Nursing Management: Endocrine Problems Chapter 50 Overview Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

Disorders of Anterior Pituitary Gland Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. Acromegaly Etiology and Pathophysiology Clinical Manifestations Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. Acromegaly Fig. 50-1. Progressive development of facial changes associated with acromegaly. Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. Acromegaly Diagnostic Studies Collaborative Care Surgical therapy Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. Acromegaly Fig. 50-2. Surgery on the pituitary gland is most commonly performed with the transsphenoidal approach. An incision is made in the inner aspect of the upper lip and gingiva. The sella turcica is entered through the floor of the nose and sphenoid sinuses. Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. Acromegaly Collaborative Care, continued Radiation therapy Drug therapy Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

Nursing Management: Acromegaly Nursing Assessment Nursing Implementation Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

Excesses of Other Tropic Hormones Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

Hypofunction of Pituitary Gland Etiology and Pathophysiology Clinical Manifestations and Diagnostic Studies Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

Nursing and Collaborative Management: Hypofunction of Pituitary Gland Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

Disorders of Posterior Pituitary Gland Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

Syndrome of Inappropriate Antidiuretic Hormone Etiology and Pathophysiology Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

Syndrome of Inappropriate Antidiuretic Hormone Fig. 50-3. Pathophysiology of syndrome of inappropriate antidiuretic hormone (SIADH). Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

Syndrome of Inappropriate Antidiuretic Hormone Clinical Manifestations and Diagnostic Studies Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. Nursing and Collaborative Management: Syndrome of Inappropriate Antidiuretic Hormone Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. Diabetes Insipidus Etiology and Pathophysiology Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. Diabetes Insipidus Fig. 50-4. Pathophysiology of diabetes insipidus (DI). Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. Diabetes Insipidus Clinical Manifestations Diagnostic Studies Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

Nursing and Collaborative Management: Diabetes Insipidus Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

Disorders of Thyroid Gland Fig. 50-5. Continuum of thyroid dysfunction. Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. Goiter Fig. 50-6. Exophthalmos and goiter of Graves’ disease. Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. Goiter Table 50-4. Drugs that are Goitrogens. Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

Thyroid Nodules and Cancer Types of Thyroid Cancer Clinical Manifestations and Diagnostic Studies Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

Thyroid Nodules and Cancer Fig. 50-7. A large “cold” nodule on the thyroid gland (arrow) detected by a scan. Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

Nursing and Collaborative Management: Thyroid Cancer Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. Thyroiditis Fig. 50-8. Hashimoto’s thyroiditis. Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. Hyperthyroidism Etiology and Pathophysiology Graves’ disease Toxic nodular goiters Clinical Manifestations Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. Hyperthyroidism Fig. 50-9. Thyroid acropachy. Digital clubbing and swelling of fingers. Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. Hyperthyroidism Complications Diagnostic Studies Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. Hyperthyroidism Collaborative Care Drug therapy Antithyroid drugs Iodine Β‑adrenergic blockers Radioactive iodine therapy Surgical therapy Nutritional therapy Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

Nursing Management: Hyperthyroidism Nursing Assessment Nursing Diagnoses Planning Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

Nursing Management: Hyperthyroidism Nursing Implementation Acute intervention Acute thyrotoxicosis Thyroid surgery Ambulatory and home care Postoperative care Evaluation Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. Hypothyroidism Etiology and Pathophysiology Clinical Manifestations Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. Hypothyroidism Fig. 50-10. Common features of myxedema. Dull, puffy skin; coarse, sparse hair; periorbital edema; andprominent tongue. Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. Hypothyroidism Complications Diagnostic Studies Collaborative Care Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

Nursing Management: Hypothyroidism Nursing Assessment Nursing Diagnoses Planning Nursing Implementation Health promotion Acute intervention Ambulatory and home care Evaluation Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

Disorders of Parathyroid Glands Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. Hyperparathyroidism Etiology and Pathophysiology Clinical Manifestations and Complications Diagnostic Studies Collaborative Care Surgical therapy Nonsurgical therapy Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

Nursing Management: Hyperparathyroidism Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. Hypoparathyroidism Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

Nursing and Collaborative Management: Hypoparathyroidism Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

Disorders of Adrenal Cortex Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. Cushing Syndrome Etiology and Pathophysiology Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. Cushing Syndrome Table 50-13. Causes of Cushing Syndrome. Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. Cushing Syndrome Clinical Manifestations Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. Cushing Syndrome Fig. 50-11. Cushing syndrome. Facies include a rounded face (“moon face”) with thin, reddened skin.Hirsutism may also be present. Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. Cushing Syndrome Fig. 50-12. Common characteristics of Cushing syndrome. Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. Cushing Syndrome Fig. 50-13. Cushing syndrome. Truncal obesity; broad, purple striae; and easy bruising (left antecubital fossa). Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. Cushing Syndrome Diagnostic Studies Collaborative Care Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

Nursing Management: Cushing Syndrome Nursing Assessment Nursing Diagnoses Planning Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

Nursing Management: Cushing Syndrome Nursing Implementation Health promotion Acute intervention Preoperative care Postoperative care Ambulatory and home care Evaluation Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

Adrenocortical Insufficiency Etiology and Pathophysiology Clinical Manifestations Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

Adrenocortical Insufficiency Fig. 50-14. Hyperpigmentation typically seen in Addison’s disease. Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

Adrenocortical Insufficiency Complications Diagnostic Studies Collaborative Care Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

Nursing Management: Addison’s Disease Nursing Implementation Acute intervention Ambulatory and home care Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

Nursing and Collaborative Management: Corticosteroid Therapy Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. Hyperaldosteronism Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

Nursing and Collaborative Management: Primary Hyperaldosteronism Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

Disorders of Adrenal Medulla Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. Pheochromocytoma Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

Nursing and Collaborative Management: Pheochromocytoma Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.