Question

Care of Patients with Pituitary & Adrenal Gland Problems

Introduction

Learning Outcomes

Disorders of the posterior Pituitary Gland

   Diabetes Insipidus

   SIADH

Answer 1

Pituitary and adrenal gland problem:
Introduction:
Abnormalities of the adrenal gland that cause inadequate adrenocorticotrophic hormone by the pituitary gland. this is underactive adrenal gland cause fatigue, poor appetite, weight loss, weakness, and other gastrointestinal problem.
Learning outcome:
The adrenal gland is endocrine glands that secrete many hormones like adrenaline, steroids, aldosterone, and cortisol. it is situated above the kidneys. the pituitary gland and adrenal gland plays an important role in physiological and endocrine changes. The hypothalamic pituitary adrenal axis stimulates hormone adrenocorticotrophic hormone From the pituitary by the hypothalamus. severe disorders occur when dysfunction of the hormones produced by the adrenal glands. there are 4 types of diabetes insipidus called a central, nephrogenic, dipsogenic, and gestational disorder.
Disorders of posterior pituitary disorder:
The posterior pituitary gland releases the antidiuretic hormone(ADH) and oxytocin. the antidiuretic hormone helps kidneys to holds water. inadequate ADH lads to excess urination and loss of water and cause dehydration and sodium loss. this condition is called diabetes insipidus. Too much ADH leads to more retention of water in the body and low sodium level cause syndrome of inappropriate antidiuretic hormone secretion(SIADH)
diabetes insipidus patients will have symptoms like dry skin, more thirst, polyuria, colorless urine, weak muscle, and bedwetting.
Care of patients with DI:
-Monitor the patient intake and output
-Monitor patient weight daily
-Monitor patient urine specific gravity, serum sodium, potassium
-administer more fluids and observe the patient for hypovolemic shock and dehydration.
-Administer IV fluids with 0.45% and 0.9% of NS.
-administer medication like chlorpropamide, carbamazepine as per doctor advice to stimulate the ADH.
-Inspect the patient skin for dryness
-educate the patient about disorder and fluid balance and weight management.
-administer derepression to replace the antidiuretic hormone.
-Advice the patient low sodium intake diet and during enough water.
SIADH:
   the patient will have signs and symptoms like nausea, vomiting, muscle cramps, depression, fatigue, confusion, seizure, tremors, coma, edema, etc.
Care plan:
- Monitor the patient's intake and output and monitor the weight daily.
- monitor patient ECG to find any dysrhythmias.
-monitor the patient vital signs 1-2 hours to find the changes in the heart rate and BP.
-monitor the patient respiratory changes.
-Administer medication like demeclocycline to avoid ADH overact
-administer electrolyte supplements.
-monitor the patient serum sodium, potassium, chloride, osmolality, and urine specific gravity.