Ch 49 disorders of anterior pituitary Flashcards
condition characterized by overproduction of GH from a tumor. can cause gigantism in children. can lead to hyperglycemia and vision changes
acromegaly
treatment options acromegaly (3)
- hypophysectomy
- radiation
- drug: octreotide
why is hyperglycemia common with acromegaly
growth hormone blocks action of insulin, causing glucose intolerance and S+S of diabetes
assessment findings acromegaly (6)
- change in ring size, hat size
- joint pain
- change in facial features
- organomegaly
- hypertension
- deepening of voice
treatment of choice for acromegaly
hypophysectomy
important nursing considerations for pts after hypophysectomy surgery (4)
- avoid vigorous coughing, sneezing and blowing nose
- avoid bending over
- avoid use of toothbrushes until incision heals
- keep hob atleast 30 degrees
what puts pt at higher risk for developing meningitis after hypophysectomy surgery
(fluid with glucose >30=) CSF leakage from open connection with brain through nose
what hormones need to be replaced lifelong after hypophysectomy surgery (3)
- ADH
- cortisol
- thyroid
2 potential complications after hypophysectomy surgery
diabetes insepidus
meningitis
possible causes SIADH (3)
- head injury
- cancer
- anesthesia
S+S SIADH (7)
- less urine output (INCREASED URINE OSMOLALITY)
- dilutional hyponatremia
- muscle cramps
- pain
- weakness
- weight gain
- DECREASED BLOOD OSMOLALITY
treatment mild SIADH (3)
- restrict fluid (800-1000 mL/day)
- maybe give furosemide
- maybe give demeclocycline
treatment severe SIADH (2)
- hypertonic IV solution (3%NaCl) at SLOW infusion rate
- restrict fluid (500 mL/day)
treatment chronic SIADH (3)
- give lithium
- hob <10 degrees
- restrict fluid (800-1000 mL/day)
is there too much or too little ADH made in SIADH
too much
