NCMB 316 CARE OF CLIENTS WITH PROBLEMS IN NUTRITIONAL & GASTROINTESTINAL METABOLISM &
ENDOCRINE PERCEPTION, AND COORDINATION (ACUTE & CHRONIC)
MEDICAL SURGICAL II
PITUITARY GLAND
Anterior Pituitary Gland (Adenohypophysis)
Growth Hormone (GH)
o Gigantism - Is hypersecretion of GH in children
(before epiphyseal closure). This condition is
characterized by exaggerated growth in height and
weight.
o Acromegaly - Is hypersecretion of GH in adults (after
epiphyseal closure). This is caused primarily by
pituitary tumors. The clinical manifestations are:
large hands and feet; thickening and protrusion of
the jaw; organomegaly; visual disturbances; arthritic
changes; diaphoresis; oily rough skin; hypertension;
dysphagia; deepening of voice.
o Dwarfism - Is hyposecretion of GH. It is
characterized by failure to grow in height.
Prolactin (Mammotropic, Lactotropic, Luteotropic
Hormone)
o Galactorrhea - Is hypersecretion of prolactin. It is
characterized by excessive milk production.
o Absence of milk production during lactation results
from hyposecretion of prolactin.
Adrenocorticotropic Hormone (ACTH)
o Secondary Cushing's Disease - Is hypersecretion of
ACTH.
o Secondary Addison's Disease - Is hyposecretion of
ACTH.
Thyroid Stimulating Hormone (TSH)
o Secondary Hyperthyroidism - Is hypersecretion of
TSH.
o Secondary Hypothyroidism - Is hyposecretion of
TSH.
Gonadotropins (FSH and LH)
o Hypersecretion of hormones results to precocious
puberty.
o Hyposecretion of the hormones results to failure to
develop secondary sex characteristics that normally
develop at the age of puberty.
The manifestations are as follows:
Melanocyte-Stimulating Hormone (MSH)
o Hypersecretion of the hormone results to
hyperpigmentation of the skin ("eternal tan" or
bronze appearance of the skin).
o Hyposecretion of the hormone results to albinism
(hypopigmentation of the skin). It is characterized by
REGINA SOPHIA CAPUNPON
absence of the melanin epithelial pigment of the
retina. This results to difficulty in vision during
daytime or in the presence of bright light.
Posterior Pituitary Gland (Neurohypophysis)
Antidiuretic Hormone (ADH)
o Hypersecretion of the hormone is Syndrome of
Inappropriate Antidiuretic Hormone (SIADH).
 Causes include trauma, stroke, medications, and
stress.
 SIADH is characterized by excessive retention of
water by the renal tubules.
The characteristic manifestations of SIADH are as follows:
 Edema, weight gain. This is due to excessive
retention of water.
 Hypertension. Vasopressin causes
vasoconstriction.
 Dilutional hyponatremia. This is due to
excessive retention of water, without
proportionate retention of sodium.
Interprofessional collaborative management for patients
with SIADH include the following:
 Administer diuretics as prescribed to reduce
body fluids.
 Administer Demeclocyline (Declomycin) as
prescribed. It inhibits ADH-induced water
reabsorption and produces water diuresis.
 Posterior Pituitary Gland (Neurohypophysis)
 Restrict fluid intake as prescribed.
 Monitor VS, cardiac and neurologic status.
Water intoxication may cause CHF and increase
in ICP.
 Monitor I and O, daily weight, electrolyte levels.
o Hyposecretion of ADH is Diabetes Insipidus (D.I.)
o Diabetes insipidus is characterized by inability of the
renal tubules to retain water (water loss). The most
characteristic manifestation of D.l. is polyuria (as
much as 20 L of urine/day).
o The urine is diluted or water- like, with low specific
gravity.
o Other manifestations of D.I. are as follows:
polydipsia, dehydration, constipation, retarded
growth in children.
o The diagnostic test for D.I. is the water deprivation
test. Fluids are withheld for 4 to 18 hours. If there is
no increase in urine concentration (sp. gr.), this
confirms presence of D.I.
The antidiuretic hormones used in diabetes insipidus are
as follows:
 Desmopressin acetate (DDAVP, Stimate)
 Vasopressin (Pitressin)
o Clofibrate has antidiuretic effect on clients with D.I.
o Chlorpropramide (Diabenese) and thiazide diuretics
potentiate the action of vasopressin.
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