Page 332 - Critical Care Nursing Demystified

Chapter 7 CARE OF THE PATIENT WITH ENDOCRINE DISORDERS 317

Prognosis
Since all soft tissues and organs of the body are enlarged and affected by excesses
in the production and release of GH, marked improvement of symptoms can
be achieved with careful monitoring of pituitary hormone serum levels, and
adequate pharmacologic and medical management.

4 Nursing Diagnosis for
Pituitary Tumors Expected Outcomes
Impaired nutrition less than body Patient will demonstrate an improved
requirements related to increased nutritional status within 1–2 weeks
GH hormone levels and difficulty Patientʼs level of dysphagia will gradually
chewing and swallowing improve

GH levels will return to within normal
limits (2–5 ng/mL)

Nursing Interventions

Weigh patient daily to assess weight gain or loss.
Provide a soft diet in small portions and easy to swallow, enjoyable snacks for
easier chewing. Downloaded by [ Faculty of Nursing, Chiangmai University 5.62.158.117] at [07/18/16]. Copyright © McGraw-Hill Global Education Holdings, LLC. Not to be redistributed or modified in any way without permission.
Maintain accurate intake and output to ensure adequate hydration.
Offer prn muscle relaxants if prescribed to reduce discomfort of dysphagia.
Assess for signs of aspiration such as choking, coughing, tearing, or cyanosis
when ingesting food or fluids.
Allow the patient sufficient time to eat and chew slowly without being rushed.
Teach jaw movement exercises to enhance mandibular movement.
Suction patient if danger of aspiration is pronounced.

Maintain emergency tracheostomy equipment on standby.
Provide prescribed medications to lower GH levels and monitor laboratory
results, for example, Sandostatin, Depot, Dostinex.

Recounting a True Story

In 1933, a young woman clutched her diploma with pride. She had just graduated
after completing a rigorous 3-year nursing program and was ready to cure illness
and conquer the world. In addition to all of the challenges facing new nurses in
those days, she had one additional challenge—Giantism. She was well over 7 ft tall