Hypopituitarism

Pathophyisiology

Decreased levels of growth hormone

Due to the oppression of the pituitary gland by pituitary tumour or secondary underlying necrotic degeneration

Causes

Low or decreased growth secretion

Defective growth hormone action

Impaired skeletal response

Pituitary tumours

Primary and secondary hypothyroidism

Decreased stimulation of skeletal and muscle generation

Clinical Manifestation

Growth velocity is reduced

Abnormally short statue

Decrease function of anterior pituitary gland

Reduced skeletal and muscle tone

Diagnostic Tests

Growth hormone studies will reveal growth levels

X-ray and CT Scan should be done to confirm bone

Physical examination

Monitor weight

Medical Management

Radiation therapy

Surgical removal of pituitary malignant tumours

Nursing Interventions

Monitor vital signs, caidiac and ventilator status

Visual acuity is assessed at regular intervals and to promote drainage

The head of the bed is raised to decrease pressure on the selle turcica

Monitor intake and output

Health educate patient against blowing the nose or engaging in any activity that raises ICP such as bending over or straining during urination or defecation

Daily weight monitoring

Fluids generally give in case of nausea ceases and then the patient proceeds to a regular diet

Oral care is provided every 4 hours or more frequently

A room humudifer assist in keeping mucous membranes most

Craniotomy Transphodial approach

Hormone replacement with corticosteriods and thyroid hormone

Muscular weakness aching and cramping

Hyperpituitarism

Causes

Hyperplasia

Edenoma or tumour of the anterior pituitary gland

Definition

Syndrome of excessive secretion of the growth hormone

Clinical Manifestation

Lip thickening

Bulging of forehead

Enlargement of hands and feet

Large and abnormal structure for age

Sweating

Elevated blood pressure

Electrolyte changes

Polyuria

Snoring, sleep apnea

Respiratory failure

Diagnostic Tests

Immuno esssay of hormone levels

CT Scan of the skull and MRI may show evidence of tumor or adenoma

Fluid replacement with suitable intravenous fluid

When at home the

Termed Acromegaly in adults and Gigantism in children