1. Assessment and Management of Patients With Endocrine Disorders Prepared by Dr. Iman Abdalla

2. Out line  Glands of the Endocrine System  Classification and Action of Hormones  The Thyroid Gland  Regulation of Thyroid Hormone  Function of Thyroid Hormone  Assessment and Diagnostic Findings  Hypothyroidism  Hyperthyroidism  Thyroid Storm (Thyrotoxic Crisis)  Thyroiditis  Thyroid Tumors

3. Out line  Endemic (Iodine-Deficient) Goiter  Management  prevention  Nodular Goiter  Thyroid Cancer  The Parathyroid Glands  Pathophysiology  Hyperparathyroidism  Hypoparathyroidism

4. Learning Objectives On completion of this lecture, the student will be able to: Describe the functions of each of the endocrine glands and their hormones. Compare hypothyroidism and hyperthyroidism: their causes, clinical manifestations, management, and nursing interventions. Develop a plan of nursing care for the patient undergoing thyroidectomy. compare hyperparathyroidism and hypoparathyroidism: their causes, clinical manifestations, management, and nursing interventions.

5. Glands of the Endocrine System

6. Classification and Action of Hormones Hormones are classified as: Steroid hormones ( hydrocortisone ) Peptide or protein hormones ( insulin ) Amine hormones ( epinephrine ) Fatty acids derivatives ( retinoids )

7. The Thyroid Gland The thyroid gland produces three hormones: 1- Thyroxin (T 4 ), 2- Calcitonine. 3- Triiodthyronine(T 3 ),

8. Regulation of Thyroid Hormone

9. Function of Thyroid Hormone Calcitonin Assessment and Diagnostic Findings

10. Specific Disorders of the Thyroid Gland Causes of Hypothyroidism Clinical Manifestation Medical Management Medication Interaction Nursing Management

11. Hyperthyroidism

12. Clinical Manifestation Medical Management Pharmacotherapy Surgical Management Nursing Process The Patient With Hyperthyroidism

13. Thyroid Storm (Thyrotoxic Crisis) Causes : It is precipitated by stress, injury, infection, thyroidectomy, tooth extraction, insulin reaction, diabetic ketoacidosis, pregnancy, abrupt withdrawal of antithyroid medications Clinical manifestations Management

14. Thyroiditis Thyroiditis, inflammation of the thyroid gland, can be:  acute,  subacute,  or chronic.

15. Thyroid Tumors Tumors of the thyroid gland are classified on the basis of being benign or malignant. If the enlargement is sufficient to cause a visible swelling in the neck, the tumor is referred to as goiter. All grades of goiter are encountered, from those, that are barely visible to those producing disfigurement. Goiter either symmetrical and diffuse or nodular. It might accompanied by hyperthyroidism (toxin); others are non toxic goiters

16. Endemic (Iodine-Deficient) Goiter

17. Management Many goiters of this type decreased after correction of iodine insufficiency. When surgery is recommended, post operative complications can be minimized by pre operative iodide administration to reduce the size & vascularity of goiter. Prevention Providing children in iodine-poor region with iodine compounds. Use of iodized salt.

18. Nodular Goiter

19. Thyroid Cancer Causes Types Assessment and Diagnostic Findings Medical Management Nursing Management

20. The Parathyroid Glands

21. Pathophysiology Excess parathormone can result in markedly increased levels of serum calcium, a potentially life- threatening situation. When the product of serum calcium and serum phosphorus (calcium x phosphorus) rises, calcium phosphorus may precipitate in various organs of the body (kidneys) and cause tissue calcification.

22. Hyperparathyroidism Primary Hyperparathyroidism. Secondary Hyperparathyroidism. Clinical Manifestation Assessment and Diagnostic Findings Medical Management Nursing Management Complications Hypercalcemic Crisis

23. Hypoparathyroidism Pathophysiology Clinical Manifestation Assessment and Diagnostic Findings Medical Management Nursing Management

24. Reference Brunner, L. and Suddarath, D. (2010). Text Book of Medical Surgical Nursing. 12 th Edition. J.B. Lippincott Williams & Wilikins, Library of Congress Catalging-in-Publication Data.].

25. Thank you