1. The anterior pituitary gland controls growth metabolic activity and _____________ development through the action of hormones.

Ans: Sexual 2. T or F Primary pituitary dysfunction can result from problems arising outside the anterior pituitary gland.

Ans: F-primary pituitary disfunction can result from problems within the anterior pituitary. 3. What is Panhypopituitarism? Ans: decreased production of all the anterior pituitary hormones, very rare. 4. Name 4 hormones secreted by the anterior pituitary gland? Ans: 1. Growth hormone(GH), 2. Lutenizing hormone(LH), 3. Prolactin Thyrotropin(TSH),4. Melanocyte stimulating hormone(MSH), 5. Corticotropin/adrenocortroic(ACTH), 6. Follicle stimulating hormones (FSH) 5. What 2 hormones are most life threatening to be deficient in hypopituitarism? Ans: Adrenocorticotropic hormone (ACTH). Thyroid stimulating hormone (TSH b/c they result in a corresponding decrease in the secretion of vital hormones from the adrenal and thyroid glands. 6. Hypopituituitarism results in a deficiency in gonadotropins (LH & FSH) which alter sexual function. Name 2 changes that occur? Ans: Men: Testicular failure Decreased testosterone Sterility D/T decreased Test. Level 7. As a result of hypopituitarism a deficiency can result in the growth hormone. All of the following clinical manifestations can occur as a result of these except: a. thin, fragile bones in adults What are the causes of hypopituitarism? Name 4 Women: Ovarian failure Amenorrhea Infertility

Ans: PP hemorrhage Renign or malignant tumors Sever malnutrition Shock or severe hypotension Partial or total hypophysectomy radiation to the brain metastatic cancer Idiopathic hypopituitary Trauma Infarction post systemic shock 9. T or F After a bilateral adrenalectomy, clients require life long glucocorticoid replacement, starting immediately afeter surgery. Ans: True 10. What neurological manifestations of hypopituitarism would you see due to abnormal tumor growth formation? Name 3. Ans: Loss of visual acuity Loss off peripheral vision Temporal HA Ocular muscle paralysis Diplopia

11. what is a stimulation test? Ans: a test to check pituitary function, involves injecting agents that are know to stimulate secretion of specific pituitary hormones then measuring their response. 12. Hyperpituitarism is hormone oversecretion that occurs from what? Ans: Tumors Hyperplasia 13. what is the most common cause of hyperpituitarism? Ans: Pituitary adenoma-benign tumor 14. T or F The skeletal changes that occur in gigantism or acromegaly are permanent and do not return to normal after treatment. Ans: True: Gigantism or acromegaly have a slow onset of dz. And may go unnoticed for years. Changes in soft tissue of the face, hands and skin, may to a certain extent change patients treatment but skeletal changes are permanent. 15. name 3 signs or symptoms you would see in a client with a prolactin secreting tumor (pituitary adenoma)?

Ans: Galactorrhea Amenorrhea Infertility Neurologic SX (compress brain tissue) Visual changes Headache Increased ICP 16. T or F Growth hormone is an insulin antagonist in hyperpituitarism and causes hyperglycemia Ans: True: the growth hormone blocks the secretion of insulin thus causing an increase in the blood sugar. 17. excessive adrenocorticotropic hormone causes over stimulation of the adrenal cortex and results in excessive production of glucocorticoids, mineral corticoids and androgents. What syndrome (Dz.) does it lead to? Ans: Cushhings Disease 18. What are the goals of therapy for a client with hyperpituitarism? Name 2 Ans: Return hormone levels to all or near normal. Reduce or eliminate vision changes Prevent complications Reverse as many body changes as possible 19. Name one drug used in the treatment of hyperpituitarism? Ans: Cabergoline (Dostinex) Mesylate (Parlodel) These drugs are dopamine agonists. Stimulate dopamine receptors in the brain and inhibit release of pituitary hormones. 20. Name 3 ways to treat hyperpituitarism? Medication Management Radiation Therapy Hypophysectomy 21. after a transphenodial Hypophysectomy what type of dressing is applied? a. Sphenodial dressing b. Craniotomy dressing c. Mustache dressing d. Patellar dressing Ans: C 22. The mustache dressing after a transphenoidal hypophysectomy is saturated with clear, yellow tinged fluid. What would you as the nurse do? Ans: Assess the nasal drainage for quantity, quality and the presence of glucose. Glucose indicates a CSF leak.

23. Name 2 things a nurse should teach a client after a hypophysectomy? Ans: Avoid coughing because increased pressure in the incision and may lead to a CSF leak Instruct client not to brush teeth until incision healed-use dental floss and oral mouth rinse Instruct client not to bend at waist because this increases ICP. Teach self administration of prescribed hormone. 24. The client with hypopituitarism is asking the nurse how long he will have to take testosterone. What is the nurses best response? Ans: the client will need to take testosterone (HRT) forever because he is not producing any hormone. 25. when the treatment for diabetes insipidus is effective the urinary output will be____________and the specific gravity_____________. Ans: urinary output will be decreased; specific gravity will be increased. 26. A client is taking desmopressin acetate (DDAVP) nasally for diabetes insipidus. What is a possible side effect? Ans: Nasal Viceration and irritation. 27. This condition is a water metabolism problem caused by ADH deficiency, either a decreasein ADH synthesis or an inability of the kidneys to respond to ADH. What is the condition? Ans: Diabetes Insipidus 28. In Diabetes insipidus water is excreated as urine rather than being absorbed in these areas which leads to ______________? Ans: Polyuria and dehydration 29. Pheochromocytoma is a catecholamine-producing tumor that usually occurs as a single lesion in the right______________ ________________. Ans: Adrenal gland 30. Emergency care of acute adrenal insufficiency include all of the following except: a. Administer SoluCortet b. Manage Hyperkalemia c. manage Hypoglycemia d. Manage hypernatremia Ans: D Acute adrenal insuffiency is an ER. Manage hormone by giving SluCortef. Manage the hyperkalemia by administering insulin with dextrose in NS to shift K+ out of cells, or use Kayexalate. Administer IV glucose. Adrenal insufficiency. Causes hyponatremia D/T Na and H2O excretion. 31. Which assessment maneuver should the nurse avoid in a client with a pheochromocytoma?

Ans: Palpation of the Abdomen, because this could cause a sudden release of catecholamines and sever hypertension. 32. What is the treatment for syndrome of inappropriate antidiurecti hormone (SIADH)? Ans: Fluid restriction, Diuretics, Hypertonic saline z3% NaCL, demeclocycline (Declomycia) 33. What is treatment for diabetes insipidus: Ans: Vasopressin Therapy DDAVP., Lypressin, Pitressin 34. In syndrome of inappropriate antidiuretic hormone (SIADH) water is retained, which results in dilutional ______________ and expansion of the extracellular fluid volume. Ans: Hyponatremia