Pituitary and Adrenal Gland Disorders Pituitary Hormones Anterior Lobe TSH-Thyroid Stimulating Hormone ACTH-Adrenocorticotropic Hormone FSH-Follicle Stimulating Hormone LH-Luteinizing Hormone GH-Growth Hormone Prolactin Posterior Lobe ADH-Anti-Diuretic Hormone aka Arginine Vasopressin (AVP) or simply vasopressin Oxytocin Anterior Pituitary Disorders Acromegaly GH Overgrowth of soft tissues and bone
6/1,000,000 Adults Shortens life span 5-10 yrs Clinical Manifestations Enlarged Hand and Feet Thickening of bony and soft tissue of the face Leather, thick, and oily skin Visual disturbances Peripheral neuropathy Headaches Menstrual changes Acromegaly Diagnostic H&P Abnormal tissue growth Increase in hat, ring, glove, shoe size Growth Factor levels Oral glucose tolerance test (OGTT) Growth Hormone response to oral glucose challenge MRI/CT with contrast Acromegaly Treatment Surgery (Hypophysectomy) Treatment of Choice Transsphenoidal Approach Permanent Loss of Pituitary Hormones Target organ hormone replacement for lifetime Radiation Therapy Used when surgery failed to produce complete remission/high risk surgery candidate Offered in combo with drug therapy Drug Therapy Used for inadequate response to/cannot be treated with surgery or radiation therapy Most common medication is octreotide (Sandostatin) given IM. Reduces GH levels within norm range Nursing Management- Surgical Post-Surgical Head of Bed 30 degrees Neuro Assessment Pupillary Response, Speech Patterns, Extremity Movement and Strength Q 4hr Mouth Care, No teeth brushing for 10 days Hemorrhage Avoid Coughing, Sneezing, or Straining
CFS (glucose test) Nursing Management- Radiation Stereotactic Radiosurgery Specialized Radiation Neuro ICU Headaches, Seizures, Nausea, Vomiting Pin Site Care Diabetes Insipidus (Loss ADH) Infertility (FSH, LH) Increased Risk for Colon Polyps and Colorectal Cancer Nursing Management-Medication Octreotide (Sandostatin) lowers GH Subcutaneous three times a week Dopamine agonist reduces secretion of GH Combination Drugs Hormonal Therapy Life Long Therapy ADH Cortisol Thyroid Hypopituitarism Selective Hypopituitarism verses Panhypopituitarism Causes Pituitary tumor Autoimmune disorders Infections Pituitary Infarction (Sheehan Syndrome) Destruction of Pituitary (trauma, radiation, surgery) Anterior pituitary hormone deficiency = end organ failure. Life Threatening Hypopituitarism Clinical Manifestations Vary with the Pituitary dysfunction. Headache, visual changes, anosmia, seizures Growth hormone deficiency Truncal obesity Decreased muscle mass Decreased energy Reduced exercise capability.
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- Fall '18
- Cortisol, ADH, Growth Hormone response, Treatment of Choice, Infertility, Increased Risk