Panhypopituitarism or Simmonds' disease is a rare disorder. You happen to have a client with this disorder and need to brush up on it to teach your new employee who is with you this shift
a. What causes this disorder?
b. What gland is involved?
c. What do you expect to find when doing a physical assessment on the client?
d. What is the medical treatment for this disorder?
Students' answers should include the following:
a. Destruction of the anterior pituitary gland followed by no hormonal activity
Caused usually by hemorrhage, surgery, tuberculosis, or postpartum emboli
b. All hormones in the anterior pituitary are affected.
c. Sex organs are atrophied; thyroid and adrenals fail to secrete adequate amounts of hormones; hypothyroidism, adrenal insufficiency, and hypoglycemia are seen
Premature aging; skin becomes pale due to lack of melanocyte-stimulating hormone
Labs reveal decreased levels of reproductive, thyroid, and corticosteroid hormones.
Fatal if left untreated.
d. Growth hormone replacement is necessary only in children; Synthroid for TSH replacement is life-long.
Females receive estrogen; both sexes need LH and FSH.
Nursing management includes replacement of hormones.
Teaching and education to client of compliance of all hormone therapy
Small meals daily, monitoring of vital signs and energy levels, weight, mental status, etc.
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