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- 1. CNA 2 OSBN Curriculum http://www.medcomrn.com/dev/flash/flvpla yer/movie.php?movie=http://ss1.medcomrn. com/flv/78723r_sec01_300k.flv&title=&dete ctflash=false&detectflash=false
- 2. This project was funded $3,000,000 (100% of its total cost) from a grant awarded under the Trade Adjustment Assistance Community CollegeandCareerTraining Grants, as implementedby the U.S. Department of Labor’s Employment and Training Administration. Rogue Community Collegeis an equal opportunity employer/program. Auxiliary aids and services, alternate form and language services are available to individuals with disabilities andlimitedEnglish proficiency free of cost upon request. This work is licensed under a Creative Commons Attribution 4.0 International License.
- 3. System of Glands Function: ◦ Body Metabolism ◦ Growth ◦ Reproduction 4 Major Glands ◦ Pituitary ◦ Thyroid ◦ Pancreas ◦ Adrenals
- 4. Master Gland ◦ Makes Hormones for other glands Regulates ◦ Growth ◦ Reproduction http://www.medcomrn.com/dev/flash/flvplayer/movie.php?movie= http://ss1.medcomrn.com/flv/78723r_sec02_300k.flv&title=&det ectflash=false&detectflash=false
- 5. Sit on kidneys Secrete Epinephrine Flight or Fight http://www.medcomrn.com/d ev/flash/flvplayer/movie.php? movie=http://ss1.medcomrn.c om/flv/78723r_sec03_300k.flv &title=&detectflash=false&det ectflash=false
- 6. Cortisol Exposure for Too Long #1 Cause: Excessive Steroid Use ◦ Chronic Breathing ◦ Chronic Inflammation
- 8. Diet: ◦ High: protein & K+ ◦ Low: carbohydrates & Na+ Body Image Adjustment Emotional Support
- 9. Regulates Metabolism ◦ Parathyroid Regulates Ca Hypothyroidism ◦ Not enough hormone Hyperthyroidism ◦ Too much hormone
- 10. Overactive Thyroid Causes: ◦ Graves’ Disease ◦ Excessive Intake of Thyroid Hormones ◦ Thyroiditis ◦ Excessive Iodine Intake Significantly Accelerated Metabolism
- 12. Not enough hormone Lack of Iodine Pituitary disease Advancing age
- 13. Observation & Reporting Facial Myxoedema Weak/Fatigue Depression Wt. Gain Cold Intolerances Constipation Dry, Thick Skin
- 14. Monitor: ◦ VS ◦ Accurate I&O ◦ Weight ◦ Activity Limit Fatigue Cluster activities Plan rest periods ◦ Report Abnormals Medical Id bracelet Refer questions/concerns to nurse
- 15. Regulates Blood Glucose and Insulin
- 16. Three Types ◦ Type 1 Onset early in life Pancreas not producing enough insulin Insulin injections ◦ Type 2 Adults Body doesn’t use insulin well Diet/exercise/PO meds ◦ Gestational (GDM) During pregnancy Generally goes away after birth http://www.medcomrn.com/dev/flash/flvplayer/movie.php?movie =http://ss1.medcomrn.com/flv/m231_sec01_300k.flv&title=&det ectflash=false&detectflash=false
- 18. Observations & Reporting Blood Sugar < 60 Cold, clammy skin Irritability Rapid, shallow breathing Rapid pulse Vision Changes Convulsions Faintness
- 19. Observation & Reporting CBG>125 Polydipsia Polyphagia Polyuria Weakness Low BP Kussmaul Breathing
- 20. Report ◦ Abnormal CBG ◦ s/s ◦ Food intake Emotional Support Adequate Intake
- 21. Dangerous Complication Too Many Ketones Body Acidic CBG > 400 Up to 1000 Mostly in ICU
- 23. Generally in Critical Care As directed by the nurse Hourly CBG Report ALL Readings Regulate Diet Emotional Support
- 24. Excessive Urination ◦ 5-15L/day May be from ◦ Rx’s ◦ Head Trauma ◦ Pituitary Disorders Treated with Meds
- 25. Urinary Frequency Thirst Dehydration
- 26. Accurate I&O Daily Weights Monitor for Dehydration Report changes to nurse
- 27. https://www.youtube.com/watch?v=oiqDx1g33CU https://www.youtube.com/watch?v=8XAYkFBJFrU https://www.youtube.com/watch?v=zO8qOwizUNI CBG Testing A1C testing the “cornerstone” of diabetes management. ◦ a blood test that provides information about a person’s average levels of blood glucose, also called blood sugar, over the past 3 months.
- 28. This project was funded $3,000,000 (100% of its total cost) from a grant awarded under the Trade Adjustment Assistance Community CollegeandCareerTraining Grants, as implementedby the U.S. Department of Labor’s Employment and Training Administration. Rogue Community Collegeis an equal opportunity employer/program. Auxiliary aids and services, alternate form and language services are available to individuals with disabilities andlimitedEnglish proficiency free of cost upon request. This work is licensed under a Creative Commons Attribution 4.0 International License.
Notas del editor
- System of glands that secrete directly into bloodstream • Function: controls body metabolism, growth and reproduction • 4 Major glands are: Pituitary- “master gland” regulates growth and reproduction Thyroid- regulates metabolism Pancreas- regulates blood glucose and insulin Adrenals- sit on top of each kidneys- secrete epinephrine (which stimulates the body to produce energy during an emergency)
- Cushing’s Syndrome • Cushing’s syndrome occurs when the body’s tissues are exposed to high levels of cortisol for too long • One cause is- excessive use of steroids (usually prescribed for breathing, or other inflammatory diseases) Definition Cushing's syndrome is a relatively rare endocrine (hormonal) disorder resulting from excessive exposure to the hormone cortisol. The disorder, which leads to a variety of symptoms and physical abnormalities, is most commonly caused by taking medications containing the hormone over a long period of time. Chronic breathing or inflammation. A more rare form of the disorder occurs when the body itself produces an excessive amount of cortisol. Cushing's syndrome, also called hypercortisolism, has an adverse effect on all of the processes described above. The syndrome occurs in approximately 10 to 15 out of every one million people per year, usually striking adults between the ages of 20 and 50. Causes and symptoms The most common cause of Cushing's syndrome is the long-term use of glucocorticoid hormones in medications. Medications such as prednisone are used in a number of inflammatory conditions. Such conditions include rheumatoid arthritis, asthma, vasculitis, lupus, and a variety of other autoimmune disorders in which the body's immune cells accidentally attack some part of the body itself. In these disorders, the glucocorticoids are used to dampen the immune response, thereby decreasing damage to the body.
- Muscular weakness Thinning of hair Weight gain Depression Thinning of skin
- Hyperthyroidism • Hyperthyroidism is a condition in which the thyroid gland makes too much thyroid hormone. The condition is often referred to as an "overactive thyroid.” • • Causes: Graves' Disease (autoimmune disorder; the thyroid is extremely active) Excessive intake of thyroid hormones Abnormal secretion of TSH (thyroid stimulating hormone) Thyroiditis (inflammation of the thyroid gland) Excessive iodine intake
- Can significantly accelerate the body's metabolism • Can cause sudden weight loss, a rapid or irregular heartbeat, sweating, and nervousness or irritability
- • Hypothyroidism is a condition in which the thyroid gland does not make enough thyroid hormone. • Causes: Severe lack of iodine Pituitary or hypothalamic disease Thyroid destruction (from radioactive iodine or surgery) Advanced age (thyroid function can decrease as we age) Observation & Reporting: Slow Metabolism Down ask what they think Tiredness, Weakness, Fatigue Social withdrawal & depression Wt. gain and hoarseness Cold intolerance and Raynaud’s phenomenon Decreased sweating Thick, course, hair Facial myxedema Loss of lateral third of the eyebrows Cold dry, thickened skin Constipation
- Endocrine cells in the pancreas form clusters called the Islets of Langerhans after a German scientist named Paul Langerhans who discovered them. Each islet contains two types of endocrine cells: alpha cells and beta cells. These cells produce two very important hormones: alpha cells produce glucagon and beta cells produce insulin. These two hormones regulate blood glucose levels. When blood glucose levels rise higher the beta cells release insulin. When blood glucose levels fall lower the alpha cells release glucagon. Diabetes mellitus is a disease in which the body either doesn't produce enough insulin—type 1 diabetes—or has decreased sensitivity to insulin—type 2 diabetes. This results in elevated levels of blood glucose which, without treatment, can lead to serious complications including coma and death.
- Diabetes Mellitus: A chronic disorder marked by hyperglycemia. Results from either failure of the pancreas to produce insulin (type 1)or from insulin resistance, with inadequate insulin secretion to sustain normal metabolism (Type 2) • Three types: Type 1: Also called “Insulin Dependent” or IDDM Occurs most in children and young adults Pancreas produces little or no insulin. Insulin lowers blood glucose Need to use insulin therefore is a less stable form of this disease Type 2: Also called Non-Insulin Dependent or NIDDM Occurs in adults Body cannot use body’s supply of insulin well Can be managed with diet, exercise and oral meds (occasionally insulin) Gestational or GDM: Usually goes away after delivery of baby
- One of the crucial tasks for a clinical nurse is to stay alert for signs and risk factors. If you work in a general practice office, you may be the first person to notice signs or complaints of developing diabetes, such as: Increased thirst Polyuria Unexplained weight loss Blurred vision Non-healing lesions or rashes Frequent vaginal yeast infections These should be brought to the attention of the physician. Gastrointestinal, genitourinary and cardiovascular symptoms are also common. Adults with diabetes have a heart disease death rate 2 to 4 times greater than persons without diabetes, and are 2 to 4 times at greater risk for a stroke. Hypertension comorbidity is seen in 73 percent of adult diabetes patients. Complications For many patients, the required lifestyle changes of diet, exercise and self-care can be quite difficult to adjust to. Without your active assistance and encouragement, and your testing to supplement their self-monitoring, diabetes patients risk serious long-term consequences. Common long-term complications can include retinopathy and loss of vision. Diabetes is the leading cause of blindness in persons 20 to 74 years old. There is also a risk of renal failure, and peripheral neuropathy that can lead to foot ulcers and even amputations. Sixty to 70 percent of those with diabetes will have mild to severe nervous system damage. In addition, poorly controlled diabetes before conception and into the first trimester can cause major birth defects in 5 to 10 percent of pregnancies, and is responsible for 15 to 20 percent of spontaneous abortions.
- Hypoglycemia- (Low Blood Sugar- below 60) Most common cause is skipping a meal Signs and Symptoms: • Irritability • Headache • Rapid, shallow breathing • Convulsions • Hunger • Dizziness • Confusion • Unconsciousness • Weakness • Faintness • Difficulty thinking • Trembling • Rapid Pulse • Changes in vision • Sweating • Low Blood Pressure • Cold, clammy skin
- Hyperglycemia- (High Blood Sugar- above 125) May be caused by stress, infection, illness, dehydration, and certain medications. Signs and Symptoms: • Excessive thirst (polydipsia) • Leg Cramps • Unconsciousness • Excessive hunger (polyphagia) • Flushed, dry skin • Blurred vision • Excessive urination (polyuria) • Sweet breath odor • Headache • Weakness • Low blood pressure • Nausea/ vomiting • Drowsiness • Deep, labored respirations(Kussmaul) • Rapid, weak pulse • Convulsions
- Report abnormal s/s to nurse- Hypoglycemia protocol Ensure patient gets correct diet Report dietary intake less than 75% to nurse Provide for skin integrity (skin in extremities may be fragile or compromised) Provide emotional support
- Diabetic Ketoacidosis (DKA) Is a dangerous complication of diabetes mellitus in which the chemical balance of the body becomes far too acidic Ketones are poisonous acidic chemicals produced by the body when fat instead of glucose is burned for energy
- Normal UOP: 1000-3000 ml/day Excessive urination caused either by inadequate amts of circulating vasopressin (antidiuretic hormone) in the body, or by failure of the kidney to respond to antidiuretic hormones. UOP if often massive (5-15L/day), which may result in dehydration.in patients who cannot drink enough liquid to replace urinary losses (impaired consciousness. The urine is dilute( spc gravity > 1.005. Pt.s serum sodium and osmolality rise as free water is eliminated as urine.