Care of the Patient With Endocrine Disorders

Diagnostic Tests
Gerontologic Considerations
Diagnostic Tests

• Blood Test
• MRI (Magnetic
Resonance Imaging)
• CT Scan
 Comparing Disorders of the
Posterior Pituitary
SIADH DI
• HYPER secretion of ADH • HYPO secretion of ADH
• Produces water • Results in large urine
intoxication output
• Serum chemistry….THINK • Serum chemistry….THINK
DILUTE CONCENTRATED
• Urine chemistry….THINK • Urine chemistry….THINK
CONCENTRATED DILUTE
Syndrome of Inappropriate ADH Secretion
(SIADH)
 Critically Thinking Like a Nurse
If a patient is suspected to have an acute onset of SIADH
which would be the most important assessment finding for
the nurse to report to the doctor immediately?
a.) A weight gain of 3lbs overnight
b.) A weight loss of 3lbs overnight
c.) A normal set of vital signs
d.) A urine specific gravity of 1.010
 Critically Thinking like a Nurse
A patient with SIADH is treated with water restriction. What does the patient
experience when the nurse determines that the treatment has been effective?
1. Increased urine output, decreased serum sodium, increased urine specific
gravity
2. Increased urine output, increased serum sodium, and decreased urine
specific gravity
3. Decreased urine output, increased serum sodium, and decreased urine
specific gravity
4. Decreased urine output, decreased serum sodium, and increased urine
specific gravity
 Critically Thinking Like a Nurse
A nurse is assessing a client who takes vasopressin
(Pitressin) for diabetes insipidus. For which of the
following adverse effects should the nurse
monitor?
A. Hypovolemia
B. Hypercalcemia
C. Hypoglycemia
D. Hypertension
Disorders of the Thyroid Gland

• Hyperthyroidism- Excessive
hormone production

• Hypothyroidism-Insufficient
hormone production
Population at Risk for Hyperthyroidism
Diagnostic Tests of the Thyroid
Hyperthyroidism Collaborative Care

•
 Critically Thinking Like a Nurse
A nurse is caring for a client who is take Propylthiouracil
(PTU). For which of the following adverse effects of this
medication should the nurse monitor?
A. Bradycardia
B. Insomnia
C. Heat intolerance
D. Weight loss
 Critically Thinking Like a Nurse
A nurse in a provider’s office is reviewing laboratory
results of a client who is being evaluated for secondary
hypothyroidism. Which of the following laboratory
findings is expected for a client who has this condition?

A. Elevated serum T4
B. Decreased serum T3
C. Elevated serum thyroid stimulating hormone
D. Decreased serum cholesterol
Population at Risk for Hypothyroidism
Collaborative Care of Hypothyroidism
 Critically Thinking Like a Nurse
A nurse is caring for an older adult client in a long-term care
facility who has hypothyroidism and is beginning levothyroxine
(Synthroid). Which of the following dosage schedules should
the nurse expect for this client?
A. The client will start at a high dose, and the dose will be tapered
down as needed.
B. The client will remain on the initial dosage during the course of
treatment.
C. The clients dosage will be adjusted daily based on blood levels.
D. The client will start on a low dose, which will be gradually
increased.
Clinical Manifestations of Hyperparathyroidism
 Hyperparathyroidism Collaborative Care

• Goal of Medication
Management
• Decreases Calcium Level
• Dietary Considerations
• Monitor Electrolytes Levels
• Exercise Therapy
Hypoparathyroidism
Hypoparathyroidism Collaborative Care

• Goal of Treatment • Medication Management

• Management of Hypocalcemia
• Cardiovascular Arrhythmia
• Respiratory
• Tetany
• Dietary Considerations
•
• Restore Serum Calcium
• IV In Acute Clinical Scenario
• Oral Calcium Supplements
• Vitamin D
Disorders of the Adrenal Cortex
 Critically Thinking Like a Nurse
A nurse is admitting a client to an acute care facility for a
total hip arthroplasty. The client takes hydrocortisone for
Addison’s disease. Which of the following is the priority
nursing action?
A. Administering a supplemental dose of hydrocortisone
B. Instructing the client about coughing and deep
breathing
C. Collecting additional information from the client about
his history of Addison’s disease
D. Inserting an indwelling urinary catheter
Corticosteroid Therapy