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Frank Macdonald RN, MN UNIT 16 (OPTION) Alterations in Endocrine Function Lorraine Anderson, Ph.D. Rankin, Reimer & Then. © 2000 revised edition. NURS 461 Pathophysiology, University of Calgary Unit 16 Alterations in Endocrine Function 1 Unit 16 Table of Contents Overview....................................................................................................4 Aim ....................................................................................................... 4 Objectives ................................................................................................ 4 Resources................................................................................................. 5 Web Links................................................................................................ 5 Section 1: Mechanisms of Hormone Regulation ....................................................6 Learning Activity #1 ................................................................................... 6 Regulation of Hormone Action ....................................................................... 6 Learning Activity #2 ................................................................................... 7 Hormone Transport .................................................................................... 7 Cellular Mechanisms of Hormone Release ......................................................... 7 Structure and Function of Endocrine Glands....................................................... 9 Hypothalamic Trophic Hormones ................................................................. 10 Anterior Pituitary Trophic Hormones ............................................................. 10 Other Anterior Pituitary Hormones ............................................................... 10 Posterior Pituitary Hormones....................................................................... 11 Learning Activity #3 ................................................................................. 12 Thyroid Gland......................................................................................... 12 Learning Activity #4 ................................................................................. 13 Adrenal Glands ....................................................................................... 13 Learning Activity #5 ................................................................................. 15 Section 2: Alterations of Hormonal Regulation ...................................................16 Mechanism of Hormonal Alterations.............................................................. 16 Alterations of the Hypothalamic-Pituitary System .............................................. 16 Learning Activity #6 ................................................................................. 18 Alterations of the Thyroid Function ............................................................... 19 Learning Activity #7 ................................................................................. 22 Alterations of Adrenal Function.................................................................... 23 Learning Activity #8 ................................................................................. 24 Final Thoughts...........................................................................................25 References ................................................................................................26 Glossary...................................................................................................27 Acronym List .............................................................................................28 Checklist of Requirements ............................................................................29 Required Readings ................................................................................... 29 Required Activities ................................................................................... 29 Answers to Learning Activities.......................................................................30 Learning Activity #1 ................................................................................. 30 Learning Activity #2 ................................................................................. 30 Learning Activity #3 ................................................................................. 30 Learning Activity #4 ................................................................................. 30 Learning Activity #5 ................................................................................. 30 Learning Activity #6 ................................................................................. 31 Rankin, Reimer & Then. © 2000 revised edition. NURS 461 Pathophysiology, University of Calgary 2 Unit 16 Alterations in Endocrine Function Learning Activity #7 ................................................................................. 31 Learning Activity #8 ................................................................................. 31 Rankin, Reimer & Then. © 2000 revised edition. NURS 461 Pathophysiology, University of Calgary Unit 16 Alterations in Endocrine Function 3 UNIT 16 Alterations in Endocrine Function The regulation of homeostasis by the endocrine system is both complex and subtle. During your nursing career you will encounter patients with mild to significant alterations in endocrine regulation. Your role as patient educator is of particular importance in the successful long-term management of these disorders. It is hoped that by increasing your own understanding of endocrine pathophysiology, your skills in assessment and patient education will be improved. This module will contain two basic components: the mechanisms of hormonal regulation and alterations of hormonal regulation. Each component is further subdivided into hypothalamic-pituitary, thyroid and adrenal sections. Rankin, Reimer & Then. © 2000 revised edition. NURS 461 Pathophysiology, University of Calgary 4 Unit 16 Alterations in Endocrine Function Overview Aim The general aim of this module is to facilitate your understanding of the mechanisms underlying hormone regulation and hormonal alterations. Upon completion of this unit, you will have a thorough understanding of the regulation of hormone release and transport. You will be introduced to the cellular mechanisms of hormone release and you will review the structure and function of the endocrine glands. You will have a good understanding of the pathophysiology, clinical manifestations and evaluation and treatment for most of the endocrine diseases you will encounter during your nursing career. Objectives On completion of this unit, you will be able to: 1. Name the five general functions of the endocrine system. 2. Be able to identify the following hormones as proteins, polypeptides, amines or lipids: growth hormone, prolactin, adrenocorticotropic hormone, antidiuretic hormone, oxytocin, epinephrine, thyroid hormone, glucocorticoids, aldosterone, estrogen and testosterone. 3. Name the 3 basic patterns of hormone release. 4. Define signal transduction, first and second messengers and identify at least two second messengers. 5. Describe the structural relationship between the hypothalamus and the anterior pituitary and posterior pituitary. 6. Name the two posterior pituitary hormones and describe their actions. 7. Describe the synthesis, regulation of release and actions of thyroid hormone, cortisol, aldosterone, adrenal estrogens/androgens and epinephrine. 8. Describe the various mechanisms of hormone alteration. 9. Describe the pathophysiology, clinical manifestations, evaluation and treatment of the following disorders: a. Syndrome of inappropriate antidiuretic hormone (SIADH) b. Diabetes insipidus c. Hypopituitary disorder d. Hyperpituitarism (primary adenoma and acromegaly) e. Thyrotoxicosis f. Hypothyroidism (primary, congenital) g. Disorders of the Adrenal Cortex (Cushing’s Disease, hypersecretion of adrenal androgens/estrogens and hypocortical functioning) h. Disorders of the adrenal medulla Rankin, Reimer & Then. © 2000 revised edition. NURS 461 Pathophysiology, University of Calgary Unit 16 Alterations in Endocrine Function 5 Resources Required McCance, K., & Huether, S. (2001). Pathophysiology: The biologic basis for disease in adults and children (4th ed.). St. Louis: Mosby. Pages: 597-610; 614-618; 24-638, (including Table 20-2) and 655-666. Print Companion: Alterations in Endocrine Function Learning Activities Student Activities One to Eight Supplemental Materials Student Activity Nine Web Links All web links in this unit can be accessed through the Web CT system. Rankin, Reimer & Then. © 2000 revised edition. NURS 461 Pathophysiology, University of Calgary 6 Unit 16 Alterations in Endocrine Function Section 1: Mechanisms of Hormone Regulation Read: McCance, K., & Huether, S. (2001). Pages: 597-598. Hormones may be classified by structure. Review Table 19-1 on page 626 of McCance and Huether. Recall that thyroid hormone, epinephrine and norepinephrine (amines) are derived from a single amino acid – tyrosine. For an overview of the interactions between hormones and their receptors, follow this link: Colorado State University http://arbl.cvmbs.colostate.edu/hbooks/pathphys/endocrine/moaction/ Learning Activity #1 Match each of the hormones with its structural category. a. protein _____ 1. Mineralcorticoids – Aldosterone b. polypeptide _____ 2. Growth Hormone c. amine _____ 3. Thyroid Hormone d. lipid _____
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