1 / 56

PITUITARY GLAND

PITUITARY GLAND. Where is it located??? Name its’ 3 parts or sections. What hormones are secreted by the pituitary gland???. Pituitary Gland. Anterior Pituitary (adenohypophysis). SECRETES 6+ HORMONES: ACTH (adrenocorticotropic hormone) aka (corticotrphin)

juliet
Download Presentation

PITUITARY GLAND

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. PITUITARY GLAND • Where is it located??? • Name its’ 3 parts or sections. • What hormones are secreted by the pituitary gland???

  2. Pituitary Gland

  3. Anterior Pituitary(adenohypophysis) • SECRETES 6+ HORMONES: • ACTH (adrenocorticotropic hormone) • aka (corticotrphin) release of cortisol in adrenal glands • TSH (thyroid stimulating hormone) • aka (thyrotropin) release of T3 & T4 in thyroid gland • GH (growth hormone) • aka (somatotropin) stimulates growth of bone/tissue

  4. ANTERIOR PITUITARY(adenohypophysis) • FSH (follicle stimulating hormone) stimulates growth of ovarian follicles & spermatogenesis in males • LH (lutenizing hormone) regulates growth of gonads & reproductive activities • Prolactin • aka (luteotropin/mammotropin) promotes mammary gland growth and milk secretion

  5. Positive vs Negative Feedback Mechanisms • Give some examples of • Negative • Positive

  6. Anterior HYPERpituitary Disorders • ETIOLOGY • Primary: the defect is in the gland itself which releases that particular hormone that is too much or too little. • Example: Cushings • Secondary: defect is somewhere outside of gland i.e. GHRH from hypothalamus TRH from hypothalamus

  7. Pituitary Tumors • 10% OF ALL BRAIN TUMORS • What are the diagnostic tests to diagnose a pituitary tumor? • tumors usually cause hyper release of hormones (Recall all hormones)

  8. Anterior HYPERpituitary Disorders • What would happen if you had TOO MUCH secretion of prolactin? • Too much release of Lutenizing Hormone (LH)?

  9. Anterior PituitaryHYPERfunctioning • What would happen if you had too much growth hormone secretion??? • Which goolish character on the Addam’s Family may have had too much GH secretion?

  10. Too Much Growth Hormone • GIGANTISM IN CHILDREN • skeletal growth; may grow up to 8 ft. tall and > 300 lbs • ACROMEGALY IN ADULTS • enlarged feet/hands, thickening of bones, prognathism, HTN, wt. gain, H/A, visual disturbances, diabetes mellitus, enlargement of the heart and liver

  11. GIGANTISM IN CHILDREN • ACROMEGALY IN ADULTS

  12. What assessment findings would the nurse document?

  13. What assessment findings would the nurse document?

  14. Medical Interventions for Pituitary Tumors • Medications • *Parlodel (bromocriptine) to ________ & GH levels. • Radiation therapy • external radiation will bring down GH levels 80% of time

  15. *Neurosurgery: • procedure called “transsphenoidal hypophysectomy”; New Method • Most common method: incision is made thru floor of nose into the sella turcica.

  16. Transsphenoidal Hypophysectomy

  17. Nursing Management &Nursing Diagnosis • Pre op hypophysectomy • Anxiety r/t • body changes • fear of unknown • brain involvement • chronic condition with life long care

  18. Nursing Management &Nursing Diagnosis • Sensory-perceptual alteration r/t visual field cuts • diplopia • secondary to pressure on optic nerve. • Alteration in comfort (headache) r/t tumor growth/edema

  19. Nursing Management &Nursing Diagnosis • Knowledge deficit r/t post-op teaching • pain control • ambulation • hormone replacement • activity

  20. Incisional disruption after transsphenoidal hypophysectomy Avoid bending and straining X 2 months post transsphenoidal hypophysectomy, Use stool softeners Avoid coughing Saline mouth rinses No toothbrushes for 7-10 days

  21. Post-op CSF Leak where sella turcica was entered any clear rhinorrhea - test for glucose + glucose = CSF Leak Notify physician HOB 30 degrees Bedrest

  22. Post op problems cont. Periocular edema/ecchymosis Headaches Visual field cuts/diplopia Meningitis

  23. Post operative care Post-op complications of hormone deficiency: What would happen if you didn’t have enough ADH? What is that disorder called?

  24. Other deficiency: • Decrease ACTH will require cortisone replacement due to decrease glucocorticoid production. • Can you live without glucocorticoids????

  25. Other deficiency: • in sex hormones can lead to infertility due to decreased production of ova & sperm • What were those hormones called again?

  26. Anterior PituitaryHYPOfunction • Etiology (rare disorder) may be due to disease, tumor, or destruction/removal of the gland. • Diagnostic tests • CT Scan • Serum hormone levels

  27. S & S Anterior Pituitary HYPOfunctioning • GH • FSH/LH • Prolactin • ACTH • TSH

  28. Medical Management • neurosurgery -- removal of tumor • radiation - tumor size • hormone replacement • cortisol, thyroid, sex hormones

  29. Nursing Management • Assessment of S & S of hypo or hyper functioning hormone levels • Teaching-Compliance with hormone replacement therapy • Counseling and referrals • Support medical interventions

  30. Posterior Pituitary(Neurohypophysis) What hormones are released by the posterior pituitary? _____ & _____are released when signaled by hypothalamus

  31. ADH (Vasopressin/AVP) • secreted by cells in the hypothalmus and stored in posterior pituitary • acts on distal & collecting tubules of the kidneys making more permeable to H20 -- or volume excreted?

  32. Bonus Round... • Under what conditions is ADH released? • ADH has vasoconstrictive or vasodilation action???

  33. http://www.cvphysiology.com

  34. Oxytocin • Controls lactation & stimulates uterine contractions • ‘Cuddle hormone’Research links oxytocin and socio-sexual behaviors

  35. Posterior HYPERpituitary Disorders • SIADH (TOO MUCH ADH!!) • small cell lung cancer, Ca duodenum/pancreas, trauma, pulmonary disease, CNS disorders • drugs -- Vincristine, nicotine, general anesthetics, tricyclic antidepressants

  36. Think tank: • If you have increased ADH secretion... What would the clinical signs/symptoms be?

  37. Clinical manifestations-SIADH • Weight gain or weight loss? • or urine output? • or serum Na levels? • thirst • weakness • muscle cramps • H/A • Diarrhea

  38. If hyponatremia worsens development of neurological manifestations • lethargy • decrease tendon reflexes • abdominal cramping, vomitting • coma • seizures

  39. Diagnostic Tests-SIADH • Serum Na+ <134meq/l • Serum osmolality <280 OSM/kg H2O • urine specific gravity >1.005 • or normal BUN

  40. Medical Treatment • ***FLUID RESTRICTION • Stop drugs causing issue • LIMIT TO 1000ML/24HRS • may be as little as 500-600ml/24hrs • IF CHF -- Lasix (temporary fix) • What do watch for? • Treat underlying problem • Chemo, radiation • demeclocycline (Declomycin) & Lithium • 600 po-1200mg/day to inhibit ADH

  41. Nursing Interventions-SIADH • Fluid restriction • Daily weights • 1 lb. weight = 500ml fluid retention • Accurate I & Os

  42. Nursing Management-SIADH • F & E imbalances • fluid intake • High risk for injury r/t complications of fluid overload (seizures)

  43. Posterior HYPOpituitaryADH Disorders Diabetes Insipidus (too little ADH)

  44. Etiology of DI • 50% idiopathic • Central (aka. neurogenic) • usually occurs suddenly • head trauma, brain tumors, infection • Nephrogenic • inability of tubules to respond to ADH • drug therapy, renal damage, heredity • Psychogenic • what is this?

  45. Clinical Manifestations-DI • Polydipsia • Polyuria (10L in 24 hours) • Severe fluid volume deficit • wt loss • tachycardia • constipation • Shock

  46. Diagnostic Tests-DI • or urine specific gravity orserum Na orserum osmolality

More Related