Hypopituitarism Disease with Causes and Nursing Intervention

Definition of Hypopituitarism Disease:

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

The most important 8 hormones are mentioned in the following:

1. Adrenocorticotropic hormone (ATCH)- Stimulates the adrenal gland to release cortisol. Cortisol helps to maintain blood pressure and blood sugar.
2. Anti-diuretic hormone (ADH)- Controls water loss by the kidneys.
3. Follicle-stimulating hormone (FSH)- Controls sexual function and fertility in males and females.
4. Growth hormone (GH)- stimulates the growth of tissues and bone.
5. Luteinizing hormone (LH)- Controls sexual function and fertility in males and females.
6. Oxytocins- Stimulate the uterus to contract during labor and the breasts to release milk.
7. Prolactine- Stimulates female breast development and milk production.
8. 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:

1. Tumor or carcinoma of the pituitary gland,
2. Head injury,
3. Brain surgery,
4. Radiation therapy to the head and neck area,
5. Infection or inflammation of the brain,
6. Stroke,
7. Necrosis of pituitary gland,
8. Subarachnoid hemorrhage,
9. Postpartum hemorrhage,
10. Hypovolemia and hypotension during delivery,
11. Infiltrative disease such as sarcoidosis,
12. Congenital hypopituitarism disease.

Sign and Symptoms of Hypopituitarism Disease:

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

1. Fatigue and weakness,
2. Decreased appetite,
3. Sensitivity to cold,
4. Slow growth,
5. Immature facial features and immature voice,
6. The slow growth of nails and thin hair,
7. Weight loss,
8. Delayed puberty,
9. Infertility (In women),
10. Uterine and vaginal atrophy,
11. Potential atrophy of breast tissues,
12. Oligomenorrhea or Amenorrhea,
13. Decreased sex drive,
14. 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 hemorrhage during childbirth),
15. Decreased serum level of prolactin,
16. Papilledema,
17. Low blood sugar,
18. Hydrocephalus,
19. Headache,
20. Visual disturbance,
21. Dizziness.

Diagnosis and Test of Hypopituitarism Disease:

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

1. Brain CT Scan,
2. Pituitary MRI,
3. Serum ACTH (Adrenocorticotropic hormone),
4. Serum Cortisol,
5. Serum Estradiol,
6. Serum FSH (Follicle-stimulating hormone),
7. Serum Luteinizing Hormone,
8. Serum testosterone level,
9. Serum TSH( Thyroid-stimulating hormone),
10. S.Free thyroxine (FT4 ),
11. Vision test.

Treatment for Hypopituitarism Disease:

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

1. Treatment of underlying cause,
2. 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),
• The 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 intervention for hypopituitarism disease are described below:

1. Monitor vital signs blood pressure, heart rate, and rhythm every 2 hours.
2. Assess lung and heart sounds 4 hourly, be alert for s/s of congestive heart disease
3. Watch for chest pain or dyspnea because hypothyroidism can develop chronic arteriosclerosis.
4. Monitor weight daily because ADH from the pituitary gland regulates fluid retention and excretion in the body.
5. Administer human growth hormone as prescribed.
6. Somatropin should be injected subcutaneously daily, preferably in the evening.
7. Teach patients that thyroid replacement therapy must be taken for a lifetime and administered in the morning on an empty stomach because thyroid medications can cause insomnia if taken at night.
8. Teaching patients to never miss any dose of medication without consulting with a physician.
9. Provide high protein, low-calorie fiber food.
10. Provide an iodine-rich diet, which is easily accomplished with iodized salt.
11. Instruct patient to avoid constipation and provide stool softeners.
12. Monitor laboratory tests for hormonal deficiencies until the patient completes hormone replacement therapy.
13. Administer replacement fluids, electrolytes, and glucose as prescribed by a physician to maintain normal serum levels.
14. Monitor intake and output to ensure the balance are equal due to hormone regulation.
15. Monitor physical and mental status and Encourage patients to express their feelings.
16. Instruct the patient when sleeping with a head elevation position to reduce trauma to the eye.
17. Teach patients to change positions slowly and to notify healthcare providers immediately if they develop an increased or irregular pulse, palpitations, nervousness, heat intolerance, diarrhea, sweating, or irritability.
18. Encourage clients to ask about the issue of face.
19. Encourage clients to discuss the issue of sexual dysfunction with their partners.
20. Generate patient motivation to continue the treatment program regularly.
21. Give the clients a chance to meet their needs independently.
22. Make a mutual trust relationship with the client.
23. Provide emotional and psychological care that patients feel comfortable.
24. Give skincare and encourage patients to perform regular skincare.
25. If the patient has cold sensitivity, keep the patient warm, and provide extra clothing, and avoid the patient getting chilled.
26. Avoid using heating pads and electric blankets because of the risk of peripheral vasodilation.
27. Refer the family for psychological counseling.
28. Observe eyelids, nail beds, and skin pallor which indicate anemia.
29. Ensure safety precautions for patients with the impaired visual field.
30. Wet the eye with sterile water to provide comfort to the eye.

More questions related to this topic:

1. Hypopituitarism (Panhypopituitarism): Background.
2. Hypopituitarism – Hormonal and Metabolic Disorders.
3. Overview – Hypopituitarism
4. Types of Hypopituitarism.
5. Hypopituitarism. Medical information about Hypopituitarism.
6. Hypopituitarism in Kids: Definition, Symptoms, Treatment.
7. How Common is Hypopituitarism?
8. What is Hypopituitarism? | The Symptoms of Hypopituitarism.
9. Hypopituitarism: Causes, Symptoms, & Treatment.
10. Hypopituitarism Definition.
11. Hypopituitarism Causes.
12. What are the Symptoms of Panhypopituitarism?
13. Hypopituitarism Symptoms.
14. Hypopituitarism Disease Symptoms.
15. Hypopituitarism Diagnosis.
16. Hypopituitarism Disease Diagnosis.
17. Hypopituitarism Treatment.
18. Hypopituitarism Disease Treatment.

Maria Mona

Maria Khatun Mona is a Founder and Editor of Nursing Exercise Blog. She is a Nursing and Midwifery Expert. Currently she is working as a Registered Nurse at Evercare Hospital, Dhaka, Bangladesh. She has great passion in writing different articles on Nursing and Midwifery. Mail her at “maria.mona023@gmail.com”