Ch 48 Pituitary and adrenal disorders

Question 1

Posterior pituitary secretes what

Answer 1

Antidiuretic hormone (ADH), or vasopressin
Oxytocin

Question 2

Posterior pituitary(smaller lobe) is also known as

Answer 2

neurohypophysis

Question 3

What causes hyperpituitarism

Answer 3

excess production of one or more of the anterior

pituitary hormones

Question 4

Common factor of the hyperpituitarism is:

Answer 4

presence of a pituitary adenoma

Question 5

Hyperpituitarism can lead to:

Answer 5

Growth hormone and prolactin often in excess

Question 6

Overproduction of growth hormone can lead to

Answer 6

Gigantism or acromegaly

Question 7

Increased growth hormone without closed epiphysis plate causes what?

Answer 7

Makes the patient get taller leading to gigatism

Question 8

Overproduction of prolactin causes

Answer 8

Prolactinemia

Question 9

When the patient gets a tumor causing growth hormone to be released, it can no longer affect the epiphysis plate so it makes the bones wider and leads to:

Answer 9

Acromegaly

Question 10

More common than gigantism

Answer 10

Acromegaly

Question 11

Most patients with acromegaly

Answer 11

have pituitary macroadenomas that secrete excess growth hormone

Question 12

GH production occurs AFTER epiphyseal closure so bones increase in thickness and width instead of longitudinal growth

Answer 12

Acromegaly

Question 13

what systems in the body does patients with acromegaly affect in patients

Answer 13

Cerebrovascular, gastrointestinal, nervous system and gastro-urinary system.

Question 14

Assessment of acromegaly

Answer 14

Enlargement of the jaw, forehead, nose, tongue, and teeth, hands, and feet.
A soft doughy, damp handshake is characteristic of this disorder

Question 15

Assessment of acromegaly

Answer 15

Assess for a deep, hollow sounding voice

Assess for hemianopsia and loss of visual acuity

Question 16

Assessment of acromegaly

Answer 16

If surgery, determine what patient knows and expects
Remember to talk with them about body changes that are NOT reversible
If enlarged tongue assess respiratory alterations

Question 17

Intervention of acromegaly

Answer 17

Disturbed Body Image
Activity Intolerance
Chronic Pain
Ineffective Therapeutic Regimen Management

Question 18

Post operative nursing care for acromegaly

Answer 18

STRICT Intake and output because the patient is at risk for DI or SIADH

Question 19

Hypophysectomy

Answer 19

Surgery for acromegaly

Question 20

Post-operative nursing care of hypophysectomy

Answer 20

Neurologic status and vision must be monitored closely with particular attention to level
of consciousness, pupil size and equality, and vital signs.
Inspect nasal packing.
Signs and symptoms of infection

Question 21

Hypopituitarism

Answer 21

Inadequate secretion of GH occurs during preadolescence

Question 22

Dwarfism (attainment of a maximum height that is 40% below normal) as a result of

Answer 22

Hypopituitarism

Question 23

If growth has been completed and some pathologic process impairs
the function of the pituitary, this can lead to

Answer 23

Panhypopituitarism

Question 24

In this situation all hormones of the anterior pituitary are usually affected

Answer 24

Hypopituitarism

Question 25

What is SIADH

Answer 25

Blood = dilute
Decreased serum sodium
Decreased serum osmolality

Question 26

SIADH

Answer 26

Excess ADH secretion increases renal tubular permeability and reabsorption of
water into the circulation, resulting in excess extracellular fluid volume,
reduced plasma osmolality, increased glomerular filtration rates, and
decreased sodium levels.

Question 27

Diabetes Insipidus

Answer 27

Blood = concentrated
Increased serum sodium
Increased serum osmolality

Question 28

Diabetes Insipidus

Answer 28

Urine = dilute
Decreased urine sodium
Decreased urine osmolality

Question 29

What happens during diabetes insipidus

Answer 29

ADH deficiency leads to little or no water reabsorption
Which causes dilute urine formed in the more proximal parts of the nephron to be excreted essentially unchanged.
This loss of solute free water causes mild dehydration, a rise in plasma osmolality, and the stimulation of thirst

Question 30

SIADH

Answer 30

Urine =- CONCENTRATED
Increased sodium
Increased urine osmolality

Question 31

Addison’s disease

Answer 31

Adrenal insufficiency

Question 32

(Adrenal Insufficiency)
Decreased production of cortisol
Alters metabolism, decreases stress tolerance, emotional lability occurs in which condition?

Answer 32

Addison’s disease

Question 33

(Aldosterone deficiency)

Urinary loss of sodium, chloride, and water leading to dehydration and electrolyte imbalances occurs in what condition?

Answer 33

Addison’s disease

Question 34

(Androgen deficiency)

Loss of secondary sexual characteristics occurs in what condition?

Answer 34

Addison’s disease