Module 5 day 1

Question 1

What are the anterior pituitary gland hormones?

Answer 1

TSH, FH, LH, GH, ACTH, Prolactin

Question 2

What are the posterior pituitary gland hormones?

Answer 2

Oxytocin & Vasopressin (ADH)

Question 3

What is Acromegaly?

Answer 3

Too much of Growth Hormone

Question 4

What are some visible changes of a person who has Acromegaly?

Answer 4

Increasing head size, hands and feet, lower jaw protrusion, barrel chest

Question 5

What vision changes does a person who has Acromegaly have?

Answer 5

blindness & color distortion

Question 6

what changes should we be worried about?

Answer 6

Increase in intracranial pressure, ↓LOC, pupillary changes, widened pulse pressure, severe HTN, bradycardia, seizures

Question 7

What lab test is done for Acromegaly?

Answer 7

Growth hormone suppression test

Question 8

What diagnostic test is done to detect Acromegaly?

Answer 8

CT or MRI of the head to find soft tissue lesions (tumors)

Question 9

What medications are used for treatment of acromegaly?

Answer 9

Dopamine agonists (bromocriptine mesylate) & 
Growth hormone receptor blockers (pegvisomant)

Question 10

What 2 therapeutic procedures are done for acromegaly?

Answer 10

Transsphenoidal Hypophysectomy & Radiation Therapy

Question 11

What is a Transpheodial Hypophysectomy

Answer 11

removal of the pituitary gland

Question 12

What is Radiation Therapy?

Answer 12

shrinks pituitary tumor over time

Question 13

What pre-operative nursing care should be done for acromegaly therapeutic procedure?

Answer 13

No brushing teeth, blowing nose, coughing, or bending at the waist

Question 14

What post-operative nursing care should be done for acromegaly therapeutic procedure?

Answer 14

Monitor postnasal drainage to mustache dressing (drip pad) (folded 4x4 up against both nares) we want to see blood drainage.
Notify HCP of presence of glucose in the drainage (cerebral spinal fluid leakage) (test if note yellowish drainage).
High-Fowler’s position.
Administer replacement hormone (lifelong if radiation therapy).
Use oral rinses and flossing to clean teeth.
Diet high in fiber to minimize straining to defecate or stool softeners.

Question 15

What does SIADH stand for

Answer 15

Syndrome of Inappropriate Antidiuretic Hormone

Question 16

What is SIADH?

Answer 16

Excess secretion of antidiuretic hormone. Causes the body to retain water (stops the pee-pee)

Question 17

What are some example of causing SIADH? “think things that cause swelling”

Answer 17

Head trauma, Brain tumors, Cerebral edema, Infection (meningitis), Meds

Question 18

What are the symptoms of SIADH?

Answer 18

Headache (Early stage)
Weakness
Altered LOC
Cheyne-Stokes respirations (late stages)

Question 19

In SIADH is the urine concentrated or diluted?

Answer 19

concentrated

Question 20

In SIADH is the blood concentrated or diluted?

Answer 20

diluted

Question 21

Signs of fluid volume excess? (SIADH)

Answer 21

Hypertension, JVD, Crackles, weight gain, no swelling

Question 22

what does a person with SIADH urine look like?

Answer 22

sticky & dark

Question 23

What nursing management is done for a person with SIADH?

Answer 23

Restrict fluids
Monitor I/O
Daily weights
Monitor vital signs 
Monitor labs: decreased blood Na; elevated urine sodium
Monitor for heart failure
Neuro checks 
Reduce environmental stimuli 
Maintain seizure precautions

Question 24

What medications are given for SIADH?

Answer 24

Tetracycline derivative (demeclocycline)
Vasopressin antagonists (tolvaptan)
Loop diuretic – increase water excretion from the kidneys  (rare)