Pituitary Gland Disorders

Define Acromegaly

Overproduction of growth hormone

Acromegaly s/s? (3)

• Thickening and enlargement of face, feet, and head

• Visual changes

• Tongue enlargement

Diagnostic study for Acromegaly?

CT scan to detect pituitary adenoma (common underlying cause)

Define Transphenoidal Hypophysectomy

Surgical procedure through the nose to remove pituitary tumor

Nursing interventions for Transphenoidal Hypophysectomy? (3)

• Assess nasal/ear draining (csf?)

• Elevate HOB (decrease ICP)

• Avoid bending/straining (increase ICP)

Define SIADH

Increased ADH → increased water reabsorption → decreased serum osmolality & fluid excess

Establish the following for SIADH:
Serum Sodium
Serum Osmolality
Urine Output
Urine Specific Gravity

• Low sodium (diluted by water)

• Diluted serum osmolality (low)

• Low UOP (increased anti-diuretic hormone)

• High urine gravity (concentrated urine)

Key general s/s of SIADH?

• Fluid volume excess

• Neuro changes (very low Na+)

Key CV findings of SIADH?

• HTN (early)

• Tachycardia

• CHF (late)

Key medications for SIADH? (4)

• Furosemide

• Demeclocycline (increases UOP)

• Vasopressin Antagonist

• Sodium 3% saline IV

Nursing considerations for SIADH? (4)

• Frequent oral care (fluid restriction)

• HOB no more than 10 degrees elevated (fluid shifts → seizure risk)

• Seizure + fall precautions

• Frequent turning + positioning

Diet/fluid considerations for SIADH?

• Limit fluid intake (800-1000mL/day)

• Daily weights after peeing

Define DI

Decreased ADH → decreased water reabsorption → increased serum osmolality & fluid deficit

Establish the following for DI:
Serum Sodium
Serum Osmolality
Urine Output
Urine Specific Gravity

• High sodium (decreased water)

• Increased serum osmolality (high)

• High UOP (decreased anti-diuretic hormone)

• Low urine gravity (diluted urine)

Key general s/s of DI? (4)

• Fluid volume deficit

• Polyuria

• Polydipsia

• Dehydration

Key CV findings of DI? (2)

• Hypotension

• Shock (late)

Key medications for DI? (2)

• Vasopressin

• Carbamazepine (control thirst)

Nursing considerations for DI?

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