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