The client under study sustained significant head and back injuries from a car accident. As a result, the doctor gave an order for a simulation test to be carried out.
Simulation testing is ordered by a healthcare provider to ascertain the reactivity of the adrenal gland within the endocrine system towards various types of hormones. ACTH stimulation is recommended as it examines the production level of cortisol by the adrenal glands and eliminates or confirms the possibility of congenital adrenal Hyperplasia. Low levels of hormone cortisol secreted indicate that the accident caused damage to the adrenal gland (Bazarian et al., 2009). This ensures that the patient receives the correct diagnosis and treatment.
A nurse should be concerned if the client sustained damage to his pituitary gland because it plays an important role in hormone regulation and the production of essential hormones in the endocrine system. According to Bazarian et al. (2009), an injury to the head can affect the pituitary gland and cause reduced secretion of two major hormones in the endocrine system. Injuries sustained on the head could affect how the pituitary gland controls the growth hormone (GH) hence interfering with the normal functionality of the endocrine system. The effect of low production of the growth hormone leads to increased fatigue in the patients; it affects their stamina and may cause anxiety and depression in the patient. These effects occur in approximately 18 percent of patients with sustained brain injuries.
Apart from that, the pituitary gland also produces the antidiuretic hormone (ADH) hence head injuries could affect its production. Bazarian et al. (2009) stipulate that low levels of ADH can lead to a diabetic condition in the patient-diabetes insipidus. A patient suffering from diabetes insipidus is likely to experience extreme thirst and urinate excessively. The dehydration leads to fatigue in the patient hence an indication of the patient having developed diabetes as a result of damage to the pituitary gland. This information is important to nurses, especially when checking and making reports on the patient’s conditions for further checkups hence correct diagnosis.
Another important aspect of the endocrine system is its self-regulation mechanism. The positive and negative feedback in the endocrine system helps the internal environment maintain the body’s homeostasis. Negative feedback is the most common of the two feedback mechanisms, it works towards reversing or causing the desired effect of the original stimulus. “When certain predetermined blood levels of those hormones are reached, the hypothalamus and/or the pituitary ceases hormone release, thereby react by turning off the cascade.” (Sturmhofel & Bartke, 1998) Positive feedback in the endocrine system is rare; however, it is responsible for the release of special hormones including oxytocin. Unlike negative feedback which operates to attain a homeostatic internal environment through reduction of production levels of hormones, positive feedback increases hormones in the endocrine system. For instance, during labor; the level of oxytocin is increased to aid in the stimulation of muscle contractions hence aiding in the birth process (Casas, 2019). Although the two endocrine feedback systems function differently, they serve important roles.
To investigate and determine issues in the endocrine system practitioners apply various diagnostic tests for endocrine dysfunction. Two of the common tests are the blood and urine tests (Olooto, 2013).
Blood tests
- Advantage: Blood tests provide a timely diagnosis of issues affecting the endocrine system as hormonal levels can be measured and desired information obtained.
- Disadvantage: Blood tests may be inconvenient to undertake due to the procedures and lack of specificity.
Urine tests
- Advantages: Obtaining the test sample is easy compared to other methods
- Disadvantages: the presence of impurities in the test sample can alter hormone metabolism concentration hence it is an unreliable method.
References
Bazarian JJ, Cernak I, Noble-Haeusslein L, Potolicchio S, & Temkin N. (2009). Long-term neurologic outcomes after traumatic brain injury. Journal of Head Trauma Rehabilitation, 24(6):439-451.
Casas, Raph P. (2019). Positive and negative feedback.
Olooto, W. E. (2013). Diagnostic importance of URINALYSIS in endocrinology-A review.
Sturmhöfel, S., & Bartke, A. (1998). The endocrine system: an overview. Alcohol Health and Research World, 22(3), 153.