Pituitary Tumours
Types of Tumours
Functional Tumours - secrete pituitary hormones.
Non-Functional- no secretions
Three Principles of Pituitary Tumours
Eosinophilc Cells - develop early in life and result in Gigantism, person can be large in all proportions, yet weak and lethargic. Adult excessive skeletal growth occurs, red hands, the superciliary ridge the motor eminences the nose and chin
Basophilic Cells - give rise to Cushing Syndrome attribute to hyper adrenalism, hypertension, osteoporosis, polycthemia, masculinazation, amnenorrhea in females and obesity
Chromophobic Cells - 90% of pituitary tumours do not produce hormones but destroy the pituitary gland
Diagnostics
Physical Assessment
Medical Management
Hypophysectomy - surgical pituitary tumor removal through a transsphenodial approach
Assessment of visual acuity
CT and MRI
Serum levels of pituitary hormones
Octeotide and Lanreotide (somatoline depot, a somatostatin analogue) to improve clinical condition and to disintegrate the tumour
Steorectatic radiation therapy, conventional radiation therapy: bromocriptino (parlodel/dopamine antagonist), actreotide sandostatin synthetic analogue inhibit production or release of growth hormone and improvement of symptoms.
Nursing Interventions
Administer medication timeoulsy
Vital sign monitoring
Evidence of decreasing of decreasing visual acuity
The head of the bed is raised to decrease pressure on the sella turcica and and to promote normal drainage
The patient is is cautioned against blowing nose or engaging in activity that raises ICP
Intake and output are measured as guide electrolyte replacement
Daily weight is measured
Syndrome of inappropriate ADH Secretion
Pathophysiology
Malignancy of tumour pressing the pituitary gland
May be related to major head surgery
Clinical Manifestation
Confusion
Seizures
Loss of conscious
Hyponatraemia from fluid excess
Weight gain and eadema
Diagnostic Test
CT Scan
Urine Test
Hormone Assessment Levels
Management
Restrict fluid and keep record of intake and output
Excessive production of anti- diuretic hormone
Accumulation of excess water
Maintain Sodium Chloride infusion prescribed to replace sodium serum levels
Administer diuretics to free water clearance
Administer enema to draw water out of excess
Monitor neurologic assessment
PITUITARY GLAND TUMORS AND DISORDERS