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Acromegaly Acromegaly (Signs and symptoms (• Enlarged hands, • …
Acromegaly
Definition
A disorder in adult in which the pituitary gland produces too much growth hormone
Pathophysiology
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Caused by growth hormone (GH) secreting pituitary adenomas
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The pituitary adenomas lead to hypersecretion of the GH from the somatotroph cells
Signs and symptoms
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Enlarged hands
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Impaired vision
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Enlarged tongue
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Enlarged liver, heart, spleen & other organs
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Erectile dysfunction in men
Causes
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Nonpituitary tumor
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Pituitary tumor
Complications
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High blood pressure
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Osteoarthritis
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Cardiomyopathy
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Hypopituitarism
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Sleep apnea
Diagnostic test
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GH and IGF-I measuremen
t
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GH suppression test
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CT scan
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MRI scan
Treatment
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Surgery
Transphenoidal surgery
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Radiation
stereotactic radiosurgery
conventional radiation therapy
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Pharmacology
somatostatin analogues (Octreotide & lanreotide)
dopamine agonist (Cabergoline and bromocriptine)
GH antagonist (Somavert)
Risk factors
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Lung cancer
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Adrenal tumor
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Family history
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MacCun Albright syndrome
Nursing management
Preoperative care
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Explaining the procedure to be done
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Asking for consent
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Expectation from the patient to relief anxiety
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Demonstrating and making the site
Postoperative care
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Periodic assessing the surgical dressing and re-inforce it if necessary
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Assess any signs of bleeding to prevent haemorrhage
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Vital signs observations two hourly
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Administrating of IV fluids as ordered to prevent dehydration
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Strictly bed rest
Nursing care plan
Problem
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Ineffective coping related to stress
Specific outcome
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Enhancing coping measures
Nursing intervention
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Keep the environment quiet and uncluttered
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Encourage relaxing activities
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Remind the client to take medication
Health education
avoid head injury
Eat food high in protein
see a sexual specialist for any signs of sexual dysfunction
Nursing care plan
specific outcome
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Improving self-esteem
Nursing intervention
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Discourage smoking or simply use of drugs
• Proving psychological talks to void committing of suicide
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Referral to sexual specialist for sexual dysfunction
Problem
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Low self-esteem
