NURS6501 Week 6 Concepts of Endocrine Disorders Papers

Module 4: Endocrine Disorders

What’s Happening This Module?

Module 4: Endocrine Disorders is a 1-week module, Week 6 of the course. In this module you will examine fundamental concepts of diseases and disorders that impact endocrine systems. You will also evaluate the impact of patient characteristics, including racial and ethnic variables, on physiological functioning within these systems.

What do I have to do?	When do I have to do it?
Review your Learning Resources	Days 1–7 of Week 6
Knowledge Check: Endocrine Disorders	Complete by Day 5 of Week 6
Midterm Exam	Complete by Day 7 of Week 6

Week 6: Concepts of Endocrine Disorders

Endocrine disorders are complex matters, and there is not always a one-size-fits-all treatment. Particularly in matters requiring the adjustment of hormone levels, treatment may require a custom approach tailored to individual patients. An understanding of these complications is essential to supporting these individual treatment plans.

This week, you examine alterations in the endocrine system and the resultant disease processes. You also consider patient characteristics, including racial and ethnic variables, and the impact they have on altered physiology.

NURS6501 Week 6 Concepts of Endocrine Disorders Papers Learning Objectives

Students will:

Analyze concepts and principles of pathophysiology across the lifespan

Learning Resources

NURS6501 Week 6 Concepts of Endocrine Disorders Papers Required Readings

McCance, K. L. & Huether, S. E. (2019). Pathophysiology: The biologic basis for disease in adults and children (8th ed.). St. Louis, MO: Mosby/Elsevier.

Chapter 21: Mechanisms of Hormonal Regulation, including Summary Review
Chapter 22: Alterations of Hormonal Regulation, including Summary Review
Chapter 23: Obesity and Disorders of Nutrition, including Summary Review

American Diabetes Association (2020). Standards of medical care of patients with diabetes mellitus. Diabetes Care, 26(suppl 1), pp. s33-s50. https://care.diabetesjournals.org/content/26/suppl_1/s33

Orlander, P. R. (2018). Hypothyroidism. Retrieved from https://emedicine.medscape.com/article/122393-overview

Hoorn, E. J., & Zietse, R. (2017). Diagnosis and treatment of hyponatremia: Compilation of the guidelines. Journal of the American Society of Nephrology, 28(5), 1340–1349

Document: NURS 6501 Midterm Exam Review (PDF document)

Note: Use this document to help you as you review for your Midterm Exam in Week 6.

NURS6501 Week 6 Concepts of Endocrine Disorders Papers Required Media

Module 4 Overview with Dr. Tara Harris

Dr. Tara Harris reviews the structure of Module 4 as well as the expectations for the module. Consider how you will manage your time as you review your media and Learning Resources throughout the module to prepare for your Knowledge Check and your Midterm. (3m)

Online Media from Pathophysiology: The Biologic Basis for Disease in Adults and Children

In addition to this week’s media, it is highly recommended that you access and view the resources included with the course text, Pathophysiology: The Biologic Basis for Disease in Adults and Children. Focus on the videos and animations in Chapters 21 through 23 related to the endocrine system and disorders. Refer to the Learning Resources in Week 1 for registration instructions. If you have already registered, you may access the resources at https://evolve.elsevier.com/

Optional Resources

The following source provides various tutorials related to maximizing your time management and managing stress. Feel free to access this resource to support you as you move through this course.

Walden University. (2019). ASC success strategies interactive tutorials. Retrieved from https://academicguides.waldenu.edu/academic-skills-center/skills/tutorials/success-strategies

Knowledge Check: Endocrine Disorders

In this exercise, you will complete a 10- to 20-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

Photo Credit: Getty Images/Science Photo Library RF

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

Complete the Knowledge Check By Day 5 of Week 6

To complete this Knowledge Check:

Module 4 Knowledge Check

NURS6501 Week 6 Concepts of Endocrine Disorders Papers Midterm Exam

This 101-question exam is a test of your knowledge in preparation for your certification exam. No outside resources, including books, notes, websites, or any other type of resource, are to be used to complete this exam. You are expected to comply with Walden University’s Code of Conduct.

This exam will be on topics covered in Weeks 1, 2, 3, 4, 5, and 6. Prior to starting the exam, you should review all of your materials. This exam is timed with a limit of 2 hours for completion. When time is up, your exam will automatically submit.

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

Photo Credit: Getty Images

To prepare:

To help you review for your midterm exam, access the Midterm Exam Review document found in this week’s Learning Resources as well as any Knowledge Check feedback you might have received. (Note: You will also need to review all of your materials from each of these weeks to also help you better prepare for your midterm.)

By Day 7 of Week 6

Submit your Midterm Exam.

To complete your exam:

Midterm Exam

NURS 6501 Knowledge Check: Module 2 Answer Key

Scenario 1: Myocardial Infarction
CC: “I have been having terrible chest and arm pain for the past 2 hours and I think I am having a heart attack.”
HPI: Mr. Hammond is a 57-year-old African American male who presents to the Emergency Department with a chief complaint of chest pain that radiates down his left arm. He states that he started having pain several hours ago and says the pain “it feels like an elephant is sitting on my chest”. He rates the pain as 8/10.

Nothing has made the pain better or worse. He denies any previous episode of chest pain. Denies nausea, dyspnea, or lightheadedness. He was given 0.4 mg nitroglycerine tablet sublingual x 1 which decreased, but not stopped the pain.

Lipid panel reveals Total Cholesterol 324 mg/dl, high density lipoprotein (HDL) 31 mg/dl, Low Density Lipoprotein (LDL) 122 mg/dl, Triglycerides 402 mg/dl, Very Low-Density Lipoprotein (VLDL) 54 mg/dl

His diagnosis is an acute inferior wall myocardial infarction.
1 of 2 Questions:
Why is HDL considered the “good” cholesterol?
<Type your response here>
Answer: HDL is considered the good cholesterol because it collects excess cholesterol in the body cells and transports it to the liver where it is excreted in the body cells and transports it to the liver where it is excreted in the body. HDL carries 20-25% of total plasma cholesterol.

2 of 2 Questions:
Explain the role inflammation has in the development of atherosclerosis.
<Type your response here>
Answer: Inflammation in the heart muscle caused by chronic inflammatory processes leads to mitochondrial damage that results in an increased free radical production that further activates the chronic inflammatory vicious cycle.

Scenario 2: Pleural Friction Rub

A 45-year-old woman with a history of systemic lupus erythematosus (SLE) presents to the Emergency Room (ER) with complaints of sharp retrosternal chest pain that worsens with deep breathing or lying down. She reports a 3-day history of low-grade fever, listlessness and says she feels like she had the flu. Physical exam reveals tachycardia and a pleural friction rub. She was diagnosed with acute pericarditis.

Question:
What does the Advanced Practice Registered Nurse (APRN) recognize as the result of the pleural friction rub?
<Type your response here>
Answer: The inflammation of the pericardium, due to either the underlying autoimmune disease or a post viral syndrome, causes roughening of the pericardium. The roughening of the pericardium causes the classic “rub” which can best be heard at the apex of the heart and left sternal border.

Scenario 3: Rheumatic Heart Disease (RHD)

A 15-year-old adolescent male comes to the clinic with his parents with a chief complaint of fever, nausea, vomiting, poorly localized abdominal pain, arthralgias, and “swollen lymph nodes”. States he has felt “lousy” for a couple weeks. The fevers have been as high as 102 F. His parents thought he had the flu and took him to an Urgent Care Center. He was given Tamiflu® and sent home. He says the Tamiflu didn’t seem to work. States had a slight sore throat a couple weeks ago and attributed it to the flu.

Physical exam revealed thin young man who appears to be uncomfortable but not acutely ill. Posterior pharynx reddened and tonsils 3+ without exudate. + anterior and posterior cervical lymphadenopathy. Tachycardic and a new onset 2/6 high-pitched, crescendo-decrescendo systolic ejection murmur auscultated at the left sternal border. Rapid strep +. The patient was diagnosed with acute rheumatic heart disease (RHD).

Question:

Explain how a positive strep test has caused the patient’s symptoms.
<Type your response here>

Answer: Rheumatic Heart Disease (RHD) only develops after a pharyngeal infection with Group A beta hemolytic streptococcus. It is an abnormal response to humoral and cell-mediated response to M proteins on the microorganisms. The intense inflammation caused by these reactions cause proliferative and exudative lesions in connective tissue.

This inflammation causes scarring of the valve tissue. The inflammation usually affects the endocardium which contains the valves. Endocardial inflammation causes swelling of leaflets in the valves.

Scenario 4: Deep Venous Thrombosis (DVT)

The APRN sees a 74-year-old obese female patient who is 2 days post-op after undergoing left total hip replacement. The patient has had severe post op nausea and vomiting and has been unable to go to physical therapy. Her mucus membranes are dry. The patient says she feels like the skin on her left leg is too tight. Exam reveals a swollen, tense, and red colored calf. The patient has a duplex ultrasound which reveals the presence of a deep venous thrombosis (DVT).

Question:
Describe the factors that could have contributed to the development of a DVT in this patient explain how each of the factors could cause DVT.
<Type your response here> NURS6501 Week 6 Concepts of Endocrine Disorders Papers

Answer: Virchow’s Triad caused damage to the walls of the vessels. When there is injury to the intimal layer of the vessel, antiplatelet substances such as nitric oxide and prostacyclin, along with the expression of collagen on the vessel wall, causes adherence of the platelets to the vessel wall. The platelets become activated then aggregate forming clots.

Venous stasis as a result of obesity, patient’s advanced age and inability to go to physical therapy.

Scenario 5: Pulmonary Embolus

A 45-year-old woman is 10 days status post partial small bowel resection for Crohn Disease and has been recuperating at home. She suddenly develops severe shortness of breath, becomes weak, and her blood pressure drops to 80/40 mmHg (previous readings ~130/80s mmHg). The pulse oximetry is 89% on room air. The APRN suspects the patient experienced a massive pulmonary embolus.

Question:
Explain why a large pulmonary embolus interferes with oxygenation.

Answer:

The embolus lodges somewhere in the pulmonary circulation and causes a ventilation/perfusion mismatch (V/Q). Ventilation Perfusion mismatch or “V/Q defects” are defects in total lung ventilation perfusion ratio. It is a condition in which one or more areas of the lung receive oxygen but no blood flow, or they receive blood flow but no oxygen due to obstruction somewhere in the pulmonary circulation. This causes a decreased area for oxygen exchange.

Scenario 6: Right Ventricular Strain

Next Week 7 Discussion