Adrenal and Pituitary

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Adrenal and Pituitary

• Dr. Kathleen Ethridge
• Northeast Texas Community College

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Anatomy and Physiology

• Pituitary
• Adrenal

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Hormones

• Pituitary
• Adrenal

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Adrenal Gland

• Gross and microscopic anatomy
• Hormones
• Sugar (glucocorticoids)
• Salt (mineralcorticoids)
• Sex (androgens)

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Adrenal HormonesFunction and Dysfunction

• Mineralocorticoids
• Aldosterone
• Glucocorticoids
• Cortisol
• ACTH
• Androgens

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Addisons Disease

• See handout

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Diagnostic Tests ofAdrenocortical Function

• See chart
• Cortisol levels
• plasma
• urine
• with suppression (dexamethasone)
• Aldosterone level
• Plasma ACTH
• with stimulation (cosyntropin)
• Renin level
• Corticotropin-releasing hormone
• stimulation test

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Corticosteroids

• See chart
• Glucocorticoids
• Dexamethasone
• Decadron
• methylprednisolone
• Medrol
• hydrocortisone
• Hydrocortone
• Mineralocorticoids
• Florinef

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Corticosteroid Use

• Diabetes mellitus
• Inflammatory bowel disorder
• Hypertension
• Congestive heart failure
• Renal insufficiency
• Note Steroids are contraindicated in clients
  with viral, fungal, or tubercular infections.

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Addisonian Crises

• Sudden profound weakness
• Sever abdominal , back, and leg pain
• Hypothermia
• Hypotension
• Coma
• Renal shutdown
• Death
• see handout for treatment

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Cushings Syndrome

• See handout

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Transphenoidal Hypophysectomy
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Hyperaldosteronism

• See handout

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Complications of Spironolactone

• See chart
• Drug of choice for primary hyperaldosteronism
• Side effects
• GI distress
• impotence
• gynecomasatia
• Drug interaction
• with Digoxin
• with Aspirin

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Pheochromocytoma

• Adrenomedullary disorder
• See handout

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Effects of Epinephrine and Norepinephrine

• Cardiovascular
• Respiratory System
• Nervous System
• Metabolism

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Adrenalectomy

• TCDB
• Check for hemorrhage
• Watch for shock
• Vital Signs
• I O
• Replacement hormones

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Pituitary Disorders

• Anterior Pituitary
• Hyperpituitarism and Hyperprolactinemia
• Hypopituitarism

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Pituitary

• Posterior Lobe
• Diabetes insipidus
• SIADH (Syndrome of Inappropriate Secretion of
  Antidiuretic Hormone)

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Monitor clients for DI SIADH

• See Chart
• ADH
• Urine Output
• Urine Osmolality
• Urine Specific Gravity
• Serum Sodium
• Urine Sodium
• Plasma Osmolality
• Daily Weight
• Mental Changes