The nurse is teaching a client about the need for supplemental thyroid hormone following a hypophysectomy because of an anterior pituitary adenoma. The client says, "I thought thyroid hormone came from a gland in my neck."

Question

Which follow-up statement by the nurse is most appropriate?
1. "Your thyroid gland no longer gets messages from the pituitary."
2. "You will only need to take thyroid hormone until healing occurs."
3. "You need this hormone because your TSH is too high since surgery."
4. "Your thyroid gland was damaged because of the long surgical procedure."

Answer 1

Correct Answer: 1
Rationale 1: A hypophysectomy removes the anterior pituitary. Hormones normally produced by this portion of the pituitary are lacking. TSH is absent, so the thyroid gland does not receive messages to make thyroid hormone, and a life-long supplement is needed.
Rationale 2: This statement does not explain the role of the pituitary gland in thyroid regulation.
Rationale 3: The client's TSH level is not too high from surgery.
Rationale 4: The thyroid is in the neck, and the pituitary gland is in the cranium.
Global Rationale: A hypophysectomy removes the anterior pituitary. Hormones normally produced by this portion of the pituitary are lacking. TSH is absent, so the thyroid gland does not receive messages to make thyroid hormone, and a life-long supplement is needed. The TSH level is not too high following surgery. The thyroid is in the neck and the pituitary gland is in the cranium.