Multidimensional Nursing Guide on Endocrine Disorders

Multidimensional Nursing Guide on Endocrine Disorders

Endocrine disorders constitute a health concern to the global healthcare system. These disorders primarily affect the thyroid, gonad, parathyroid, and adrenal glands. Addison’s disease and Cushing’s syndrome are endocrine disorders related to adrenal gland functionalities. This paper compares and contrasts Addison’s disease and Cushing’s syndrome, emphasizing their clinical presentation and multidimensional care aspects. Our assignment writing services will allow you to attend to more important tasks as our experts handle your task.

Causes and Diagnostic Tests

Addison’s disease results from the inability of the adrenal cortices to produce the required amount of adrenocortical hormones. Autoimmune destruction of the adrenal glands, infections, adrenal hemorrhage, adrenal infiltration, and medications such as ketoconazole can result in adrenal insufficiency and, subsequently, Addison disease. Secondary adrenal insufficiency is another exogenous cause of the disease that results from steroid administration (Mosca et al., 2021). On the other hand, Cushing’s syndrome is a disease of adrenal excess and results from prolonged exposure to high levels of circulating cortisol. Endogenous causes include ACTH-secreting pituitary adenomas, ectopic ACTH secretion, and adrenal hyperplasia (Cai et al., 2022). Exogenous hypercortisolism is iatrogenic.

The major diagnostic tests for Addison’s disease include the ACTH level and Corticotropin Stimulation tests. Abdominal CT scan to exclude adrenal hemorrhage, MRI of the hypothalamic-pituitary region, anti–21-hydroxylase antibodies to eliminate immune destruction of the adrenal glands, and serum TSH levels tests can be used to diagnose the disease (Ignatavicius et al., 2021). For Cushing’s syndrome, the 48-hour low-dose dexamethasone suppression test can confirm hypercortisolism indicative of the disorder. Other tests include serum ACTH level tests, late-night salivary cortisol tests, and 24-hour urine-free cortisol tests.

Signs and Symptoms

Addison’s disease manifests with fatigue, weight loss, prolonged nausea, dizziness, generalized weakness, tachycardia, hypotension, and hyperpigmentation. In an acute adrenal crisis, hyponatremia, hypotension, hypoglycemia, and hyperkalemia may present (Ignatavicius et al., 2021). Conversely, Cushing’s syndrome manifests with weight gain, skin thinning with consequent easy bruising, acne, striae, irregular or absent menses, delayed wound healing, back and bone pain, low sexual drive and erectile dysfunction in men, loss of height, hirsutism, and others (Cai et al., 2022). Recurrent bacterial and fungal infections and infertility are also indicative of Cushing’s syndrome.

Nurses’ Role

The main focus in the comprehensive management of Addison’s disease is effective hormonal therapy and prevention of the Addisonian crisis. Nurses’ roles, in this regard, include medication administration, monitoring fluid and electrolyte imbalance, monitoring weight loss, monitoring and promoting adequate fluid volume, and monitoring hypoglycemia and hypotension. Nurses also play a role in the management of Cushing’s syndrome. They lower the risk of injury for these patients by providing a protective environment that lowers the likelihood of fractures, falls, and other injuries and recommending foods high in calcium and vitamin D to lessen muscle wasting. Nurses also lower the infection risk for these patients by assessing for signs of infection and assisting them in avoiding unnecessary exposure to pathogens. Nurses also educate patients with Cushing’s syndrome on self-care, assessing, monitoring, and managing disease complications, and promoting skin integrity for these patients by encouraging and assisting them to change positions.

Evaluation to Responses

Responses to nursing interventions will be evaluated by assessing their outcomes. Responses to the nurses’ interventions in Addison’s disease will be said to be effective if the patient maintains adequate hydration with freedom from the deficient fluid volume, weight loss is detected, and revisitation is lowered due to electrolyte imbalances. Responses to the nurses’ interventions in Cushing’s syndrome will be considered effective if the patient maintains freedom from infections, is injury-free, and demonstrates aspects of self-care such as medication adherence, enhanced intake of calcium and vitamin-rich diets, and lowered hospital revisitation.

References

Cai, Y., Ren, L., Tan, S., Liu, X., Li, C., Gang, X., & Wang, G. (2022). Mechanism, diagnosis, and treatment of cyclic Cushing’s syndrome: A Review. Biomedicine & Pharmacotherapy, 153, 113301. https://doi.org/10.1016/j.biopha.2022.113301.

Ignatavicius, D. D., Workman, M. L., Rebar, C. R., & Heimgartner, N. M. (2021). Medical-Surgical Nursing: Concepts for Interprofessional Collaborative Care. Elsevier.

Mosca, A. M., Barbosa, M., Araújo, R., & Santos, M. J. (2021). Addison’s disease: A diagnosis easy to overlook. Cureus. https://doi.org/10.7759/cureus.13364.

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Module 09 Content

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.

Multidimensional Nursing Guide on Endocrine Disorders

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.