nursing management: endocrine problems chapter 50 overview copyright © 2011, 2007 by mosby, inc.,...

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


3

Acromegaly

Etiology and Pathophysiology

Clinical Manifestations


4

Acromegaly


Fig. 50-1. Progressive development of facial changes associated with acromegaly.

5

Acromegaly

Diagnostic Studies Collaborative Care

Surgical therapy


6

Acromegaly


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


8

Nursing Management: Acromegaly

Nursing Assessment Nursing Implementation


9

Excesses of Other Tropic Hormones


10

Hypofunction of Pituitary Gland


Clinical Manifestations and Diagnostic Studies


11

Nursing and Collaborative Management:

Hypofunction of Pituitary Gland


12

Disorders of Posterior Pituitary Gland


13

Syndrome of Inappropriate

Antidiuretic Hormone Etiology and Pathophysiology


14


Antidiuretic Hormone


Fig. 50-3. Pathophysiology of syndrome of inappropriate antidiuretic hormone (SIADH).

15


Antidiuretic Hormone Clinical Manifestations and Diagnostic Studies


16

Nursing and Collaborative Management: Syndrome of

Inappropriate Antidiuretic Hormone


17

Diabetes Insipidus



18

Diabetes Insipidus


Fig. 50-4. Pathophysiology of diabetes insipidus (DI).

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Diabetes Insipidus

Clinical Manifestations Diagnostic Studies


20


Diabetes Insipidus


21

Disorders of Thyroid Gland


Fig. 50-5. Continuum of thyroid dysfunction.

22

Goiter


Fig. 50-6. Exophthalmos and goiter of Graves’ disease.

23

Goiter


Table 50-4. Drugs that are Goitrogens.

24

Thyroid Nodules and Cancer

Types of Thyroid Cancer Clinical Manifestations and

Diagnostic Studies


25

Thyroid Nodules and Cancer


Fig. 50-7. A large “cold” nodule on the thyroid gland (arrow) detected by a scan.

26

Nursing and Collaborative Management: Thyroid Cancer


27

Thyroiditis


Fig. 50-8. Hashimoto’s thyroiditis.

28

Hyperthyroidism

Etiology and Pathophysiology Graves’ disease Toxic nodular goiters



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Hyperthyroidism


Fig. 50-9. Thyroid acropachy. Digital clubbing and swelling of fingers.

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Hyperthyroidism

Complications Diagnostic Studies


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Hyperthyroidism

Collaborative Care Drug therapy

Antithyroid drugs Iodine Β‑adrenergic blockers

Radioactive iodine therapy Surgical therapy Nutritional therapy


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Nursing Management: Hyperthyroidism

Nursing Assessment Nursing Diagnoses Planning


33

Nursing Management: Hyperthyroidism

Nursing Implementation Acute intervention

Acute thyrotoxicosis Thyroid surgery

Ambulatory and home care Postoperative care

Evaluation


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Hypothyroidism




35

Hypothyroidism


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


37

Nursing Management: Hypothyroidism

Nursing Assessment Nursing Diagnoses Planning Nursing Implementation

Health promotion Acute intervention Ambulatory and home care

Evaluation


38

Disorders of Parathyroid Glands


39

Hyperparathyroidism


Clinical Manifestations and Complications


Surgical therapy Nonsurgical therapy


40

Nursing Management:Hyperparathyroidism


41

Hypoparathyroidism


42


Hypoparathyroidism


43

Disorders of Adrenal Cortex


44

Cushing Syndrome



45

Cushing Syndrome


Table 50-13. Causes of Cushing Syndrome.

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Cushing Syndrome



47

Cushing Syndrome


Fig. 50-11. Cushing syndrome. Facies include a rounded face (“moon face”) with thin,reddened skin.Hirsutism may also be present.

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Cushing Syndrome


Fig. 50-12. Common characteristics of Cushing syndrome.

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Cushing Syndrome


Fig. 50-13. Cushing syndrome. Truncal obesity; broad, purple striae; and easy bruising(left antecubital fossa).

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Cushing Syndrome



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Nursing Management:Cushing Syndrome

Nursing Assessment Nursing Diagnoses Planning


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Nursing Management:Cushing Syndrome

Nursing Implementation Health promotion Acute intervention

Preoperative care Postoperative care

Ambulatory and home care Evaluation


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Adrenocortical Insufficiency




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Fig. 50-14. Hyperpigmentation typically seen in Addison’s disease.

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Complications Diagnostic Studies Collaborative Care


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Nursing Management: Addison’s Disease

Nursing Implementation Acute intervention Ambulatory and home care


57


Corticosteroid Therapy


60

Disorders of Adrenal Medulla


61

Pheochromocytoma


62


Pheochromocytoma


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