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Summary NURS 172 Unit 3 Study Guide
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Unit 3 172 NotesParathyroid hormone PTC response when there is a low calcium level, if
calcium levels are high calcitonin from the thyroid pushes it back in.
The pituitary gland produces many hormones that travels throughout the body, directs
certain processes, and stimulates other glands to produce hormone.
In the upcoming semesters you will continue to learn about the endocrine system. In
Nursing 172, Unit 3, the focus areas are
1. Thyroid Disorders
2. Diabetes Mellitus
3. Parathyroid (r/t thyroid gland removal, renal disease)
The endocrine system includes glands found in various locations in the body and works
in conjunction with the nervous system in coordinating many life-sustaining functions
associated with metabolism, growth and development, blood glucose control, and
sexual functioning (Hoffman & Sullivan, 2020).
The pituitary gland produces many hormones that travels throughout the body, directs
certain processes, and stimulates other glands to produce hormone.
The anterior pituitary gland hormones.
1. Thyroid-Stimulating Hormone (TSH)- Rememeber!
2. Prolactin
3. Follicle-Stimulating Hormone (FSH)
4. Luteinizing Hormone (LH)
5. Adrenocorticotropic Hormone (ACTH)
6. Growth Hormone (GH)
Most hormones are regulated by feedback mechanisms. A feedback mechanism is
a loop in which a product feeds back to control its own production. Most hormone
feedback mechanisms involve negative feedback loops. Negative feedback keeps the
concentration of a hormone within a narrow range.
Negative feedback occurs when a product feeds back to decrease its own production.
This type of feedback brings things back to normal whenever they start to become too
extreme. The thyroid gland is a good example of this type of regulation. he
hypothalamus secretes thyrotropin-releasing hormone, or TRH. TRH stimulates the
pituitary gland to produce thyroid-stimulating hormone, or TSH. TSH, in turn,
stimulates the thyroid gland to secrete its hormones. When the level of thyroid
hormones is high enough, the hormones feedback to stop the hypothalamus from
secreting TRH and the pituitary from secreting TSH. Without the stimulation of TSH,
the thyroid gland stops secreting its hormones. Soon, the level of thyroid hormone
starts to fall too low.
Pituarty gland mother thyoid t3 t4 act out ( TSH level stays low, when T3
T4 are high) ( when it’s not suppose to being, but wants to fix it self)
Positive feedback occurs when a product feeds back to increase its own production.
This causes conditions to become increasingly extreme. An example of positive
feedback is milk production by a mother for her baby. As the baby suckles, nerve
messages from the nipple cause the pituitary gland to secrete prolactin. Prolactin, in
,turn, stimulates the mammary glands to produce milk, so the baby suckles more. This
causes more prolactin to be secreted and more milk to be produced. This example is
one of the few positive feedback mechanisms in the human body. What do you think
would happen if milk production by the mammary glands was controlled by negative
feedback instead?
ENDOCRINE ASSESSMENT
o Health History
o Vital Signs
o Laboratory and Diagnostic Results
Physical Assessment:
o Inspection
o Auscultation
o Palpation
o Percussion
Nursing Diagnosis, goals, interventions, and evaluations
Some of the following are pertinent data of assessment:
Pertinent past and present endocrine disorders.
Changes in mood, memory, ability to concentrate, altered sleep pattern, and changes in
energy level and fatigue.
Changes in sexual function and secondary characteristics.
Tolerance of heat and cold tolerance.
Elimination patterns.
Changes in physical appearance (facial hair in women, moon face, buffalo hump,
changes in eyes, skin changes, recent weigh changes
General Appearance: Vital signs, height, weight, and nutritional status.
Inspect eyes, palpate throat, .
Evaluate cognition, mood, memory, orientation, sensory function.
Auscultate heart sounds and listen to breath sounds.
Abdomen: Inspect, auscultate, and palpate all four quadrants, bowel and urinary
elimination.
Integumentary: Skin color, texture, moisture, temperature, hair texture, hair growth,
nail beds, wound healing, inspect lymph nodes, and jugular vein distention.
DIAGNOSTIC TESTING
Laboratory assessment of urine and blood
o Tests are related to disorder under investigation
Imaging studies
o Assess for changes in the size or presence of tumor formation in the
glands of the endocrine system
o Computed tomography (CT)
o Magnetic resonance imaging (MRI)
o X-rays
o Diagnostic evaluation of the patient with a suspected endocrine disorder
includes laboratory assessment of urine and blood samples as well as
, imaging studies. The specific laboratory tests conducted are associated
with the disorder under investigation (Table 40.3). For example, in the
patient with suspected diabetes mellitus, blood and urine levels of
glucose are measured. In the patient with suspected dysfunction of the
adrenal cortex, serum potassium levels are evaluated.
o Measurements of circulating hormone levels are also evaluated. In patients
with suspected thyroid disease, T3, T4, and T S H levels are assessed.
o Stimulation and suppression tests are also ordered for patients with suspected
endocrine disease. With stimulation testing, a selected hormone is administered
to stimulate the target tissue to produce its hormone. Failure of the target to
secrete sufficient hormone indicates hypofunction of that gland.
Conversely, suppression tests are indicated when there are excess levels of
circulating hormone. When levels of circulating hormone do not decrease with
suppression testing, hyperfunction of the gland is confirmed.
o Imaging studies — Diagnostic imaging studies are indicated to assess for
changes in the size or presence of tumor formation in the glands of the
endocrine system. Disorders of the posterior pituitary gland may occur as a
result of a pituitary tumor. A pheochromocytoma, a tumor of the adrenal
medulla, may be confirmed with imaging studies of the retroperitoneal area.
Computed tomography (CT) and magnetic resonance imaging, as well as x-rays
are used to confirm abnormalities of the endocrine glands.
o Hoffman & Sullivan, 2020
THYROID GLAND
Thyroid gland — Located in the anterior neck, the thyroid gland lies directly below the
cricoid cartilage (Fig. 40.6). Composed of two lobes, it is connected by a strip of tissue
called the isthmus. The thyroid gland consists of two lobes and is located beneath the
larynx in front of the trachea. It regulates metabolism.
THYROID GLAND: ( weight changes, hair falling, sleep pattern, masses or enlarge lads,
mood changes (low-depressed, high- irritated, fatigue, tenderness around the neck.))
o Assessment
o Inspection
o Palpation
o Auscultation
Thyroid Gland Normal Findings:
o Symmetrical movement swallowing
o Adam’s apple more pronounced in males
o No masses, tenderness, or enlargement
o Absent bruit
o Some of the important assessment findings to noted in the thyroid gland are;
Mass, enlarged gland, goiter, asymmetrical enlargement, and presence of
nodule or bruit.
Thyroid Gland Assessment:
When palpating the thyroid gland (mostly completed by a medical provider, students
will normally not be found completing this). ( done behind, bilateral)
, Palpate, evaluate the size, symmetry, shape, or nodules. S&S
Thyroid Gland Function Test:
o Total T3 (triiodothyronine): 70–204 ng/dL
o Free T4 (thyroxine): 0.8–1.5 ng/dL
o Total T4 (thyroxine): 4.6–12 mcg/dL
o Thyroid-stimulating hormone (TSH): 0.5–8.9 microinternational
units (mIU)/mL
Diagnostic Testing: Thyroid US, CT, MRI.
The thyroid gland produces three thyroid hormones, triiodothyronine (T3), thyroxine
(T4), and thyrocalcitonin (calcitonin). Production of these hormones requires adequate
dietary intake of protein and iodine. Release of T3 and T4 is controlled by the
hypothalamic-pituitary system and is based on the circulating levels of these thyroid
hormones. When T3 and T4 levels are low, the hypothalamus secretes T R H that
stimulates the release of T S H from the anterior pituitary gland. In turn, T S H acts on
the thyroid gland, leading to secretion of T3 and T4. While the circulating levels of T3
and T4 increase, the feedback system causes the hypothalamus to decrease release of T
R H. Other conditions that increase secretion of T R H, independent of circulating T3
and T4, are cold and stress. The end result is an increase in metabolic activity with
both conditions.
Regulation of metabolic activity is controlled by T3 and T4, and secretion of both
hormones increases metabolism. Specific actions of T3 and T4 include:
Increased rate and contractility of the heart
Increased rate and depth of respirations
Increased oxygen use
Increased glucose intake by cells
Increased glycolysis and enhanced gluconeogenesis
Increased protein synthesis and catabolism
Increased mobilization of fatty acids
Increased oxidation of free fatty acids
Decreased cholesterol and phospholipids
PARATHYROID GLANDS
The Parathyroid Hormone (PTH):
The major factors regulating calcium and phosphate are parathyroid hormone
(PTH), calcitonin, and calcitrol.
PTH: Single most important hormone in controlling calcium homeostasis. Its release is
triggered by falling blood calcium levels and inhibited by hypercalcemia. (high-
nothing, low will fight to get high –best way through medication it doesn’t work hard.)
There are three target organs for PTH: Skeleton, kidneys and the intestines.
The parathyroid glands are small in size and are found on the posterior aspect of the
thyroid gland (typically there are four of them). It secretes PTH hormone.
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