Nursing Implications for the Endocrine System

 

The endocrine system regulates growth, reproduction, and metabolism and consists of the pituitary gland, thyroid gland, parathyroid glands, adrenal glands, pancreas, and reproductive gland. The endocrine glands secrete hormones which affect all body tissues and organs. 

 

Nursing Assessment:

            Common Signs and Symptoms of Endocrine Dysfunction: 

·        Swollen lymph nodes (Goiter)

·        Enlargement at the base of the neck (Goiter)

·        Dyspnea (hypothyroidism)

·        Fatigue/weakness

·        Unexplained weight loss or gain

·        Fluid retention and edema

·        Decreased appetite

·        Hair loss

·        Brittle nails

·        Dry, rough skin (hypothyroidism)

·        Husky or hoarse voice

·        Loss of libido

·        Menstrual disturbances

·        Dull expression

·        Constipation (hypothyroidism) or Diarrhea

·        Exopthalmos, blurred vision, diplopia, photophobia (hyperthyroidism)

·        Increased heart rate, hypertension

·        Hypotension

·        Moon face, buffalo hump over the back (Cushing’s syndrome)

           

Nursing Diagnosis:  Common nursing diagnosis associated with endocrine disorders includes:

 

·        Activity Intolerance related to fatigue, exhaustion, and heat intolerance secondary to hypermetabololism; related to decreased metabolic rate and mucin deposits in joints and interstitial spaces

·        Constipation related to GI hypomotility

·        Decreased Cardiac Output related to a deficit in thyroid hormone (TH)

·        Disturbed Self-Esteem related to altered body image, emotional lability, and diminished physical capabilities

·        Disturbed Sensory Perception: Visual related to visual changes secondary to hyperthyroidism

·        Fluid Volume Excess related to excess cortisol secretion

·        Hypothermia related to cold intolerance

·        Imbalanced Nutrition: Less than Body Requirements related to hypermetabolism and inadequate diet

·        Imbalanced Nutrition: More than Body Requirements related to hypometabolism; related to increased appetite, high caloric content of foods, and inactivity

·        Risk for Infection related to lowered resistance to stress and suppression of immune system

·        Risk for Injury related to decreased blinking or inability to close eyelids secondary to exophthalmos

 

 

Nursing Implications/Interventions for Endocrine Dysfunction: Depending on the disease process, nursing care will be aimed at implementing measures to maintain normal vision and protect the eyes (hyperthyroidism), regain normal bowel patterns, and monitoring cardiac and respiratory status through on-going assessment of extremities for edema, monitoring of body weight, VS, and breath sounds. 

 

Endocrine dysfunctions require life long care.  Patient education will include:

 

·        Medication administration and the need to for periodic dosage adjustments. 

·        Proper nutrition, diet planning, and proper intake to maintain weight, prevent nutritional deficiency, avoid excess weight gain or prevent additional weight loss.  

·        Self-care practices to avoid infection

·        Self-care methods to improve appearance

·        Measure to prevent skin breakdown and promote intact skin (skin care, frequent position changes, routine/regular self-assessment of skin)