MANAGEMENT OF

PATIENTS WITH
PROBLEMS OF ENDOCRINE
SYSTEM

CHARLES Z. ARIOLA JR., MSN., LPT, RN.

INSTRUCTOR I
 ASSESSMENT
METHODS
PATIENT HISTORY
- use of systems approach
- identifying patients response to actual or perceived changes
- use of Gordon's Functional Health Patterns
1. Nutritional -Metabolic Pattern
2. Elimination Pattern
3. Sleep-Rest Pattern
4. Sexuallity-Reproductive Pattern
5. Activity-Exercise Pattern
 ASSESSMENT
METHODS
NUTRITION HISTORY
- ask about history of nausea, vomiting, and abdominal pain
- ask for increase in fluid and food intake
- assess for dietary deficiencies
FAMILY HISTORY AND GENETIC RISK
- ask about any history of obesity, growth or development difficulties, DM,
infertility, or thyroid disorders.
 ASSESSMENT
METHODS
CURRENT HEALTH PROBLEMS
- assess energy level changes such as ability to perform ADLs
- assess for elimination pattern such as urinary pattern
- assess sexual and reproductive functions
- assess for physical appearance changes
 PHYSICAL
ASSESSMENT
INSPECTION
-an endocrine problem can change physical features because of its effect on
growth and development, regulation of sex hormone levels, fluids and
electrolyte balance and body's use of nutrients.
- use head to toe approach
- observe for patients general appearance, and assess height, weight, fat
distribution and muscle mass in relation to age.
- check the ler half of the neck for visible enlargement of the thyroid gland
 - assess for skin colors (ex: vitiligo- patcy areas of pigment loss which often
occurs in face, neck and extremities
- inspect patient's fingernails for malformation, thickness or brittleness
- examine the extremities and the base of the spine for edema.
- check for abnormalities in chest size and symmetry
- inspect the breast for both men and women for size, symmetry,
pigmentation and discharge
- assess the patient's hair distribution
 PHYSICAL
ASSESSMENT
PALPATION
- this is done in assessing thyroid gland and testes
- the thyroid gland is palpated for symmetry, size, general shape and the
presence of nodules or irregularities
AUSCULTATION
- auscultate the chest to assess for cardiac rate and rhythm
 DIAGNOSTIC
ASSESSMENT
LABORATORY ASSESSMENT
- Use of body fluids such as saliva, blood urine
1. STIMULATION/SUPPRESSION TEST
- measurement of specific hormone levels
STIMULATION TESTING- a stimulus is provided to determine whether
the gland is capable of normal hormone production. Failure of hormones to
rise indicates HYPOFUNCTION
SUPPRESSION TESTING- used when hormones are high. failure of
suppression of hormone during testing indicates HYPERFUNCTION.
 DIAGNOSTIC
ASSESSMENT
2. ASSAY
- measures the level of hormone in the blood or other body fluid.

3. URINE TESTS
- 24- hour urine collection reflects overall function of certain glands.

4. TEST FOR GLUCOSE

- tests for functions of the islet cells of the pancreas. the glycosylated
hemoglbin (HBA1c) reveals average blood glucose level for 2-3 months
 DIAGNOSTIC
ASSESSMENT
6. IMAGING ASSESSMENT
- Anterior, posterior , or lateral skull X-rays
- MRI
- CT Scan

7. OTHER DIAGNOSTIC ASSESSMENT

- Needle Biopsy