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Chapter 32 Metabolic and Endocrine Conditions

Chapter 32 Metabolic and Endocrine Conditions. Functions of the Endocrine System. Body growth and development Reproduction Metabolism of energy Maintenance of homeostasis Response to stress and injury. Characteristics of the Endocrine System.

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Chapter 32 Metabolic and Endocrine Conditions

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  1. Chapter 32Metabolic and Endocrine Conditions

  2. Functions of the Endocrine System • Body growth and development • Reproduction • Metabolism of energy • Maintenance of homeostasis • Response to stress and injury

  3. Characteristics of the Endocrine System • Consists of glands that synthesize and secrete hormones • Two major classes of hormones: • Steroids and thyronines • lipid soluble • Polypeptides and catecholamines • water soluble.

  4. Increased Incidence of Glucose Intolerance • A physiologic deterioration of glucose tolerance occurs with increasing age. • Improvement of diagnostic techniques enable more persons with the condition to be detected. • There is an increase in the incidence of diabetes throughout the general population.

  5. Indications of Diabetes in Elders • Orthostatic hypotension • Periodontal disease • Stroke • Gastric hypotony • Impotence • Neuropathy

  6. Indications of Diabetes in Elders (cont.) • Confusion • Gaucoma • Dupuytren contracture • Infection

  7. Criteria for the Diagnosis of Diabetes • Random plasma glucose concentrations are greater than or equal to 200 mg/dL. • Fasting blood glucose concentrations are greater than or equal to 136 mg/dL on two occasions. • Plasma glucose concentrations after oral glucose intake are greater than or equal to 200 mg/dL.

  8. Patient Education for Diabetes • General overview • Nutrition • Activity and exercise • Medications • Monitoring • Recognizing hypoglycemia and hyperglycemis • Recognition of symptoms • Prevention of complications

  9. Primary Symptoms of Hypoglycemia • Behavioral disorders • Convulsions • Somnolence • Confusion • Disorientation • Altered sleep • Nocturnal headache • Slurred speech • Cardiac symptoms

  10. Effects of Aging on the Thyroid Gland • Moderate atrophy • Fibrosis • Increasing colloid nodules • Some lymphocytic infiltration

  11. Hypothyroidism • Definition • A subnormal concentration of thyroid hormone in the tissues. • Types • Primary: results from a disease process that destroys the thyroid gland • Secondary: caused by insufficient pituitary secretion of thyroid-stimulating hormone (TSH).

  12. Symptoms of Hypothyroidism • Fatigue, weakness, and lethargy • Depression and disinterest in activities • Anorexia • Weight gain • Impaired hearing • Periorbital or peripheral edema

  13. Symptoms of Hypothyroidism (cont.) • Constipation • Cold intolerance • Myalgia, paresthesia, and ataxia • Dry skin and coarse hair

  14. Symptoms of Hyperthyroidism • Diaphoresis • Tachycardia • Palpitations • Hypertension • Tremor • Diarrhea • Stare • Lid lag

  15. Symptoms of Hyperthyroidism (cont.) • Insomnia • Nervousness • Confusion • Heat intolerance • Increased hunger • Proximal muscle weakness • Hyperreflexia

  16. Treatment of Hyperthyroidism • Graves’ Disease or Single Autonomous Nodule • Treatment typically includes antithyroid medications or radioactive iodine. • Toxic Multinodular Goiter • Surgery may be preferred due to the delayed and incomplete response to medications.

  17. Factors Contributing to Hyperlipidemia • Increase in low-density lipoprotein (LDL) with aging • Uncontrolled diabetes • Hypothyroidism • Uremia • Nephrotic syndrome • Use of corticosteroids, thiazide diuretics, and other drugs that increase the risk.

  18. Treatment for Hyperlipidemia • Dietary changes • Exercise • Weight reduction • Limiting alcohol intake • Medications • Alternative and complementary therapies

  19. Source • Eliopoulos, C. (2005).  Gerontological Nursing, (6th ed.).  Philadelphia: Lippincott, Williams & Wilkins (ISBN 0-7817-4428-8).

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