Documenti di Didattica
Documenti di Professioni
Documenti di Cultura
• Two portions; each with unique functions • Vertical growth + increased muscle
• Weight generally in proportion to height
• Anterior, Posterior
Pituitary Hyperfunction: Acromegaly
Hypopituitarism:
• Growth Hormone Deficiency
• Excess GH after epiphyseal closure is called
acromegaly
• Inhibits somatic growth • Typical facial features
Diagnostic Evaluations
• Primary site of dysfunction appears to be in the
hypothalamus • Radiologic studies
• Endocrine studies
Diagnostic Evaluation of GH Deficiency Therapeutic Management
• Surgical treatment to remove tumor
• Family history
• Radiation and radioactive implants
• Growth patterns and health history • Hormone replacement therapy after surgery in some
cases
• Definitive diagnosis bases of radioimmunoassay of plasma Nursing Considerations
GH levels
• Early identification of children with excessive growth
rates
• Hand x-rays to evaluate growth potential vs. ossification
• Early treatment for improved outcomes
• Endocrine studies to detect deficiencies • Emotional support
• Body image concerns
Therapeutic Management of GH Deficiency Precocious Puberty
• Defined as sexual development before age 9 in boys or
• Biosynthetic growth hormone (injections) before age 8 in girls
• Other hormone replacements as needed • Occurs more frequently in girls
– Thyroid extract
• Potential causes
– Cortisone
– Disorder of gonads, adrenal glands, or
– Testosterone or estrogens and progesterone hypothalamic-pituitary gonadal axis
Prognosis – No causative factor in 80%-90% of girls
and 50% boys
• GH replacement successful in 80% of affected
children Types of Precocious Puberty
• True or complete precocious puberty
• Growth rate of 3.5-4 cm/yr before treatment and
increase to 8-9 cm/yr after treatment • Precocious pseudopuberty
• Incomplete puberty
• Response varies based on age, length of treatment,
frequency of doses, dosage, weight, and GH receptor Therapeutic Management
amount • Treatment of specific cause if known
Creutzfeldt-Jakob Disease (CJD) • May be treated with Lupron
• Rare neurodegenerative condition reported in some – Slows prepubertal growth to normal rates
patients after receiving human GH from cadavers
– Treatment is discontinued at age for normal
• Does not occur with biosynthetic GH pubertal changes to resume
• Psychologic support for child and family
• Blood banks will not accept donation from former
human GH recipients for risk of infection with CJD Diabetes Insipidus (DI)
Nursing Considerations • The principle disorder of the posterior pituitary
• Family support needs • Results from hyposecretion of ADH
• Child’s body image • Produces uncontrolled diuresis
The Child with Endocrine Dysfunction