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Destruction of a pituitary gland; avascular necrosis of the anterior pituitary Tumors or Trauma
Lack
Before puberty : signs of delayed puberty Female Amenorrhea, Anovulation, Breast atrophy Male Small & soft testes; Lack of beard After puberty : secondary gonadal dysfunction : Decreased axillary & pubic hair, Decreased libido, Infertility, Fine facial wrinkles Female Menopause Male Testicular atrophy, Oligospermia, Azoospermia
Lack
Lack
Lack
Lack
Glucocorticoids Hypoglycemia, Lethargic, Generalized body malaise, headache Mineralocorticoids Hyponatremia - orthostatic Hypotension, Anorexia, Nausea & Vomiting Sex hormones (Androgens) Decreased axillary and pubic hair
Pituitary
crisis - Coma
Blood tests
Basal test: T3 & T4, testosterone & estradiol, LH/ FHS, TSH Stimulation test: GH, ACTH, TSH, LH / FSH, PRL
Skull Xrays
CT scan/ MRI Cerebral angiography
Goals: removing the underlying cause treating the hormone deficiencies addressing any other repercussions that arise from the hormone deficiencies
Prolactinomas: Dopamine agonist treatment Tumors: Super voltage or proton beam irradiation Diet: high calorie, high CHON If untreated = fatal
Monitor vital signs Monitor I & O Monitor weight daily Assess mental status, emotional state, energy level, and appetite Administer hormone replacements as prescribed Advise patient for a long-term follow up by specialists in Endocrinology
Explain to the patient: The need to take medication for the rest of the patients life The need for frequent laboratory tests Provide emotional support If the patient experiences fatigue: Instruct in methods to conserve energy
Observe emotional changes Assist in correcting underlying problems Assume all individuals are sensitive to changes in appearance but avoid stereotyping Set limits on maladaptive behavior and assist client to identify positive behaviors
Establish therapeutic nurse-client relationship Assist with treatment of underlying problems Provide factual information about individual conditions involved Provide information about availability of corrective measures such as medications Encourage client to engage in regular selfexamination, as indicated