nursing management: endocrine problems chapter 50 overview copyright © 2011, 2007 by mosby, inc.,...
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Nursing Management: Nursing Management:
Endocrine Problems Endocrine Problems
Chapter 50 OverviewChapter 50 Overview
Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.
2
Disorders of Anterior Pituitary Gland
Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.
3
Acromegaly
Etiology and Pathophysiology
Clinical Manifestations
Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.
4
Acromegaly
Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.
Fig. 50-1. Progressive development of facial changes associated with acromegaly.
5
Acromegaly
Diagnostic Studies Collaborative Care
Surgical therapy
Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.
6
Acromegaly
Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.
Fig. 50-2. Surgery on the pituitary gland is most commonly performed with the transsphenoidal approach. Anincision is made in the inner aspect of the upper lip and gingiva. The sella turcica is entered through the floorof the nose and sphenoid sinuses.
7
Acromegaly
Collaborative Care, continued Radiation therapy Drug therapy
Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.
8
Nursing Management: Acromegaly
Nursing Assessment Nursing Implementation
Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.
9
Excesses of Other Tropic Hormones
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10
Hypofunction of Pituitary Gland
Etiology and Pathophysiology
Clinical Manifestations and Diagnostic Studies
Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.
11
Nursing and Collaborative Management:
Hypofunction of Pituitary Gland
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12
Disorders of Posterior Pituitary Gland
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13
Syndrome of Inappropriate
Antidiuretic Hormone Etiology and Pathophysiology
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14
Syndrome of Inappropriate
Antidiuretic Hormone
Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.
Fig. 50-3. Pathophysiology of syndrome of inappropriate antidiuretic hormone (SIADH).
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Syndrome of Inappropriate
Antidiuretic Hormone Clinical Manifestations and Diagnostic Studies
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16
Nursing and Collaborative Management: Syndrome of
Inappropriate Antidiuretic Hormone
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17
Diabetes Insipidus
Etiology and Pathophysiology
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18
Diabetes Insipidus
Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.
Fig. 50-4. Pathophysiology of diabetes insipidus (DI).
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Diabetes Insipidus
Clinical Manifestations Diagnostic Studies
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20
Nursing and Collaborative Management:
Diabetes Insipidus
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21
Disorders of Thyroid Gland
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Fig. 50-5. Continuum of thyroid dysfunction.
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Goiter
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Fig. 50-6. Exophthalmos and goiter of Graves’ disease.
23
Goiter
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Table 50-4. Drugs that are Goitrogens.
24
Thyroid Nodules and Cancer
Types of Thyroid Cancer Clinical Manifestations and
Diagnostic Studies
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25
Thyroid Nodules and Cancer
Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.
Fig. 50-7. A large “cold” nodule on the thyroid gland (arrow) detected by a scan.
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Nursing and Collaborative Management: Thyroid Cancer
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27
Thyroiditis
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Fig. 50-8. Hashimoto’s thyroiditis.
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Hyperthyroidism
Etiology and Pathophysiology Graves’ disease Toxic nodular goiters
Clinical Manifestations
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29
Hyperthyroidism
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Fig. 50-9. Thyroid acropachy. Digital clubbing and swelling of fingers.
30
Hyperthyroidism
Complications Diagnostic Studies
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31
Hyperthyroidism
Collaborative Care Drug therapy
Antithyroid drugs Iodine Β‑adrenergic blockers
Radioactive iodine therapy Surgical therapy Nutritional therapy
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32
Nursing Management: Hyperthyroidism
Nursing Assessment Nursing Diagnoses Planning
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33
Nursing Management: Hyperthyroidism
Nursing Implementation Acute intervention
Acute thyrotoxicosis Thyroid surgery
Ambulatory and home care Postoperative care
Evaluation
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34
Hypothyroidism
Etiology and Pathophysiology
Clinical Manifestations
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35
Hypothyroidism
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Fig. 50-10. Common features of myxedema. Dull, puffy skin; coarse, sparse hair; periorbital edema; andprominent tongue.
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Hypothyroidism
Complications Diagnostic Studies Collaborative Care
Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.
37
Nursing Management: Hypothyroidism
Nursing Assessment Nursing Diagnoses Planning Nursing Implementation
Health promotion Acute intervention Ambulatory and home care
Evaluation
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38
Disorders of Parathyroid Glands
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39
Hyperparathyroidism
Etiology and Pathophysiology
Clinical Manifestations and Complications
Diagnostic Studies Collaborative Care
Surgical therapy Nonsurgical therapy
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40
Nursing Management:Hyperparathyroidism
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42
Nursing and Collaborative Management:
Hypoparathyroidism
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44
Cushing Syndrome
Etiology and Pathophysiology
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45
Cushing Syndrome
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Table 50-13. Causes of Cushing Syndrome.
46
Cushing Syndrome
Clinical Manifestations
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47
Cushing Syndrome
Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.
Fig. 50-11. Cushing syndrome. Facies include a rounded face (“moon face”) with thin,reddened skin.Hirsutism may also be present.
48
Cushing Syndrome
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Fig. 50-12. Common characteristics of Cushing syndrome.
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Cushing Syndrome
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Fig. 50-13. Cushing syndrome. Truncal obesity; broad, purple striae; and easy bruising(left antecubital fossa).
50
Cushing Syndrome
Diagnostic Studies Collaborative Care
Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.
51
Nursing Management:Cushing Syndrome
Nursing Assessment Nursing Diagnoses Planning
Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.
52
Nursing Management:Cushing Syndrome
Nursing Implementation Health promotion Acute intervention
Preoperative care Postoperative care
Ambulatory and home care Evaluation
Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.
53
Adrenocortical Insufficiency
Etiology and Pathophysiology
Clinical Manifestations
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54
Adrenocortical Insufficiency
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Fig. 50-14. Hyperpigmentation typically seen in Addison’s disease.
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Adrenocortical Insufficiency
Complications Diagnostic Studies Collaborative Care
Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.
56
Nursing Management: Addison’s Disease
Nursing Implementation Acute intervention Ambulatory and home care
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57
Nursing and Collaborative Management:
Corticosteroid Therapy
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59Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.
Nursing and Collaborative Management:
Primary Hyperaldosteronism
60
Disorders of Adrenal Medulla
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