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Adult Medical-Surgical Nursing Endocrine Disorders Module: Anterior Pituitary Hypersecretion: Growth Hormone Growth Hormone.

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Presentation on theme: "Adult Medical-Surgical Nursing Endocrine Disorders Module: Anterior Pituitary Hypersecretion: Growth Hormone Growth Hormone."— Presentation transcript:

1 Adult Medical-Surgical Nursing Endocrine Disorders Module: Anterior Pituitary Hypersecretion: Growth Hormone Growth Hormone

2 The Anterior Pituitary: Hormones  Growth Hormone (Somatotropin)  Thyroid Stimulating Hormone (TSH)  Adrenocorticotrophic Hormone (ACTH)  Follicle Stimulating Hormone (FSH)  Luteinising Hormone (LH)  Prolactin  Melanocyte Stimulating Hormone

3 Anterior Pituitary: Hypersecretion  Related to a pituitary adenoma, usually a benign tumour of the pituitary gland  A space-occupying lesion  Results in increased hormone secretion

4 Anterior Pituitary: Hypersecretion  Most common disorders are related to hypersecretion of:  Growth Hormone (eosinophilic cells)  ACTH (basophilic cells)  Prolactin (Prolactinoma)

5  Growth Hormone

6 Functions of Growth Hormone  Growth and repair of bone and soft tissue by:  Protein synthesis  Mobilisation of glucose and fatty acids  GH stimulates liver to produce Somatomedin-C (IGF-1) mediated by Somatostatin (GH release inhibiting hormone) under control of Hypothalamus)  Production increased during deep sleep

7 Pituitary Adenoma: Hypersecretion of Growth Hormone  Hypersecretion leads to:  Uncontrolled growth of bone and soft tissue  Uncontrolled mobilisation of stored fat increasing levels of fatty acids and glucose in circulation

8 Hypersecretion of Growth Hormone  Uncontrolled growth leads to:  Gigantism in young (very tall, exhaustion)  Acromegaly in adults

9 Hypersecretion of Growth Hormone Acromegaly: Clinical Manifestations  Large jaw, forehead, cheek bones, hands, feet  Enlargement of heart and all soft tissues  Hypertension

10 Hypersecretion of Growth Hormone Clinical Manifestations (cont)  Uncontrolled mobilisation of stored fat →  Atherosclerosis and hypertension  Truncal obesity, muscle-wasting  Diabetic tendency  Menstrual disturbances  FATIGUE  Visual disturbance, headache, neuropathy related to space-occupying lesion

11 Hypersecretion of Growth Hormone Diagnosis  History and clinical picture  Brain MRI  CT with contrast  Blood hormone levels especially Somatomedin-C  GTT (assessment of GH after glucose)

12 Hypersecretion of Growth Hormone Medical Treatment  GH (may stabilise levels reducing secretion)  Octreotide: synthetic Somatostatin (lowers level GH secretion)  Carbelogine: (Dopamine agonist) ↓ GH secretion  Somavere: GH receptor antagonist

13 Hypersecretion of Growth Hormone Neurosurgical Management  Surgery: trans-sphenoidal excision of pituitary adenoma  Craniotomy: removal of tumour or hypophysectomy (removal of gland)  Radiation prior to surgery to reduce size or instead of surgery if inaccessible  Gamma knife to target deep tissue

14 Hypersecretion of Anterior Pituitary: Nursing Considerations  Patient education and support  Post-neurosurgery: care in ICU  Elevate head of bed 30 0 ( ↓ ICP ↑ drainage)  Watch conscious level/ no convulsion  Monitor vital signs (infection risk/ haemodynamics)  Fluid balance (risk of Diabetes Insipidus)  Administer medications as prescribed: Dexamethasone, Epanutin, Antibiotics,HRT


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