acromegaly, hypopit. & hyperaldo.

Question 1

The following flashcards are going to be from the endocrine disorders/problems blackboard recording video

Question 2

What is acromegaly?

Answer 2

an overproduction of growth hormone

Question 3

what is the usual cause of by patients develop acromegaly?

Answer 3

caused by a benign pituitary tumor

Question 4

how does acromegaly present itself in a patient?

Answer 4

overgrowth in hands, feet, face

Question 5

what are the major complications for patients who have acromegaly ?

Answer 5

thick tongue, hypertrophy of vocal cords, sleep apnea

Question 6

what are some complications, listing them through systems, that patients with acromegaly can experience?

skin
eyes
pancreas
endocrine
life span ?

Answer 6

skin thickens = leathery
vision changes from pressure
GH causes hyperglycemia
hyperlipidemia
life expectancy is decreased by 5-10 years

Question 7

what is the diagnosis for acromegaly ? (3)

Answer 7

testing of insulin-like growth factor 1

GH response to oral glucose tolerance test
(GH levels would fall normally, with acromegaly, levels are stable or increase)

MRI

Question 8

what is the treatment of acromegaly ?

Answer 8

transsphenoidal removal of pituitary gland with replacement of target hormone replacement
( steroids, thyroid hormone, sex hormones )

Question 9

how does a transsphenoidal work? surgery wise

Answer 9

up through the upper lip and goes up even further

Question 10

what are post-op care we are going to need to perform on a patient who is post-op from acromegaly removal? (3)

Answer 10

oral care Q4 hours
observe for transient DI
neurologic evaluation

Question 11

what are 3 things we are going to tell patients post-op care from acromegaly ?

Answer 11

no tooth brushing for 10 days

avoid valsalva ( straining )

surgery may result in infertility loss of FSH and LH

Question 12

now are going to talk about hypopituitary disorders

Question 13

what is the anterior pituitary hormones?

Answer 13

ACTH, TSH, FSH,LH, GH

Question 14

what is the posterior pituitary hormones?

Answer 14

ADH
oxytocin

Question 15

what is selective hypopituitarism ?

Answer 15

deficiency of one hormone

Question 16

what is panhypopituitarism?

Answer 16

deficiency of all pituitary hormones

Question 17

what is the most common reasons why patients end up developing hypopituitary disorders?

Answer 17

pituitary tumor
( most common ^ )

autoimmune disorder
infection
gland damage

Question 18

its important to note that when patients end up developing hypopituitary disorders, the symptoms are going to be what?

Answer 18

related to the hormone that is affected.

( meaning if you have two hormones, a & b, and a is being affected, you are only going to see symptoms that are related to A. nothing of B symptoms will show )

Question 19

If there is a tumor growing up in the pituitary, which more than often is the main cause for these disorders, what are we worrying about?

think about how the tumor is taking up space and where the pituitary is located

Answer 19

vision changes
loss of smells
n/v
seizures
headache

Question 20

what is the treatment for hypopituitarism ?

Answer 20

surgery ( transphenoidal or radiation )

Question 21

for post op management for patients with hypopitutairy, what do we want to monitor ?

Answer 21

vision changes
neuro function
mental status
hematoma affecting optic nerve
CSK leakage

Question 22

what do we want to educate patients on after post op care for hypopitu ?

Answer 22

no
noseblowing
coughing
sneezing
straining with bowel
for 48 hours

Question 23

additional information
what type of dressing do patients have after surgery for hypo pit?

Answer 23

mustache dressing
- we look for csf leakage
- halo sign

Question 24

most of the time
if we are removing the entire pituitary, we are more than likely replacing what?

Answer 24

all the hormones
- gh
- corticosteroids
- thyroid hormone
- sex hormones

Question 25

now we are going to talk about is hyperaldosteroinism

Question 26

hyperaldosteronism is another name for what?

Answer 26

conn’s syndrome

Question 27

excess aldosterone does what to our electrolytes? (2)

Answer 27

sodium and fluid retention
potassium & hydrogen excretion

Question 28

are 2 major complications from hyperaldosteronism?

Answer 28

hypertension
hypokalemic alkalosis

Question 29

what is primary hyperaldosteronism?

Answer 29

solitary adrenocortical adenoma
( tumor )

Question 30

what is secondary hyperaldosteronisms?

Answer 30

nonadreal cause
- renal artery stenosis
- renin secreting tumors
- chronic kidney disease

Question 31

since patients with hyperaldosteronism, they end up having hypernatremia, what does that put them at risk for ?

Answer 31

seizures, coma, death
( remember think of neuro when you see sodium )

Question 32

what are the symptoms associated with hypokalemia?

Answer 32

muscle weakness
faitgue
dysrhtymias
glucose intolernace
metabolic alkalosis - tetanty

Question 33

how do you diagnosis hyperaldosteronisms ?

Answer 33

lab tests

Question 34

how do we treat hyperaldosteronism?

Answer 34

adrenalectomy to remove adenoma

Question 35

before we go into surgery for patients with hyperaldosteronism, what do we have to do ?

Answer 35

potassium-sparing diuretics
antihypertensive
oral potassium supplements
sodium restrictions

Question 36

what medication will we use prior to starting surgery for patients with hyperaldosteronism and what does it do?

Answer 36

helps decrease/shrink the adrenal gland

dexamethasone

Question 37

nursing management of hyperaldosteronism

careful assessment
- fluid and electorally balance
- cardiovascular status

patient teaching
- medication and side effects
- signs and symptoms of hypokalemia and hyperklamiea
- blood pressure management