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    9 views56 pages

    MS Endocrine Disorders

    Uploaded by

    Maria Theresa Buscas

    Copyright:

    © All Rights Reserved
    Download as PDF or read online from Scribd
    Flag for inappropriate content
    of 56
    45 Assessment and Management of Patients with Endocrine Disorders ‘on complon ois cape; the amor wi bo able to: “Deseret functors of aan of he endoerne gands and ee home + Diarentaie dagnoste states and lical manesttion for fndocine Sorder. » Domonsrao knowladge of management statis for endocing (deordare 4 Balan nizing Itrvenons nthe are of patent wth endocrine finordem «6 Une the nursing process as a framework forcare ofthe paint ‘wihan engocrne order, 0 CetrReguton Fenty btorerton See {SERA zee ma ne cy dain tence bed prcice mill You nsoe when eéesng Bi pet? [Gem ae he sea pecs information you wold inluce 2 FET You caring fr pon who aie ngs adinsaton fof eine Menty tre port musing digas fortis pet feted othe use of he pein Ste te expected ots a {ea ee pry nrvetions wah sees raters fr er mag 3 GE A pata wi « emo hima of Adlon’ dace Tae or Adnan era wd staid a mei ik et er lil le tf Da aes Eotsorve rounds te cum ese spat. What ato wl he pia provide, the mus, he psc thers, an the dcharge Poe combats o he Uscsian? What pattem aba Wl each (Gecpoe efor te ptt “TEE lent te prs, pron nd eclges you woul sew ferfrm comprehensive scament ona O-yexrol paler newly ‘Sagnned wih Casi’ synarme How wil your pres ppc anc ccna ier ifthe patie bas vial pare or hard of Beang? Ifthe pate som a cukae with very dire ales yourawa REFERENCES ‘Asari inde rang tech Books: ‘Ama aga, (2019) Thi ast nlite D ‘Eiferee CA ray. W (Ede Pore Brasher and rate rasta ong ved), Mla PA: Woles Kier Il KT Clty, W009) Hype) rows ‘Mei Sites Fs) he Washington mana endo ‘abi conn thet). Mada a Woes Kiawee ‘Bae KT, ie, AT (019) Thre an IT. ra ‘ect Sines eh Whim mana enoriloy Dahil col (thed) Pali, Ps Wolter (camer Ky Dk TQ). ring 220 drag hand ‘Phindpsa PA: Woes Raver 3980 ‘sepa st in ie eo ane of een ie eae pent bandera Asie eo tate eon et te te See! usin omen it ‘thence so sa age ‘i ad Hees macs Mea aad ie ‘moter cera fetid oe awaie scromegay: prorossieenargamert of paripea ody ‘tor exeatve sce o fon Farman |Adsnon' disease: enone arenocoiealinetciency duo Snaseqte nena coos eon Adainonian crane orenocorcalinsiency: cureterzed by hypotension, ances, eer nausealoritng, ae sigs of shock arealectony: surgical removal one or both anal las Strenocorcctopl hormone (ACTH): bamone secreted bythe ‘rl’ pala eter fr gow an developer narogons: male sx nomena Sasa tabi tes cranial eactonsaccurng when Me bey iat calslonin: haymane sce by ety gang ‘atsum egaton ‘Chvostok sign: spasm ofthe facil meals produced by sharply “asp over the cal Nerve so ol he Sra la an te {oie ea suggstve tet etary in pees win Pypocstema conicostoroas: Hormones produced by te arena cate oho “pike equal ‘cushing's synrome: group of ymptoms prosuce by an ‘eraeceon of arenooorentope hemane earatetzed by ‘none ebesty. "on face ave, abdornal stan ard hypertension dabetes epi ean inwhich abnormal large volnes of ‘Ste urne ae exceed ae sas of ohn prososon ‘asoposin ‘uthyoi: late of romal hyo hemene production Sxophthaimes”sbramal prtusion fone ar ot eyeball ‘slucoconicolde: tri armones seoretaaby he adreral eaten rerponse o aerecricavope homone.peduce ae er ‘Gyeagen and sad gone got: rlargomert of ha thyroid glare Graves siscns aor af hyperhyomiam, characte bya fuse (ole an exophalnos hormones: chemi nena subtans produced none organ art he body andearadby he slocdeteam severe ‘Srgans on wich hey havo a space regulary eft rinerslocortcole: lad homnes sctld byte adrenal coer Imysedma: severe nyotnyreain canbe with oF winout coma rotting rips in fincten ote organ prodvong ts sibetance sanz ‘pheochromocytoma: attenal medula turer ‘Smarome of appropriate atiluretic hermene (SIADH): excessive cretion of arsureicomane fom be pty gland esos bw eran ours lvl ‘nyroidectony: surges removal sf par te tyro land {hyo ammaton ae Byles may ado cone hypenylasm or rey reste oporanesuy ‘thyroid. stimolating hormone (3H): relesed fom the tary gland {utes srdaton ofthe tel ose release oT, and ‘thyroid storm: Me-tretenieg contin of he tyro cue to uriested hypetacien thyrotoxicosis: conden prosuced by excessive endoganus ‘erogenous hed nemene Inyroue (7) Byro Nammore, iv eine compound formed ana "soredin he byod: celocnat in pais eeves ory Fosstyronne, mains body metabofom na saad} Se ‘riodtyenine (yea hemonefrmod and are inthe tyro rome ‘Aes span ym ees ‘toma en war wc Sees crcl fo ‘nig peep nige ri) Aerts ng ft nde ogc emai icimaen Ana it i id inees ner ganar bogey rare serve rater “ me seta acon han Te ndeapeay eon cu meebo cores “rouea sgn crpopeda sen aie whe as ow eam serge aria itacrued Jang ond pose cant ean arama [eine dai nente see gt en es nuns eeu "vasopressin: anfsuetie eerane secreted by the poster ptary aca eee the enlsine scm ples val ae testing gasp of ae union S2P'Gcnte tame ad tw tans, Sgn and epedton a ae ‘Sinie 219) The imercomnoned newer a lander clomy Inked ith ‘he eros and nmne systems, reali te fonctions of multe bay ain The fypllanes i rsporaibe forthe Inerelaont. The iy nd fc fi the meg pe nmr: rere in theorem, woh m um fess eccrine ands sacha ‘heiired Distdes of the doting sytem ae common an re ast sbyyer and ypotiacion, ‘Newent stl inthe sapien of lid i odorine dere Ths shper fcc heater logy of {te cadore sytem he os oman enccine Sse of the pity, ‘Avoid putt and sietal lnds eal manfetaons, dens (Gre mag ng pee SSS Aveta in hohetrei sens BEM 6 cin orn rte roan ssscied yore dnd ar aed in Caper 46 sod repre Stirs foci he avast ee dened in Chaps SD snd SSrapectve. ASSESSMENT OF THE ENDOCRINE SYSTEM ‘Anatomic and Physiologic Overview loins hormone Test subsanses ee and sept boy functions 1 ogo lvl o stat ae ss, Hormones ae gery proce Dy he ence suns ut aya be uoduced by sete uc such 8 Toe four nthe gies (Gayton, he Ry, and wie Mond fli The Gace prndces hormones (ees earn entopssione, Seren colesytkinn) that ae isprat In ibe digestive proces the LEdneys pou erytopeein a homone that stu he oe mao S| Froluce rd Bool eos and te whe blot cals produce tines (rormarelike pon) thats paite nina and mane “Te endocsne system has niu relnship with he omen ad che secs sym. Chemicals sah ts netcactoes (egy pce) frase the nevus stim capaho fan Hommes When Rede “Theimmne ser rondo Be indacon of fren ashy meas Semel messengers eokies ands alo sje eon fy anal fontcacaa homes (Nos, Glands of the Endocrine System The cowie syste Is composed of te pity lad tyoid ghd, oral ods eal glans pte lets, ova ab ste. Soe Feu 1 for major armor ecg guns he waders ste Noodsream However crown ps, suchas seat glands see her ‘roduc owgh ics os eth sare othe ac Function and Regulation of Hormones Hormones hp rete orn fection in concert withthe nervous eaten, “Ther ocionythenewous sss alanced ty slower harmon aon This dal regulary sstom porns pecse covtel of fg Tncons ropa taings nitinandoanie bets stots Koon asa rch lod spy provi weil fr the armanes proce hy the edarineelands fee theWsedstam rapid sans The ara fecalring hormones dope nti nue fton ad te ‘cama, hee hormones mat enacted conan by 4 mega {eedbac spam so tat when the hormone concenation inrease, her brodacoe of th hormone tiated Convery, when the ere cla omnes at lito fur aegis csr othr sou: (1) nines anf ine cds eps epncnvine nupeeerng and ad armen (2) peniden pevpepider pacman eens (ory ‘igravoptselesing horoae [TRI folle-sinaatng hormone FS nd woth hormone OUI). G) stsois (eg careers, which ee ne produced by teeta cate tne ya uae ed (Gy fay at dren (ep cone eas) (Nor, 2019) Aloo ‘not hormones released by cadre san can be tana! ean {get ses for aon see hormones never eter the bloodstream base the at foci th are where they ae velased thi lle prac toe eg th ele of ex homens othe vari). Othe a) ot the tcl om wich hy ware les eld arn cto ‘he eet of nin ron pancreat betel on ha xl (Nor 209), fication and Action of Hormones ss & eatog Patents Root Set care ‘he mise dss the pation, Sami, and carps tht sete aren Insley and unceryng smptms wil sf corteeteoi then i ope wit eon The pe bal ben Conteng an Tansonal Care “Tae patent who requires conned cocoa they i maxtor to “misunderstanding th meccaone ud he need rs dosage a es Ihe useing dade we milang the ieee, Hose eae Feral fay be indeed ere a safe ernment ines ses ak of Sa ae eet, Te ne mae he eels i ak 4s sees the poles undesanding of ad aby mage the Idiom fein’ aud eafre pei efucon abr the metas fhe tara fig te rac: The ne ep he inthe cfs of tonply ésconinng conser, tr aaiton he Poses fly re reminded boat ite imperance of hah pomoson eves and ecommended heath ssa. ude toe tr ety ‘sing so, Absorption of tpl apes vais with body locaton, For example, stort ree tough teaver of skin om ese fae, ea ‘ec han one fram uri thea foal apoio hoes Stern the ik of de cet The sally of avetnecoune ops ‘costed rae he a of de fee pains wae are of ‘ter poten ols Excessive we of tee apts epi om ge sae ‘eso lanes a ead to ecu herpetic eles en ered Dosage ‘Pharmacsoge does of servi symtoms have Ben cole ann oF [hour progam, a. oncedlly on ever-herany sede ray be Inplnentd In epi wis te atral eteton of eco the Bes ine of day the tl octet dae a Ue emy tani between 7a Sm. Lagednethenpy at 8 am, when the ales! pln mo ate, Droicesmacinalsuprssion sf the plan A large # am ove is more Bisiologe teense alls the ody to ecape fe fhe eos am # pm to 6 am, wb scum lehcls we somal fo, Henri bigots pmo ofthe dsr bing weed esses, Patens recunngpoknged ery. Some pains pat scoot “Seoltd wth sympor thr may es on he soon as these, theese mst xn wo pats Dt hs gin cary to iis Tapering nics dosages ae ape eed gral): alow aoe anal ero langer ater hee of ater the ae i il 3k or ‘cl isin i ies of tes, For expe gery a ary Teason |s reves, the pats ely to eq V coroxrtds ding dae surgery to reace ek oa dene ‘Nursing Management Naming management of conicorid ery Stelager many imporaré Inerveson Tae 4.8 poids an evetiew ofthe ets of eoicstad ‘hen aod te using nies Promoting Home, Community-Based, and Transionl Care sos ernones cn ar the incon ofthe tars se hy nesting th ‘enacts ted eer othe cell ebate oi eerie 0 te fell Fr eal, pad rin armani wih esp ses 08 Be cll str, reali i lon of th near eee ales ‘monophosphate (AMP). The eylic AMP inside the cellars enzyme activity, “Ths cele AMP isthe second messenger that aks the pee Rrmone at ‘Becellswcetoa cane te iacell evsoneat Som pte ok Fee ens caging ee ee lo wae {ta for pepe rtnes Noes, 2019). "Ser harmane, cae of th lr sie and hgher ip soit, seca el mentrans end iat wis ec eeoos The eid Rentar conyle: aofe cal cubic el te fai of ete ‘bone ad RNA) om deonywhenekc ci (DNA). The mRNA fon amuses pen thes wii he cell. Steldorones ree ‘evel ows fo eve dsr elec, base they exe te ato WY the edison often sates Assessment The using asesmen ofthe pst with ndotne dination ncaes | cl stay ad psc eae ht vats he ees enone Health History Athouh specific endocrine duos are ofensccmptiod by specie inp ee eal maton my ao i & eh Iansremem of thee door aterse shoals be atked Hf they ave ‘peroned ching inthe following ara: energy level tlre to et oF ole, wei, Bist Reever of unaton toe! ncon, Bouy operons Utero groh af, mens le memory concen sep pars ‘moods, joi pin, and sea dystincton, Docume I poi ‘Remdiag the Svey of these cages, te Tegth of hve the pet bas ‘erence these cong, the na er wich hese change fave acted “nthe patents sleepin a amily to. Physical Assessment “The physical examination shoul include vial sigs eadsodneinpecion, nd palpation hin aan od inkng® shold be compared wah brevis finigs, if avalale Phi paycholgial, and Behav ‘nage be ied Exam f change tn psi characteris on fa harp.” exaphithatns nem! pstason of ene ert eal, ‘ison changes, dea thine ofthe sissy he can hes ‘he euremi, Ieee sve of the fe an hats, ede, ahd Hype of ype The pater ay aso eal hanes in oo aed Boor sth nervous leg), age ens 2019, Diagnostic Evaluation ‘Avr of agri ssie re e evaate the endosn sytem. The tue edicts he put abot he pes ofthe peed ste, what ‘pst and ry poste side efoc Rated to tse exameaon por 1 ‘oti The ue ses tnd ores th provera ou eae rogresin a wel asthe sins response otha. request paiets be observed elo for id fe nd athe dase be roe ws gh ce ae er ure Spr of he ke Therapeutic Uses of Corticosteroids “The onge of coco is detemined bythe nate ard trio the mena wel a he ses cher etl cons, Rhames sh French "stbms, ano mage sls ate chronic sso ta fealceseods dos cus however, these Redeadons ay Bese whe tthe measures do a6 provide adestte coc f spn. In aon Tnsuchstaas be avers eft o cores re mgd opin thease canton. Thte msaton ma be ure fora peri ‘hon are daly duced or taped asthe spans suse The muse Piss dperant ein provides encourpemen tad te finer kone aio is apriening or appebnsve steal exper) ‘Reames ofeympone whe king male dose ‘Treatment of Acute Conditions 'stmncs and for spe shock fo sepiceia cased hy gan-tepative ‘ctr Other teste sch a anv agen or eden, so ‘ed wi coon wo ashok nd oe sae syaptoms, A ies, Ophthalmologic Treatment Sop, Besa he agar 6 not ete tn ont Homer lotr Spotieon cin sant an ieee i farce res, which Tesi ‘Brum le sane pes. Ina, rologed seo sareasers ean Serine lad rst fran, Dermatologe Disorders “opel adnstaton of coos inthe fora of teas, seme le ads cy ees mary able en The atid pat to achiere manimum sborton ofthe medeston Pett nd snpion ae knead te eso apd he Ihe is tyed or ose, medal ater bt sone = Conant Used Conse Prpartons Beane AG Oo ntienole Depa, Sete eine Pelee cs noe Tike — evi Tiers eR Narang ag Pa Corticosteroid Therapy Srey sed eipresing.inlanmation and simmers onling allie eatons, and redwing. Tefen “poses ‘tneplactison, Commonly uso coos esparaonsae Ld in Tbe {G2 Teer eiviatenauor sod allergy tees take contends ‘sual ants aed SLE, They ae alo euenly wed inh ane! oF {thm mlipe cleo. and oder atimane disorder igs dost ppt lo pent rts igh degen of sts. Such antstess atom may be caused by the ably of eoricestois wo ald Seulsing anger mbsiner Ip keeping the Rood rere cloves ‘her fy, sucha manenance of th seu pet eve 0 m9 Resp ond peste deve Side Effects ‘Aoi tee cuca ess or stn pts bc ‘iste feokm fom winersacoricod acy, mot nal ted yi rcoserodeproace sma kine of side sists The Se regi for feieianmatery abd asilgy eos also poiues metbole ete, ia an sera an upprsion aed lanes he Laon of ie Sain! serous sytem. Thain, sboogh coro ae Mighly| ‘Seve herpetic hey may 0 every danger, Dep of tes Ineicatons are feicny ated to alow gh concenaons when stcsnzy andthe aperd it a tee oad uodesabe fet. Tas Blood Tests Blod tts determine the levels of cisulting homens, the preset of ‘uta, nd the eect ofa speilehomove on oe substances, Te ell of sulin ea Bod glace level). Tae seus evel f= pec pert sf be andor sem wnthe sit ofineton. An eum saspecflhomne thas uerble to analyzing by ood eights Hermans (i, Ty an Tee Ie dues). Rails) ese ‘roquly sed fo detest angen lvls which ge ational nfrmaton| out hottone levels and level foe sistance (Fsebch & Fschvch, dor, Urine Tests sine es aud wo metre she aman afhamanes othe en prt of harraes terete) feds. Once species oe sue dre, Fob For example, rary fetes ol fee cect (rorepinetries.einetrine. ane apumine) ay he eas Fes ‘th supeted pheochromocytoma, a unor ofthe atl mull. Several Usdvoage ltd fo acta ta nt be ccered re Bat pales ‘Sone str map ale theres Nar 2019) ‘Additional Diagnostic Studies Stimulation tes ae sed conte tpatusin of a enderne psn The ter deemine how a endote gnd responds the adiaon of Simdning hormone tht se rary produce Teese ye iputlonas or pay ea. the core and opomis te Smut, the secfe order may be i ie hyetalanes ptt. Fait of be todcine pnd rap to sion hs nye Prolonarbeing nh endoie pa eet. ‘urreson ret ae ese ote Npewcin of an enoetine oz. ey termine fe og is tt reapnding a the nseathe ack fechanans tht sorcaly”conrol ‘secre orm fomthe Tppotlamas or pitty gan. Supresin tes mesure the ef: of ¢ [pvc ctoetivs dove af he hoeone on the eae tern of te formas ore he sera of silat eons om Be Appts pga dae ai (ath comsed tomography (C1, ulesoegrans poston eon ecwarphy (PEN, and dane Xray absorptiomeny (DXA) (or ani9, isoers (se Cat 5-1, DNA ieting canbe ued forte heen of ‘pew sees atv wih ndorne Sarde selene rg fv velopment and incteasd undrsaning of the Tui af he eo ‘ha may pepo porn to oral condton, he pcan of wh ‘mus be consee byte pate. nce sel to fetus in adencona ments and eques Pinion of cerca Md an her agen lo mula Sood replacement of caricosteroids will be lifelong. A normal serum glooose level {ermamaind ith net, appropri IV Tidy and Stary” modesto Hypolaemia pial esses oral pens er sey and iypereson iroled i 5% fe SO Poteenly spmsaone a pt Scere. Patan levee shcle be checked once a wesk fr woke postop (Ma Berns 201) Mia neat aber tha gy [consented fr put ws ltl ae sole Cat 1 Pe Pharmacologic Therapy Phamacolgle manageent i requked for pens wh Wer tena pels unis! idstemne hypersecretion who do tat es Saye Spronsacone ie recommended a te filine dra 9 onl hypertension, Epler, a more expense dug, recommended a 0 Stconeline dag i he pte camo! folate side eof sptuelaone (bts Sark 2019) Serum pousunand cess soul e lone ronioring wil he dstemined y he le! sae Te alee of dons fy be ieased when take win spiomlotne an it age my ed esas Nursing Management Nursing management in the posupersive paid icles foqent assessment efi sig to det ery is and pons of wea ice and Sn of henntage Isola ll eaten i procedes,provalg| omfos mens aed proving rot pass can rede the pen et Sans ve som 2019) bustle hae indesod that underestimated (Monon, ‘taiesabons tae Sapo of ths encen, Clinical Manifestations Iiypeceson ise ost point and lon sven pn of pinay Aldoseonsm. Pals wih utcomplate, complied, and teaimet ‘isan Avgerieasoe” and. hyperson wid hypkaeoia. shou be enshed ih fri sorer However Ryokan old lege be nse arse oth agnosis now recognize hat pit ‘scene al ofthe pts (Ma arash, 2019). hppa ‘Spree may beresonile forthe saab msl wees ssi ramping, ad age spe wih aoe, a well she deys ‘Etily fo aclyor concert the cn, Accord, the roe volute eneeraed, cout topobsia (ecesve thr) dane person Asconduy reat in bod vlc and penile est efits aldnerone on nerve seep cha th usd ss, re the aes retone the pan: fey and parerberasCinotck ané Teste es may be se fo ass newromuscr iy before ove paresthesia sl cy oe ‘se ome may ee eae fp ‘Assessment and Diagnostic Findings Wilding atiypetensive seca bel lbury tesiag 26 Teno I the ples sings antypstonive ape hs nero ‘Should he consider hr ering the ree ofthe PACPRA pasa $dpserone concn plioms renin civ) soy ae wll a the AR {aiosero-ren ao Ma Boras, 209) Medical Management father than open sugey. Caaoscopie suey I associa wih shore asia says and generally fever comphcaons following szgery (0 ‘ig Daeg popes pn ln rs pe etibole and eaocrne dart nna by gna etree pln and Npeaty gst mati ody myer. ane sgh Dace manne cs (. phenyetnare, bamscsra Deorors ot emanate malaolem eaten) Decrsre of ety aad oxcbton (og meaurrctah acy-Com eiyegente sean aden aan owas ina. Pong Sana. Yon ‘ites Decrers of yaoroma storage cease (eg. Tay Sachs, Couche, Nesrenrc Faby Gowee Decwors of muconadeacrhaes (2g, Hurkr enero, Hine ‘ineaes Mori syns) Decrersi es eh oa ne wanscamanyate dency) Necune-Abgrt eye Nate andoueneopna pe Lod ype Refer Chapter 4 har 4-2: Gana n NarsingPrctin: Gana ‘Aeses fol iar fr bane wh exvorel heat: parcel Inge stot ‘ory members wih aetna th age trae ‘Asses fry hyo te ree gone coraon sue ee ‘ees bhacsrtosh decency. srahemeavonalss. Aasees for prytcal symptoms. atch ae mucral_ neuroma, typerropnas ow sau ranma, ard mara spear, meester tare of aris and” harechonatnsonae ‘mento af ki). res ky of ncn ven sels, ie {Shing ipo. seoesnotepee. epaneay fan 3190 ‘Sooar ‘Seectape's hat = frcompennis ents eal gre 4.2» Theta gan, reas ofthe bro (linac ue nm enon pocued by satan Prstoro’ teary abe, ADH, aaretc mare GH ew Ferrans, AGTH, asecostetonishemone. TSH byes ‘indstnghomene FSI oe aainghamave ‘omaingrarmone ISM, sleet cabanmulng Romane ‘THE PITUITARY GLAND. ‘Anatomie and Physiologic Overview 1, Manas autre fon Bod rare mies bn wep ges 1. Pan eves ae within neal aes © Abveneofpedl eka Ts twat fata 5 sue is 1 Ie teotecctymte et ‘nro tae 44 Anita in te Change psn Fuge andes Bony prominence ly 5. “Actes nprove oy mee 2 ens ing aout changes in appearance, el ition od sets ve 1 Strat yal hanger area ecient 1, Eahoisimproved ou nee 4. sti eos of compen 4 Exiaomal vil ine nd welt nd eof mgs of 1 ies sans wd sos fase pinto tat ‘Soe pre ed ene ake se eee ls 8d Primary Aldosteronism inane of this hormone, tbe Kidheys ence Tess fiom and mare Fetus nd Byogea. Primary also also known os Cont Dire, Hille itr fos pinay altri ine tomas of he “he tus idence of omy aldosterone finan (ie ean 940 {AL thecomplation of ucaton the patent ancir caregiver wi Sita the ingac of Cutbigs, syrdame and ester! on Pryedone Sssonng ADL IAD es, rebar and Scr ‘Snelson bataon arlene, etn, Sita te pupon, doe, ove, sede, side ofa and [ecntors fs peroesencains erarcostal mba) Sia mserans compare wh mace aia St nn oi pry pobre na one Seeger sn. di tty scary fran Viteng metal ke Serge rts rari ble elin, Stace ana rains acon unace “a idea boc ir pomnour en bwin sun care, nt Snecma decree a of Stic td ‘ery sm sree Rati how lo rach pray prover wm auton Sims te ant ate of ol mesa aporimers, era test. Wali souces of sppor (ea, fonds, tees, fan Samia IGeriy te oral ett fr spo arnt for saber and Soret tas Idy nee or heath oromcon, danas proven, ard ccona hes Le sts aly ig BOL, uma cin tal ing. Expected pt cucomesmoy ince: he pay gan, ohypoplyl, s commonly refed 0 a the maser eed boots of be ii bassoon hemo by the Encinas seg 452) Tetoand sare beat 127 cm (12:90) fn amir, rote om the nero spec of he Hn and oe tere a pester abs. The glands conoled by the hypo, which an aljcem ae of be in scones oh ptr By he Py Anterior Pituitary he mse hoones of he asain pity glad ae FSH, alin ormans (Li) pln (PRI, adrencartcotrpic hormone (ACT) ‘Myroidcatmalngharmone (FSI, and Gl fate tered fo smerny The socom of thee ror hoommes i corel Ieesing factors sacred bythe hylan. These leasing ators each Tae stir ptr by ey ofthe louse na specs called Whe pay poral ond spe “Oler homonerieade menace Sinclaing otmone and betaipaopn he incon of pp spor ners The meron fase bythe antrorputary eer the geet elation Intssnsd ACTH sereton charterer hath Addon See Uippopediton) ad Cushing's spname hyperrocetin PRI: ats on te treat stile milk produto Mormors sume Per aie nd Tote ae denn cnjnton with hc ae an “GL, he mot aboncant anor pstary ome, eles prove 5 chien and energy and meaboten inal GH rene pon sme in many dues teen se ak own of fay aids In apo tat td Insets bow glucose eves Dr horas, cha yes arsed increned oy csp sey, se, cere sing mloatio, ype semin tums, hypevolenie shock, ané spe and aces ne sees oF est, Jopreson an yp reds Non, 2019, Posterior Pituitary ‘The iota hormones ete by the poster lobe of the pein gland te vatopresin sg loved as ue nerene (ADH ad xy Iyptslas the pot stay plan! or sors. Vasopressin contol The eeron of mur the Hides sce sme y a eae Ine osmolality af he Boe aby a decease In Mood ress Oxsto< 3192 Secretion sued ding pregrane sad at cin, Oxstaca also Seas milk cjecton uray lctaton and ray th free fine Pathophysiology Abcomaltes of pty fenton we eased by ove or underssion of ty af th bansones prodoed elas te land Abra oe fstesor al postr prtors uf the snd muy car epee. Ippoptarsm, oe aypoluctin of the psy eli car saul bom inet ofthe pity sland el! er ee of the ypu te ‘come is seal te same. Hypopitatarsm can rest fom rain Shera ote hed and eck aren Toe destruct oh uy lcd yu, to sel lei removes al sl tha ae oral’ ec hy the hye tbe gona apd the aenl lands Te leas creme weigh ls, emaciaion,arohy ofall endocrine plas ard ergs, Ini fos, impotence, anevrte,hyporabotsn and hapglyexma Coma neat ewer the msg hormenes a nt repacl (Nes, 201) Anterior Pituitary version hypetseton} of th att pay gland most commas {Evuves ACTHE GH asl ras ia Cusiag’ syndrome. (gp Syoplamsprused oy “an overseen ACTH) eaters, Rinesnely eromegaly disor coed by an exe of Cl frat ‘usm enlagemen of priperal oy par and sof stu, afer he sien ‘the cls! ls ns oecered likey & veri, 2019), abou an ‘Ecreoe Right wh focdece of ein 02 wn Lt caer 100000 eple Latent Plus, Was el 2017) Alp rare, overseen [SE GI sm chen before te ison sf epiphyseal gro pins rest atary was a peson may gow tobe? o ever 8 fetal, Convers [rulcent ston of GH aig chldiod en aut a generalized Lmtd ipovth and piutery daca, Unirscon Qypetstin).cxmely Sones all ofthe smerny homones and it termed ‘antpepstatarim Iathis edn, the toi lad, the aera cre, {nd the gov soph (sins) Dense of Tos of he wopesineling mone Hpopeutarsn may rut em dessin of heater late of ‘he ply lan Nor 201). Posterior Pituitary crepasins the inparance of regular medi flop he sie tes ed tose elles of motcaons upd the need ‘next med st an family are reminded aot he portance of eal promotion Ieiviier and resoomended heath scenig,Inlng tone mineral es ese sm Adis Costs The patent wih Cushing's syndrome hase Srby amoral of pia tamara i or aie! Rpt snd ‘Xedsnian ris thigh level of cols adrenal Pmones hve ‘pressed te Rint fhe deal Src soph af eae orn seh the cvetiing hormone Keli decreased pid beste of Daten wth Cathy's nome souls Be assed for sie and Syaptons of Addsola ls ws dscssed pelos. Ada cis er te pet ee ir cape ck leorlte suis by monitoring iabrsry vives and diy wiht [Braue of the easel Hk of lease nelernce aed Inger, lad ee mtg ate Te ae persed Dn ‘sod Finite, the patent may ned abe eats slong ‘Feat lacose nds econ Eucting Paints Abo Sel-Cae, The pe, fay, and caregles should be edueed that sete adel insuicleney and Sila pil cima ape say wink {emi adeqos aus ake witout Inresting there Topercuion. hyperemia and wih gas The mre cates fe (bet and fay shot bow to mocir Bed presse, bod gcae lesen and sight Pas ahold be aed lo wear a ea le acl nt mi ier hh are pore deni) abut hl on ee Cha 4515 "tng sd Tanto Ca, The med fr fallow depends a the fad i te ee se pt ak ‘bse coast ara fenton hae asc pon nd ‘Meguncy” of ceuiing ana hormones, Heme sre refer ay fe inated to cnue se enone a miies rest and of fils and ahr side eect, The hae bes ye ase Ie pant ysl and pgchlgie tau aed reports hunger to he iy over, The mse alo asses the pres ndesanng of wa {manage fe miata regen nd rors previa oto abot ttemediaons andthe portance of lig Detected. The re he most commen dsrder led 1 poser lobe dpstuncton is dab iii nn whch shel ae les ie {sowing ste xine o's han oman conc To ronal Sas tuners, aumatc tram ry, Icons of the nero ye, post Ipeptsetam rove te ptuayfaeof eats to respond Pituitary Tumors, te"prinay or sevonday an factional or oncom (Nos 203) Finconal mes seve puta barons, whee soft tas from thr afanconal flee on tre ongane The poncal per of uta tuners ees: overgrowth of eoaophii cll tape cel feelorophosc eels (ey ells wth mo ai) ar Set coop espe st Clinical Manifestations sini us tht vp cy in i est in iat, The toed the exenive steal growth occu ony inthe feet the handy, the Sapte vids, te molar eines te sean the ci ing ia 0 Be lk ce sad rome. Hole nae Optic eres (Noi, 2019 Assen a ea sin ad vial ts may ‘els lr dsctinination, Sita oe sn, elo a fm of df sian Dstt of he ako ae ‘Sihnypstnyadon, ase a soe wh pe of enor asopi tuner pe re fo Cain’ syndrome ith etc ay sstuubl ohypesienalisn. Ieudlng asclineaion sd amon {ain taal hey, person cotapros, alpoyeytbon, “Cromophbie hanes epesen SON pry tmirs, Tene ors usualy prdaee no hooves bat deo the ret of Be pay gan, Causing iopopiuiasa People with is ace an have bss ae Smale a exhib ie amy ha dy 2 i psy compen nd sell tones Tey aso expereneheadates, ss of ido, ad vista Dolgphaia a lonercg of te baal metabelie rate chemi Fac [Securing wes te bys es) abd 2 abnormal Boy emer Sion 2010, Ast ssment and Diagnostic Findings Diagnostic evshaton rors 8 caf istry and ysl exainain, Unsung assent of wa aculy ad visual els. CT and MII sas ‘edo dagane the prsmor ad eet of play uo, Sr ees of ty armanct map Seabed long essary 3 ‘Score eid dona a ai Sago Medical Management Iypoiysesiomy, or sri remaral of te pty and though ‘rampneoial spn the ul rate Servint raion herp thio ees ese of e ewstgetpe sere me, maybe wed {dvs externa rit therapy psf the pry ur wh ‘snl les on taal ae bee Chul 12) Other ene ole ‘reine ii te pacucton er ren of Gland mayne hos ‘uted improvement of symptoms, Oct an laetde may aso be {hed prepara to improve the pats inal conton ands sik the tmrAmerozs Asin of Newlopal Sugeons 2019 ‘Surgical Management ypoptysecumy isthe neament of ac in pats with Casing’ dase stuling bor ekenive podcior of ACTIN Oy pry tance ‘rss ae Be rm on ion lathe mee drei Sl spots ew oe ody he ny an ‘repeal poacher iadaon and soning The tancphooial Spresh nd theming management of pate! undernnecran spe fe dscused iChat st Feautes of syepions of acme ae ‘Galcctaty sia removal of te te Te ace feu Pa he he Sesin f iy ay {ato ofthe puiay la Replacement hey with ears nd ‘yrobarnene sess. sis ‘he patent ho I taking eaicosoid means shad be ontored forthe prose of types nd byl The rare sete ta clase saa by monteing ber acy an day ip ‘hep shel becca sos fd le in sam to este fd ‘een ad ods high in possum efeal toa tan may be ese The pal hal abe arc eet nd llr or ngs [Eabshing 8 poectvecaviooment help even ills aces, and ‘irre bes an an anes. The pte wha very weak may Fegiessstance fom emus In arin vo aig buping Sp cre fate fonds ghana aie toa hetian ray assis he psn I seleing appoine fods x we tio lw nsdn an clos The pao should vod umeesisry expo 10 others with fons “he re Segue asec he pln forse sgn of ine, euine the snflammatry eons of crcomersgs may mask the omen sigs of ianmaton ad inet, Meteo sin ce secs tated raumating he pate’ rile ‘Sin Tho wie o adhesive ape heed, Seca ie ein tnd care apie sue when the tape removed. The ue ees ‘eter te stn and Roy prominent and encourages and sce the otet change psn Regu to pve ke Bek Te ptt ny beet rm dcsion of the eet th hae have had Sa kr seltcncepe an relsonshis with anes. Weigh als andes ty be moiety a Tosca, fowsosiam di, ania ih Pron ake may tlic some of he her bhersome spans. THe Fett ny as nett fo dco fhe changes being empoy it spans fo the pains end fami menbers boot the case of ‘total nsaiy are impor in Melpng tem cape wth the mood ‘igs, inal, and depron ny Peco Babar ay ct aot nly ments vet te sings an conc 576 [NURSING PROCESS “The Patient with Cushing's Syndrome Tei hyn ainsi the ota igh Sel ees respond to changes in cases aoseone level The tinor nelaes norton sou the pte'evl of wey sd silty {o cany ot rouiae ai selearescis. The shin cere and Ds appanc ae mtd, rks pars reponse ose hangs See eld The use wees the pet's meta fiom. celle ‘ond, raponcs fo qusiong,avanness of exe ad ltl of ‘Epes The aml ta god sou of infraton soul ra ‘huge inte pen’s ysl appearance rel cmon sas Diagnosis ‘sed on he neement ta mr pry asng ago nae te fallow "Rise fr impaied care fnston astoitd with changes ‘sada cto Rik forintry associ with weakness ‘Sand fale stn imped sea foci, nd decreased yee! + iy coping asc wth mood swings, iil, and epson Adverts fatrnacoric avy ‘The jer gol lor the pln inode maniac of ses ee Fancton decreed kf nay desea ri of inetin, mpotet stunner. improved Boy mage, improved mera fenetn, and fistec of compen sons Diabetes Insipidus Dist spd (DI ie a rae ise hat ccs de oir 2 he Ispesalaus opty ged with a geicesy of ADI esos dat rel excrdom a age volumes af ate ie snd extreme hs DL Shared ss cena eprops vopei a wel sx peel Uta Sven, 2019, "tbe primary tg fr om Dis head auma bt ter cassie sarge lfc. elton. le amor, cera asa sees the my be tupac Nepogens Delgo inde ie ey ‘Redeons sun lhon, hypokalemia and hpeclninDipopeieB) iresanes hy dfet inthe aptamer an may eth rel of amaze | the pay gane om a heal joy. sige, Icio, atari Frovisorttme (Safonl tie of Diabetes and Digerive and Key Dees, 2019) Di mt be dltrnated om diabetes, whic may ae Clinical Manifestations Say ope (pater tan 250 pera ver i ine apie pag of 101 20 LNs gcc (inlar & Sibert, 2119) The one fonts wo abnormal sutstnes sul as gloss or abi. Because of te seek th pent ede ok 216 201 fT ly en raves cal ‘ater nase the one of I may ens ora “ihe Gare canot be cone by ining Haak, besa he ik volume os of wie eons even id replacement. Aten 0 Felt Mls case th pao expen an able raving oad te develop ype an sever deers Assessment and Diagnostic Findings "he ld dpeatin et care ut by wtb Mads or 81012 hours ran 8 hth bay weigh oe The pent i weighed gue Sng the tert Plas and core samolity sides e petmed a the ‘eghning and en hee, The nyt erento pei vy and stole the wie le curacteraiof DT pats cones exe lege oles fe wih py a xs et Sond needs tote monitored fuenly dung te tx and het ‘eines chyna ees weg sso hypeensio etelps, ‘er Gagnon procedure inde coneuret ewan a plasma 86 supe theapy and lseaenoas (IV) lfsion of hypeane saie Solute Ihe ages cone a he ase (ea nr) ak Stour, pnt i fly ante fortis Ca may be sting te hone Medical Management ‘The bjs of they azo veplace ADI (bch aly angst ‘herpes program). ena alone fd replsemen. and ent and Sorc the unin Inara polos” Nereis cases requ ren aganel spaces Hellz & Sveti, 209), Pharmacologic Therapy Deanopresin, a ite vtoressin witout he vel fe oft ADH. te drug of eof ened DL: The dug my be given erally or ‘meatal (Nor, 201). Vasopressin capes vacant hale, ‘mut fe wie uateuty in pens wih srmary avey cee Chlepepamise ans thse ities le ed in mid forms of te ‘deere Dectse they pose the acon of vacopeein Bt ae aed wi ‘son ds tothe ik or ypoycriaMo,201), ‘nlf: Tie ceo mild adept and posapain inbers (a iometnci and aspire asda te the epiropnie for of Nursing Management ‘Ongoing pss asesment a pte escaton are he plas of sil ‘using mangement ofthe pat ih Sgr of Daly he mee ‘ve the pact history and psc! assessment and mars for la SBunesatns fuera. Sever deprecated to dereised rae ops and, terns, decreed perfaion of te isl pa Spel th anand ge}. Ongoing ontoring of via sg aswell Intake and owt (1&0) resent Te nei respon ede te fue aly and ater etepvers abut fllop car. prveron of Splenda. metre Spiel aed wn All mediestons and the sgps and rymytns of Ryponsemia, Tae mse ‘ould demoese abd observe a reucn demonsrwion of melee “Minsttoa toeeae tha the plat recived he pressed dosage The I Cushing's syne ia su of te adiisvaton of cricosid an stent eo lace thc ot nn dn Seas, econ of stasis ren). Prequel, aerateny (eons creas the syepons of Castings syne and alows Teaver of Be ‘al plans sprains to ACTH. “Ther nn apy td nea fe poet or et pep ee ae Inne tose. Bete, daring and ae suger, lod glucose moore th sesctmeot of sol for blood ae cated Ow to mor for these Sorplicons. Ihe aie has ober spams of Cable's sadn, ee Se cmidcredin the preoperative poration or camp ipl! as Sxparenced sph gun, mei intrcton fe ven shout poten Freaing etre ‘A vow) cri! test auies @ our write eallcton The ae ‘ther ets anormal, Casing ssypdome can eased ’an avert dextnetatnesopressn fe se 0 diagnos pany anneal eases of Casings syedrome canbe formed om captetinis Danco (or np i grenwal lac eg ‘Sappessoo of eoisol Tess than 5 mg. indicates that he hypothalamic~ pty adrea xs suring prope (isehback & Fischbach, 2018, ‘Sten, obey, dpe and. meicows sch tn etcorst ope, cage ig eg or la) a imp an ay Tnctr of Casing symtoms nce anne ns sion an ‘ond gles levee and eee fn eam pots edn the futber of Moed_ sop tad dappenanee of yaphoi tae ‘araon in plana eel Is pes thie variate is equemy abs Sonal yan. If seve! Nod samples are rege. thy mas be Medical Management ‘renal ee eames deste the pty pant Sie roel of the tumor by tamephenidl Ryopipsectony. (ee Couper I) 3 the ‘tenet of chokes Ration ofthe pituitary land Has also Ben sucess, ‘Sheu tty ae sever son or cote of pepo. Adresleony ypenonhs Mescl management is econmended fr Bsr ara ‘Sepia Prstpeaivey symptoms of etal insufney tay bela ape 2 to db uns afr ssp been of retain of he igh ine of eaing Sibel hormones Temper replacement hap i hy corsone mst Se ecesry fr sever orth the aren gland Bein tren oral othe ots ees ‘Akeal rayne bier (8, metrapns, aminoacids, mate, snd ketone} may be wid fo eee Hyper i he Saco ‘Suse yeeopie AIT cect ya mor tat enna be cra. Clase Iomeig specs, case smo of acts aes fein ‘uy esa and sie flee fhe meets may ee ‘Syndrome of Inappropriate Antidiuretic Hormone Secretion wine fein Mes an develop a soil dete know a dnl ponte, SIADH ts ohn of wonendcrioe rly for ini ata angels there ad ee ADIL SADA as tn secu in ote ih sever peu, pareshrox and ther ice of te Tings os wells alga tars at oer rats Nous, 201 ‘Ded of ve cen enous sae, ad yeu Srey tamer, infestor re though produce ADIT y Se simlato the psa plant (Nori 2019). Some matcaiow (ea. niin Pnthiarne tye adept, ire Crete) sod icrne have seine in IAD to eer dct silt te pttry an Inset th soy fel oes clang AD Medical Management SIADH is generally sling and emetic on einige veying chee if pasble end coticing id ike ates Sivemiin, 2019) ecuse veined water ier slo tough the Funes te cttsssr ed vohane cot andthe sam ani fonsetaon waa teases oman formal, Direc gets soo a5 Frosenide may be used slog with Md seein, Ie sere hypoarer Smee «Bypernie NaCl (4) ay bears aed ied 1 (Seis 201), Nursing Management mene and explantone of paces and texment as ep Boeing is irae THE THYROID GLAND ‘ee ty lane eet died hate apd lnveral lobes connected hy an sts, The gland is about Sem long. andl 3 em tide aad weighs svt 30 The Blond fw othe yl ey igh abo Saini pear of oi sue approximately Tv ime he aed Ta to the lke The tyold gland produ the hormones: thyroxine (T. Arodethyronine (T,), and eateninThyrwine and tsadohreine ae steel lod el fr etal (Moee, 2018) yp Helston Fite 453+ The yf end ang surouding sbucues, Anatomie and Physiologic Overview ‘Key arng thom srethyeighomare, cto, anda Thyrold Hormone ‘Tiyoidnorone compl of Ta, wo spurte bamones paid ty the thyroid gland Bh ate ain acs that coin odie moles Shunde amino aod suc Ty coals four oie sams ck sole ad Ts contains tee. These hormones ae sythszed ml seed ound open inthe cel of th nro gland uni ede lene Bo Ueadseam, Thee tiyeie binding" hemoner rnin inde otuin (TBO), antrein (omer krown wrote feb), a albania ued wer Ts a Ty (Noes, 2019) ‘Synthese of Thyroid Hormone Iodine eel the thyroid a for snes of mone, The nor he a oie ie he hoy 9) the yo, sd the mor drape ‘sepereoni erat irebrtcomposton aces “The noran wth Curbing seen ha eer cleo elt eal "a bila mo, s moon ace. epane win pean om ab, 2 Seay, OS. 8 Mabm Gola) ne panooay (Oh rel Praesens i ‘Assessment and Diagnostic Findings ‘The tre tet ued to dngots Cubig’ssyaone are seu cota tree tests need. io be unequivaclly abnormal io diagnose Cushing's ‘snirme thes af al ue ess arora he sie Ses nt Hate Cushing’ sje (bt may have ld ase the manrains fy beget For ewe pte fat ening 2 ot recomend let Spoons progres Ie en ae eer ily steormal or dacodan, Fite ting recommend. ‘Scrum corso levels re uty higher in he cy mming (6 0 & a) and oer Be evening (206 pe This Yaron i ok pats Wh Cesk’ syne acnacs & Fock 201) rieoson Pewee ‘Tong tee peace pear some Se ecg tae Snes obesity Pepe det ‘ecranas arma rnprses Irate sce fain Sons Season lone defiioney iar of yi anton lies ingested in tee felis where fade or reconvened ne molecles ich react Wh pein an amin cfr the tad homens (Sos, 201). Regulation of Thyrola Hormone ‘The sertin f Tandy hy theyre i aay TSH (ao ald yrarpi) Kas be nei laity lad. TSH coals tbe a of Spe on ree na a epi Kea mechs ake The hamoe cossration inthe loo ders, he rete of TS Inte, neh causes inteased ouput of Ty a Ty he fr euhyeid resto tyrid rmone pada tha ra "RIL, sceed by the hypotalns, exer a molting infuence onthe reese oF TSH tor dhe pry. Etre ts, such a decease Teper, my eed te incensed sceton of TRH, renting in eevee Tyrese wh repulsed nomone roto Function of Thyroid Hormone “The maa fron af ty armani ol calla metbiatiy ‘Torley west heonone, muna bay mbm nasty le. 1 abot fe tine a pote ws Tan hs amore rapid metabo acon specif eames tht cove Yo oxygen cesumpon ad aig the Fesporivnes of asus wo ter hoon. The ren hormones ncn nse fron, nls the basal meta ra ee erage, ‘Sum sles eve ad velar eine Non, 2019 Calcitonin Calta or holon, anather isporarshoomone secreted by the ‘yoid plan. The Bonzo a sete ia response o Beh pasa eves of cali rls pases neg non gute 44+ Tehypetatne gti ane Theo ‘aleaig haomene (EN fo fe ypc rites he Dir aon seveteteesernteng een TS, 18H mute the pod duce byrod harane inedenyronce {tala myrrh reltng onl of yon, tuner 8H seeton ae tyros pomote prodiconIweugh& ‘rege ieedbsck mech (sated et Pathophysiology Conga iypethyraisom, which occas when tee i equ secretion ff bproid homone dang eal and neonatal develope rs Inclectal diably ‘and sted pips grwth botnse of pee dresioe of mele avy (Nor 201). In als, hspetyredae ‘Buea leap, sow sean, weigh. gin consign cad ‘Resins, and gncalvd slowing of bay Fncons (Sigh Chie, 2019, partyin (ovesseton of hid rman) is mared by a gealy erased metbole rue, Many of te ober cheeses of Sipe rout fom the intel capone io cuing ‘Stechlamies pipe wd neice) 301 s970 renal cone (Sig & Slvr, 2018), Hower, veproduton of ‘amr of te play ln fal pours ACTH and silts hea Sonex ts ina homane cen Sept production of ade Snes Primary ype ofthe aie! lads th he sens of Pitunry tzor & le comme, Anwtc ee cmon cate of Cahn’ ‘fae i to ect redken of ACTH by malignancy rnchogee Clrcnoma ite mont common pe, Repti a he cane he oom ‘Eecbck mechanisms that enol he fansion of the aren sex hase ‘nef, andthe sual anal pater of cal i ost The ls abd Syapioms of Cushioe’s sure ie pul result eves of lnoorisis and androgens lfuph micas craton may Ese aswell Noy 203) Clinical Manifestations “The classe picture of Cushing's syndrome inte ad is that of centrale sig th ay "bufalo hump inet and Supratclraes Ay ha el eatey in ct T nh, ag aed ely ‘rurale: ecipmone ire) and aia velop. The ae complain sf weakens and Tasie. Sleep f dure eee of ered ral xcesive pun caubolim oc producng muscle wasting and xsi an tad orn fan of Se eee ‘iteloerioi acy, progiinghypereson and hea fe “he fest develops "iconacl” appease and tay expen ‘geese lines ft sin a ace Hypergene vet bts ay

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