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:
- 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 the growth of tissues and bone.
- Luteinizing hormone (LH)- Controls sexual function and fertility in males and females.
- Oxytocins- Stimulate the uterus to contract during labor 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 the pituitary gland,
- Head injury,
- Brain surgery,
- Radiation therapy to the head and neck area,
- Infection or inflammation of the brain,
- Necrosis of pituitary gland,
- Subarachnoid hemorrhage,
- Postpartum hemorrhage,
- Hypovolemia and hypotension during delivery,
- Infiltrative disease such as sarcoidosis,
- 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:
- Fatigue and weakness,
- Decreased appetite,
- Sensitivity to cold,
- Slow growth,
- Immature facial features and immature voice,
- The 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 hemorrhage during childbirth),
- Decreased serum level of prolactin,
- Low blood sugar,
- Visual disturbance,
Diagnosis and Test of Hypopituitarism Disease:
Various diagnosis ways and test for hypopituitarism disease are given in below:
- Brain CT Scan,
- Pituitary MRI,
- Serum ACTH (Adrenocorticotropic hormone),
- Serum Cortisol,
- Serum Estradiol,
- Serum FSH (Follicle-stimulating hormone),
- Serum Luteinizing Hormone,
- Serum testosterone 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),
- 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:
- 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 disease
- Watch for chest pain or dyspnea because hypothyroidism can develop chronic arteriosclerosis.
- Monitor weight daily because ADH from the pituitary gland regulates fluid retention and excretion in the body.
- Administer human growth hormone as prescribed.
- Somatropin should be injected subcutaneously daily, preferably in the evening.
- 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.
- Teaching patients to never miss any dose of medication without consulting with a physician.
- Provide high protein, low-calorie fiber food.
- Provide an iodine-rich diet, which is easily accomplished with iodized salt.
- Instruct patient to avoid constipation and provide stool softeners.
- Monitor laboratory tests for hormonal deficiencies until the patient completes hormone replacement therapy.
- Administer replacement fluids, electrolytes, and glucose as prescribed by a physician to maintain normal serum levels.
- Monitor intake and output to ensure the balance are equal due to hormone regulation.
- Monitor physical and mental status and Encourage patients to express their feelings.
- Instruct the patient when sleeping with a head elevation position to reduce trauma to the eye.
- 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.
- Encourage clients to ask about the issue of face.
- Encourage clients to discuss the issue of sexual dysfunction with their partners.
- Generate patient motivation to continue the treatment program regularly.
- Give the clients a chance to meet their needs independently.
- Make a mutual trust relationship with the client.
- Provide emotional and psychological care that patients feel comfortable.
- Give skincare and encourage patients to perform regular skincare.
- If the patient has cold sensitivity, keep the 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 counseling.
- Observe eyelids, nail beds, and skin pallor which indicate anemia.
- Ensure safety precautions for patients with the impaired visual field.
- Wet the eye with sterile water to provide comfort to the eye.
More questions related to this topic:
- Hypopituitarism (Panhypopituitarism): Background.
- Hypopituitarism – Hormonal and Metabolic Disorders.
- Overview – Hypopituitarism
- Types of Hypopituitarism.
- Hypopituitarism. Medical information about Hypopituitarism.
- Hypopituitarism in Kids: Definition, Symptoms, Treatment.
- How Common is Hypopituitarism?
- What is Hypopituitarism? | The Symptoms of Hypopituitarism.
- Hypopituitarism: Causes, Symptoms, & Treatment.
- Hypopituitarism Definition.
- Hypopituitarism Causes.
- What are the Symptoms of Panhypopituitarism?
- Hypopituitarism Symptoms.
- Hypopituitarism Disease Symptoms.
- Hypopituitarism Diagnosis.
- Hypopituitarism Disease Diagnosis.
- Hypopituitarism Treatment.
- Hypopituitarism Disease Treatment.
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 “[email protected]”