MEDICAL SURGICAL NURSING 2 DENN HILL RIOROSO
1
“ENDOCRINE DISORDERS”
HYPERPITUITARISM
• Hyperplasia of pituitary tissue
• Prolactinomas account for 60-80% of all pituitary
hormones
• Bitemporal Hemianopia because of compressed Optic
nerve due to increased size of prolactin
• Homogenous hemianopia (kalahati lang nakikita sa
isang side ng mata)
ASSESSMENT:
✓ Over production of growth hormone
✓ Neurologic Manifestation
✓ Hemianopia
✓ Scotomas or blindness
✓ Somnolence due to pressure
✓ Increased ICP
✓ Behavioral changes, seizure
✓ Disturbance in appetite, sleep, temperature
✓ Endocrine manifestation
✓ Oligomenorrhea, amenorrhea
✓ Infertility
✓ Dyspareunia (pain during sex)
✓ Decreased libido and impotence
✓ Galactorrhea
MANAGEMENT:
▪ Transsphenoidal Hypophysectomy
o Keep head elevated for 2 weeks due to increased
ICP
o Maintain nasal packing due to increased secretion
o Provide oral care
o Instruct to avoid blowing nose that increase ICP
o Monitor for postnasal drip, it may indicate CSF
o Report urine spG is below 1.004 indicated DI
o Normal urine spG 1.010-1.030
o Administer glucocorticoids – to compensate don sa
tinanggal
o CARDINAL SIGN OF INCREASED ICP =
Hyperthermia, hypertension, bradycardia,
bradypnea, headache, wide pulse pressure
▪ Radiation therapy
▪ Parlodel to lower GH and prolactin levels
HYPOPITUITARISM
• Simmonds’s Disease – total absence of all pituitary
hormones
• Sheehan’s Syndrome – cause by post-partum pituitary
necrosis
CAUSES:
Tumors
Trauma
Encephalitis
Autoimmunity
Stroke
Surgery
Radiation of pituitary gland
ASSESSMENT:
✓ Mild to moderate obesity
✓ Infertility
✓ Fatigue,
✓ Hypotension
✓ Hemianopsia
