FSUU NURSING PROGRAM

Careof Clients with

Problems of
Regulation and
Metabolism
NCM 321

01
FSUU NURSING PROGRAM

The Endocrine
System : Review
NCM 321
Before class: Prepare!

Ready your materials

and mind for learning.
 Learning Outcomes:
After the discussions, the students will be able to:
1. Recall the functions of each of the endocrine glands;

1. Describe the functions of the endocrine gland and its

hormones;
2. Identify the endocrine changes associated with aging.
The
Locations of
Various 2 1

Glands 3

within the 4

Endocrine 5

System 6

7
The
Locations of
Various
Glands
within the
Endocrine
System
THE ENDOCRINE SYSTEM

- Regulates the body’s internal

environment;
- Working with the Nervous system controls
overall body function and regulation
including???
Hormones Secreted By Various
Endocrine Glands
“Lock and Key” Hormone
Receptor Binding
Disorders of the endocrine system
usually are related to:
Disorders of the endocrine system usually are related to:
• A Receptor defect
● An Excess of a specific hormone
• A Deficiency of a specific hormone
The Endocrine System

Anatomy and
Physiology:
Review
NCM 321
Negative Feedback Control Mechanisms
Complex Negative Feedback
Control Mechanisms
Involves a series of reactions:
Excesses or deficiencies of hormone secretion
can lead to pathologic conditions.
 Hypothalamus and
Pituitary Glands
Hypothalamic-hypophyseal portal system.
Hypothalamus and
Pituitary Glands
Pituitary Hormones: Target Tissues and Subsequent
Actions
Gonads
 Adrenal Cortex
Mineralocorticoids
Aldosterone is the major
mineralocorticoid and
maintains extracellular fluid
volume.
Renin
is produced by specialized
cells of the kidney arterioles.
Glucocorticoids
The main glucocorticoid
produced by the adrenal
cortex is cortisol.
Cortisol affects:
• The body's response to stress
• Carbohydrate, protein, and fat
metabolism
• Emotional stability
• Immune function
• Sodium and water balance
What are the Functions of Glucocorticoid
Hormones??
• Prevent hypogycemia by increasing liver
gluconeogenesis and inhibiting peripheral glucose use
• Maintain excitability and responsiveness of cardiac
muscles
• Increase protein catabolism
• Degrade collagen and connective tissue
• Increase the number of mature neutrophils released
from the bone marrow
• Exert anti-inflammatory effects that decrease the
migration of inflammatory cells to sites of injury
• Maintain behavior and cognitive functions
Sex Hormones secreted in low
levels by the Adrenal Cortex

• Estrogens
• Androgens
 Adrenal Medulla
-a sympathetic nerve ganglion
catecholamines
• Epinephrine
• norepinephrine
Catecholamines are secreted
in small amounts at all times
to maintain homeostasis.
Stress triggers increased
secretion of these
hormones
“fight-or-flight”
resulting in the “fight-or-flight”
response, a state of
heightened physical and
emotional awareness.
Catecholamine Receptors and Effects of Adrenal
Medullary Hormone
Stimulation on Selected Organs and Tissues
Thyroid Gland
Functions of Thyroid Hormones in Adults
• Control metabolic rate of all cells
• Promote sufficient pituitary hormone and
gonadotrophins
• Regulate protein, carbohydrate and fat
metabolism
• Exerts effects on heart rate and
contractability
Functions of Thyroid Hormones in Adults

• Increase red blood cell production

• Affect respiratory rate and drive
• Increase bone formation and decrease
bone reabsorption of calcium
• Acts as insulin antagonist
Parathyroid Gland
The Pancreas
The Pancreas
Endocrine Changes Associated with Aging
The three endocrine tissues that usually have reduced function
with aging( Touhy & Jett, 2014):
• the gonads
• the thyroid gland
• and the endocrine pancreas

Regular Screening Examinations:

• fasting and random blood glucose checks
• calcium level determinations, and
• thyroid function testing
Nursing Focus on the Older Adult
CHANGES CLINICAL FINDINGS
Decreased ADH production Urine is more dilute and may
not concentrate when fluid
intake is low

Decreased ovarian production • Bone density decreases

of estrogen • Skin is thinner, drier and at a
greater risk of injury
• Perineal and vaginal tissues
becomes drier and the risk for
cystitis increases

Decreased glucose tolerance Weight becomes greater than

ideal along with:
Elevated FBS levels & RBG
levels, slow wound healing,
frequent yeast infections,
polydipsia, polyuria
Decreased general metabolism Less cold tolerance
decreased appetite, HR and BP
Nursing Focus on the Older Adult
CHANGES NURSING ACTIONS

Decreased ADH Assess older patient

production more frequently for
dehydration

Decreased ovarian • Teach the patient to

production of estrogen engage in regular
exercise and weight-
bearing activity to
maintain bone density
• Handle the patient
carefully to avoid injury
from pathologic
fractures
Nursing Focus on the Older Adult
CHANGES NURSING ACTIONS
• Obtain a family history of
Decreased glucose diabetes
tolerance • Encourage the patient to engage
in regular exercises and ideal
BMI for age
• Teach the patient clinical
manifestations of DM and
suggest diabetes testing if with
manifestations
• Can be difficult to distinguish with
Decreased general hypothyroidism check addtn’l
metabolism ✔
manifestations of:
Lethargy
✔ Constipation
✔ Decreased cognition
✔ Slowed speech
✔ Body temp consistently below 36 deg
Celsius
✔ HR below 60 bpm
• Teach patient to dress warmly in cold
weather
Summary
• Endocrine glands
• Functions of each of the endocrine
glands and the endocrine gland
hormones;
• alterations in function of the
endocrine glands associated with
aging.