Health Care Concepts 2

METABOLISM

RNSG 2572

Health Care Concepts 2

Concept – METABOLISM

Concept Definition

The processes of biochemical reactions occurring in the body’s cells that are necessary to produce energy, repair, and facilitate the growth of cells, and maintain life.

Exemplars

Diabetes Type 1

Diabetes Type 2

Gestational Diabetes

Graves’ Disease – Hyperthyroidism

Hypothyroidism

Addison’s Disease – Hypo-Cortisolism (chronic adrenal insufficiency)

Cushing’s – Hyper-Cortisolism

Objectives

1. Explain the correlation between the above exemplars (Diabetes, Graves’ Disease,

Hypothyroidism, Addison’s Disease and Cushing’s Disease) to the concept of Metabolism (including compromised antecedents, deficit measurement in attributes, a list of negative consequences, and the interrelated concepts which may be involved).

2. Identify conditions that place an individual at risk for imbalance leading to a

compromised metabolic regulation resulting in Diabetes, Graves’ Disease, Hypothyroidism, Addison’s Disease and Cushing’s Disease.

3. Apply the nursing process with collaborative interventions for individuals

experiencing a metabolic imbalance (Diabetes, Graves’ Disease, Hypothyroidism, Addison’s Disease and Cushing’s Disease) and to promote normal metabolic regulation.

Concept Analysis Diagram

Note: Diagram is on separate page.

Explanation of Metabolism Diagram

The Metabolism concept analysis diagram clearly depicts the definition as it is related to the attributes. The antecedents identify the events that must happen prior to the concept. These include ingestion of nutrients, normal growth and development, adaptive response to stress, and organ perfusion among others. For example if nutrients are unable to be ingested the process of metabolism in the body will be affected.

The sub concepts of the metabolism concept are critical elements of the major concept and are to be closely examined throughout the lecture content. The interrelated concepts are clearly identified and relate in such a way that negative consequences will occur if one is depleted or impaired. These concepts are to work together harmoniously to ensure a normal process. For example perfusion of the organs is essential for production of hormones and enzymes to regulate metabolism. The consequences are divided into negative and positive outcomes. When metabolic homeostasis occurs, positive outcomes are realized. However, when a malfunction or imbalance in metabolism occurs negative outcomes result.

The concept of Metabolism is essential to maintain life and is an integral process in the production of energy as well as growth and repair of the body’s cells.

Assignments

Prior to class:

1. Review definitions of inter-rated concepts on concept analysis diagram.

2. Review concept analysis diagram.

3. Review anatomy and physiology of the endocrine system.

4. Review reading:

ü Giddens, J.F. (2013). Concepts for nursing practice. St. Louis. MO: Mosby

Elsevier.

§ Chapter 12: Glucose Regulation

§ Chapter 13: Nutrition

§ Chapter 18: Reproduction

§ Chapter 27: Stress

ü Lewis, S.L., Heitkemper, M.M., Dirksen, S.R., O’Brien, P.G., & Bucher, L.

(2011). Medical surgical nursing (8th ed). St. Louis: Mosby Elsevier.

§ Chapter 17: Fluid, Electrolyte, and Acid/Base Imbalances

§ Chapter 39: Nursing Assessment: Gastrointestinal System

§ Chapter 48: Nursing Assessment: Endocrine System

5. Assigned reading:

ü Lewis, S.L., Heitkemper, M.M., Dirksen, S.R., O’Brien, P.G., & Bucher, L. (2011).

Medical surgical nursing (8th ed). St. Louis: Mosby Elsevier.

§ Nursing Management Diabetes Mellitus, Chapter 49

§ Nursing Management Endocrine Problems, Chapter 50

ü Giddens, J.F. (2013). Concepts for nursing practice. St. Louis. MO: Mosby

Elsevier.

§ Glucose Regulation, Ch. 12

§ Nutrition, Ch. 13

§ Stress, Ch. 27

6. Internet resources to review:
ü Endocrine System Anatomy: http://www.nlm.nih.gov/medlineplus/ency/anatomyvideos/000048.htm
ü Hypothyroidism:
http://www.videomd.com/Hypothyroidism-fv-674.aspx
ü Difference between hypothyroidism and Hashimoto’s disease
http://video.about.com/thyroid/The-Difference-Between-Hashimoto-s-Disease-and-Hypothyroidism.htm
ü Grave’s Disease:
http://www.streamingwell.com/graves-disease-explained-video.html
ü Parathyroid Disease
http://www.youtube.com/watch?v=sD9st1ZPFrQ
ü Cushing’s Syndrome
http://www.youtube.com/watch?v=1osIAtrto2k
ü Addison’s Disease
http://www.endocrine.niddk.nih.gov/pubs/addison/addison.aspx
ü Animation about diabetes and the body
http://www.youtube.com/watch?v=jHRfDTqPzj4
ü Diabetes Medications
http://www.youtube.com/watch?v=m9afVC-m1i0
ü Diabetes during Pregnancy, Gestational Diabetes
http://www.youtube.com/watch?v=A-8de9LuVJQ
ü Gestational Diabetes
http://www.youtube.com/watch?v=qvUCo5z9ZGk
ü American Diabetes Association
http://www.youtube.com/user/AmericanDiabetesAssn

7. Review the following Nursing Diagnoses:

Ø Alterations in elimination

Ø Impaired skin integrity

Ø Activity intolerance

Ø Imbalanced nutrition: more/less than body requirements

Ø Pain

Ø Knowledge deficit of self-management (medication, disease process, diet,

lifestyle)

Ø Risk for fluid volume deficit

Ø Ineffective self-health management (Juvenile Type I Diabetes)

Ø Risk for infection

Ø Risk for injury

Concept content outline:

Concept: Metabolism

Sub Concepts: Hormonal Endocrine Regulation

Deviations from Normal

Nutrient Utilization

Risk Factors: Applies to each exemplar

Abnormal growth and development

Impaired immune response

Hormonal imbalance

Age

Dysfunction of the organs/glands that participate in the endocrine system

Lifestyle

Genetics

Assessment: Comprehensive history

Physical assessment

Cultural, behavioral, social assessment

Physical and psychological clinical manifestations

Diagnostic tests

Positive Outcomes:

Normotensive

Euglycemia

Normal thermoregulation

Adequate hydration status

Negative Outcomes:
Physiological

Psychological

Clinical Management:

Nursing interventions

Collaborative interventions

Pharmacological therapy

Non Pharmacological therapy

Procedural therapy

Diagnostic studies