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.

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• Preface ixAcknowledgements xi1 The Anatomy and Physiology of the Endocrine System 1Introduction 1The Endocrine Organs 3Endocrine Signalling 4Hormones as Chemical Messengers 4Factors Influencing Hormone Action 6Control of Hormone Release 8Physiology of the Endocrine Organs 8The Thyroid Gland 10The Parathyroid Glands 13The Adrenal Glands 14The Pancreas 18The Gonads 23Other Endocrine Glands 24Conclusion 24Glossary of Terms 25Multiple Choice Questions 26References 272 Engaging with Patients and Assessing the Endocrine System 28Introduction 28The Importance of Language in Endocrinological Assessment 29Promoting Patient-centred Communication in Endocrinological Care 30Valuing the Patient Experience in Endocrinological Care 32Creating a Collaborative Relationship in Endocrinological Health 33Cultural Sensitivity in Endocrinological Health 34Health Literacy and Endocrinology 35Assessing the Endocrine System 35Preparation and Professional Approach 36The Patient History 37Physical Examination 38Tests and Investigations in Endocrine Assessment 45Vital Signs and Other Observations 45Clinical Judgement and Communication 48Documentation and Interpretation of Endocrinological Findings 48Conclusion 48Glossary of Terms 49Multiple Choice Questions 50References 513 Health Promotion 53Introduction 53Health Promotion 54Core Principles of Health Promotion 54Intersectionality in Endocrine Health 55The Role of Healthcare Professionals 55Overview of Common Endocrine Conditions 58Primary, Secondary and Tertiary Prevention of Endocrine Conditions 61The Role of Those Who Provide Care and Support: Multidisciplinary and Community Approaches 64Behaviour Change Communication and Motivational Interviewing 65Empowering Informal Carers and Families 65Community Health Workers, Champions and Navigators 66Integrated and Multidisciplinary Approaches 66Bridging Clinical and Community Care 66Digital Health 68Conclusion 68Glossary of Terms 69Multiple Choice Questions 70References 714 Planning Care: Diabetes Mellitus 73Introduction 73Diabetes Mellitus 74Diabetes Mellitus Prevalence and Demographics 75Disparities in Diagnosis and Treatment Access 75Types of Diabetes Mellitus 76Pathophysiology of Diabetes Mellitus 78Overview of Diabetes Mellitus 81Diabetes Mellitus and Systemic Illness 82Multidisciplinary Care 83Signs and Symptoms of Diabetes Mellitus 84Assessment and Early Detection of Diabetes Mellitus 85Opportunistic Detection 86Planning Individualised Care 92Pharmacological Management 93Comprehensive and Safe Care in Diabetes Management 94Conclusion 95Glossary of Terms 96Multiple Choice Questions 97References 985 Vital Signs 100Introduction 100Vital Signs 103Temperature 103eart Rate (Pulse) 104Respiratory Rate 104Blood Pressure 104Oxygen Saturation 104Pain 105Normal Parameters and Age-related Variations 105Endocrine Conditions and Their Impact on Vital Signs 105Clinical Assessment and Decision-making 111Using NEWS2 and SBAR for Communication and Escalation 111SBAR for Escalation 112Pharmacological Considerations 112Timing and Monitoring of Medications 114Person-centred Care and Communication 115Conclusion 117Glossary of Terms 118Multiple Choice Questions 119References 1206 Capillary Blood Glucose 122Introduction 122Physiology of Blood Glucose Regulation 123Key Hormones in Glucose Regulation 126Pathophysiology of Hypoglycaemia and Hyperglycaemia 127Hormonal Regulation 127Clinical Implications for Capillary Blood Glucose Testing 128Blood Glucose Monitoring 129Capillary Blood Glucose, HbA1c and Plasma Glucose 129Blood Glucose Targets an Individualised Approach 130Frequency of Monitoring 130Indications for Capillary Blood Glucose Monitoring 130Steroid-induced Hyperglycaemia 131Equipment and Infection Prevention 132Types of Glucometers 132Infection Prevention and Control 133Safety and Quality Assurance 133Preparation and a Patient-centred Approach 133Ensuring Comfort, Privacy and Dignity 134When to Escalate Concerns 135Performing the Capillary Blood Glucose Test 135Interpretation of Results 138Actions for Hypoglycaemia (Less Than 4.0 mmol/L) and Hyperglycaemia (More Than 11.1 mmol/L) 139Adjusting Care Plans and Monitoring Treatment Responses 139Special Considerations 140Documentation and Communication 143Conclusion 143Glossary of Terms 143Multiple Choice Questions 144References 1467 Continuous Glucose Monitoring 148Introduction 148Continuous Glucose Monitoring 148Continuous Glucose Monitoring System Components 149Consent and Explanation 152The Informed Consent Process 154Helping Patients to Self-manage 154Addressing Common Fears and Misconceptions 154Procedure 155Preparation 155Key Skills 155Equipment Checklist 155Infection Prevention and Control 156Sensor Insertion 156Site Selection 156Steps for Sensor Insertion 157Skill Emphasis 157Calibration and Activation (if Applicable) 158Activation Steps 158Skills Required 158Patient Information and Education 158Key Teaching Points 158Communication Skills 158Promoting Autonomy 158Troubleshooting Common Issues 159Practical Tips 160Interpretation of Results 160Key Continuous Glucose Monitoring Metrics 161Glucose Variability 161Trend Arrows 161Using Continuous Glucose Monitoring Reports 161Recognising Patterns and Trends Versus Isolated Readings 162When to Seek Specialist Advice 162Communicating Continuous Glucose Monitoring Results to Patients 163Documentation and Patient Support 163Conclusion 164Glossary of Terms 164Multiple Choice Questions 165References 1668 Transdermal Hormone Replacement Therapy 168Introduction 168Importance of Transdermal Route and Other Hormone Replacement Therapy Delivery Methods 169Skills Development in Transdermal Hormone Replacement Therapy 169Transdermal Hormone Replacement Therapy 170Indications for Transdermal Hormone Replacement Therapy 171Advantages and Limitations of Transdermal Delivery 171Formulations and Their Pharmacokinetics 172Obtaining Consent 173Procedure 177Interpretation of Results 181Monitoring and Follow-up 182Raising Concerns 183Conclusion 183Glossary of Terms 184Multiple Choice Questions 185References 186MCQ Answers 188Index 189

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.

Select Guide Rating

• Preface ixAcknowledgements xi1 The Anatomy and Physiology of the Endocrine System 1Introduction 1The Endocrine Organs 3Endocrine Signalling 4Hormones as Chemical Messengers 4Factors Influencing Hormone Action 6Control of Hormone Release 8Physiology of the Endocrine Organs 8The Thyroid Gland 10The Parathyroid Glands 13The Adrenal Glands 14The Pancreas 18The Gonads 23Other Endocrine Glands 24Conclusion 24Glossary of Terms 25Multiple Choice Questions 26References 272 Engaging with Patients and Assessing the Endocrine System 28Introduction 28The Importance of Language in Endocrinological Assessment 29Promoting Patient-centred Communication in Endocrinological Care 30Valuing the Patient Experience in Endocrinological Care 32Creating a Collaborative Relationship in Endocrinological Health 33Cultural Sensitivity in Endocrinological Health 34Health Literacy and Endocrinology 35Assessing the Endocrine System 35Preparation and Professional Approach 36The Patient History 37Physical Examination 38Tests and Investigations in Endocrine Assessment 45Vital Signs and Other Observations 45Clinical Judgement and Communication 48Documentation and Interpretation of Endocrinological Findings 48Conclusion 48Glossary of Terms 49Multiple Choice Questions 50References 513 Health Promotion 53Introduction 53Health Promotion 54Core Principles of Health Promotion 54Intersectionality in Endocrine Health 55The Role of Healthcare Professionals 55Overview of Common Endocrine Conditions 58Primary, Secondary and Tertiary Prevention of Endocrine Conditions 61The Role of Those Who Provide Care and Support: Multidisciplinary and Community Approaches 64Behaviour Change Communication and Motivational Interviewing 65Empowering Informal Carers and Families 65Community Health Workers, Champions and Navigators 66Integrated and Multidisciplinary Approaches 66Bridging Clinical and Community Care 66Digital Health 68Conclusion 68Glossary of Terms 69Multiple Choice Questions 70References 714 Planning Care: Diabetes Mellitus 73Introduction 73Diabetes Mellitus 74Diabetes Mellitus Prevalence and Demographics 75Disparities in Diagnosis and Treatment Access 75Types of Diabetes Mellitus 76Pathophysiology of Diabetes Mellitus 78Overview of Diabetes Mellitus 81Diabetes Mellitus and Systemic Illness 82Multidisciplinary Care 83Signs and Symptoms of Diabetes Mellitus 84Assessment and Early Detection of Diabetes Mellitus 85Opportunistic Detection 86Planning Individualised Care 92Pharmacological Management 93Comprehensive and Safe Care in Diabetes Management 94Conclusion 95Glossary of Terms 96Multiple Choice Questions 97References 985 Vital Signs 100Introduction 100Vital Signs 103Temperature 103eart Rate (Pulse) 104Respiratory Rate 104Blood Pressure 104Oxygen Saturation 104Pain 105Normal Parameters and Age-related Variations 105Endocrine Conditions and Their Impact on Vital Signs 105Clinical Assessment and Decision-making 111Using NEWS2 and SBAR for Communication and Escalation 111SBAR for Escalation 112Pharmacological Considerations 112Timing and Monitoring of Medications 114Person-centred Care and Communication 115Conclusion 117Glossary of Terms 118Multiple Choice Questions 119References 1206 Capillary Blood Glucose 122Introduction 122Physiology of Blood Glucose Regulation 123Key Hormones in Glucose Regulation 126Pathophysiology of Hypoglycaemia and Hyperglycaemia 127Hormonal Regulation 127Clinical Implications for Capillary Blood Glucose Testing 128Blood Glucose Monitoring 129Capillary Blood Glucose, HbA1c and Plasma Glucose 129Blood Glucose Targets an Individualised Approach 130Frequency of Monitoring 130Indications for Capillary Blood Glucose Monitoring 130Steroid-induced Hyperglycaemia 131Equipment and Infection Prevention 132Types of Glucometers 132Infection Prevention and Control 133Safety and Quality Assurance 133Preparation and a Patient-centred Approach 133Ensuring Comfort, Privacy and Dignity 134When to Escalate Concerns 135Performing the Capillary Blood Glucose Test 135Interpretation of Results 138Actions for Hypoglycaemia (Less Than 4.0 mmol/L) and Hyperglycaemia (More Than 11.1 mmol/L) 139Adjusting Care Plans and Monitoring Treatment Responses 139Special Considerations 140Documentation and Communication 143Conclusion 143Glossary of Terms 143Multiple Choice Questions 144References 1467 Continuous Glucose Monitoring 148Introduction 148Continuous Glucose Monitoring 148Continuous Glucose Monitoring System Components 149Consent and Explanation 152The Informed Consent Process 154Helping Patients to Self-manage 154Addressing Common Fears and Misconceptions 154Procedure 155Preparation 155Key Skills 155Equipment Checklist 155Infection Prevention and Control 156Sensor Insertion 156Site Selection 156Steps for Sensor Insertion 157Skill Emphasis 157Calibration and Activation (if Applicable) 158Activation Steps 158Skills Required 158Patient Information and Education 158Key Teaching Points 158Communication Skills 158Promoting Autonomy 158Troubleshooting Common Issues 159Practical Tips 160Interpretation of Results 160Key Continuous Glucose Monitoring Metrics 161Glucose Variability 161Trend Arrows 161Using Continuous Glucose Monitoring Reports 161Recognising Patterns and Trends Versus Isolated Readings 162When to Seek Specialist Advice 162Communicating Continuous Glucose Monitoring Results to Patients 163Documentation and Patient Support 163Conclusion 164Glossary of Terms 164Multiple Choice Questions 165References 1668 Transdermal Hormone Replacement Therapy 168Introduction 168Importance of Transdermal Route and Other Hormone Replacement Therapy Delivery Methods 169Skills Development in Transdermal Hormone Replacement Therapy 169Transdermal Hormone Replacement Therapy 170Indications for Transdermal Hormone Replacement Therapy 171Advantages and Limitations of Transdermal Delivery 171Formulations and Their Pharmacokinetics 172Obtaining Consent 173Procedure 177Interpretation of Results 181Monitoring and Follow-up 182Raising Concerns 183Conclusion 183Glossary of Terms 184Multiple Choice Questions 185References 186MCQ Answers 188Index 189