Hypopituitarism: Nursing

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With hypopituitarism, hypo- means low and pituritism refers to the pituitary gland. So hypopituitarism describes an excessive decrease or absence of the pituitary hormones. Now, hypopituitarism comes in two flavors: selective hypopituitarism, meaning only one pituitary hormone is deficient, and this is the more common scenario; and panhypopituitarism, a rare situation when all pituitary hormones are deficient, which can be life threatening.

Now, the pituitary is a small, pea-sized gland at the base of the brain. Specifically, the pituitary gland sits in the sella turcica, a small bony cavity in the sphenoid bone. This is really just a fancy way to say “behind the nose!” Above the pituitary gland, there’s the optic chiasm, and laterally, there are the cavernous sinuses. Now, let’s quickly review some anatomy and physiology.

The pituitary gland is made up of an anterior lobe and posterior lobe. The anterior lobe, also called the adenohypophysis, contains endocrine cells that produce tropic hormones, which in turn control the secretion of hormones from other endocrine glands or influence a response in target tissues. These include thyroid stimulating hormone, or TSH; adrenocorticotropic hormone, or ACTH; growth hormone, or GH; the gonadotropins, namely follicle stimulating hormone, or FSH, and luteinizing hormone, or LH; prolactin. Additionally, a smart part of the pituitary gland that can be considered part of the anterior lobe secretes melanocyte stimulating hormone, or MSH.

So for the anterior lobe, TSH stimulates thyroid hormone production, which, in turn, increases the basal metabolic rate in all cells. Next, ACTH stimulates adrenal cortisol production, which, in turn, has plenty of effects around the body, such as regulating glucose metabolism, blood pressure, and electrolyte balance, and immunity.


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