself or disease of the
hypothalamus,
complication of radiation therapy to the head and neck
area,
total destruction of the pituitary gland by trauma,
tumor, or vascular lesion.
The result is extreme weight loss, emaciation, atrophy of
all endocrine glands and organs, hair loss, impotence,
amenorrhea, hypo metabolism.
13. Cushing's syndrome.( ACTH or growth hormone)
Acromegaly
Gigantism.
Dwarfism.
Panhypopituitarism.
Hypopituitarism may result from destruction of the
anterior lobe of the pituitary gland.
Postpartum pituitary necrosis (Sheehan's syndrome)
14. The most common disorder related to posterior lobe
dysfunction is Diabetes insipidus.
15. Pituitary Tumors
Pituitary tumors are usually benign types of pituitary
tumors represent an overgrowth of
(1) eosinophilic cells,
(2) basophilic cells, or
(3) chromophobic cells (i.e., cells with no affinity for
either eosinophilic or basophilic stains).
16. Definition
Gigantism, an overgrowth of the long bones,
develops in children before the age when the
epiphyses of the bones close. Clients
suffering gigantism may grow to 9 feet tall.
Acromegaly is a disease of adults and
develops after closure of the epiphyses 'of the
long bones.i.e. increase in bone thickness
and hypertrophy of the soft tissues.
17. Etiology
Gigantism and Acromegaly result from GH-
secreting adenomas of the anterior pituitary
gland.
19. Clients with gigantism: develop
hyperglycemia. About 10 per cent of the
clients develop full-blown diabetes mellitus.
As the tumor grow, destruction of the entire
pituitary gland, leading to hypopituitarism.
Pressure on the optic nerve, may lead to
blindness.
20. Prognosis: depends on the age at which the
client develops an over secretion of GH and
seeks health intervention.
26. In addition, clients with acromegaly develop
local manifestations such as,
diplopia,
headache
blindness,
and lethargy,
due to compression of brain tissue by the tumor.
27. In advanced cases, clients can suffer from
associated hormonal disturbances such as,
diabetes mellitus,
goiter,
Cushing's disease,
changes in libido and
menstrual disorders.
28. Irradiation of the pituitary gland to destroy
the tumor. This is usually performed through a
radiation implant via the transsphenoidal
approach.
29. Sromocriptine (Parlodel) can reduce the levels
of growth hormone and decrease tumor size.
This agent can be used if the levels of growth
hormone remain high after surgery or until the
effects of radiation occur.
30. The treatment of choice for both gigantism
and acromegaly is a surgical
hypophysectomy.
Partial or complete removal of the pituitary
gland.
Following surgery, the need for cortisone
replacement may be permanent.
31. Nursing Diagnosis:
Knowledge Deficit R/T surgery and possible
outcomes.
High risk for injury R/T postoperative
complications.
Knowledge Deficit R/T self administration of
pituitary replacement hormones.
33. Hypopituitarism is a deficiency of one or
more of the hormones produced by the
anterior lobe of the pituitary.
When both the anterior and posterior lobes
fail to secrete hormones, the condition is
called panhypopituitarism. (Simmond’s
disease)
35. Etiology/Pathophysiology
The five most important causes of hypopituitarism
Hypophysectomy
Nonsecreting Pituitary Tumors:
Nonfunctioning chromophobe adenoma and
craniopharyngioma.
Decreased Growth Hormone
Postpartum Pituitary Necrosis
Functional Disorders: anorexia nervosa, severe
anemia, and GIT disorders.
36. Short stature, stunted growth results from either:
- congenital lack of GH or
- the development of space-occupying intracranial tumors,
meningitis, or brain injury during early childhood.
Secondary adrenocortical insufficiency due to
diminished synthesis of ACTH
Hypothyroidism,(diminished TSH)
Sexual and reproductive disorders r/t deficiencies
of the gonadotropins (LH and FSH) can produce
sterility, diminished sexual drive, and decreased
secondary sex characteristics,infertility and
amenorrhea, diminished spermatogenesis, and
testicular atrophy.
37. ACTH: secondary adrenal insufficiency.
Cortisol levels: are low in both primary and
secondary hypothyroidism.
Thyroid hormone, TSH levels:
hypothyroidism.
FSH and LH: Sexual and reproductive
disorders
38. Treatment for hypopituitarism involves:
(1) removal, if possible of the causative factor
(e.g., tumors) and
(2) permanent replacement of the hormones
secreted by the target organs.
39. Injections of HGH successfully treat GH
deficiency
Medications prescribed to replace hormones
include
(1) corticosteroids for correction of secondary
adrenocortical insufficiency,
(2) thyroid hormone for treatment of
myxedema, and
(3) sex hormones to correct hypogonadism.
42. The major disorder of the posterior lobe is
ADH deficiency (diabetes insipidus)
Excessive ADH causes the syndrome of
inappropriate ADH secretion (SIADH).
44. Definition
Diabetes insipidus is a deficiency of ADH
resulting in a physiologic imbalance of water.
Incidence
Diabetes insipidus is a rare disorder.
45. Primary diabetes insipidus: Abnormalities in the
hypothalamus and pituitary gland from familial or idiopathic
causes.
Secondary diabetes insipidus: Destruction of the gland by
tumors in the hypothalamic-pituitary region, trauma,
infectious processes, vascular accidents, or metastatic
tumors from the breast or lung.
Medications such as phenytoin (Dilantin), alcohol, and
lithium carbonate, can interfere with the synthesis or release
of ADH in some clients.
Nephrogenic diabetes insipidus: Owing to an inherited defect,
the kidney tubules cannot respond to ADH.
46. Risk factors include
head injuries,
infections, and
other factors that lead to destruction of the
gland.
Certain medications also may lead to the
development of diabetes insipidus.
47. The major functions of ADH are to promote water
reabsorption by the kidney and control the osmotic
pressure of the extracellular fluid.
ADH production decreases excessively
kidney tubules fail to reabsorb water
large amounts of dilute urine excreted
diabetes insipidus.
48. Its two major manifestations are
Polyuria (urine is dilute, with a specific
gravity of 1:001 to 1.005 (normal
specific gravity is 1.00 1 - 1.030).
Polydipsia (The client can drink and
excrete 5 to 10 liters of fluid per day.)
49. A water deprivation test.
Instruct the client not to drink water, to
concentrate the urine. Test results are
positive for diabetes insipidus if the urine
remains dilute.
50. Pharmacologic Management
Administration of the benzothiadiazine diuretics, either alone
or in combination with sylfonylurea clorpropamide.
Injection of ADH or vasopressin (aqueous Pitressin) can
control the symptoms of diabetes insipidus.
The synthetic polypeptide desmopressin acetate (DDA VP) can
be insufflated through the nose in the morning and at
bedtime.
After administering vasopressin, clients need to be assessed
for signs and symptoms of water intoxication, which can lead to
fluid overload, cerebral edema, and seizures .
51.
52. Maintaining adequate hydration,
Electrolyte balance, and
Preventing complications.
Assess the effectiveness of the medication.
The client also must learn self-administration
of either the injections or the nasal spray.
If the client undergoes hypophysectomy,
nursing care for the same.
54. Definition
SIADH is a disorder associated with excessive
amounts of ADH, resulting in a water
imbalance.
55. Incidence
SIADH is one of the most common causes of
hyponatremia, although the exact incidence
of SIADH itself is not known.
56. Etiology
There are a wide variety of causes of SIADH, including
the stress of surgery and many disorders and
medications.
Risk Factors
Treatment of diabetes insipidus with vasopressin can
lead to SIADH if excessive amounts are administered.
A variety of malignancies are risk factors for SIADH.
57. SIADH is the opposite of diabetes insipidus.
Instead of large fluid losses, clients with SIADH may have water
intoxication due to fluid retention.
Under normal circumstances, ADH regulates serum osmolality.
When serum osmolality falls, a feedback mechanism causes
inhibition of ADH.
This, in turn, promotes increased water excretion by the kidneys to
raise serum osmolality to normal.
When this feedback mechanism fails and ADH levels are sustained,
fluid retention results.
Ultimately, serum sodium falls, resulting in hyponatremia and water
intoxication.
58. CNS dysfunction, characterized by
alterations in level of consciousness,
seizures, and coma, can become evident
when serum sodium falls to 120 mEq/L or
less.
Hyponatremia can result in diminished
gastrointestinal function, and this problem
is further complicated by the need for fluid
restriction.
59. DIAGNOSTIC ASSESSMENT
Diagnosis rests on the presence of
hyponatremia with a normal or expanded
plasma volume.
60. fluid restriction,
very careful replacement of sodium
chloride,
administration of diuretics and
demeclocycline,
and correction of the cause, if possible.
61. Assessment:
Fluid status and electrolytes should be closely monitored.
cardiovascular status also should be assessed regularly so
any alterations are immediately noted.
The client's weight should be recorded, and any gain of more
than 2 pounds should be reported to the physician.
The client's neurologic status should be monitored so any
alterations related to the hyponatremia are immediately
diagnosed and treatment can be started.
62. Injury, High Risk for R/T to the danger of
cerebral edema, water intoxication, and CNS
dysfunction.
Fluid Volume Excess R/T excessive
secretion of ADH secondary to SIADH.