SEMINAR

ON
PITUITARY DISORDER

PRESENTED BY:
Zorinsangi
R.no.37 1st year PBBSC
Faculty of nursing
Assam Downtown University
 Introduction
The pituitary is the “master control gland”- it makes
hormones that affect growth and the functions of other glands
in the body. With pituitary disorders you often have too much
or too little of one of your hormones. Injuries can cause
pituitary disorder, but the most common cause is a pituitary
tumor. Most pituitary tumors are noncancerous(benign). But
when a tumor grows on or near the pituitary gland the tumor
can change hormone production leading to symptoms such as
weight gain, stunted or excessive growth, high blood pressure,
low sex drive or mood changes.
 Definition
Pituitary disorders are conditions caused by too
much or too little of one or more of the hormones
produced by the pituitary gland. A pituitary
tumor compressing surrounding tissues can also
cause symptoms of a pituitary disorder.
 INCIDENCE
 The current metaanalysis estimated the prevalence rate of
pituitary adenomas to be 16.7% . Separate analyses of
postmortem and radiologic data produced estimated rates of
14.4% and 22.5% respectively. These figures indicate that
pituitary tumors are fairly common in the general population.
 Hypopituitarism has an estimated prevalence of 45.5
cases per 100,000 without gender difference.
 In Hyperpituitarism, the incidence of Acromegaly is 60
cases per million and Gigantism which is very rare with a
prevalence of 36 – 69 cases per million.
RELATED ANATOMY AND PHYSIOLOGY
 The pituitary gland and the hypothalamus act as a unit,
regulating the activity of most of the other endocrine glands. It
is the size of a pea, weighs about 500 mg and consists of two
main parts that originate from different types of cells. The
anterior (adenohypophysis) is an upgrowth of glandular
epithelium from the pharynx and the posterior pituitary
(neurohypophysis) a downgrowth of nervous tissue from the
brain. There is a network of nerve fibers between the
hypothalamus and the posterior pituitary.
BLOOD SUPPLY:
Arterial blood: The anterior lobe is supplied indirectly by
blood that has already passed through a capillary bed in the
hypothalamus but the posterior lobe is supplied directly.
Venous drainage: Containing hormone from both lobes, venous
blood leaves the gland in short veins that enter the venous
sinuses between the layers of dura mater.
The hypothalamus controls release of hormones from both the
anterior and posterior but in different ways.
 Anterior pituitary: The anterior pituitary is supplied
indirectly with arterial blood that has already passed
through a capillary bed in the hypothalamus. This network
of blood vessels forms part of the pituitary portal system,
which transports blood from the hypothalamus to the
anterior pituitary where it enters thin – walled sinusoids
that are in close contact the secretory cells. As well as
providing oxygen and nutrients, this blood transports
releasing and inhibiting hormones secreted by the
hypothalamus.
The anterior pituitary gland produces the following hormones and releases
them into the bloodstream:
•Adrenocorticotropic hormone, which stimulates the adrenal glands to secrete

steroid hormones, principally cortisol

 
•Growth hormone, which regulates growth, metabolism and body composition
 
•Luteinising hormone and follicle stimulating hormone, also known as

gonadotrophins. They act on the ovaries or testes to stimulate sex hormone

production, and egg and sperm maturity
• prolactin, which stimulates milk production

 
 
• thyroid stimulating hormone, which stimulates the thyroid gland
to secrete thyroid hormones.
• Each of these hormones is made by a separate type of cell within
the pituitary gland, except for follicle stimulating hormone
and luteinising hormone, which are made together by the same
cell.
 Posterior pituitary: The posterior pituitary is formed from nervous
tissue and consists of nerve cells surrounded by supporting glial
cells called pituicytes. Posterior pituitary hormones are
synthesized in the nerve cells bodies, transported along the axon
and stored in vesicles within the axon terminals in the posterior
pituitary.
 Two hormones are produced by the hypothalamus and then stored
in the posterior pituitary gland before being secreted into the
bloodstream. These are:
• anti-diuretic hormone (also called vasopressin), which controls
water balance and blood pressure
 
• oxytocin, which stimulates uterine contractions during labour and
milk secretion during breastfeeding.
 ANTERIOR PITUITARY DISORDER
HORMONE HYPOACTIVITY HYPERACTIVITY

Growth hormone(GH) • Dwarfism(child) • Gigantism (Child)

It is a condition caused by
insufficient amounts of growth
hormone. Children with GHD have
abnormally short stature with normal
body proportions.
Adrenocorticotrophic • Addison’s disease
hormone(ACTH) It occurs when the adrenal glands
produce insufficient amounts of the
hormone cortisol and sometimes
aldosterone.
Thyroid Stimulating • Hypothyroidism
Hormone (TSH) It is a condition in which the thyroid
gland does not produce enough
thyroid hormone.
• Acromegaly (Adult)
Acromegaly occurs when pituitary gland
produces too much growth hormone during
adulthood. In children this leads to
increased height and is called Gigantism
• Cushing’s disease
It occurs when pituitary gland releases too
much ACTH..
• Hyperthyroidism
It is overproduction of thyroxine hormone.
 POSTERIOR PITUITARY DISORDER

HORMONE HYPOACTIVITY HYPERACTIVITY

Antidiuretics hormone • Diabetes insipidus • Syndrome of inappropriate

(ADH) It is caused by a deficiency of antidiuretic hormone(SIADH)
production or secretion of ADH or SIADH results from abnormally
a decreased renal response to high production or sustained
ADH. secretion of ADH.
 Disorders of pituitary gland
1. Hypopituitarism
Hypopituitarism refers to a rare clinical syndrome
that is characterized by the low secretion of one or more hormones
secreted by the pituitary gland. It is a condition primarily affecting
the anterior lobe of the pituitary gland . The hormones that are
produced by the pituitary glands and may be affected by
hypopituitarism are Adrenocorticotrophic Hormone(ACTH),
Antidiuretic Hormone(ADH), Follicle-Stimulating Hormone (FSH),
Thyroid stimulating Hormone(TSH), Luteinizing Hormone(LH),
Growth Hormone (GH) and Prolactin.
 CAUSES AND RISK FACTORS
The most common cause of hypopituitarism is anterior
pituitary tumors. A tumor can squeeze the pituitary gland as it
grow , which can cause damage. A pituitary tumor can also
put pressure on the optic nerves in the eyes and cause visual
problems. The causes of hypopituitarism include:

• Pituitary adenomas
• Head injuries
• Brain tumor
• Brain surgery
• Radiation treatment
 Autoimmune inflammation (hypophysitis)
 Infections: cerebral abscess, meningitis, encephalitis, tuberculosis,
syphilis
 Infiltrative processes: Sarcoidosis , histiocytosis X,
haemochromatosis
 Ischaemia and infarction
 Severe loss of blood during childbirth, which may cause damage to
the front part of the pituitary gland (Sheehan syndrome or
postpartum hypopituitarism)
 Genetic mutations resulting in impaired pituitary hormone
production
 Genetic causes, e.g. PIT1( PROP1) gene mutations, septo-optic
dysplasia
CLINICAL MANIFESTATIONS
HYPOPITUITARISM is often progressive. Although the
sign and symptoms can occur suddenly, they more often develop
gradually. They are sometimes subtle and may be overlooked for
months or even years. Sign and symptoms of hypopituitarism
vary, depending on which pituitary hormones are deficient and
how severe the deficiency is .
 Adrenocorticotrophic Hormone (ACTH) Deficiency:
Symptoms include fatigue, pallor, anorexia, weight loss,
dizziness, weakness, depression, nausea, or vomitting,
circulatory collapse, fever and shock. Hypoglycaemia,
hypotension, anaemia, lymphocytosis, eosinophilia and
hyponatraemia are also present.
• Children: delayed puberty , failure to thrive
 Thyroid-stimulating Hormone (TSH) Deficiency: Symptoms
include constipation, weight gain, bradycardia, hypotension,
sensitivity to cold , decreased energy and muscle weakness,
tiredness or aching, hair loss, dry skin, hoarseness, cognitive
slowing.
• Children: retarded development, growth retardation
 Gonadotropin Deficiency:
• Women: irregular or stopped menstrual periods, loss of libido,
dyspareunia, infertility and osteoporosis
Men : loss of libido, impaired sexual function, mood
impairment, loss of facial, scrotal and body hair, decreased
muscle mass, osteoporosis, anemia, weakness, lack of interest
in sexual activity, erectile dysfunction and infertility
Children: delayed puberty
 Growth Hormone Deficiency: in children , symptoms
include fatigue , short height, decreased muscle mass and
strength, fat around the waist and in the face, poor overall
growth or growth retardation
• In adults, symptoms include low energy, decreased strength
and exercise tolerance, weight gain, visceral obesity,
decreased muscle mass, feelings of anxiety or depression,
decreased quality of life, impairment of attention and
memory.
 Prolactin Deficiency: In women, symptoms include lack of
milk production , fatigue, and loss of underarm and pubic
hair . No symptoms are seen in men.
 ADH Deficiency: Symptoms include increased thirst and
urination (polyuria, polydipsia) , decreased urine osmolality
and hypernatraemia .
 PATHOPHYSIOLOGY
Hypopituitarism refers to deficiency of one or more anterior pituitary
hormones.
 GH deficiency → growth retardation (during childhood), ↓ bone
density, muscle atrophy, hypercholesterolemia
 Prolactin deficiency → lactation failure following delivery
 FSH/LH deficiency → hypogonadotropic hypogonadism (secondary
hypogonadism)
 TSH deficiency → secondary hypothyroidism
 ACTH deficiency → secondary adrenal insufficiency
 PATHOPHYSIOLOGY
In addition to the aforementioned hormone deficiencies, patients
with severe pituitary damage (panhypopituitarism) also present
with deficiencies of posterior pituitary hormones:
 ADH deficiency → central diabetes insipidus
 Oxytocin deficiency → No effect
Diagnostic evaluations

To diagnose hypopituitarism, there must be low hormone levels due to

a problem with the pituitary gland. The diagnose must also rule out
diseases of the organ that is affected by this hormone.
 Blood tests
 Stimulation or dynamic testing
 Brain imaging
 Vision tests
 X- ray
 MANAGEMENT
Hormone replacement medicines include :
• Corticosteroid (such as prednisolone and hydrocortisone)
• Thyroid hormone replacement therapy
• Desmopressin(DDAVP) to replace adrenocorticotropic
hormone missing because of an anti- diuretic hormone
deficiency.
• GH replacement therapy is used for children as appropriate .
Growth hormone stimulates linear growth and growth of
skeletal muscle and organs.
 Sex hormone deficiency is treated with sex- appropriate hormones
 Testosterone replacement therapy (andro-LA, androderm) is used in
men. Testosterone promotes and maintains the development of
secondary sexual characteristics in males with androgen deficiency.
 Estrogen replacement therapy with or without progesterone is used
in women. Estrogens are important in developing and maintaining
the female reproductive system and secondary sexual
characteristics.
 COMPLICATION
Adrenal crisis is the most acute complication that can arise in
the treatment of patients with hypopituitarism and occurs
when glucocorticoid replacement is not appropriately
administered or more likely when the child develops a
concurrent illness or medical treatment that increases the
requirement for medical glucocorticoid and prevents oral
replacement.
Growth hormone therapy is reported to cause some rare
adverse effects. These include benign intracranial
hypertension and slipped capital femoral epiphysis.
PROGNOSIS: Morbidity and mortality due to
hypopituitarism are caused by the individual hormone
deficiencies or the underlying cause of hypopituitarism.
Stable patients who are diagnosed with hypopituitarism
have a favourable prognosis with replacement hormone
therapy. Patients with acute decompensation are in
critical condition and may have a high mortality rate.
 Disorders of pituitary gland
 Hyperpituitarism :
Hyperpituitarism is the excessive production of growth
hormone, which continues to be produced well. Hyperpituitarism is a
chronic, progressive disease marked by hormonal dysfunction and
startling skeletal overgrowth .
ACROMEGALY : The term acromegaly comes from Greek words
meaning “extremities” and “enlargement”. Enlargement of the hands
and feet is one of the most common signs of the disease. Acromegaly
is a chronic metabolic disorder in which there is too much growth
hormone and the body tissues gradually enlarge. Acromegaly occurs
in about 6 of every 100,000 adults. Acromegaly occurs in adulthood,
usually during middle age. It is caused by abnormal production of
growth hormone after the skeleton and other organs finish growing.
CAUSES OF ACROMEGALY
Acromegaly occurs when body produces too much growth hormone. In adults
a tumor is the most common cause of excess growth hormone :
 Pituitary Tumors: most cases of acromegaly are caused by a noncancerous
(benign) tumor, or adenoma, of the pituitary gland. In addition to producing
excess growth hormone, these tumors can press on nearby tissues as they
grow. This pressure can cause some of the symptoms of acromegaly, such as
headaches and impaired vision.
 Nonpituitary Tumors: In a few people, acromegaly is caused by benign or
cancerous tumors in other parts of the body, such as the lungs, pancreas or
adrenal glands. Some of these tumors actually secrete growth hormone. In
other cases, they produce a hormone called growth hormone- releasing
hormone (GH-RH) which stimulates the pituitary gland to make more growth
hormone.
CLINICAL MANIFESTATION:
Symptoms can be divided into 2 groups: those that are effects of the
tumor pressing on surrounding tissues and those caused by excess
growth hormone and IGF-1 in the blood. Symptoms due to pressure
on surrounding tissues depend on the size of the tumor:
 Headaches and partial loss of vision are the most common
symptoms.
 Partial loss of vision may occur in one or both eyes.
 Pituitary tumors also can damage the pituitary gland itself,
disrupting hormone production. The resulting hormone imbalances
are responsible for symptoms such as impotence, low sex drive, and
changes in the menstrual cycle.
Symptoms due to excess growth hormone or IGF- 1 vary widely:
 Increase in ring size or tightness of rings (due to hand swelling,
“sausage- like” fingers).
 Increase in shoe size ( due to foot swelling).
 Increased sweating.
 Coarsening or thickening of facial features, especially the nose.
 Increased prominence of jaw and/ or forehead.
 Thickened skin, especially on palms of hands or soles of feet.
 Swelling of tongue
 Thickening or swelling of the neck (due to goiter).
 Arthritis (pain, swelling, or stiffness in any joint).
 Difficulty breathing during sleep ( sleep apnea) , causing poor
sleep and excessive sleepiness.
 Pain, numbness, tingling, or weakness in hands and wrist (carpal
tunnel syndrome).
 Large numbers of skin tags.
 Increased thirst or urination
 Shortness of breath, chest pain
 Palpitations or rapid heart beat and heart failure
PATHOPHYSIOLOGY
The somatic growth and metabolic
dysfunction associated with acromegaly
results from excess secretion of GH
and subsequent elevation of circulating
and locally produced insulin- like growth
factor-1 .
DIAGNOSTIC EVALUATIONS:
IGF-1 and growth hormone levels together usually are used to
confirm the diagnosis of acromegaly.
After acromegaly has been confirmed by growth hormone and
IGF-1 levels, patient will probably undergo a CT scan or MRI of the
head to confirm adenoma in pituitary gland. CT scans of the abdomen
and pelvis look for tumors of the pancreas, adrenal glands, or ovaries
that might secrete growth hormone or GHRH. CT scan of the chest
looks for lung cancer, which also can secrete growth hormone or
GHRH.
MANAGEMENT : The goals of therapy are to relieve and reverse
the symptoms of acromegaly. This is done by normalizing
production of growth hormone and IGF-1 and reducing the effects of
the pituitary tumor on the surrounding tissues. A secondary goal is
avoid damaging normal pituitary tissue.
 SURGERY: Surgery is the first treatment used for most people
with excess growth hormone, regardless of the cause. Surgery
brings about remission in some people, but not in all.The operation
of choice for pituitary adenoma is transsphenoidal
hypophysectomy. The tumor is removed via one of the nasal
sinuses through an incision inside the nose.
MEDICATION:
Medication can be used if surgery is not possible, or not wanted. It is
also used whilst waiting for surgery or radiotherapy. It can be used
in cases where surgery fails to remove the tumor totally and the
level of growth remains high.
The following medications may be used to treat acromegaly:
 Somatostatin analogues (octreotide and lanreotide ) reduce the
level of growth hormone to normal in over half of cases, and
reduce the size of the tumor in about 8 in 10 cases. However, these
medicines need to be given as an injection.
 Dopamine agonists (such as cabergoline, bromocriptine and
quinagolide ) can be taken as tablets. They work by preventing the
release of growth hormone from tumor cells. However, they only
work well in about 1 in 5 cases. Side effects such as feeling sick and
dizzy are also quite common.
 Growth hormone receptor antagonists are taken as a daily injection.
However, unlike the other medicines listed above, it does not act
directly at the pituitary. Pegvisomant works by blocking the action
of growth on your body’s cells. Therefore , although many of the
symptoms of growth hormone excess will be eased it does not
reduce the size of the tumor and headaches are not eased.
 Radiotherapy is an option to reduce the size of the tumor and
hence reduce the production of growth hormone. Radiotherapy
focuses high- intensity radiation at pituitary tumor to destroy the
abnormal cells. Radiation treatments are given in 2 forms,
external beam and stereotactic.

PROGNOSIS:
Outcomes for people with acromegaly depend on how severe
the disease is and how effectively therapies treat the symptoms.
Many people see a significant improvement in symptoms after
treatment. If it is not treated, acromegaly can cause disabling and
disfiguring symptoms.
ACROMEGALY
 Disorders of pituitary gland
 GIGANTISM:
Gigantism is abnormally large growth due to an excess of growth
hormone during childhood , before the bone growth plates have closed.
Gigantism begins before epiphyseal closure and causes proportional
overgrowth of all body tissues.

CAUSES AND RISK FACTORS:

The most common cause of too much growth hormone release is a
noncancerous ( benign) tumor of the pituitary gland . Other causes
include: Carney complex, McCune- Albright syndrome (MAS), Multiple
endocrine neoplasia type 1 ( MEN-1) and Neurofibromatosis. Gigantism
is very rare.
CLINICAL MANIFESTATION: The child will grow in height , as well as in
the muscles and organs. The excessive growth makes the child extremely
large for his or her age. Other symptoms include :
 Delayed puberty
 Double vision or difficulty with side ( peripheral) vision
 Frontal bossing and a prominent jaw
 Headache
 Increased sweating
 Irregular periods
 Large hands and feet with thick fingers and toes
 Release of breast milk
 Thickening of the facial features
 Weakness
DIAGNOSTIC EVALUATION:
CT or MRI scans of the head showing pituitary tumour. Failure to
suppress serum growth hormone (GH) levels after an oral glucose
challenge (maximum75g) , High prolactin levels and increased
insulin growth factor-1 (IGF-1) levels.
Damage to the pituitary may lead to low levels of other hormones,
including: Cortisol, estradiol (girls), testosterone (boys) and thyroid
hormone .
MANAGEMENT:
In pituitary tumors with well – defined borders, surgery is the
treatment of choice and can cure many cases. Treatment is mainly
surgical ( transfenoidal adenectomy or hypophysectomy of the
acidophil adenoma) is the treatment of choice.
For situations in which surgery cannot completely remove the
tumor, medication is the treatment of choice. The most effective
medications are somatostatin analogs (such as octreotide or long -
acting lanreotide), which reduce growth hormone release
 Dopamine agonists have also been used to reduce growth hormone
release , but these are generally lest effective. Pegvisoment , a
medication that blocks the effect of growth hormone may be used.
Radiation therapy has also been used to bring growth hormone levels to
normal. However it can take 5-10 years for the full effects to be seen and
almost always leads to low levels of other pituitary hormones.
COMPLICATIONS:
• Mobility problems
• Osteoarthritis
• Peripheral nerve
• Lung problems
• Metabolic complication such as diabetes
PROGNOSIS: When the condition is successfully treated,
children with gigantism can have a normal life expectancy
and avoid most of the complications caused by it. However,
they may still have symptoms such as muscle weakness and
restricted movement, and some may also have psychological
problems.
 PITUITARY GLAND TUMOR
Pituitary tumors are abnormal growths that develop in your pituitary
gland. Some pituitary tumors result in too much of the hormones that
regulate important functions of your body. Some pituitary tumors can
cause your pituitary gland to produce lower levels of hormones.

Most pituitary tumors are noncancerous (benign) growths (adenomas).

Adenomas remain in your pituitary gland or surrounding tissues and
don't spread to other parts of your body.
Pituitary tumors are divided into three groups:
 Benign pituitary adenomas
 Invasive pituitary adenomas
 Pituitary carcinomas
 Pituitary tumors may be either non functioning or functioning.
CAUSES AND RISK FACTORS
A risk factor is anything that increases a persons chance of
developing a tumor. The cause of most pituitary is unknown,
although there may be a genetic factor.
CLINICAL MANIFESTATION:
Sign and symptoms of a non functioning pituitary tumor are
• Headache
• Some loss of vision
• Loss of body hair
• In women, less frequent or no menstrual periods or no breast milk
• In men, loss of facial hair,growth of breast tissue and impotence
• Lower sex drive
• In children, slowed growth and sexual drive
Sign and symptoms of a functioning pituitary tumor are
• Too much prolactin may cause: headache, loss of vision, less
frequent or no menstrual periods or menstrual period with a very
light flow, trouble becoming pregnant, impotence in men, lower sex
drive and flow of breast milk in a women who is not pregnant or
breastfeeding.
• Too much ACTH may cause: headache, loss of vision, weight gain
in the face, neck and trunk,and thin arms and legs,skin that may be
purple or pink stretch mark on the chest or abdomen, easy bruising,
growth of fine hair on the upper back or arms,bones that break easily
, anxiety ,irritability and depression,
• Too much Thyroid stimulating hormone may cause: Irregular
heartbeat, shakiness, weight loss, trouble sleeping, frequent bowel
movements and sweating.
• Too much GH may cause: headache, loss of vision, in adult
acromegaly, in children the whole body may grow much taller and
larger than normal, tingling or numbness in the hands and fingers,
snoring or pauses in breathing during sleep, joint pain, sweating.
• Others general signs and symptoms : nausea and vomiting,
confusion, dizziness, seizures,runny or droppy nose.
DIAGNOSTIC EVALUATION
• Health history and physical examination
• Complete endocrinology evaluation
• MRI
• CT SCAN
• Blood test
• Blood chemistry study
• Venous sampling for pituitary tumors
• Visual field examination
• Neurological examination
• ECG
• Radiological examination
• Twenty- four- hour urine test
• Lumbar puncture
• Biopsy

MANAGEMENT
• Active surveillance
• Surgery
• Radiation therapy
• Chemotherapy
• Mediactions
COMPLICATIONS
• Vision loss
• Pituitary hormone insufficiency
• Pituitary apoplexy: is bleeding into or impaired blood supply of the
pituitary gland at the base of the brain.

PROGNOSIS
Prognosis depends on the type of tumor . The five year survival rate
for people with a tumor is 82% . Survival rates depends on the type of
tumor, persons age and other factors.
NURSING MANAGEMENT
1. NURSING DIAGNOSIS: Disturbed body image related to changes in body
structure and function of the body due to excessive or deficiency of gonatropin
and growth hormone deficiency.
 GOALS: Patient incorporate changes into self concept, patient verbalizes
acceptance of self in situation
 INTERVENTION:
 Assess the perceived impact of change in social participation, personal relationship
and occupational activities.
 Acknowledge and accept expression of feelings of frustration,dependency,
anger,grief and hostility.
 Exhibit positive caring in routine activites
 Be realistic and positive during care
 Refer to physician and occupational therapy
 OUTCOMES: Patient will be incorporates with changes into self concept .
2. NURSING DIAGNOSIS: Ineffective individual coping related to the
chronicity of the disease condition.
 GOALS: To increase individual coping
 INTERVENTION:
 Assess for the presence of defining characteristics
 Observe for strengths such as the ability to relate to the facts
 Assist patient set realistic goals and identify personal skills and knowledge
 Encourage the patient to recognize his or her own strength and ability
 Refer for counselling if necessary
 OUTCOMES: Individual coping will be increase.
3. NURSING DIAGNOSIS: Disturbed sensory perception (visual)
related to impaired transmission of impulses as a result of a suppression
of tumor on the optic nerve.
 GOALS: To regain optimal vision
 INTERVENTION:
 Assess patients ability to see and perform activities
 Encourage patient to see an ophthalmologist atleast yearly
 Provide sufficient lightning to carry out activities
 Prepare patient for surgery if warranted
 Provide large print objects and visual aids for teaching
 OUTCOMES: Optimal vision will be regain
4. NURSING DIAGNOSIS: Acute pain related to increased intracranial pressure
due to pituitary tumor.
 GOALS: To reduce or relieve pain
 INTERVENTION:
 Assess pain by pain scale
 Provide quiet and calm environment
 Provide diversional therapy
 Massage the affected area when suitable
 Determine the appropriate pain relief method
 Report to the physician when interventions are unsuccessful and ineffective
 OUTCOMES: Pain will be relieve
OTHER POSSIBLE NURSING DIAGNOSIS ARE:
 Risk for impaired skin integrity related to declining hormonal levels
 Risk for electrolyte imbalance related to Diabetes Insipidus and
appropriate ADH secretion syyndrome
CONCLUSION
 Hypopituitarismis a rare disorder in which a pituitary gland fails to
produce one or more hormones or does not produce enough
hormone. Symptoms typically vary, based on which hormones or
hormones you are missing.
 Inhyperpituitarism, patients with acromegaly has too much
hormone produce by the pituitary gland. Middle aged adults are
most commonly affected. Patients with gigantism are
predominantly male. Treatment delay may increase the harm from
GH excess, particularly on tall stature.
 Pituitary
tumor are benign growths called pituitary adenomas.
But a pituitary gland tumor can occasionally act like a
cancerous tumor by growing into nearby tissue and structures.
THANK YOU