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Interventions for clients with pituitary adn adrenal gland disorders

HYPOpituitarism deficiency of one of more anterior hormones
Deficiencies of_______ and _______ are the most life threatening ACTH and TSH
HYPOpituitarism (GH) The lack of groth hormone causes short stature
HYPOpituitarism Etiology(causes) Tumors, malnutrition, anorexia causing loss body fat, poor circulation to pituitary gland, radiation, cancer, trauma, infection, congenital defects
Low Growth Hormone (GH) fractures, decreased muscle strength
Low Thyroid Stimulating Hormone (TSH) < TSH levels, weight gain, cold intolerance, alopecia, hirsuitism, slowed cognition, lethargy
Low Adrenocorticotropic horomone (ACTH) decreased cortisol levels,h/a, pale complexion, malaise, anorexia,hypoglycemia, hyponatremia
Low Anti-diuretic hormone (ADH) Diabetes insipidus w/ increased urine output, hypovolemia, increased thirst and osmolarity of plasma
Pituitary tumors cause diplopia(double vision), Head aches
HYPERpituitarism oversecretion of hormones from pituitary tumors(adenoma) or enlarged pituitary
Hyperpituitarism Disorder- Gigantism Increased GH before puberty , grow tall
Hyperpituitarism Disorder- Acromegaly Increased GH after puberty, enlarged hands and feet, protruding lower jaw, enlarged heart, lungs, and liver
Hyperpituitarism labs elevated PR>, ACTH, and GH most common
Causes of SIADH-Excess ADH malignant tumors lungs, pancreas, leukemia, hodgkins disease, head injury, pituitary surgery, barbiturates, anesthetics, diuretics
SIADH causes/intervention water retention and dilutional hyponatremia/restrict po fluids 500-600 ml/day
Diabetes insipidus causes head trauma, radiation to pituitary, cranial surgery, renal failure, infection, CVA
Diabetes insipidus treatment Hypotonic saline IV and giving ADH or Vasopressin
Adrenal Gland hyperfunctions Cushings, hyperaldosteronism, and pheochromocytoma
Hyperaldosteronism excess aldosterone, na retention, potasium excretion have htn, treated by adrenalectomy
Pheochromocytoma- adrenal tumor causing hypertension/ surgery to remove
Cushings too much ACTH from pituitary causes increase release of cortisol which is a glucocorticosteroid hormone from adrenal gland
additional causes of Cushings long term steroid medications to treat asthma, allergic responses, autoimmune disorders, after organ transplants
Cushing manifestations MUSCULO(weakness, wasting, prone fractures,osteoporosis), Moon face, buffalo hump
Skin/CNS Stria, contusions, hirsutism, prone breakdown/Psychoses, depression
GI/CV Ulcers & truncal obesity, GI bleeding/Hypertention
others Renal calculi, elevated glucose, decreased K+, increase Na+
Labs Cortisol elevated, Decreased K and Ca, Elevated Glucose and Na, 24 hour urine for coritsol, Dexamethason Suppression test
Treatment (for cushings) medication, radiation, surgery
ADDISON'S DISEASE Adrenal gland cortex hypofunction
Cortex produces aldostrone(mineralocorticoid) and cortisol (glucocorticoid)
Decrease ACTH causes decrease production of steroids
Addison's disease is causeed by autoimmune diseases that destroys cortex, abrupt withdrawal oflong term steroids, TB, CA, AIDS, Adrenalectomy, pituitary tumors, pituitary removal
In Addison's disease there is not enought aldosterone secreted from adrenal gland
Aldosterone retains sodium and water, w/o enough... Lose Na and water, retain K, hypovolemia, orthostatic hypotension, syncope, shock
Continue from ^above^ Loss of Na- dizziness, confusion, seizuresCV- tachycardia, increas K= arrest/ decreased cortisol decreases glucose level
Manifestation of Addison's Disease Skin- bronze or tan skin/ musculoskeletal- weakness & wasting/GI-Anorexia,N/V/D /Psychosocial- lethargic, depressed, confused to psychotic
Lab findings Cortisol,Na,and glucose decreased/ BUN and K increased/ CT to check pituitary tumors/ EKG look T waves(k)
Treatment Replace Cortisol: cortisone, hydrocortisone, prednisone, florinef, decadron, medrol, solu- medrol
What type of effects do these^ steroids have? Anti-inflammatory and immunosuppresant effects. They mask symptoms of infection and increase glucose levels
Created by: letta