Nursing Tips: Endocrine

Addison's Disease

Endocrine Medical-Surgical

A patient with Addison's Disease (a form of adrenocortical insufficiency) will have increased potassium, calcium, and BUN, but decreased cortisol, sodium, and glucose.

Glipizide and glyburide are Sulfonylureas used to treat type 2 Diabetes.

HINT: Think of riding down a slide, as your blood sugar comes down with this medication. Key side effect = hypoglycemia.

Hyperpituitarism

Endocrine Med-Surg

A patient with hyperpituitarism may require surgical treatment with a hypophysectomy.

Corticosteroids: Patient Teaching

Endocrine Pharmacology

Patients taking corticosteroids (e.g., prednisone, hydrocortisone) are at increased risk of infection. Monitor for signs of infection, and educate patients taking these medications to avoid crowded areas and perform frequent hand hygiene.

Metformin

Endocrine Pharmacology

Because of the unpleasant GI side effects of metformin, educate patients to take this medication with a meal.

When caring for a child with pheochromocytoma, be sure not to palpate the abdomen. Palpation can cause a sudden release of catecholamines, triggering severe hypertension!

Pheochromocytoma in Children

Endocrine Pediatrics

When caring for a child with pheochromocytoma, be sure not to palpate the abdomen. Palpation can cause a sudden release of catecholamines, triggering severe hypertension!

A patient taking a strong iodine solution to treat hyperthyroidism or thyrotoxicosis in preparation for thyroidectomy should be educated as to the symptoms of iodism (e.g., metallic taste, stomatitis, severe GI upset).

Iodism: Patient Teaching

Endocrine Pharmacology

A patient taking a strong iodine solution to treat hyperthyroidism or thyrotoxicosis in preparation for thyroidectomy should be educated as to the symptoms of iodism (e.g., metallic taste, stomatitis, severe GI upset).

Negative Feedback Loop

Endocrine Med-Surg

A negative feedback loop governs most endocrine hormones. In this type of feedback, when the body senses there is not enough of a hormone circulating in the blood, changes are initiated to increase production of that hormone. Once the body senses there is too much of that hormone, changes are initiated to decrease production of that hormone.

Growth Hormone Deficiency

Endocrine Pediatrics

A child with Growth Hormone Deficiency would have an average birth weight/length, but show delayed growth through childhood.

Antidiuretic Hormones

Endocrine Pharmacology

Antidiuretic hormones (ex: vasopressin and desmopressin) are used to treat Diabetes Insipidus.

Mixing insulin

Endocrine Pharmacology

When mixing insulin, remember CLEAR before CLOUDY. Inject air in the longer-acting insulin (NPH), then inject air in the shorter-acting insulin (regular). Without withdrawing needle, draw up shorter-acting insulin, then draw up longer-acting insulin.

Diabetic Foot Care

Endocrine Med-Surg

Diabetic foot care teaching: Inspect feet; Apply moisturizer; Wear cotton socks; Cut nails straight across; Don't use OTC products or use heating pads on feet.

Diabetes Insipidus

Endocrine Med-Surg

With Diabetes InSIPidus, you will want to SIP a lot of water. Diabetes Insipidus causes the patient to urinate large quantities of dilute urine, leaving the patient dehydrated and thirsty!

Syndrome of Inappropriate ADH

Endocrine Med-Surg

Syndrome of Inappropriate ADH (SIADH) causes the excess water to be reabsorbed by the kidneys, resulting in hypervolemia.

NPH- Intermediate-Acting Insulin

Endocrine Pharmacology

NPH is an intermediate-acting insulin. Onset is 1-2 hours, peak is 4-12 hours, and duration is 18-24 hours.

HINT: Neil Patrick Harris (NPH) is a hard-working actor of intermediate height. If you call him, he will be "on set" in 1-2 hours and he will stay there for up to 24 hours.