Synthesis on Endocrine Disorders

By: Jake S. Moreno

The most valuable class I took this semester was Medical- Surgical Nursing.

The class was a series of real-world case studies followed by discussion. At the end of every

lecture, everyone in the class share their personal insight and experience about the topic they

have reported. Sharing your personal knowledge and experience is an effective tool for student

to learn. It gives real case scenario of the disease or disorder and keep students interested and

intellectually stimulated. Every time I listen from my classmates’ experience and opinion it

challenge my abilities, teach me new skills and still give me the experience as a nurse.

Everyone in the class has given assigned topic by Ma’am Sophie. Endocrine

System and its disorder is the assigned topic for me. This system was interesting because of the

fact that it influences nearly all cells, organs, and functions of the human body. The endocrine

system is the collection of glands that produce hormones that regulate metabolism, growth and

development, tissue function, reproduction, sleep, and mood among other things.

The body requires information in order to develop properly and maintain

physiological balance. In order for the body to develop properly and maintain physiological

balance it requires many different types of information. The endocrine system is one way in

which these communications happen. By using hormones, organs and tissues alike contribute to

the regulation of bodily processes.

The endocrine system is made up of the pituitary gland, thyroid gland,

parathyroid glands, adrenal gland, pancreas, ovaries (in females), and testicles (in males). The

endocrine system gets some help from other organs such as the kidney, liver, heart and
gonads, which have secondary endocrine functions. The kidney for example, secretes hormones

such as erythropoietin and renin.

Disorder of the Endocrine System

Hormones levels that are too high or too low indicate a problem with the

endocrine system. Hormone diseases also occur if your body does not respond to hormones in

the appropriate ways. Stress, infection and changes in the blood’s fluid and electrolyte balance

can also influence hormone levels.

Pituitary Gland

The pituitary gland has been, and still often thought as the “master

gland” because of its role controlling the functions of many of the other endocrine glands. The

pituitary gland secretes many different hormones into the bloodstream to target organs and is

controlled by hypothalamus. There are two parts to the pituitary gland; one is called the

anterior lobe, and the other is the posterior lobe. One of the major roles of the pituitary gland

is to produce growth hormones which control growth. Too large an amount of these hormones

causes gigantism. A condition where facial features, hands, etc become abnormally large. Too

little causes dwarfism, where the overall stature of a person is very small.

Disorder of the Posterior Pituitary gland includes Diabetes Insipidus and

Syndrome of Inappropriate Antidiuretic Hormone. In DI and SIADH the body has a problem

producing Anti diuretic hormone (ADH) too much or not enough. This hormone is produced in

the hypothalamus, and stored and eventually released in the posterior pituitary gland. Each

condition is related the secretion of ADH which plays a major role in how the body retains
water. Each condition presents oppositely of each other, in SIADH the patient retains water vs.

DI where the patient loss water.

Thyroid Gland

The thyroid gland produces and stores the thyroid hormones thyroxine (T4)

and triiodothyronine (T3), as well as secretes calcitonin. T4 and T3 increase the rate cells

metabolize energy. Calcitonin produces calcium balance in the blood by inhibiting the

breakdown of bone. Overproduction or underproduction of the thyroid hormones, or a complete

loss of function, the diseases bring about systemic changes that affect the metabolic

functioning. Hyperthyroidism is caused by excessive circulating thyroid hormone and it

produces hyper metabolic state. Thyroid storm is the severe form of hyperthyroidism. It results

from a sudden surge of large amounts of thyroid hormones into the bloodstream that causes an

even greater increase in body metabolism. Hypothyroidism occurs from an inadequate amount

of circulating thyroid hormone that causes a decrease in metabolic rate that affects all body

system. Myxedema is a life threatening condition, can occur when hypothyroidism is untreated

or when a stressor such as infection affects an individual with hypothyroidism.

Parathyroid Glands

The parathyroid glands secretes parathyroid hormones (PTH), helps maintain

the correct balance of calcium and phosphorus in the body.PTH regulates the level of Calcium in

the blood, release of calcium from bone, absorption of calcium in the intestine and excretion of

calcium in the urine. Disorders of the Parathyroid glands includes Hyperparathyroidism, High

secretion of PTH by parathyroid gland and presents with hypercalcemia and hypophosphatemia
and Hypoparathyroidism, Low secretion of PTH by parathyroid gland and presents with

hypocalcemia and hyperphosphatemia.

Adrenal Gland

The adrenal glands are small glands located on top of each kidney. They

produce hormones including adrenaline and the steroids aldosterone and cortisol. Cortisol helps

you respond to stress and has many other important functions. With adrenal gland disorders,

your glands make too much or not enough hormones.

Cushing’s disease is increased secretion of cortisol. Cushing’s syndrome- an

outside cause due to medical treatment such as glucocorticoid therapy (prednisone).

Addison disease Decreased secretion of cortisol and aldosterone. Causes

Autoimmune causing body to attack the cortex due to cancer, TB, trauma.

Diabetes

There are two types of Diabetes mellitus, Type 1 and Type 2 DM. Glucose-a

simple sugar that is an important energy source in living organism and is a component of many

carbohydrates. Insulin- a hormone produced in the pancreas by the islets of Langerhans that

regulate the amount of glucose in the blood. Glucagon- a hormone formed in the pancreas that

promotes the breakdown of glycogen to glucose in the liver.

 Diabetic Ketoacidosis is a life-threatening condition caused by extreme lack of

effective insulin and resulting in major hyperglycemia and acidosis from abnormal

carbohydrate, fat, and protein metabolism, occuring in persons with Diabetes mellitus(DM).

Hyperosmolar Hyperglycemic Nonketotic Syndrome(HHNK) is a life-threatening

emergency resulting from a lack of effective insulin, or severe insulin resistance, that causes

extreme hyperglycemia. Affected patients often are older adults, with undiagnosed or

inadequately treated type 2 diabetes mellitus (DM). Often HHNK is precipitated by a stressor,

such as trauma, injury, or infection, which increases insulin demand.

The main goal for treatment in DKA and HHNK is to correct hyperglycemia and treat

underlying diseases.
Synthesis on Cancer of Female and Male Reproductive System and Family Planning

By: Jake S. Moreno

In most people’s minds there is no scarier diagnosis than that of cancer.

As we all know, cancer is often untreatable, unbearably painful disease with no cure. However

popular this view of cancer may be, it is exaggerated and over-generalized. Cancer is undoubtly

a serious and potentially life threatening illness.

I have given the chance to discuss the cancer of female and male

reproductive system. I focused on two popular cancer of reproductive system, the cervical

cancer for women and prostate cancer for men.

What is Cancer?

Our body is composed of many millions of tiny cells, each a self- contained

living unit. Normally, each cell coordinates with the others that compose tissues and organs of

our body. One way that this coordination occurs is reflected in how our cells reproduce

themselves. Normal cells in the body grow and divide for a period of time and then stop

growing and dividing. Thereafter, they only reproduce themselves as necessary to replace

defective or dying cells. Cancer occurs when this cellular reproduction process goes out of

control. In other words, cancer is a disease characterized by uncontrolled, uncoordinated and

undesirable cell division. Unlike normal cells, cancer cells continue to grow and divide for their

whole lives, replicating into more and more harmful cells.

Cancers of the Reproductive System

The reproductive system is one of the most vital systems because it

determines whether a species will survive. The reproductive system produces human offspring.

Cervical Cancer

One of the cancer affecting female is the cervical cancer. Cervix is located in the vagina.

Cervical cancer is a disease that can be very serious. However, it’s a disease that you can help

prevent. Carcinoma of the cervix is predominantly squamous cell cancer. Cervical cancer is less

common than it once was because of early detection of cell changes by Pap smear. Pap

screening can identify preinvasive lesions and prevent cancer (Bernard et al., 2004). Cervical

cancer occurs when normal cells in the cervix change into cancer cells. The exact cause of the

cervical cancer is not known, but certain things appear to increase the risk such as; human

papilloma virus (HPV), Sexual activity, Multiple sex partners, Early age( younger than 20) at first

coitus( exposes the vulnerable young cervix to potential viruses from a partner), Sex with

uncircumcised males, Sexual contact with males whose partners have had cervical cancer,

early childbearing and exposure to human papillomavirus. HIV infection and other causes of

immunodeficiency, smoking and exposure to second-hand smoke, Exposure to diethylstilbestrol

(DES) in utero, family history of cervical cancer, Low socioeconomic status ( may be related to

early marriage and early childbearing), Nutritional deficiencies (folate, beta-carotene, and

vitamin C levels are lower in women with cervical cancer than in women without it), Chronic

cervical infection , and overweight status . The symptoms that cervix cancer causes are;

abnormal vaginal bleeding, abnormal vaginal bleeding after the menopause, and discomfort
during intercourse. Diagnosis of cervical cancer includes; Pap test, Cervical Cone Biopsy

(Conization), HPV DNA Test and Examine your cervix, during an exam called colposcopy, your

doctor uses a special microscope to examine your cervix for abnormal cells. Treatment option

for cervix cancer includes surgery (Hysterectomy), radiotherapy and chemotherapy.

Prostate Cancer

Prostate cancer is the most common cancer in men. Prostate cancer is an

androgen dependant adenocarcinoma. The tumour is slow growing and often begins in the

posterior side of the prostate. Clinical manifestation includes early stage;

1. Usually asymptomatic

2. Nodule felt within the substance of the gland or extensive hardening in the posterior lobe.

Advanced Stage

1. Lesion is “stony hard” and fixed.

2. Obstructive symptoms occur late in the disease; difficulty and frequency of urination, urinary

retention, decreased size and force of the urinary stream.

3. Metastasizes to bone, lymph nodes, brain, and lungs.

4. Symptoms of metastases include backache, hip pain, perineal and rectal discomfort, anemia,

weight loss, weakness, nausea, and oliguria: hematuria may result from urethral or bladder

invasion.

It is important for men to know signs and symptoms and screening measures to

detect the disease. Detecting prostate cancer can be accomplished by Digital Rectal Exam

(DRE), Confirmed by histologic examination of tissue, open prostatectomy, fine- needle

aspiration. Early detection of cancer - Every man over age 40 should have a digital rectal

examination as part of his regular health check-up- key to a higher cure rate.

Treatment is based on the stage of the disease and on the patient’s age and

symptoms. Prostate-specific antigen (PSA) concentration is used to monitor patient response to

cancer therapy and detect local progression and early recurrence. Treatment may include

surgery (Radical Prostatectomy, Cryosurgery), Radiation therapy and Hormonal therapy.

Showing sensitivity to issues of sexuality as a result of disease or therapy assists in the

rehabilitation process. Help patient and family to cope with diagnosis, alterations in usual

activities, and uncertainty of the future.

Family Planning

Family planning is the planning of when to have children, and the use of birth

control and other techniques to implement such plans. The Philippines has now ranked as the

13th most populated country in the world. Family planning is the basic principle that is used by

families in determining how many children they are going to have and how the family is going

to be spaced in terms of age. There are two types of Family planning methods; the Natural and

Artificial Methods.

Natural Family Planning

The Natural Family Planning methods do not include any chemical or

foreign body introduction into the human body. Most people who are very conscious of their

religious beliefs are more inclined to use the natural way of birth control. Some want to use

natural methods because it is more cost effective.

Types of Natural methods.

1. Standard Days Method

2. Calendar (Rhythm) method

3. Basal Body temperature method

4. Cervical Mucus method

The success of the Natural Family Planning methods depends on: the accuracy of

the method in identifying the woman’s actual fertile days, couples’ ability to correctly identify

the fertile time, Couples’ ability to follow the rules of the method they are using.

Artificial Method of Family Planning

In this method, the live sperm is prevented from entering the uterus either by

killing them with spermicidal or by obstructing them through the use of condom and

diaphragms.

Artificial methods include; Temporary (Barrier, Hormonal, IUD) and Permanent

(Tubectomy and Vasectomy)

Contraceptives are products used to prevent pregnancy by women and men.

Each individual has their own choice in what they contraceptive they want to use.