lOMoARcPSD|11495627

Phinma endo GI - ENDO/GI LECTURE

Nursing (University of Pangasinan)

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Endocrine Disorders
By: Keith Kainne “D” Garino, RN, LPT, MAEd

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Antidiuretic Hormone/Vasopressin

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Syndrome of Inappropriate Antidiuretic

Hormone Secretion
Cause:
1. Stroke
2. Tumor
3. Medications

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Interventions:
1. ADH 4. Oliguria/Polyuria
• DOC • Monitor
• I
• S
2. Fluid status
• DOC
• Monitor
• Monitor V/S
• Fluid intake 5. Cerebral Edema/Shrinkage
• Position • Monitor
• Priority
3. Hyponatremia/Hypernatremia • Precaution
• Monitor
• Neurological
• Serum osmolality
• IV fluids

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Diabetes Insipidus
Types:
1. Neurogenic/Central
•
•

2. Nephrogenic
•
•

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Interventions:
1. Neurogenic/central
• DOC
• Route
• WOF

2. Nephrogenic
• DOC
• T
• C
• C

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4. Fluid status 6. Oliguria/Polyuria

• Monitor - • Monitor
• Monitor vital signs •I
• BP - •S
• HR - • Avoid foods
• RR -

5. Hyponatremia/Hypernatremia
• Monitor
• Neurological
• Serum osmolality
• IV fluids
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Findings DI SIADH

Low ADH

Increased body weight

Hypertension

Tachycardia

Increased Serum Osmolality

Decreased urine specific gravity

Low serum sodium

Increased urine output

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Adrenal Glands
Parts:
1. Medulla
•
•
2. Cortex
•
•
•

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Adrenal Cortex
1. Glucocorticoids
• Natural release
• Sugar
• Stress
• Suppress
• Breakdown
• Blocks

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Adrenal Cortex
2. Mineralocorticoids
• Na and H2O
•K

3. Androgen

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Cushing’s
1. Syndrome
• Steroids
• Tumor

2. Disease
• ACTH

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Cushing’s
1. Glucocorticoids
• Natural release
• Sugar
• Stress
• Suppress
• Breakdown
• Blocks

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Cushing’s
2. Mineralocorticoids
• Na and H2O
•K

3. Androgen

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Interventions:
1. Cortisol 5. Calcium
• Avoid
• DOC
• M 6. Na & H2O
• M
• K
7. Potassium
2. Glucose

8. Androgen
3. Immunity

9. Surgery
4. Protein •

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Addison’s Disease/Adrenal Insufficiency

Types:
1. Primary
• Cause

2. Secondary
• Cause

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Addison’s Disease/Adrenal Insufficiency

1. Glucocorticoids
• Sugar
• Stress
• Suppress
• Breakdown
• Blocks

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Addison’s Disease/Adrenal Insufficiency

2. Mineralocorticoids
• Na and H2O
•K

3. Androgen

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Interventions:
1. Cortisol 5. Potassium
• Avoid
• DOC
6. Androgen
2. Glucose

3. Calcium

4. Na & H2O

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Findings Addison’s Cushing’s

Muscle weakness
Weight loss
Hirsutism
Hypoglycemia
Hypernatremia
Hypokalemia
Hypercalcemia
Hypertension
Bronze skin
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Thyroid Gland

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Hypothyroidism
• Cause
• Goiter
• Types:
1. Primary

2. Secondary

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Clinical Manifestations:
1. T3
• Metabolism
• GIT
2. T4
• Heat Production
• skin
3. SNS
• Muscle
• V/S

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Interventions:
1. V/S 5. Exophthalmos/Myxedema
2. Body wt. • Assess
• Monitor 6. Activity
• Calorie • Sedatives
• Activity 7. DOC
3. GIT • Time
• Fiber & fluids • With food or empty
4. Intolerance • WOF
• Environment • Over
• Under

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Hyperthyroidism:
• Cause
• Goiter
• Laboratory
• Clinical Manifestations

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Clinical Manifestations:
1. T3
• Metabolism
• GIT
2. T4
• Heat Production
• skin
3. SNS
• Muscle
• V/S

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Interventions:
1. DOC:
• 6. Exophthalmos/Myxedema
2. V/S • Dry
3. Body wt. • Sun
• Monitor • Sleep
• Calorie • HOB
• Activity • DOC
4. GIT 7. Activity
• Fiber & fluids • Sedatives
• Stimulants
5. Intolerance • Environment
• Environment
8. Avoid:

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Findings Hypothyroidism Hyperthyroidism

Lethargy
Tremors
Heat intolerance
Weight gain
Dry skin
Tachycardia
Diarrhea
Myxedema
Goiter
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Gastrointestinal Disorders
By: Keith Kainne “D” Garino, RN, LPT, MAEd

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Peptic Ulcer Disease

Factors:
• Stress
• Drinks
• Caffeine and decaffeinated
• Vices
• Drugs
• Infection

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Clinical Manifestations:

Gastric Duodenal
Pain
Time
Relief of pain
Bleeding

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Interventions:
1. Meal
2. Diet
•
• Chew
• Milk
• Active phase
3. Avoid Factors

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Medications:
1. Antacids
• Action
• Time
•S

•C

•A

•M

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Medications:
2. Gastric Protectants/Cytoprotective
• Sucralfate
• Time
• Action

• Misoprostol
• Time
• Action
• Contraindication

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Medications:
3. Histamine-2 Receptor Antagonist
• Action
• Time

4. Proton Pump Inhibitors

• Action
• Time

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1. Removal of the stomach with attachment of the esophagus to the jejunum

or duodenum
2. Surgical division of the vagus nerve.
3. Removal of the lower half of the stomach.
4. Partial gastrectomy with the remaining segment anastomosed to the
duodenum.
5. Enlargement of the pylorus to prevent or decrease pyloric obstruction.
6. Partial gastrectomy with the remaining segment anastomosed to the
jejunum.

A. Vagotomy
B. Total Gastrectomy
C. Pyloroplasty
D. Antrectomy
E. Billroth I
F. Billroth II

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Dumping Syndrome

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• Pallor
• Decreased bowel sound
• Bradycardia
• Hypotension
• Weakness
• Flat abdomen
• Diaphoresis
• Constipation
• Light headedness
• Nausea and vomiting

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Management
1. Diet:
• protein
• fiber
• carbohydrate
• Meals
• fluids
• Salt, sugar ,milk & caffeine
2. Position
3. Medication

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• Oatmeal
• Antispasmodics
• Coffee
• Drink fluids during meals
• Lie down after eating
• Candy
• Eat 6 meals per day
• Fried chicken
• Soda
• Cheese

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Appendicitis

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• McBurney’s point • WBC

Clinical • Rovsing’s sign • Bowel sound
Manifestation • Dunphy’s sign
• Blumberg’s sign

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Management:
1. Oral intake
2. Fluids
3. Activity
4. Hot/cold compress
5. Analgesics
6. Avoid
•
•
•

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Chronic Inflammatory Bowel Disorders

(Remission, Exacerbation & Malabsorption)
Findings Crohn’s Disease Ulcerative Colitis
Inflammation Discontinuous Continuous
And Transmural with fistula and cobble stone Mucosa & sub mucosa
Infection Crampy Crampy
Location Terminal ileum Rectum
Tenesmus
Bowel movement Less severe diarrhea Severe diarrhea
Semi solid With blood
Malabsorption Malnutrition Malnutrition
Anemia Anemia
Vitamin K deficiency
Surgery
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