Ch. 57 Concepts of Care for Patients w/ Pituitary and Adrenal Gland Problems

Question 1

Labs

Answer 1

Sodium

Potassium

BUN

Eosinophil

Adrenocorticotropic hormone (ACTH)

Question 2

Hypopituitarism

Answer 2

Deficiency of one or more pituitary hormones (anterior)

Caused by diseases of pituitary gland or diseases of hypothalamus

Most life-threatening - ACTH & TSH

Question 3

Hypopituitarism Clinical Manifestations

Answer 3

Symptoms and signs are related to specific pituitary hormone deficiency or absence

Question 4

Disorders of the Pituitary Gland - Hypopituitarism

Answer 4

Growth Hormone

Thyrotropin (thyroid-stimulating hormone (TSH))

Corticotropin (adrenocorticotropic hormone (ACTH))

Follicle-stimulating hormone (FSH) & Luteinizing hormone (LH)

Prolactin (PRL)

Question 5

Growth Hormone (GH)

Answer 5

Changes in body composition (increased fat mass, decreased lean body mass)

Question 6

Thyrotropin (TSH)

Answer 6

Bradycardia

Cold intolerance

Constipation

Facial puffiness

Question 7

Corticotropin (ACTH)

Answer 7

Mild - fatigue, anorexia, wt loss, hypoglycemia

Moderate - postural hypotension, tachycardia

Severe - vascular collapse leading to death

Question 8

Follicle-Stimulating Hormone (FSH) & Luteinizing Hormone (LH)

Answer 8

Women - ovarian hypofunction

Men - testicular hypofunction

Question 9

Prolactin (PRL)

Answer 9

Inability to lactate after delivery

Question 10

Hypopituitarism Interventions

Answer 10

Management focuses on replacement of all deficient hormones

Replace deficit hormones (hydrocortisone, levothyroxine, testosterone, estradiol, injections of GH)

Treatment of the cause & is life long

Question 11

Hyperpituitarism

Answer 11

Hormone over secretion that occurs w/ anterior pituitary tumors or tissue hyperplasia

Genetic considerations

Question 12

Pituitary Adenoma

Answer 12

Benign tumor

Classified by the hormone secreted

As tumor gets larger and compresses brain tissue, neurologic changes, as well as endocrine problems

Assess vision changes, HA, and ICP

Question 13

Acromegaly

Answer 13

Side effect of hyperpituitarism

Overproduction of GH in adults

Irreversible if not detected early

Enlargement of face, hands, and feet

Question 14

Acromegaly Clinical Manifestations

Answer 14

Coarsening of facial features

Soft tissue swelling of hands and feet

Skin thicken and darken

Question 15

Hyperpituitarism Assessment

Answer 15

Ask about changes in hat, glove, ring, or shoe size

Fatigue

Backache and joint pain

HA and vision changes

Sexual function difficulty

Question 16

Hyperpituitarism Interventions

Answer 16

Drug therapy - bromocriptine and cabergoline

Radiation therapy - gamma knife surgery

Hypophysectomy

Tumor removal

Question 17

Hypophysectomy Post Op Care

Answer 17

Monitor neurologic response

Assess for postnasal drip

Elevate HOB

Avoid coughing

Hormone replacement

Avoid bending

Avoid straining at stool

Avoid brushing teeth