Endocrine System Disorders & Diabetes — Hormonal Regulation, Emergencies, and NCLEX Nursing Care | Chapter 43: Saunders NCLEX-PN Review
Endocrine System Disorders & Diabetes — Hormonal Regulation, Emergencies, and NCLEX Nursing Care | Chapter 43: Saunders NCLEX-PN Review
Chapter 43 of Saunders Comprehensive Review for the NCLEX-PN® Examination (7th Edition) by Linda Anne Silvestri and Angela E. Silvestri provides an in-depth review of endocrine system anatomy, hormone regulation, diagnostic tests, and major disorders, with a strong focus on diabetes mellitus. This chapter integrates NCLEX-priority interventions, emergency care protocols, and long-term management strategies to prepare nursing students for endocrine-related questions and clinical challenges.
Watch the video above for a concise high-yield overview, then review the expanded written notes below. Subscribe to Last Minute Lecture for more NCLEX-PN chapter breakdowns and nursing exam preparation content.

Endocrine System Overview
The endocrine system includes the pituitary, thyroid, parathyroid, adrenal glands, pancreas, ovaries, and testes. Hormonal regulation occurs primarily through negative feedback loops, ensuring stable levels of key hormones like TSH, cortisol, and insulin.
Diagnostic Procedures
- Thyroid function tests (TSH, T3, T4)
- Radioactive iodine uptake and thyroid scan
- Dexamethasone suppression test
- HbA1C for diabetes monitoring
- VMA test for pheochromocytoma
Pituitary Disorders
- Hypopituitarism & Acromegaly: Hormone replacement, symptom monitoring
- Diabetes Insipidus: Polyuria, polydipsia; treat with desmopressin
- SIADH: Fluid retention, hyponatremia; fluid restriction, hypertonic saline
Adrenal Disorders
- Addison’s Disease: Hypotension, hyperpigmentation; steroid replacement
- Adrenal Crisis: Life-threatening; IV hydrocortisone, fluids, electrolytes
- Cushing’s Syndrome: Moon face, buffalo hump; surgical or medical management
- Pheochromocytoma: Severe hypertension; avoid palpating abdomen, surgical removal
Thyroid Disorders
- Hypothyroidism: Fatigue, weight gain; levothyroxine replacement
- Hyperthyroidism: Weight loss, tachycardia; antithyroid drugs, beta blockers
- Thyroid Storm: Fever, tachyarrhythmia; ICU management, cooling, antithyroid meds
- Myxedema Coma: Hypothermia, bradycardia; IV thyroid hormone and supportive care
Parathyroid Disorders
- Hypoparathyroidism: Hypocalcemia, tetany; calcium and vitamin D supplements
- Hyperparathyroidism: Hypercalcemia; hydration, bisphosphonates
- Chvostek’s and Trousseau’s signs indicate hypocalcemia
Thyroidectomy Post-Op Care
Monitor airway, keep calcium gluconate at bedside, assess for voice changes, and check for signs of hypocalcemia.
Diabetes Mellitus
- Type 1: Insulin-dependent; risk of DKA
- Type 2: Lifestyle modification, oral hypoglycemics, possible insulin
- Insulin therapy: rapid, short, intermediate, and long-acting types; rotation of injection sites to prevent lipodystrophy
Complications
- DKA: Hyperglycemia, ketones, dehydration; IV fluids, insulin, electrolyte monitoring
- HHS: Severe hyperglycemia without ketosis; aggressive fluid resuscitation
- Hypoglycemia: Treat with 15/15 rule or glucagon if unconscious
Chronic Diabetes Care
- Regular blood glucose monitoring
- Foot care to prevent ulcers and infection
- Dietary planning and exercise guidance
- Insulin pump education and troubleshooting
NCLEX Emergency Priorities
- Airway protection in myxedema coma and thyroid storm
- Rapid steroid replacement in adrenal crisis
- Prompt treatment of hypoglycemia and hyperglycemic crises
Conclusion
Endocrine disorders require a strong foundation in hormonal regulation, diagnostic interpretation, and both acute and chronic care strategies. This chapter provides essential tools for NCLEX success and effective endocrine nursing practice.
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