Assessing Responses to Nursing Interventions in Clients with Endocrine Disorders
Endocrine disorders are disease states that affect the endocrine glands of the body. These conditions affect the functionality of these glands and thereby cause imbalances in the functionality of hormones produced by the respective glands. Such altered functionalities are evident in endocrine diseases, which include diabetes mellitus, Addison’s disease, Cushing’s syndrome, and Grave’s disease, among others. The clinical significance of these pathological conditions is attributed to their symptomatology and forms a very significant tool in the management of these diseases.
Diabetes mellitus and thyroid disorders are the two most common endocrine disorders. Diabetes mellitus is a group of metabolic disorders that arises when the body is unable to utilize glucose. This may be either due to the lack of production of the regulatory hormone insulin as a result of the destruction of the islet cells of Langerhans or resistance to the insulin so produced. Destruction of the pancreatic Langerhans cells may result from viral infections or autoimmune reactions. The disease may also result when the insulin produced is not sufficient to fully regulate the available glucose (Raghavan et al., 2019). The overall effect is high blood glucose (hyperglycemia) and accompanying symptoms. A diabetes diagnosis is made by the fasting blood sugar test; a positive diagnosis is confirmed when values are equal to or greater than 7mmol/L.
Thyroid disorders are pathological conditions that affect the thyroid gland. These diseases include hypothyroidism, hyperthyroidism, thyroid nodules, and thyroid cancer, among others. Hyperthyroidism is characterized by excessive production of thyroid hormones and is due to increased intake of iodine, thyroid nodules, Graves’s disease, and toxic multinodular goiter. Hypothyroidism is characterized by decreased production of thyroid hormone, which may be due to Hashimoto’s thyroiditis, thyroid hormone resistance, and thyroiditis, among others (Cappola et al., 2019). Thyroid diseases are diagnosed by blood tests to determine the levels of thyroid hormones and thyroid-stimulating hormones. Values above the normal range confirm hyperthyroidism, while values below the normal range confirm hypothyroidism.
These diseases manifest differently. Diabetes is characterized by glycosuria, polydipsia, dry mouth and skin, frequent hunger, fatigue, and unexplained weight loss. Dry mouth and skin, polydipsia, and fatigue are linked to the hyperglycemia that is observed in diabetes. Other symptoms that may be indicative of developed disease and are attributed to complications of the disease include blurred vision, numbness or tingling sensations in the palms and the toes, and a slow-healing wound. Hypothyroidism, on the other hand, is characterized by fatigue, dry skin, depression, muscle and joint aches, hypothermia, fluid retention, constipation, and poor concentration. Hyperthyroidism is characterized by fatigue, tremors, sweating, tachycardia, heat intolerance, hyperactive bowel, and weight loss. These symptoms form the basis of their treatment and help in informing the decision-making process regarding the most appropriate treatment option.
Nurses play a vital role in leading, motivating, counseling, educating, coordinating, and managing the care of diabetic patients. Nurses are involved in the early detection of diabetes. Their more contact time with the patients enables them to pick up symptoms related to diabetes that may not have been picked up during diagnosis. Nurses are also involved in educating patients and their families on preventive measures to curtail the development of diabetes. Their knowledge of therapy enables them to aid in decision-making on the right therapy to start on a patient diagnosed with diabetes. They also inform on the course of therapy and whether the patients need dose adjustments, substitution, or additions depending on the patient’s response to treatment.
Nursing management of thyroid diseases entails nursing assessment, nursing diagnosis, nursing care plan, nursing intervention as well as nursing evaluation. Assessment involves checking for abnormalities within the thyroid gland. This is part of the initial diagnosis, and the process may include physicians and other care providers. Nursing diagnosis can be achieved during normal nursing care. Nurses may pick symptoms relatable to a thyroid disease that may not have been detected during the primary diagnostic process. A nursing care plan aims to manage the symptoms and establish the right course of therapy, usually done in the presence of other healthcare providers. Nursing intervention and evaluations entail all measures that are put in place by the nurse to promote the patient’s well-being and to establish the prognosis. Such includes monitoring patients’ vitals. Evaluation determines whether the patient’s disease condition is improving (Nikitara, Constantinou, Andreou, & Diomidous, 2019). This is done by measuring the quality of life of the patient.
Responses to the various nursing interventions can be determined by measuring the quality of life of these patients. Aspects that indicate improvement in patients’ states include maintaining normal blood sugar levels, reducing complications associated with diabetes, improving quality of life, and enhancing response to drug therapy among diabetics. In thyroid patients, such aspects include increased independence, maintaining normal body temperature, normal breathing patterns, restoring the normal bowel pattern, and increased participation in activities (Haugen et al., 2016). These aspects generally indicate the improved quality of life and form the objectives of nursing interventions.
Diabetes and thyroid diseases are the most common endocrine diseases in the United States. Their chronic nature makes them of clinical significance. They have been implicated in many hospital visitations and therapy with drugs. Nurses are well poised to manage patients presenting with these diseases due to their higher contact time with the patients.
References
Cappola, A. R., Desai, A. S., Medici, M., Cooper, L. S., Egan, D., Sopko, G., … Ladenson, P. W. (2019). Thyroid and Cardiovascular Disease: Research Agenda for Enhancing Knowledge, Prevention, and Treatment. Thyroid, 29(6), 760–777. https://doi.org/10.1089/thy.2018.0416
Haugen, B. R., Alexander, E. K., Bible, K. C., Doherty, G. M., Mandel, S. J., Nikiforov, Y. E., … Wartofsky, L. (2016). 2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer: The American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer. Thyroid, 26(1), 1–133. https://doi.org/10.1089/thy.2015.0020
Nikitara, M., Constantinou, C. S., Andreou, E., & Diomidous, M. (2019). The role of nurses and the facilitators and barriers in diabetes care: A mixed-methods systematic literature review. Behavioral Sciences, 9(6), 1–16. https://doi.org/10.3390/bs9060061
Raghavan, S., Vassy, J. L., Ho, Y. L., Song, R. J., Gagnon, D. R., Cho, K., … Phillips, L. S. (2019). Diabetes mellitus–related all-cause and cardiovascular mortality in a national cohort of adults. Journal of the American Heart Association, 8(4). https://doi.org/10.1161/JAHA.118.011295
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Question 
Endocrine Disorders Guide
Competency
- Evaluate responses to nursing interventions for clients with endocrine disorders.
Scenario
You are working as a nurse supervisor. You are finding a lot of new nurses are unfamiliar with certain endocrine disorders. You have decided to put together a guide for these nurses to educate them on different endocrine diseases and provide them with ways to provide quality multidimensional care.
Instructions
Compare and contrast two endocrine disorders within the guide. Include the following information:
- Identify and compare the causes and diagnostic tests.
- Identify and compare the signs and symptoms of the disorder.
- Describe the nurses’ role in caring for a patient who suffers from this disorder to include the multidimensional aspects of nursing care.
- Identify how you will evaluate responses to the interventions taken for each disorder.
Endocrine Disorders Guide
RUBRIC
- Causes and Diagnostic Tests (5 Pts): Skillfully identified and compared the causes of disorders and the diagnostic test used to identify them.
- Signs and Symptoms (5 Pts): Provided a comprehensive list of signs and symptoms of each disorder to include assessment findings.
- Nurse’s Role in Providing Multidimensional Care (15 Pts): Completely identified the nurse’s role in providing multidimensional care for the chosen disorders and provided appropriate interventions.
- Response to the Interventions (10 Pts): Created a detailed list of responses to interventions for the chosen disorders and included an evaluation of the interventions for the disorders.
- Spelling and grammar(5 points): Minimal to no spelling and grammar errors that do not detract from the audience’s ability to comprehend the material.