HYPOPITUITARISM :

Hypopituitarism Disease with Causes and Nursing Intervention

Definition of Hypopituitarism Disease:

Hypopituitarism disease is a clinical syndrome in which pituitary gland fails to produce normal amounts of one or more hormone. Pituitary gland produce 8 hormones, when it unable to supply one or more of hormone that affect normal body function such as growth, blood pressure, reproduction etc.

Hypopituitarism disease

The most important 8 hormones are mentioned in the following:

Adrenocorticotropic hormone (ATCH)- Stimulates the adrenal gland to release cortisol. Cortisol helps to maintain blood pressure and blood sugar.Anti-diuretic hormone (ADH)- Controls water loss by the kidneys.Follicle stimulating hormone (FSH)- Controls sexual function and fertility in males and females.Growth hormone (GH)- Stimulates growth of tissues and bone.Liteinizing hormone (LH)- Controls sexual function and fertility in males and females.Oxytocins- Stimulate the uterus to contract during labour and the breasts to release milk.Prolactine- Stimulates female breast development and milk production.Thyroid stimulating hormone (TSH)- Stimulates the thyroid gland to release hormones that affect the body’s metabolism.

Causes of Hypopituitarism Disease:

Various types of causes for hypopituitarism disease are in the below:

Tumor or carcinoma of pituitary gland,Head injury,Brain surgery,Radiation therapy to head and neck area,Infection or inflammation of brain,Stroke,Necrosis of pituitary gland,Subarachnoid haemorrhage,Post partum haemorrhage,Hypovolemia and hypotension during delivery,Infiltrative disease such as sarcodosis,Congenital hypopituitarism disease.

Sign and Symptoms of Hypopituitarism Disease:

There are different types of sign and symptoms for hypopituitarism disease, which are mentioned in the following:

Fatigue and weakness,Decreased appetite,Sensitivity to cold,Slow growth,Immature facial features and immature voice,Slow growth of nails and thin hair,Weight loss,Delayed puberty,Infertility (In women),Uterine and vaginal atrophy,Potential atrophy of breast tissues,Oligomenorrhea or Amenorrhea,Decreased sex drive,Failure to lactate in the postpartum women (Sheehan’s syndrome- Sheehan’s syndrome is a condition that may occur in a woman who has a severe uterine haemorrhage during childbirth),Decreased serum level of prolactin,Papilledema,Low blood sugar,Hydrocephalus,Headache,Visual disturbance,Dizziness.

Diagnosis and Test of Hypopituitarism Disease:

Various diagnosis ways and test for hypopituitarism disease are given in the below:

Brain CT Scan,Pituitary MRI,Serum ACTH (Adrenocorticotropic hormone),Serum Cortisol,,Serum Estradoil,Serum FSH (Follicle stimulating hormone),Serum Lutinizing Hormone,Serum testerone level,Serum TSH( Thyroid stimulating hormone),S .Free thyroxine (FT4 ),Vision test.

Treatment for Hypopituitarism Disease:

There are different numbers of treatment for hypopituitarism disease, those are mentioned in the following:

Treatment of underlying cause,Hormone therapy:Corticosteroids (cortisol) for adrenal insufficiency,Growth hormone,thyroid hormone-Levothyroxine for hypothyroidism,Sex hormone-Testosterone for male hypogonadism, and Estradiol for female hypogonadism (usually with a progestogen to inhibit unwanted effects on the uterus),Antidiuretic hormone can be replaced by desmopressin (DDAVP) tablets or vasopressin nose spray,Somatotropin (recombinant human growth hormone) is used to treat growth hormone deficiency.

Nursing Intervention for Hypopituitarism Disease:

Various nursing interventions for hypopituitarism disease are described in the below:

Monitor vital signs blood pressure, heart rate and rhythm every 2 hours.

Assess lung and heart sounds 4 hourly, be alert for s/s of congestive heart diseaseWatch for chest pain or dyspnea because hypothyroidism can develop chronic arteriosclerosis.

Monitor weight daily because ADH from pituitary gland regulates fluid retention and excretion in the body.

Administer human growth hormone as prescribed.Somatropin should be injected subcutaneously on a daily basis, preferably in the evening.

Teach patients that thyroid replacement therapy must be taken for lifetime and administered in the morning on an empty stomach because thyroid medications can cause insomnia if taken at night.

Teaching patient to never miss any dose of medication without consulting with physician.

Provide high protein, low calorie fibre food.Provide iodine rich diet, which is easily accomplished with iodized salt.

Instruct patient to avoid constipation and provide stool softeners.

Monitor laboratory test for hormonal deficiencies until the patient completes hormone replacement therapy.

Administer replacement fluids, electrolytes, and glucose as prescribed by physician to maintain normal serum levels.

Monitor intake and output to ensure the balance is equal due to hormone regulation.

Monitor physical and mental status and Encourage patient to express their feelings.

Instruct the patient when sleeping with head elevation position to reduce trauma to the eye.

Teach patients to change positions slowly and to notify healthcare provider immediately if they develop an increased or irregular pulse, palpitations, nervousness, heat intolerance, diarrhoea, sweating or irritability.

Encourage clients to ask about the issue of face.Encourage clients to discuss the issue of sexual dysfunction with partner.Generate patient motivation to continue the treatment programme on a regular basis.Give the clients a chance to meet their needs independently.Make a mutual trust relationship with client.

Provide emotional and psychological care that patient feel comfort.

Give skin care and encourage patient to perform regular skin care.If patient have cold sensitivity, keep patient warm and provide extra clothing and avoid the patient getting chilled.

Avoid using heating pads and electric blankets because of the risk of peripheral vasodilation.Refer the family for psychological counselling.

Observe eyelids, nails beds and skin pallor which indicate anemia.

Ensure safety prequitions for patients with impaired visual field.Wet the eye with sterile water to provide comfort to the eye