NURS-6501 Knowledge Check: Endocrine Disorders Essay

NURS-6501 Knowledge Check: Endocrine Disorders Essay

NURS-6501 Knowledge Check: Endocrine Disorders Essay

Scenario 1: Syndrome of Antidiuretic Hormone (SIADH)

1. Define SIADH and identify any patient characteristics that may have contributed to the development of SIADH 

SIADH is an endocrine disorder characterized by excessive production of antidiuretic hormone, leading to retention of water in the body and reduction in the levels of certain electrolytes in the blood such as sodium (Jones, 2018). This condition is common among heart failure patients or those with defects in the hypothalamus. Other causes include substance use, brain disorders like trauma or infection, substance abuse, and certain medications such as seizure drugs and antidepressants. The 77-year-old female patient provided in the case study displays signs of SIADH. The development of this condition might have resulted from hyponatremia in diabetic peripheral neuropathy as seen in the patient’s history of presenting illness. The patient’s smoking habits, emphysema, and use of metformin and escitalopram also contributed to the development of SIADH.

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Scenario 2: Type 1 Diabetes

2. Explain the pathophysiology of the three P’s for (polyuria, polydipsia, polyphagia)” with the given diagnosis of Type I DM.

Diabetes type 1 is an autoimmune disorder characterized by elevated blood glucose levels. The immune system attacks and destroys pancreatic beta cells, which are responsible for insulin production (Saberzadeh-Ardestani et al., 2018). This leads to complete insulin deficiency, hence unable to convert glucose to glycogen for storage. The patient will present with the 3P’s (polyuria, polydipsia, polyphagia) as the early signs and symptoms. Elevated blood glucose levels lead to increased blood osmolarity, as it makes it more concentrated, hence promoting excessive thirst (polydipsia) as a compensation mechanism. Excessive fluid intake, from thirst, in addition to glucose-induced urination, is responsible for increased urine frequency (Polyuria). Lastly, polyphagia/ increased hunger occurs because of excessive loss of glucose in the urine, which makes the body crave for more.

3. Explain the genetic relationship and how this and the environment can contribute to Type I DM.

Even though it’s still unclear on the actual triggers of β cell destruction in the development of type 1 DM, most studies have revealed the factors which regulate the risk of developing the disease. Previously reported evidence to suggest that T1DM is heritable with the HLA class II genes such as HLA-DR, DQ, DP strongly associated with the development of the disease (DiMeglio et al., 2018). While the genetic factors determine the likelihood of an individual to develop T1DM, environmental factors expose the individual to triggers that lead to the onset of the disease such as viruses.

Scenario 3: Type II DM

4. How would you describe the pathophysiology of Type II DM?

T2DM is a metabolic disorder characterized by elevated blood glucose levels because of a combination of two main primary factors, such as decreased sensitivity of insulin receptors to the ligand, and defective secretion of insulin by the pancreatic β cells (Padhi et al., 2020). Insulin is involved in maintaining the physiological levels of glucose in the blood. A defect in this mechanism can lead to increased production of glucose and decreased uptake of glucose both in the liver, muscles, and adipose tissue, leading to T2DM.

Scenario 4: Hypothyroidism

5. What causes hypothyroidism?

Hypothyroidism is an endocrine disorder characterized by the failure of the thyroid gland to produce enough amount of thyroid hormone to satisfy the body’s needs. Several factors have been associated with the cause of hypothyroidism, such as autoimmune disorders, radiation therapy, certain medications, and hyperthyroidism treatment (Chiovato et al., 2019). Some of the less common causes of hypothyroidism include pregnancy, iodine deficiency, pituitary disorder, and congenital disease.

References

Chiovato, L., Magri, F., & Carlé, A. (2019). Hypothyroidism in context: where we’ve been and where we’re going. Advances in therapy, 36(2), 47-58. https://doi.org/10.1007/s12325-019-01080-8

DiMeglio, L. A., Evans-Molina, C., & Oram, R. A. (2018). Type 1 diabetes. The Lancet, 391(10138), 2449-2462. https://doi.org/10.1016/S0140-6736(18)31320-5

Jones, D. P. (2018). Syndrome of inappropriate secretion of antidiuretic hormone and hyponatremia. Pediatrics in Review, 39(1), 27-35. https://doi.org/10.1542/pir.2016-0165

Padhi, S., Nayak, A. K., & Behera, A. (2020). Type II diabetes mellitus: A review on recent drug-based therapeutics. Biomedicine & Pharmacotherapy, 131, 110708. https://doi.org/10.1016/j.biopha.2020.110708

Saberzadeh-Ardestani, B., Karamzadeh, R., Basiri, M., Hajizadeh-Saffar, E., Farhadi, A., Shapiro, A. J., … & Baharvand, H. (2018). Type 1 diabetes mellitus: cellular and molecular pathophysiology at a glance. Cell Journal (Yakhteh), 20(3), 294. https://doi.org/10.22074/cellj.2018.5513

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NURS-6501
Knowledge Check: Endocrine Disorders
In this exercise, you will complete a 5-essay type question Knowledge Check to gauge your understanding of this module’s content.
Possible topics covered in this Knowledge Check include:
• Diabetes
• Hyper- and hypothyroidism
• Adrenal disorders
• Parathyroidism (hyper and hypo)
• Checks & balances / negative feedback
• Syndrome of Inappropriate Antidiuretic Hormone
• Pheochromocytosis
• Diabetes insipidus
• Diabetic ketoacidosis

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(Note: It is strongly recommended that you take the Knowledge Check at least 48 hours before taking the Midterm Exam.)