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- Diminished/deficient secretion of pituitary hormones. Can lead to gonadotropin deficiency with absence or regression of sex characteristics, GH deficiency, TSH deficiency
- -Most common organic cause is tumors in pituitary or hypothalamic region
- -Clinical manifestations: short stature, appear well nourished, relatively inactive, eruption of permanent teeth delayed, overcrowded teeth, sexual development usually delayed but normal.
Diagnostic evaluation of hypopituitarism:
- Aimed at isolating organic causes in addition to GH deficiency, may include hypothyroidism, oversecretion of cortisol, gonadal aplasia, chronic illness, nutritional inadequacy...
- Complete diagnostic eval: history, history of growth patterns and previous health status, physical exam, psychosocial eval, radiographic surveys, and endocrine studies.
- *Definitive diagnosis is based on absent or subnormal reserves of pituitary GH
Therapeutic management of hypopituitarism
Treatment of GH deficiency is directed towards correction of underlying disease process. **Definitive treatment is replacement of GH, which is 80% successfull.
Nursing care management of hypopituitarism
*identifying children with growth problems, establish diagnosis, provide education for pt self management (best when GH is given at bedtime)
- Excess GH before closure of epiphyseal shafts results in proprotional overgrowth of the long bones until the individual reaches 8 feet or more.
- -Vertical growth is followed with rapid and increased development of muscles and viscera, weight is proportional to height
- -If oversecretion of GH occurs after closure of epiphyseal plate, growth is in the transverse direction (acromegaly): big head, lips, nose tongue, jaw, increased facial hair,deeply creased skin, and tendency toward diabetesM.
Pituitary Hyperfunction: diagnosis
Based on history of excessive growth during childhood and evidence of increased levels of GH. radiographic studies may reveal tumor, enlarged bones, evidence of joint changes...