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Nursing Care Plan for Hyperpituitarism

Hyperpituitarism is a condition that results in excess secretion of a hormone that is secreted from the pituitary gland. Hyperpituitarism, or primary hypersecretion of pituitary hormones, rarely occurs in children. Hyperpituitarism usually the result of pituitary microadenomas. The cause of hypopituitarism is hyperplasia and carcinoma of adenohypophyseal, secretion by non - pituitary tumors and certain hypothalamic disorders and carcinoid tumors. Prolonged effects of excessive secretion of pituitary hormones include arthritis, carpal tunnel syndrome, osteoporosis, kyphosis, hypertension, arteriosclerosis, heart enlargement and heart failure.

Classification pituitary / pituitary adenoma.
  • Encapsulated (no metastases in the sella turcica)
  • Invasive (sella turcica damaged due to metastasis)
  • Microadenomas (encapsulate the tumor with a diameter less than 10 mm)
  • Macroadenomas (encapsulate the tumor with a diameter greater than 10 mm)
Clinical Manifestations
  • Changes in the shape and size of the body and internal organs (such as the hands, feet, fingers, tongue, jaw, cardiomegaly).
  • Impotence.
  • Reduced visual acuity.
  • Headache.
  • Changes in the menstrual cycle (in women clients), infertility.
  • Decreased sexual libido.
  • Muscle weakness, fatigue and lethargy. (Hotman Rumahardo , 2000: 39).

Test and Diagnosis
  • Serum prolactin levels ; ACTH , GH.
  • CT - Scan / MRI.
  • Measurement of visual field.
  • Hormone tests.
  • Angiography.
  • Glucose tolerance test.
  • The dexamethasone suppression test.
Complication
  • Hypothalamic disorders.
  • Organ disease 'target ' as failed primary thyroid, Addison 's disease or primary gonadal fail.
  • Other causes of chusing syndrome include adrenal tumors, ectopic ACTH syndrome.
  • Nephrogenic diabetes insipidus or psychogenic.
  • Parkinson syndrome.


Nursing Diagnosis for Hyperpituitarism
  1. Disturbed body image related to the change in physical appearance.
  2. Acute pain : the head relate to suppression by tumor tissue.
  3. Disturbed Sensory Perception (visual) related to disorders of impulse transmission due to compression of the optic nerve tumor.
  4. Anxiety related to threats to life status change.
  5. Risk for injury related to a decrease in sensory perception.
 
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