Endocrine Disorders
Pituitary Disorders
Diabetes Insipidus Syndrome of Inappropriate Antidiuretic
Hormone
⬇️ 🠇 ADH ⬆️ 🠅 ADH
⬇️ 🠇 Urine specific gravity (dilute) ⬆️ 🠅 Urine spec gravity (concentrated)
⬇️ 🠇 Fluid Volume ⬆️ 🠅 Fluid volume
⬆️ 🠅 Urine output ( polyuria) ⬇️ 🠇 urine output ( oliguria)
⬆️ 🠅 Sodium ⬇️ 🠇 Sodium
⬆️ 🠅 Blood osmolality ⬇️ 🠇 Blood osmolality
⬇️ 🠇 B/P ⬆️ 🠅 B/P
Monitor: Monitor
FVD FVO
Neuro Neuro - decreased LOC & seizures
Shock- hypovolemic Brain swelling
Possibly caused by lung cancer
TX: Hyperactive gland
DDAVP, Desmopressin TX:
Desmopressin antagonist or surgery
, hypopituitarism Acromegaly
⬇️ 🠇 GH ⬆️ 🠅 GH
⬇️ 🠇 Height ⬆️ 🠅 Hands,feet, organs and features
Monitor Monitor
Psychosocial First sx Visual disturbances/HA
Age appropriate activities and attire Increased ring and shoe size
Height 3rd percentile -concern Organ enlargement heart failure/high
Early treatment -better cholesterol, DMl) and joint pain
Psychosocial-irreversible changes
DX growth hormone suppression (NPO prior)
During this test, your GH blood level is
measured both before and after you drink a
preparation of sugar (glucose). In people who
don't have acromegaly, the glucose drink
typically causes the GH level to fall. But if you
have acromegaly, your GH level will tend to
stay high.
Tx: Tx:
Somatotropin injections before closure of Meds or surgery to reduce GH (dopamine
growth plate agonist-inhibit GH)
Worse HA/visual changes=Possible
enlargement of tumor
Soft diet
Monitor organ function
Hypophysectomy
Preop- neurological status Monitor:
Education: NO increased ICP avoid Sx of CSF leak
coughing, sneezing, nose blowing, straining Consistent swallowing, drainage of clear
for BM fluid
Halo and positive glucose may be CSF
Hormone replacement therapy Sx of DI
Increased thirst and urine output
Tx stool softener, cough suppressant
Pituitary Disorders
Diabetes Insipidus Syndrome of Inappropriate Antidiuretic
Hormone
⬇️ 🠇 ADH ⬆️ 🠅 ADH
⬇️ 🠇 Urine specific gravity (dilute) ⬆️ 🠅 Urine spec gravity (concentrated)
⬇️ 🠇 Fluid Volume ⬆️ 🠅 Fluid volume
⬆️ 🠅 Urine output ( polyuria) ⬇️ 🠇 urine output ( oliguria)
⬆️ 🠅 Sodium ⬇️ 🠇 Sodium
⬆️ 🠅 Blood osmolality ⬇️ 🠇 Blood osmolality
⬇️ 🠇 B/P ⬆️ 🠅 B/P
Monitor: Monitor
FVD FVO
Neuro Neuro - decreased LOC & seizures
Shock- hypovolemic Brain swelling
Possibly caused by lung cancer
TX: Hyperactive gland
DDAVP, Desmopressin TX:
Desmopressin antagonist or surgery
, hypopituitarism Acromegaly
⬇️ 🠇 GH ⬆️ 🠅 GH
⬇️ 🠇 Height ⬆️ 🠅 Hands,feet, organs and features
Monitor Monitor
Psychosocial First sx Visual disturbances/HA
Age appropriate activities and attire Increased ring and shoe size
Height 3rd percentile -concern Organ enlargement heart failure/high
Early treatment -better cholesterol, DMl) and joint pain
Psychosocial-irreversible changes
DX growth hormone suppression (NPO prior)
During this test, your GH blood level is
measured both before and after you drink a
preparation of sugar (glucose). In people who
don't have acromegaly, the glucose drink
typically causes the GH level to fall. But if you
have acromegaly, your GH level will tend to
stay high.
Tx: Tx:
Somatotropin injections before closure of Meds or surgery to reduce GH (dopamine
growth plate agonist-inhibit GH)
Worse HA/visual changes=Possible
enlargement of tumor
Soft diet
Monitor organ function
Hypophysectomy
Preop- neurological status Monitor:
Education: NO increased ICP avoid Sx of CSF leak
coughing, sneezing, nose blowing, straining Consistent swallowing, drainage of clear
for BM fluid
Halo and positive glucose may be CSF
Hormone replacement therapy Sx of DI
Increased thirst and urine output
Tx stool softener, cough suppressant
