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15 Cards in this Set
- Front
- Back
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What may indicate hormonal imbalances
Is it hard to detect the cause of a hormonal imbalance? |
Difficult to detect cause of hormonal imbalance as multiple body systems impact control and regulation of hormones.
Any change in: mental acuity, emotional stability, skin texture, weight, appetite, body hair, libido may indicate hormonal imbalances |
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ASSESSMENT OF THE ENDOCRINE SYSTEM
Health assessment interview Exophthalmos Proptosis |
Exophthalmos
Protuding Eyes Proptosis |
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ASSESSMENT OF THE ENDOCRINE SYSTEM
Health assessment interview Trousseau’s sign Chvostek’s sign |
Trousseau’s sign
B/P cuff above anticubital space, when inflated what happens? Assessment for ? In a patient with hypocalcaemia, carpal spasm may be elicited by occluding the brachial artery. To perform the maneuver, a blood pressure cuff is placed around the arm and inflated to a pressure greater than the systolic blood pressure and held in place for 3 minutes. If carpal spasm occurs, manifested as flexion at the wrist and metacarpophalangeal joints, extension of the distal interphalangeal and proximal interphalangeal joints, and adduction of the thumb and fingers, the sign is said to be positive and the patient likely has hypocalcemia Chvostek’s sign Procedure? Assessment for ? Tapping on the face at a point just anterior to the ear and just below the zygomatic bone Positive: Twitching of the ipsilateral facial muscles suggestive of neuromuscular excitibility caused by hypocalcemia |
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Primary disease
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“Primary” disease refers to the gland that secretes the hormone: ex:
Primary Hypothyroidism means the disease originates from the thyroid |
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Secondary and Tertiary disease
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“Secondary” disease refers to insufficient stimulation of a normal thyroid gland. May be a malfunction of the pituitary or hypothalamus, or a peripheral resistance to TH.
“Tertiary” |
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ASSESSMENT OF THE ENDOCRINE SYSTEM
Health assessment interview questions to ask the client |
Describe the swelling you noticed in the front of your neck. When did it begin? Have you noticed any changes in your energy level?
When did you first notice that your hands and feet were getting larger? Have you noticed that your appetite has increased even though you have lost weight? |
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ASSESSMENT OF THE ENDOCRINE SYSTEM
Health assessment interview topics to discuss with the client. |
Ask the client about any changes in normal growth development as well as weight and height.
Changes in the size of extremeties can often be detected by asking whether the client has had to have rings enlarged or to buy increasingly larger gloves and shoes. Explore changes that include difficulty swallowing, increased or decreased thirst, appetite, or urination, visual changes, sleep disturbances; altered patterns of hair distribution, changes in menstruation, changes in memory or ability to concentrate, and changes in hair and skin texture. |
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ASSESSMENT OF THE ENDOCRINE SYSTEM
Skin assessments and abnormal findings |
Inspect skin color
Hyperpigmentation may be seen in clients with Addison's disease or Cushing's syndrome. Hypopigmentation may be seen hyperthyroidism or hypothyroidism. A yellowish cast to the skin might indicate hypothyroidism. Purple striae over the abdomen and bruising may be present in the client with Cushing's syndrome. Palpate the skin, assessing texture, moisture, and the presence of lesions. Rough, dry skin is often seen in clients with hypothyroidism, whereas smooth and flushed skin can be a sign of hyperthyroidism. |
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ASSESSMENT OF THE ENDOCRINE SYSTEM
Nails and hair assessment with abnormal findings |
Nails and hair assessment with abnormal findings
Assess texture and condition of nails and hair. Increased pigmentation of the nails is often seen in clients with Addison’s disease. Dry, thick, brittle nails and hair may be apparent in hypothyroidism; thin, brittle nails and thin, soft hair may be apparent in hyperthyroidism. Hirsutism (excessive facial, chest, or abdominal hair) may be seen in Cushing’s syndrome |
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ASSESSMENT OF THE ENDOCRINE SYSTEM
Facial Assessments with Abnormal findings |
Facial Assessments with Abnormal findings
Inspect the symmetry and form of the face Inspect the position of eyes Variations of form and structure may indicate growth abnormalities such as acromegaly |
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ASSESSMENT OF THE ENDOCRINE SYSTEM
Thyroid Gland Assessment with Abnormal Findings |
Thyroid Gland Assessment with Abnormal Findings
Palpate the thyroid gland for size and consistency Stand behind the client, and place your fingers on either side of the trachea below the thyroid cartilage. Ask the client to tilt the head to the right. Now ask the client to swallow. As the client swallows, displace the left lobe while palpating the right lobe. Repeat to palpate the left lobe. Exophthalmos (protruding eyes) may be seen in hyperthyroidism The thyroid may be enlarged in clients with Grave’s disease or goiter. Multiple nodules may be seen in metabolic disorders, whereas the presence of only one nodule may indicate a cyst or a benign malignant tumor. One enlarged nodule suggests malignancy. |
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ASSESSMENT OF THE ENDOCRINE SYSTEM
Motor function assessment with abnormal findings |
Motor function assessment with abnormal findings
Assess the deep tendon reflexes. Increased reflexes may be seen in hyperthyroidism; decreased reflexes may be seen in hypothyroidism. |
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ASSESSMENT OF THE ENDOCRINE SYSTEM
Sensory Function Assessment with Abnormal Findings |
Sensory Function Assessment with Abnormal Findings
Test the client’s sensitivity to pain, temperature, vibration, light touch, and stereognosis (the ability to identify an object merely by touch). Compare symmetric areas on both sides of the body, and compare the distal to the proximal regions of the extremities. Ask the client to close his or her eyes To test pain, use the blunt and sharp ends of a safety pin. Discard pin after use. To test temperature, use cups or other containers of cold and hot water To test vibration, use a tuning fork over one of the client’s fingers or toe joints To test stereognosis, place in the client’s hand a simple, familiar object, such as a rubber band, cotton ball, or button. Ask the client to identify the object Peripheral neuropathy and parasthesias (altered sensastions) may occur in diabetes, hypothyroidism, or acromegaly. |
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ASSESSMENT OF THE ENDOCRINE SYSTEM
Musculoskeletal Assessment with abnormal findings |
Musculoskeletal Assessment with abnormal findings
Inspect the size and proportions of the client’s body structure Extremely short stature may indicate dwarfism, which is caused by insufficient growth hormone. Extremely large bones may indicate acromegaly, which is caused by excessive growth hormone. |
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ASSESSMENT OF THE ENDOCRINE SYSTEM
Assessing for hypocalcemic tetany. |
Assessing for hypocalcemic tetany.
Assess for Trousseau’s sign: Inflate pressure cuff above antecubital space to occlude blood supply to the arm. Decreased calcium levels cause the client’s hand and fingers to contract (carpal spasm) Assess for Chvostek’s sign: tap your finger in front of the client’s ear at the angle of the jaw. Decreased calcium levels cause the client’s lateral facial muscles to contract. |
