Fn2 test 4[1].txt

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    • author "me"
    • fileName "Fn2 test 4"
    • tags "Endo"
    • description ""
    • causes of pituitary problems
    • Overrsecretion
    • Undersectrion
    • Receptor site failure
  1. What is hypopituitarism
    • Deficiency of one or more anterior pituitary hormones
    • Deficiencies of ACTH and TSH and the most life threatening (result in corresponding dec in secretion of vital hormones from the adrenal and thyroid gland)
    • Defic. Of gonadotropins (LH,FSH) change sexual function
    • Def of growth hormone
  2. Growht hormone deficiensy (somatropin)
    • Normal at birth
    • Growth patterns progressively deviate, often beginning in infancy
    • Short stature
    • Growth retardation: dwarfisim"
    • Sexual development usually normal but delayed
    • Appear younger than age and others frequently relate to them in childish ways
  3. G.H. Deficiency teatment
    • Recombinant growth hormone
    • Somatroping (genotropin, nutropin)
    • Typically show immediate inc in growth and may inc 12 in or ore in ht over several years of treatment
    • Ultimately, resistance develops to the PRO and growth tapers off
    • SC or IM
    • Given at bedtime to most closely approximate physiologic release of GH
    • Should not be given to adolescents whose epiphyses have sealed
  4. Causes of hyperpituitarism
    • Hormone oversecretion
    • Hypothalmic dyffunction
  5. Hormone oversectretion
    • Primary cause is the presence of pituitary adenoma
    • Causes: gigantism and acromegaly
  6. Hypothalmic dysfunction
    Excessive amounts of releasing hormones are produced and then overstimulate the normal pituitary gland
  7. gigantism
    • Onset occurs before puberty
    • Rapid proportional growth in the length of this bones
    • May have delayed closure of fontanels
  8. Acromegaly
    • Continues past puberty
    • Early diagnosis and treatment essential to prevent irreversible changes in soft tissue
    • Skeletal changes permanent
  9. Manifesttions of overproduction of gh
    • Changes in facial features
    • Arthritic changes
    • Vision changes
    • Inc perspiration and oil secretion
    • Organomegaly
    • Htn
    • Dysphagia
    • Deepening of voice
    • Hypersescretion of PRL
    • Hypogonadism
    • Galactorrhea
    • Hypertrophy of skin
    • In skeletal thickness
    • Hyperglycemia
  10. Changes in facial features
    • Inc lip and nose size
    • Inc head, hand and foot size
    • Prominent supraorbital ridge
    • Prognathism(lower jaw protrudes out
    • Difficulty chewing
  11. Arthritic changes
    • Degeneration of joint cartilage
    • Joint pain
    • Dec mobility
  12. therapeutic management of over production of gh
    • Surgical
    • External ratiation
    • Radioactive implants
  13. Nursing considerations for overproduction of gh
    • Early identification of excessive growth rates
    • Emotional support
  14. Precocious puberty
    • Manifestations of sexual development before age 9 in boys and 8 in girls
    • Monthly SC luteinizing hormone-releasing hormone(Lupron)
    • --regulates pituitary secretions
    • --slows prepubertal growth to normal rates
    • --discontinued in time to allow normal pubertal changes to occur
  15. Primary hypothyroidism
    Thyroid cant produce amount of hormones pituitary calls for
  16. Secondary hypothyroidism
    Thyroid isnt being stimulted by pituitary to produce hormones
  17. Hypothyroidism---congenital cretinism
    • Apear normal at birth
    • If not detected irreversible brain damage and physical signs of develop
    • Neonatal screening mandatory
    • Hormone replacement
    • Bone age surveys so ensure optimum treatment
    • Normal physical growth and intelligence if treatment started shortly after birth
  18. Nursing care for cretinism
    • Early ID
    • Be suspicious of:
    • --unusally wuiet and good baby
    • --prolonged jaundice
    • --constipation
    • --umbilical hernia
    • Life long therapy
    • Synthroid
    • Breast feeding acceptable
  19. Drug therapy for cretinism
    Signs of overdose
    Inadequate tx
    • S.o.: rapid pulse
    • --dyspnea
    • --irritability
    • --insomnia
    • --fever
    • --sweating
    • --wt loss
    • I,t,--fatigue
    • --sleepiness
    • --dec appetite
    • --constipation
  20. Juvenile hypothyroidism: manifestations
    • Develops after neonatal period but before puberty
    • Stunted growth (earliest sign)**
    • Dry skin
    • Puffiness around eyes
    • Sparse hai
    • Constipation
    • Sleepiness
    • Mental decline
    • Tx:lthyroxine
  21. Lymphocytic thyroiditis
    Chronic: hashimotos disease
    • Autoimmune diorder
    • Strong genetic predisposition
    • Thyroid becomes invaded with antithyroid antibodies and lymphocytes, causing thyroid tissue destrcution (replaced with fibrous tissue)
    • More freq after 6 years reaching peak in adolescence
  22. Manifestations of lymphocytic throiditis
    • Painless goiter
    • Tracheal compression*****
    • --sense of fullenss
    • --hoarseness
    • --dysphagia
    • Most children euthyroid, but may be hypo- or hyper-thyroid
  23. Thyroiditis management
    • In many cases, goiter regresses spontaneously within a yr or two
    • Thyroid hormone**
    • --supresses TSHsecretion
    • --surgery (subtotal thyroidectomy) if goiter does not respond to thyroid horone if it compresses other structures
    • Reassure that condition is probably temporary
  24. Goiter
    • May be mild and noticeable when inc demand TH(rapid growth)
    • Can cause resp distress
    • --if born with it, immediate precautions instituted for emergency vent
    • --position neck hyperextended to breath
    • Immediate surgery to remover part of glane may be life saving
    • THreplacement tx the hypothyroidism and reverse the TSH effect on the gland
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Fn2 test 4[1].txt
2012-05-01 13:15:52
FN2 52 endo

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