Clinical Skills and the Endocrine System
Description
Develop essential skills for enhancing endocrine health, ensuring accurate assessment and patient-focused treatment
Clinical Skills and the Endocrine System delivers a structured approach to understanding and mastering the clinical assessment and procedural skills that are essential for delivering safe, effective and compassionate care for patients with conditions affecting the endocrine system.
Part of Peate's Clinical Skills, a 12-book series that combines knowledge of human anatomy and physiology with practical, confident clinical skills, this volume is organised into chapters covering how to engage with patients, assessing the endocrine system, health promotion, planning care for diabetes mellitus, vital signs, capillary blood glucose, continuous glucose monitoring, and transdermal hormone replacement therapy.
Clinical Skills and the Endocrine System equips readers with:
- Clear explanations of anatomy, physiology, and pathophysiology relevant to the endocrine system
- Step-by-step guidance on assessment, examination, and procedural techniques, emphasising best practice and patient safety
- Insights on interpreting findings, recognising abnormalities, and applying knowledge to guide care decisions
- Guidance on teamwork, infection prevention and control, documentation, and patient-centred care throughout clinical practice
- Strategies to explain diagnoses, treatment plans, and care procedures to patients and families, while offering emotional support
Clinical Skills and the Endocrine System is an essential resource for all healthcare and social care students-including those returning to practice and newly qualified practitioners-who manage patients with endocrine conditions and seek practical ways to deliver a higher standard of care.
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Person
IAN PEATE is a Visiting Professor at Northumbria University and Buckinghamshire New University and a Senior Clinical Fellow at the University of Hertfordshire. He is also the Editor-in-Chief of the British Journal of Nursing, and Consultant Editor of the Journal of Paramedic Practice and the International Journal of Advancing Practice.
Content
Preface ix
Acknowledgements xi
1 The Anatomy and Physiology of the Endocrine System 1
Introduction 1
The Endocrine Organs 3
Endocrine Signalling 4
Hormones as Chemical Messengers 4
Factors Influencing Hormone Action 6
Control of Hormone Release 8
Physiology of the Endocrine Organs 8
The Thyroid Gland 10
The Parathyroid Glands 13
The Adrenal Glands 14
The Pancreas 18
The Gonads 23
Other Endocrine Glands 24
Conclusion 24
Glossary of Terms 25
Multiple Choice Questions 26
References 27
2 Engaging with Patients and Assessing the Endocrine System 28
Introduction 28
The Importance of Language in Endocrinological Assessment 29
Promoting Patient-centred Communication in Endocrinological Care 30
Valuing the Patient Experience in Endocrinological Care 32
Creating a Collaborative Relationship in Endocrinological Health 33
Cultural Sensitivity in Endocrinological Health 34
Health Literacy and Endocrinology 35
Assessing the Endocrine System 35
Preparation and Professional Approach 36
The Patient History 37
Physical Examination 38
Tests and Investigations in Endocrine Assessment 45
Vital Signs and Other Observations 45
Clinical Judgement and Communication 48
Documentation and Interpretation of Endocrinological Findings 48
Conclusion 48
Glossary of Terms 49
Multiple Choice Questions 50
References 51
3 Health Promotion 53
Introduction 53
Health Promotion 54
Core Principles of Health Promotion 54
Intersectionality in Endocrine Health 55
The Role of Healthcare Professionals 55
Overview of Common Endocrine Conditions 58
Primary, Secondary and Tertiary Prevention of Endocrine Conditions 61
The Role of Those Who Provide Care and Support: Multidisciplinary and Community Approaches 64
Behaviour Change Communication and Motivational Interviewing 65
Empowering Informal Carers and Families 65
Community Health Workers, Champions and Navigators 66
Integrated and Multidisciplinary Approaches 66
Bridging Clinical and Community Care 66
Digital Health 68
Conclusion 68
Glossary of Terms 69
Multiple Choice Questions 70
References 71
4 Planning Care: Diabetes Mellitus 73
Introduction 73
Diabetes Mellitus 74
Diabetes Mellitus Prevalence and Demographics 75
Disparities in Diagnosis and Treatment Access 75
Types of Diabetes Mellitus 76
Pathophysiology of Diabetes Mellitus 78
Overview of Diabetes Mellitus 81
Diabetes Mellitus and Systemic Illness 82
Multidisciplinary Care 83
Signs and Symptoms of Diabetes Mellitus 84
Assessment and Early Detection of Diabetes Mellitus 85
Opportunistic Detection 86
Planning Individualised Care 92
Pharmacological Management 93
Comprehensive and Safe Care in Diabetes Management 94
Conclusion 95
Glossary of Terms 96
Multiple Choice Questions 97
References 98
5 Vital Signs 100
Introduction 100
Vital Signs 103
Temperature 103
Heart Rate (Pulse) 104
Respiratory Rate 104
Blood Pressure 104
Oxygen Saturation 104
Pain 105
Normal Parameters and Age-related Variations 105
Endocrine Conditions and Their Impact on Vital Signs 105
Clinical Assessment and Decision-making 111
Using NEWS2 and SBAR for Communication and Escalation 111
SBAR for Escalation 112
Pharmacological Considerations 112
Timing and Monitoring of Medications 114
Person-centred Care and Communication 115
Conclusion 117
Glossary of Terms 118
Multiple Choice Questions 119
References 120
6 Capillary Blood Glucose 122
Introduction 122
Physiology of Blood Glucose Regulation 123
Key Hormones in Glucose Regulation 126
Pathophysiology of Hypoglycaemia and Hyperglycaemia 127
Hormonal Regulation 127
Clinical Implications for Capillary Blood Glucose Testing 128
Blood Glucose Monitoring 129
Capillary Blood Glucose, HbA1c and Plasma Glucose 129
Blood Glucose Targets an Individualised Approach 130
Frequency of Monitoring 130
Indications for Capillary Blood Glucose Monitoring 130
Steroid-induced Hyperglycaemia 131
Equipment and Infection Prevention 132
Types of Glucometers 132
Infection Prevention and Control 133
Safety and Quality Assurance 133
Preparation and a Patient-centred Approach 133
Ensuring Comfort, Privacy and Dignity 134
When to Escalate Concerns 135
Performing the Capillary Blood Glucose Test 135
Interpretation of Results 138
Actions for Hypoglycaemia (Less Than 4.0 mmol/L) and Hyperglycaemia (More Than 11.1 mmol/L) 139
Adjusting Care Plans and Monitoring Treatment Responses 139
Special Considerations 140
Documentation and Communication 143
Conclusion 143
Glossary of Terms 143
Multiple Choice Questions 144
References 146
7 Continuous Glucose Monitoring 148
Introduction 148
Continuous Glucose Monitoring 148
Continuous Glucose Monitoring System Components 149
Consent and Explanation 152
The Informed Consent Process 154
Helping Patients to Self-manage 154
Addressing Common Fears and Misconceptions 154
Procedure 155
Preparation 155
Key Skills 155
Equipment Checklist 155
Infection Prevention and Control 156
Sensor Insertion 156
Site Selection 156
Steps for Sensor Insertion 157
Skill Emphasis 157
Calibration and Activation (if Applicable) 158
Activation Steps 158
Skills Required 158
Patient Information and Education 158
Key Teaching Points 158
Communication Skills 158
Promoting Autonomy 158
Troubleshooting Common Issues 159
Practical Tips 160
Interpretation of Results 160
Key Continuous Glucose Monitoring Metrics 161
Glucose Variability 161
Trend Arrows 161
Using Continuous Glucose Monitoring Reports 161
Recognising Patterns and Trends Versus Isolated Readings 162
When to Seek Specialist Advice 162
Communicating Continuous Glucose Monitoring Results to Patients 163
Documentation and Patient Support 163
Conclusion 164
Glossary of Terms 164
Multiple Choice Questions 165
References 166
8 Transdermal Hormone Replacement Therapy 168
Introduction 168
Importance of Transdermal Route and Other Hormone Replacement Therapy Delivery Methods 169
Skills Development in Transdermal Hormone Replacement Therapy 169
Transdermal Hormone Replacement Therapy 170
Indications for Transdermal Hormone Replacement Therapy 171
Advantages and Limitations of Transdermal Delivery 171
Formulations and Their Pharmacokinetics 172
Obtaining Consent 173
Procedure 177
Interpretation of Results 181
Monitoring and Follow-up 182
Raising Concerns 183
Conclusion 183
Glossary of Terms 184
Multiple Choice Questions 185
References 186
MCQ Answers 188
Index 189
