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The endocrine system is a network of glands that produce and release hormones directly into the bloodstream. These hormones regulate various functions throughout the body, maintaining homeostasis and supporting growth and development. Unlike the nervous system, which uses electrical signals, the endocrine system uses chemical messengers to communicate between different parts of the body. Glands: Pituitary Gland: Often referred to as the "master gland " it regulates other endocrine glands and produces hormones that influence growth, metabolism, and reproduction. Thyroid Gland: Located in the neck, it produces hormones that regulate metabolism, energy levels, and overall growth and development. Parathyroid Glands: These small glands located behind the thyroid play a crucial role in maintaining calcium levels in the blood. Adrenal Glands: Situated above the kidneys, they produce hormones such as adrenaline and cortisol, which help the body respond to stress and regulate metabolism. Pancreas: It has both endocrine and exocrine functions. Its endocrine role involves producing insulin and glucagon to regulate blood sugar levels. Ovaries (in females): Produce estrogen and progesterone, which are crucial for reproductive health and menstrual cycle regulation. Testes (in males): Produce testosterone, which is essential for sperm production and maintaining male secondary sexual characteristics.
Thyroid (TSH)
Hypothyroid VS Hyperthyroid
Triiodothyronine (T3) &Thyoxine (T4) regulate metabolic rate of the body. For proper functioning iodine is essential (seafood)
THE PARENTS-DIVORCED PARENTS-
HENCE WHY THE CALCIUM IS OPPOSITE
Hypothyroidism
Underactive thyroid gland - TSH: T3 & T4=Metabolism Regulations Clinical Manifestations: EVERYTHING IS DOWN-EXCEPT CALCIUM Hypercalcemia Fatigue Weight gain Cold intolerance Brittle nails Slow heart rate Depression Diagnostics: T3, T4, TSH Labs Physical assessment Treatment: Life long thyroid hormone (Levothyroid/Synthyroid)- teach to take in AM on empty stomach. May feel heat intolerance in beginning or jittery. Increase fluids Nutritional support Myxedema Coma( Too Too Low) Constipation, Fatigue, Severe lethargy, hypothermia Memory issues, poor attention span depletion Warm the patient, seizure precautions
Hyperthyroidism
graves Overactive thyroid gland -TIE WITH CALCIUM (calcium regulation) Clinical Manifestations: EVERYTHING IS UP- EXCEPT CALCIUM Hypocalcemia Weight loss Heat intolerance Hyperactive Fast heart rate Diarrhea Anxiety Treatment: 1.Methimazole (antithyroid) Watch for agranuloccytosis Radioactive Iodine Therapy- PRECAUTIONS: First 8hrs- remain 3 ft away from others. For First Week- Stay away from children, pregnant women, & immunocompromised patient. 2.Avoid sharing a bed, utensils, bathrooms (avoid urine backsplash), laundry (done at home and separate), kissing/hugging Thyroid storm hyperpyrexia, tachycardia, hypertension. REPORT temperature change of 1 degree
anterior
Addisons VS Cushings- Sugar, Salt, Sex
Adrenal (ACTH)
Corticotrophin hormone from the hypothalamus releases ACTH-Corticotrophin Test to diagnose
THIS IS GRANNY & BIG BOY HENCE
THEIR CONNECTION TO SALT-GRANNY NOT ENOUGH &
BIG BOY TOO MUCH
Addison's Disease
Occurs when the adrenal glands do not produce enough cortisol and sometimes aldosterone. It is also often caused by an autoimmune response Clinical Manifestations: Hyponatremia Hypovolemia Hypotension Hypoglycemia Salt cravings due to the low levels of aldosterone affecting sodium balance. Treatment: Fluids (Isotonic) Vasopressors in extreme hypotension Glucose Hormone replacement therapy- Glucorticoid(Prednisone) to fix adrenocortical & metabolism Mineralocorticoid(Fludrocortisone) to fix aldosterone & water/electrolyte balance. TOO much can turn you into BIG BOY
Cushing's Syndrome
Prolonged exposure to high levels of cortisol. This can be due to the use of corticosteroid medications or a tumor that causes the adrenal glands to produce excess cortisol. Clinical manifestations: Hypernatremia Hypervolemia Hypertension Hyperglycemia Irritability or depression Treatment: Reducing cortisol levels-which might include surgery to remove tumors
No-Low sodium diet (max 2g)
Antihypertensives Insulin Fluid reduction/restrictions
Phenochromocytoma Found in the adrenal medulla Rare tumors; most are benign Causes hyperactivity of the gland; excessive release of catecholamines. Clinical Manifestations: 5 H’s Hypertension is the principal manifestation. = Pounding headaches, Headaches, Hyperhidrosis Hypermetabolism, Hyperglycemia Treatment: If diagnosed early, tumor can be surgically removed. Monitor Blood pressure Monitor for Cardiac Dyshythmias Pain management Diagnosis 24 hr urine of catecholamines and their metabolites
This is Aunt Pheno
The Aunt who is always
complaining of headaches
Hypopituitarism Vs Hyperpituitarism
These are the Uncles Doug and Greg
Hypopituitarism:
Not enough production of One of Multiple Anterior Pituitary Hormones (FOCUS GROWTH) Clinical Manifestations: Dwarfism
Hyperpituitarism:
Over production of One or Multiple Anterior Pituitary Hormones Clinical Manifestations: Giantism Acromegaly- increase in bone size Treatment for both: Tumor resection Transsphenoidal Hypophysectomy- Post Op Care: Assess the packing for CSF or assess for any nasal drainage. How can you be sure it’s CSF? The dressing will have a yellow color at the edge of the clear drainage or “halo sign” But more indicative --- Check it for glucose. Interventions & Treatments Monitoring for signs of increased ICP – Vision changes, Change in LOC, Monitor LOC q1h x24h then q4h. HOB elevated to ensure reduced swelling, Head in midline position Administer replacement of Thyroid, DDAVP, Gonadal, and Glucocorticoids – this is a life long practice as the gland has been removed Octreotide Teach patient to avoid sneezing, c oughing, blowing nose, or bending forward. Why? To prevent the chance of the clot dislodging. postnasal drip /Monitor for^ Teach patient to report Teach to floss and rinse but DO^ Teach to avoid constipation.^ frequent swallowing NOT brush teeth
THESE ARE THE PETS
KETO THE KITTY HAS KETONES
MOLAR THE DOG HAS NONE
THEY ARE BAD PETS WHO LIKE TO PEE
EVERYWHERE
Diabetic Ketoacidosis Pancreas is not producing insulin/or not enough insulin thus causing a patients body to break down fat as energy instead. This causes a buildup of ketones=DKA *Usually with Type 1 Diabetics Clinical Manifestations: Polyuria Polyphagia Metabolic Acidosis Acetone (Fruity) breath Elevated blood glucose > High ketones in urine Treatment: IV Fluids: Hypotonic or Isotonic Regular Insulin Drip-Monitor every hour to titrate BiCarb Blood Glucose checks hourly I & O Neuro checks Diabetic hyperglycemic hyperosmolar syndrome Complication involving extremely high blood glucose with OUT ketones and dehydration. Often a complication of infection, medications, or noncompliant Type 2 Diabetics *Dehydration is WORSE Clinical Manifestations: Polyuria Metabolic Alkalosis Elevated blood glucose > No Ketones in urine Treatment: IV Fluids: Hypotonic Regular Insulin Drip-Monitor every hour to titrate Blood Glucose checks hourly I & O. Neuro checks Urine specific gravity is generally considered to be 1.005 to 1.030. 275 and 295 mOsm/kg Osmolarity and osmolality both measure the concentration of solutes in a solution, but they express it differently
