1. Acromegaly ( GH): irreversible.most common is tumor of anterior pituitary 2. acromegaly DX an !

X: D" plasma# presence of somatome in $# glucose levels !" tumor removal by cranial%transp&enoi al &ypop&ysectomy '. acromegaly nursing consi erations: (%$ assess for s%s of acromegaly: complaints of &ea ac&e# tig&t s&oes# gloves# rings# &ats. )*rreversable +. acromegaly ,%,: -(early)enlargement of &an s# man ible an feet# an &eart -severe &ea ac&e (suppression of brain)# $(, impairment# loss of visual acuity -bone pain# t&ic.ene of tongue ( ysp&agia) -glucose intolerance (elevate bloo sugar) )GH bloc.s insulin /. A ison0s Disease: -H123 function of A renal glan -4secretions of mineralcorticoi s# glucocorticoi s# an rogens - loc. of al osteron:452# lossing t&ier salt((a6 loosing 7ater -remain stress free b%c t&eir are inmnuno compromise -Dar.ly pigmente s.in (&an s# elbo7s# .nees) -pus& flui ( e&y ration)# - iet &ig& (a# lo7 8 -H123natremia# H129:.alemia ;. a renolectomy: surgical removal of t&e a renal glan -post surg - monitor 52# (li.e removing ADH# ea ly) -not .eeping t&eir 7ater -Hypovolemic s&oc. 6 ea -preo surg# give glucocorticoi s to prevent a renal crisis <. $us&ing0s ,yn rome ,%,: glucocorticoi s# -buffalo &ump# t&in e"tremities -capillary fragility:blee ing an ecc&ymosis -(a = H23 retention: &ypernatrimia# moon face -8 secretion: H123.alemia -immunesuppression: poor &ealing - $a loss: osteoporosis - cortisol level: moo c&anges (lability) roa rage - an rogen:facil%bo y &air gastric aci ity: peptic ulcer gluconeogenesis: &yperglycemia >. cus&ings syn rome: glococorticoi s -flui restriction ue to H!( an e ema -monitor sugar levels# a couple times a ay

-(ursing D" Disturbe bo y image r%t altere appearance -electrolyte imbalance H12ernatremia# H123.alemia# -Diet 4(a(control &ypernatrimia from al osteron# 4cal (control &yperglicemia from cortisol) # 8 (&ypo.alemi) ?. Diabetes insipi us (D*): problem of t&e posterior pituitary c&aracteri@e by a eficiency of ADH (or .i ney0s inability to respon to ADH). A&en it occurs# it is mostoften associate 7it& neurological con itions# surgery#tumors# &ea inBury# or inflammatory problems -2olyuria an 2oly ipsia(increase t&irst) polurya up tp 2CD% ay colorless urine -&ypotension# tac&ycar ia# 7eigt& loss -if not treat pt 7ill &ave &ypovolemic s&oc. an ie )pt t&irsty give me ication# -e"tric *=3# caffeine fee iet# no alco&ol ( iuresis) 1C. Gigantism ( GH): - GH t&at begins in c&il &oo before epip&yseal closure -proportional gro7t& -most common cause is tumor of anterior pituitary -linear gro7t& (&eig&t) 11. Gigantism D": elevate glucose levels (GH bloc.s insulin) n%c monitor for bac.ac&e an art&ralgia (Boint pain) from bone c&anges. -monitor bloo sugar 12. Gigantism signs an symptoms: long bone lengt& &eig&t# 7ea.ness # &ea ac&e (big s.ull) -&ig& bloo sugar (&yperglycemia) 1'. Hyperparat&yroi ism: bone estruction ( eminrali@ation) pat&ological f"s -,%, ostopenia# osteomalacia# osteoporosis# s.eletelal eformaties (evi ence of bone estruction) -polurya from Hypercalcemia -female# E+C -primary cause tumor%cancer# sec. vit D eficiency -D"# X-rays s&o7 eminerali@ation - urine an $a# 2&osp&orus4 -!" iuretic- to e"crete calcium -oral (a or 2otassium p&osp&ate - ialysis in pt 7% renal failure -(%$ forcing flui s 4calcium# iet lo7 $a -&an le gentle to prevent f" 1+. Hypert&yroi ism Graves Disease )): appetite# activity level#nervous# Bittery#

 2 = !#insomnia activity level#nervous# Bittery# pulse an temp#insomnia# &eat intolerance )e"op&t&almos (bulging eyes) use tape = ointment to sleep.$alm environment (alone) -D" !+ an !' -minimi@e energy# provi e &ig& calorie iet -assess mental status -t&yrectomy (only for goiter) en o 2 isor ers ,tu y online at Fui@let.com%GBy.Fp 1/. Hypoparat&yroi ism: $alcium leaves bones an goes into bloo . -most commun acci ental removal of parat&yroi s uring s". -,%, 2arat&esias(numbness = tingling in lips) -)tet&any(carpope al%laryngeal spasm) most angerous -monitor for tetany $&voste.0s an !rousseau0s signs s&o7ing not enoug& calcium in bloo ) -D" 4 $a# 2&osp&ate = 4 parat&yroi &ormone levels -!" intravenous calcium ilute in D/A -(%$ iet 4 p&osp&orous an $a.a minister $a an vit D -)+C fat an female 1;. Hypop&ysectomy: 2ost-clear lea.age6 c&ec. for glucose -teac& s%s of &ypopituitarism -report urine grater ta&n ?CCml%&r -monitor for lo7 urine specific gravity(concentrate ) -priority *=3. ADH can .ill u iabetes insipi us - specific gravity E t&an 1.CC+ -provi e freFuent mout& care# non alco&ol# bicarbonato an -7ater# elevate H35 to 4 s7eellling -7ear me ical bracelet provi e antibiotict to prevent meningitis 1<. Hypop&ysectomy: -surgical removal of pituitary glan (most common !" for &ypertuitarism) -most use surgical approac&#minimally invasive -after glan is remove # muscle graft is ta.en often from t&ig&# to support t&e area )monitor for s7elling an c&ec. bloo glucose -freFuent s7elling6blee ing -clear flui from nose%t&roat 6 sugar# c&ec. glucose# cerebral%spinal flui contains sugar b%c t&ere0s no insulin in 1>. Hypop&ysectomy postoperative care: -observe for clear lea.age (c&ec. glucose) -teac& s%s of &ypopituitarism -c&ec. for iabetes insipi us: report urine greater t&an ?CCml%2&rs# mmonitor for lo7 urine specific gravity. *=30s

)lac. of ADH can .ill youHHH 1?. Hypop&ysectomy preoperative care: -teac& t&at ecrease &ormone levels -e"plain bo y c&anges (organ enlargement%visual c&anges are irreversible) -instruct not to brus& teet&# coug&# snee@e# blo7 nose# or ben for7ar after surgery b%c increases intracranial pressure. )if pt nee s to snee@e open mout&# if nee s to blo7 nose# one nastril at time 2C. Hypop&ysectomy types: -craniotomy (transfrontal) -transp&enoi al (incision in inner aspect of lip an gingiva -cryop&ypop&ysectomy (free@e instea cutting off) 21. Hypot&yroi ism slo7 bug: -early s%s 7ea.ness# fatigue# forgetfulness# sensitivity to col # une"plaine 7eig&t gain# constipation -my"e ema: puffy face# &an s an feet -car io: bra ycar ia# poor perip&eral circulation -!" lifelong t&yroi &ormone replacement -el erly pt lo7 ose to prevent car iac problems -($ $(, epressants contrain icate .no carcotics -stool softeners for constipation# give blan.et if col . - iet &ig& bul.# lo7 calorie )reversible if you on0t 7ait until pt is retar e 22. my"e ema coma: :are life-t&reatening# severe form of &ypot&yroi ism.r%f infection# stress# untreate severe &ypot&yroi ismI lo7 bo y temp# lo7 52 an H:# confusion# s7elling of bo y# lo7 ::# can progress to coma. s%s puffy face# &an s an feet -monitor a ults for = t&ose 7it& $AD for isc&emia (angina) 2'. 3steomalacia: A isease in 7&ic& vitamin D or calcium eficiency or e"cessive renal p&osp&ate loss causes a softening of t&e bones 7it& accompanying pain an 7ea.ness. -pat&ological fractures 2+. osteomalacia: parat&ormone# ra7s $a to t&e bloo from bone marro7. -bones become soft%7ea. Js.eletal ten erness Js.ull enlargement. -:is. for pat&ological fractures 2/. p&eoc&romocytoma: -catec&olamine (epinep&rine an norepinep&rine) secreting !KL3: 3M AD:9(AD L9DKDDA -life t&reatening H!( or car iac arr&yt&mias -Lonitor 52. Dont palpate ab omen -provi e calm# restful environment# iet in cal# vitamins

-avoi caffeine# smo.ing# alco&ol 2;. 2ituitary D7arfism: -Deficiency of gro7t& &ormone -most cases# no un erlying causes of t&e eficiency is i iopat&ic 2<. 2ituitary D7arfism DX an !X: -D" 4 GH #ot&er &ormone may be 4 if pant&ypopituitarism !X replacement t&erapy 7% synt&etic GH 2>. 2ituitary D7arfism s%s: -Abnormally s&ort &eig&t an (ormal bo y proportion -appear younger t&an c&ronological age 7% fine features - elaye se"ual maturation. fine smoot& s.in 2?. simple goiter: -ina eFuate ietary io ine ,%, enlarge t&yrio # i@@ines# syncope.!" t&yrectomy 'C. ,yn rome of *nappropriate ADH ,*ADH: -A8A sc&7arts-barter syn rome -may be a complication of many rugs -7ater is retainte -&yponatremia :M metastatic malagnacies- cancer -$(, infections meningitis# brain tumor# acute stro.es# brain surgery ),epsis - rugs opio s co in morp&in# vico in ,%, H!(# 7eig& gain# concentrate urine ( ar.%amonia)# NOD# crac.les# coma(7ater into"ication)brain cell e ema ($ strict flui restriction -*=3# aily 7eg&ts # assess neurological c&anges ue to 7ater inton"ication '1. t&yroi cancer: -pianless# &ar nu le# pain-late sign D" t&yroi scan# fine nee le biopsy !" total#subtotal t&yroi ectomy '2. !&yroi storm: -A8A t&yro"ic crissis -s%s &ypert&ermia E1C;!# H!(# tac&y ysr&yt&mias -maintain air7ay an ventilatio -monitor for car iac arryt&mt&mias ''. !&yroi ectomy: surgical removal of all or part of t&e t&yroi glan -2reop. teac& pt &o7 to coug&% eep breat& an move 7&ile supporting nec. to strain on suture line -2ost# monitor v%s every 1/min until stable t&en 'Cmin.-avoi nec. e"tension Air7ay- H35 to 4 e ema blee ing - be&in nec. t&yroi storm- ! 52 2ulse &ypocalcemia:numb-tingling lips E$&voste.0s = !rousseau speec& - say AHHH &oarseness = 7ea. voice o"ygen is nearby an available -.eep tray trac& tray an *O calcium -turn# coug& an breat&

'+. !&yroi itis: *nflammation of t&e t&yroi glan . 4!'#!+. !,H a)acute. bacterial# pain# malaise# fever#= ysp&agia b) subacute%granulatomatous# viral infection after col %K:*# fever#c&ills# ysp&agia# myalgia art&ralgia c) c&ronnic A8A &as&imotos.most commun# 7omen '.-'/. autoinmune. -!X t&yroi H# replacement