Endocrine / Metabolic System

Body Systems Endocrine / Metabolic System
Endocrine overview

Endocrine / Metabolic System

Endocrine and metabolic conditions, evidence, coding, and nursing diagnoses.

Conditions

Major endocrine conditions

Endocrine 6 sections

T1DM

T1DM is autoimmune destruction of pancreatic beta cells causing absolute insulin deficiency. Lifelong insulin therapy. Continuous glucose monitoring and closed-loop systems improve outcomes.

T1DM Type 1 diabetes IDDM
Endocrine 6 sections

T2DM

T2DM is insulin resistance + relative insulin deficiency. 90-95% of diabetes. Cardiovascular risk is paramount — GLP-1 agonists and SGLT2 inhibitors have proven CV/renal benefits.

T2DM Type 2 diabetes NIDDM
Endocrine 6 sections

DKA

DKA: hyperglycemia (>250) + anion gap metabolic acidosis + ketonemia. Predominantly T1DM. Precipitants: infection, insulin omission, new T1DM. Hourly glucose + electrolyte monitoring critical.

DKA diabetic ketoacidosis ketoacidosis
Endocrine 6 sections

HHS

HHS (formerly HONK): severe hyperglycemia (>600 mg/dL), hyperosmolarity (>320 mOsm/kg), minimal ketosis, profound dehydration. Predominantly T2DM elderly. Higher mortality than DKA.

HHS HONK hyperosmolar hyperglycemic state
Endocrine 6 sections

Hypoglycemia

Hypoglycemia: blood glucose <70 mg/dL. Symptoms: diaphoresis, tremor, palpitations, confusion, seizure, coma. Whipple triad: symptoms + low glucose + relief with glucose correction.

hypoglycemia low blood sugar insulin reaction
Endocrine 6 sections

Hypothyroid

Hypothyroidism is thyroid hormone deficiency. Most common cause: Hashimoto thyroiditis (autoimmune). Symptoms: fatigue, cold intolerance, weight gain, constipation, bradycardia. Myxedema coma is rare but life-threatening.

hypothyroidism underactive thyroid Hashimoto thyroiditis
Endocrine 6 sections

Hyperthyroid

Hyperthyroidism is excess thyroid hormone. Graves disease (most common): diffuse goiter + ophthalmopathy + pretibial myxedema. Symptoms: tachycardia, weight loss, heat intolerance, tremor.

hyperthyroidism Graves disease thyrotoxicosis
Endocrine 6 sections

Thyroid Storm

Thyroid storm is life-threatening decompensated hyperthyroidism (Burch-Wartofsky score ≥45). Mortality 10-30%. Precipitants: surgery, trauma, infection, iodine contrast. ICU admission required.

thyroid storm thyrotoxic crisis thyroid crisis
Endocrine 6 sections

Adrenal Insuff

Adrenal insufficiency: inadequate cortisol (± aldosterone). Primary (Addison disease): adrenal gland failure. Secondary: pituitary failure. Adrenal crisis: life-threatening — immediate hydrocortisone.

adrenal insufficiency Addison disease adrenal crisis
Endocrine 6 sections

SIADH

SIADH (Syndrome of Inappropriate Antidiuretic Hormone) causes hyponatremia from excess ADH. Urine osmolality >100 mOsm/kg + urine Na >40. Causes: CNS, pulmonary, medications, malignancy.

SIADH syndrome of inappropriate antidiuretic hormone euvolemic hyponatremia
Endocrine 6 sections

DI

Diabetes insipidus (DI) is ADH deficiency (central) or resistance (nephrogenic), causing large volumes of dilute urine (polyuria/polydipsia). Urine osmolality <300 + serum Na >145.

DI diabetes insipidus central DI
Endocrine 6 sections

MetS

Metabolic syndrome: 3 of 5 criteria — abdominal obesity, elevated TG, low HDL, hypertension, impaired fasting glucose. Strong predictor of T2DM and CVD. Lifestyle modification is cornerstone.

metabolic syndrome insulin resistance syndrome syndrome X
Nursing diagnoses & care plans

Related nursing diagnoses

NANDA Care plans

Nursing Diagnoses & Care Plans

Open the NANDA tool to review nursing diagnoses and care-plan concepts related to endocrine conditions.