The endocrine system: is a network of glands that produce and release hormones directly into the bloodstream to control many important body functions. Hypothyroidism. Hyperthyroidism.

1. Medical Surgical Nursing
Endocrine Disorders
‫الصحة‬ ‫معهد‬‫العالي‬
‫المادة‬ ‫مدرس‬
‫م‬.‫إختصاص‬ ‫جامعي‬
‫الوهاب‬ ‫عبد‬ ‫نزار‬ ‫صـالح‬
‫تمـريض‬ ‫علــوم‬ ‫ماجـستير‬
Salah Nazar Abdulwahhab M.Sc. Nursing
www.slideshare.net
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2. Endocrine System
The endocrine system: is a network of
glands that produce and release
hormones directly into the
bloodstream to control many
important body functions
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3. Thyroid Gland
The thyroid gland: butterfly-shaped gland consists of two lobes connected in the middle by
isthmus located in front of and sides of the trachea just below the larynx [Adam's apple].
Hormones that produced by thyroid gland and circulate directly in the bloodstream.
1- Triiodothyronine (T3): has three iodine atoms
2- Thyroxine (T4): has four iodine atoms
3- Calcitonin: Calcium metabolism (Ca2+)
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4. Thyroid Hormones Functions
Act nearly on every cell in the body.
1. Increase the basal metabolic rate
2. Affect protein synthesis
3. Help regulate long bone growth (synergy with growth hormone)
4. Neural maturation
5. Increase body sensitivity to adrenaline
6. Development and differentiation of all cells of the human body
7. Regulate protein, fat, and carbohydrate metabolism
8. Stimulate vitamin metabolism.
9. Heat generation
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5. Hypothyroidism
Hypothyroidism: the thyroid gland does not produce enough thyroid hormone, this leads to
slow down of the body activity
Goiter: is a swelling in the neck resulting from an enlarged thyroid gland, it is associated
with a thyroid disorder and over 90% of goiter cases are caused by iodine deficiency
Causes of Hypothyroidism
1- Hashimoto’s disease [chronic lymphocytic thyroiditis].
2- Thyroiditis.
3- Congenital or family history of hypothyroidism.
4- Surgical removal of part or all of the thyroid .
5- Radiation to the thyroid, neck, or chest.
6- Some medications side effect, as in amiodarone.
7- Disorder of the pituitary gland
8- Little iodine in diet
9- Older age more than 60
10- Autoimmune diseases.
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6. Signs & Symptoms of Hypothyroidism
1. Fatigue
2. Cold intolerance
3. Decreased sweating
4. Weight gain
5. Joint & muscle pain
6. Constipation
7. Dry skin
8. Dry & thinning hair
9. Depression
10. A puffy face
11. Bradycardia
12. Menstrual disturbance
The Treatment of Hypothyroidism
synthetic thyroxin, [Levothyroxine] a medication that is identical to the hormone T46

7. Hyperthyroidism
Hyperthyroidism: is the condition that occurs due to excessive production of thyroid
hormone by the thyroid gland.
Thyrotoxicosis: is elevated level of free thyroid hormone in serum (from any source)
and suppression of thyroid-stimulating hormone (TSH).
Thyroid storm: is a life-threatening complication of hyperthyroidism (over activity of
the thyroid gland). It is characterized by: [high fever (above 40 °C)], fast and often
irregular heart beat, vomiting, diarrhea, agitation, hypertension with a wide pulse
pressure occurs in early to mid crisis, hypotension and shock in late stage
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8. Causes of Hyperthyroidism
1- Graves’ disease [toxic diffuse goiter], is an autoimmune disorder
2- Thyroid nodules
3- Thyroiditis
4- Pituitary tumor may secrete excess TSH [Thyroid-stimulating
hormone]
5- Thyroid tumor
6- Overmedicating with synthetic thyroid hormone
7- Consuming too much iodine [iodine-containing medications or
some seafood].
8- Radiation exposure
9- Heredity
10- Older age more than 60
11- Women are (5 to 10) times more likely than men
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9. Symptoms of Hyperthyroidism
1- Tachycardia
2- Palpitations
3- Warm moist skin
4- Heat intolerance
5- Exophthalmos
6- Mood swings
7- Tremor
8- Insomnia
9- Dyspnea
10- Diaphoresis
11- Fine, soft hair
12- Increased appetite, weight loss, frequent
stools
13- Decreased serum lipid
14- Decreased libido, erectile dysfunction,
amenorrhea
15- Fatigue
16- Goiter9

10. Hyperthyroidism Treatment
1- Antithyroid medications: prevent the thyroid to produce excess amounts of T3 and
T4 hormones. (methimazole).
2- Radioactive Iodine Therapy.
3- Thyroid Surgery (partial or total thyroidectomy)
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11. Thyroidectomy Postoperative Nursing Care
1- Monitor signs of respiratory obstruction
2- Keep the incision site clean and dry
3- Monitor signs of hemorrhage
4- Keep patient in high Fowler's position [60 – 90]
degree
5- Check for laryngeal nerve damage by asking the
patient to speak
6- Monitor signs of thyroid storm
7- Assess for hypocalcaemia (occur when
parathyroid glands damage)
8- Administer medications as ordered
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12. Thank You
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