endocrine&metabolic assessment&diagnosis

1. assessment

 

2. diagnosis

1) stimulation testing

  • Measured amounts of selected hormones or substances are administered to stimulate the target gland to produce its hormone. Hormone levels produced by the target gland are measured.

2) suppression testing

  • Agents that normally induce a suppressed response are administered to determine whether normal negative feedback is intact.

3) radioactive iodine uptake

  • This thyroid function test measures the absorption of an iodine isotope to determine how the thyroid gland is functioning.

4) T3 and T4 resin uptake test

5) thyroid-stimulating hormone

6) thyroid scan

  • A radioisotope of iodine or technetium is administered before scanning the thyroid gland.
  • Determine whether the client has received radiographic contrast agents within the past 3 months, because these may invalidate the scan. Check with the HCP regarding discontinuing medications containing iodine for 14 days before the test and the need to discontinue thyroid medication before the test.

7) needle aspiration of thyroid tissue

  • No client preparation is necessary. Light pressure is applied to the aspiration site after the procedure.

8) GTT (Glucose Tolerance Test)

  • A 2hr post-load glucose level (2 hrs after injection or ingestion of glucose) higher than 200mg/dl confirms the diagnosis of DM.
  • Eat a diet with at least 150g of carbohydrates for 3 days before the test. Avoid alcohol, coffee, and smoking for 36 hrs before testing. Fast for 10 to 12 hours before the test. Withhold morning insulin or oral hypoglycemic medication. Avoid strenuous exercise for 8 hours before and after the test. A sample is drawn for determination of the fasting blood glucose level and then the client will be given a high-glucose drink. Blood samples will be drawn at 30-minute intervals for a minimum of 2 hours.

9) HbA1c (glycosylated hemoglobin A1c)

  • Glycosylated hemoglobin is a blood glucose (%) bound to hemoglobin. HbA1c indicates how well blood glucose levels have been controlled for the prior 2 to 3 months.
  • For clients without DM, the normal range is 4 to 6%. The goal for clients with DM is 7% or lower.
  • Fasting is not required.