Endocrine Disorders
By: Keith Kainne “D” Garino, RN, LPT, MAEd
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Thyroid Gland
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Findings Hyperthyroidism Hypothyroidism
Cause
Appearance
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Findings Hyperthyroidism Hypothyroidism
T3 & T4
TSH
Metabolism
Body Weight
Appetite
GIT
Heat Production
Skin
SNS
Vital Sign
Severe form
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Hyperthyroidism Hypothyroidism
Summary
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Findings Hyperthyroidism Hypothyroidism
Hashimoto’s
Exophthalmos
High T3 & T4
High TSH
High Metabolism
High Body Weight
Low Appetite
Diarrhea
Heat Intolerance
Dry
Lethargy
Tachycardia
Myxedema coma
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Interventions Hyperthyroidism Hypothyroidism
DOC
Calorie
Fiber
Fluids
Activity
Environment
Sedatives
Stimulants
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Parathyroid Gland
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Findings Hyperparathyroidism Hypoparathyroidism
Cause
PTH
Calcium
Phosphorus
Muscle Activity
GIT
Bones
Heart
Kidneys
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Findings Hyperparathyroidism Hypoparathyroidism
Tumor
Low PTH
Hypocalcemia
Hypophosphatemia
Trousseau’s
Muscle weakness
Tetany
Constipation
Pathologic fracture
Hypotension
Polyuria
Renal calculi
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Interventions Hyperparathyroidism Hypoparathyroidism
DOC
Calcium diet
Phosphorus diet
Fluid intake
Fiber
Activity
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Adrenal Glands
Parts:
1. Medulla
•
•
2. Cortex
•
•
•
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Adrenal Cortex
1. Glucocorticoids
• Natural release
• Sugar
• Stress
• Suppress
• Breakdown
• Blocks
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Adrenal Cortex
2. Mineralocorticoids
• Na and H2O
•K
3. Androgen
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Findings Cushing’s Addison’s
Cause
Appearance
Glucocorticoids • Sugar • Sugar
• Stress resistance • Stress resistance
• Suppression of immunity • Suppression of immunity
• Protein Break-down • Protein Break-down
• Skin & Extremities • Skin & Extremities
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• Blocks Calcium • Blocks Calcium
Findings Cushing’s Addison’s
Mineralocorticoids • Na & H2O • Na & H2O
•K •K
Androgen
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Cushing’s Addison’s
Summary
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Findings Cushing’s Addison’s
Moon face
Buffalo hump
Bronze skin
Truncal obesity
Hypoglycemia
Poor resistance to stress
Thin skin
Hypercalcemia
Hyponatremia
FVE
Hyperkalemia
Hirsutism
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Interventions Cushing’s Addison’s
DOC • M •
• M
• K
Glucose changes
Avoid
Calcium diet
Na & H2O intake
K Diet
Disturbed
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Body image
ADH/Vasopressin
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Findings SIADH DI
Cause
ADH
Fluid Imbalance
Serum Sodium
Urine Output
Urine Specific
Gravity
Concentration of
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Nursing
Summary:
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1. Hypertension
2. Weight gain
3. Flat neck veins
4. Crackles
5. Altered LOC
6. Edema
7. Tachycardia
8. Poor skin turgor
9. Dry skin
10. Distended neck vein
11. Sunken eyeball
12. Hypotension
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Findings SIADH DI
High ADH
FVD
Hypernatremia
Oliguria
High USG
Dilute urine
Polydipsia
Cerebral
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Edema
Intervention SIADH DI
• D • A
Medications
• D
Fluid intake
• D
Monitor • I
• E
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DM1 DM2
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DM1 DM2
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DKA & HHNS
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Hyperglycemia
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DM1 & DKA
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DM2 & HHNS
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Findings DKA HHNS
Blood glucose
Serum osmolarity
Blood pH
Bicarbonate
Ketonuria
Glycosuria
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Findings DKA HHNS
Kussmaul
Polyuria
Polydipsia
Polyphagia
Priority
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DKA & HHNS
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Hypoglycemia
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Findings Hypoglycemia Hyperglycemia
Increased urine output
Shakiness
Light headedness
Excessive thirst
Nervousness
Polyphagia
Dehydration
Moist skin
Glycosuria
Fruity odor
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