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Devilles, Rocel V.Felipe, Jam Marie S.
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Also known as the AnteriorPituitary Hypofunction
It refers to a term
panhypopituitarism
http://en.wikipedia.org/wiki/File:Illu_endocrine_system_New.pnghttp://en.wikipedia.org/wiki/File:Illu_endocrine_system_New.png
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Destruction of a pituitary gland; avascularnecrosis of the
anterior pituitary Tumors or Trauma
Chemotherapy, Radiotherapy, Pituitary resection
Autoimmune hypophysitis
Severe hemorrhage; hypovolemic shock
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Lack of gonadotropin (LH & FSH)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
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Lack of growth hormone (GH) Boneretardation
Lack of prolactin (PRL) Breast atrophy
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Lack of thyroxin stimulating hormone (TSH) Thyroid gland
hypofunctionT3 & T4 - Weight gain, Intolerance to cold;
Scalp
alopecia; Slowed cognition Thyrocalcitonin Hypocalcemia
- Orthosthatic hypotension,Anorexia, Nausea & Vomiting
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Lack of Adrenocorticotropic hormone ( ACTH) Glucocorticoids
Hypoglycemia, Lethargic, Generalized
body malaise, headache
Mineralocorticoids Hyponatremia
- orthostatic Hypotension, Anorexia, Nausea & Vomiting
Sex hormones (Androgens) Decreased axillary and pubic
hair
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Pituitary crisis - Coma
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Hx taking
Hemianopsia / Headache
Varying signs of hormonal disturbances:
Menstrual dysfunction
HypometabolismAdrenal insufficiency
Growth retardation
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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
http://en.wikipedia.org/wiki/File:Craniopharyngioma1.jpg
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Disturbed body image r/t illness
Sexual dysfunction r/t illness
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Goals:removing the underlying cause
treating the hormone deficiencies
addressing any other repercussions
that arise from the hormonedeficiencies
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Hormone replacement therapy Hydrocortisone (cortisol) for
adrenal insufficiency
Levothyroxine for hypothyroidism
Testosterone for male hypogonadism
Estradiol for female hypogonadism Growth hormone is available in
synthetic form
Cortrophin & Ambinon
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Prolactinomas: Dopamine agonist treatment
Tumors: Super voltage or proton beamirradiation
Diet: high calorie, high CHON
If untreated = fatal
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Monitor vital signs Monitor I & O
Monitor weight daily
Assess mental status, emotional state, energylevel, and
appetite
Administer hormone replacements asprescribed
Advise patient for a long-termfollow up by specialists in
Endocrinology
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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 inmethods to
conserve energy
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Observe emotional changes
Assist in correcting underlying problems
Assume all individuals are sensitive to
changes in appearance but avoidstereotyping
Set limits on maladaptive behavior andassist client to identify
positive behaviors
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Establish therapeutic nurse-clientrelationship
Assist with treatment of underlyingproblems
Provide factual information about individualconditions
involved
Provide information about availability of
corrective measures such as medications Encourage client to
engage in regular self-
examination, as indicated
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Surgical removal of tumors Transsphenoidal surgery
Craniotomy
