N212: Health Differences Across the Life Span 2

Health Differences Across the Lifespan 2 Study Guide androgens causes a male pattern of body hair, sometimes excessive, particularly in locations where women normally do not develop terminal hair during puberty (chest, abdomen, back, and face). The medical term for excessive hair growth in both men and women is hypertrichosis. Diagnosis: A dexamethasone suppression test is the administration of dexamethasone, which should cause a decrease in cortisol production. In Cushing’s the suppression is minimal. Treatment: Use of antidiabetic to treat hyperglycemia and adrenal suppressants; low-sodium, low- carbohydrate, low-calorie, high-potassium, and high protein diet Nursing interventions include assessing for edema, ensuring fluid balance and limiting water intake. Protect the patients from infections, provide rest periods, and weigh the patient daily. Acromegaly Acromegaly (hyperpituitarism) is the hypersecretion of growth hormone by the anterior pituitary gland. Excessive secretion of growth hormone occurs after epiphyseal closing. The tumor is located in the anterior pituitary gland. Giantism occurs if acromegaly occurs prior to epiphyseal closure (ends on long bones where tissues and cartilage are ossified to bone). The patient will have large hands and feet. Treatment is removal of the tumor. Dwarfism occurs if there is a low production of growth hormone (GH) during childhood and the result is stunted growth. In over 90 percent of acromegaly patients, the overproduction of growth hormones is caused by a benign tumor of the pituitary gland, called an adenoma . These tumors produce excess growth hormones and, as they expand, compress surrounding brain tissues, such as the optic nerves. This expansion causes headaches and visual disturbances that often accompany acromegaly. In addition, compression of the surrounding normal pituitary tissue can alter production of other hormones, leading to changes in menstruation and breast discharge in women, and impotence in men because of reduced testosterone production. In a few patients, acromegaly is caused not by pituitary tumors, but by tumors of the pancreas, lungs, and adrenal glands. These tumors also lead to an excess of GH, either because they produce GH themselves or, more frequently, because they produce GHRH (Growth Hormone Releasing Hormone), the hormone that stimulates the pituitary to make GH. In these patients, the excess GHRH can be measured in the blood to establish that the cause of the acromegaly is not due to a pituitary defect. When these non-pituitary tumors are surgically removed, GH levels fall and the symptoms of acromegaly improve. In patients with GHRH-producing, non-pituitary tumors, the pituitary still may be enlarged and may be mistaken for a tumor. Therefore, it is important that physicians carefully analyze all pituitary tumors removed from patient with acromegaly in order to not overlook the possibility that a tumor elsewhere in the body is causing the disorder. ©2017 Achieve Test Prep Page 72 of 140

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