Assessment of Client with Endocrinological Disorders Dr. Hanan Said Ali

Objectives Describe how to assess the client with Endocrinological disorders.

Endocrinological Nursing Cont. Assessment of client include: Fluid/Nutritious intake. May be increased or decreased intake, may not be associated with weight loss or gain, cover quantity and quality of food and fluids. Elimination pattern Includes frequency, amount, and colour of urinary eliminations, the presence of nocturia or dysuria, the frequency of bowel movement, constipation, diarrhea.

Endocrinological Nursing Cont. Assessment of client Cont.: Energy Level Performing proper activity of daily living, change in hair distribution, body proportion, voice, skin pigmentation. Reproduction and sexual related problems Fragility, menstruation, and pregnancy in female and impotence in males.

Endocrinological Nursing Cont. Assessment of client Cont.: Tolerance to stressors Physical and psychological stressors such as intolerance to heat and cold, infection, irritation, euphoria, depression, crying and anger. The nurse should observe the client general appearance for: 1. Hair: Texture, distribution, brittleness, and alopecia.

The nurse should observe the client general appearance for: 2. Body Size: Height and weight, size of the hand and extremities, Proportionality and posture, and facial features. 3. Skin: Skin colour, pigmentation, texture, coarseness, size of the sweat glands, diaphoresis, acne, strial, echymoses 4. Face: Colour, erythema, especially on cheeks(plethora) Pained, anxious expression.

The nurse should observe the client general appearance for: 5. Eyes: Eyebrow, hair distribution, visual scuity, lens opacity, shape, position, movements of eyelid 6. Nose: Mucosa, noisy breathing. 7. Mouth: Buccal mucosa, condition of teeth, tongue size, shape and size of jaw. 8. Voice: Hoarseness, volume, pitch and slurring.

The nurse should observe the client general appearance for: 9. Neck: Symmetry, alignment, forceful carotid pulsation, unusual bulging of thyroid lobes, gray- brain hyper pigmentation on posterior neck and axilae. Observing thyroid gland first in the normal position, then slight extensions and then as the client swallows some water.

The nurse should observe the client general appearance for: 10. Extremities: Size, shape, symmetry, proportionately( distance from symphysis pubies to foot; approximately half of total height) oedema a.Hand: Tremors, muscle strength grip, contracture, clubbing, muscle wasting. a.Legs: Muscle weakness, colour and amounts of hairs, size of feet, corns, celluses and pedal pulses.

The nurse should observe the client general appearance for: c. Toes: Fissures, deformities, toe nails with fungal infection. d. Pulses: Rate and rhythm. e. Thorax: Gynecomastia in men. f. Abdomen: increased pigmentation of scars, purplish pain on light palpation. g. Genitalia: Decreased hair distribution (a drenal tumour), size of the tests, clitoral enlargement.

Inspection and Palpation Assess fluid and electrolyte status by: Check skin turgor. Mucous membrane moisture. Jugular vein distention. Check for presence of oedema. Palpate thyroid, parathyroid and pancreas for: Size, shape, and symmetry. Asses vital signs

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