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Disorders of the Endocrine system (Pituitary gland) (Hyperthyroidism…
Disorders of the Endocrine system (Pituitary gland)
Hyperthyroidism (Gigantistm)
It a syndrome of which there is an over secretion of growth hormone.
Pathophysiology
It occurs when a child’s pituitary gland makes too much growth hormone, which is also known as somatotropin.
When a tumor grows on the pituitary gland, the gland makes far more growth hormone than the body needs.
causes
adenoma
tumours
hypaplasia
Nursing intervention
Investigate reports of chest pain or angina.
Monitor BP lying, sitting, and standing, if able. Note widened pulse pressure.
Monitor central venous pressure (CVP), if available.
Monitor ECG, noting rate and rhythm. Document dysrhythmias.
Risk factors
Anxiety
Risk for Impaired Tissue Integrity
Fatigue
Risk for Decreased Cardiac Output
signs and symptoms
Fatigue, weakness.
Weight loss.
Increased bowel movements.
Excessive sweating.
surgical managemen
t
Iodine
Patients unable to take a thionamide drug
Thionamide therapy
Beta blockers
Pituitary Surgery (Hypophysectomy)
Pituitary surgery
is usually undertaken for removal of pituitary tumours.
Pathophysiology
The absence of pituitary gland alters the function of many parts of the body.
although a frontal approach may be selected depending on the situation and the size of the tumour.
Menstruation ceases, and infertility occurs after total or nearly total ablation of the pituitary gland.
Nursing care:
Evidence of decreasing visual acuity suggests an expanding hematoma.
Vital signs are measured to monitor hemodynamic, cardiac and ventilator status.
Replacement therapy with corticosteroids and thyroid hormone is necessar
Replacement therapy with corticosteroids and thyroid hormone is necessar
Intake and output are measured in order to detect diabetes insipidus
Daily weight is monitored. Oral care must be provided every 4 hours or more frequently.
Surgical treatment:
Usually includes hpophysectomy to remove the tumour.
Assessment and common findings:
Change in facial features with nose enlargement,
Headaches and visual changes,elevated blood pressure,
lethargy and fatigue.
Shoes do not fit.
Acne, sweating, and oiliness of the skin.
lip thickening bulging of the forehead and enlargement of the hands and feet.
Diagnostic Studies:
This include; Immunoassay of hormone levels will show of excessive growth hormone.
CT scan of the skull and MRI may show evidence of a tumor or adenoma.
Nursing Management:
On nursing care includes the administration of pituitary hormones,
and general nursing care of a patient following surgery for removal of the tumour, radiation therapy or both.
Medication
Medication may be recommend if surgery is not an option. This treatment is meant to either shrink the tumor or stop the production of excess growth hormone.
In some cases, surgery may not be an option. For example, if there’s a high risk of injury to a critical blood vessel or nerve.
Drugs such as octreotide or lanreotide to prevent the growth hormone’s release. In a form of injection.
Bromocriptine and cabergoline are drugs that can be used to lower growth hormone levels. Given in a form of a pill.