Page 333 - Critical Care Nursing Demystified

318 CRITICAL CARE NURSING DeMYSTIFIED

and despite what might be viewed as a considerable setback, this nurse was well
adjusted to her condition, performed admirably, and never acknowledged any
significant limitations in her abilities to function as a nurse. Throughout the years
she traveled the world, cared for many people, and even managed to obtain a
bona fide Florence Nightingale Lamp from England, return it to the United States,
and present it to her School of Nursing. This woman faced her condition with
dignity and will always be respected and admired for her many years of active,
dedicated contributions to the profession of nursing despite all odds.

Hypopituitarism

What Went Wrong?
Hypopituitarism is caused by a lack of GH due to hypofunction of the pituitary
gland. In children, a deficiency of GH causes dwarfism or an abnormally small
stature as well as physical, mental, and sexual underdevelopment.
Sheehan’s syndrome is a type of hypopituitarism that can develop after a com-
plicated delivery with excessive bleeding and hypovolemic shock. Destruction of
the pituitary gland occurs after circulatory collapse from uterine hemorrhaging. 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.

Interpreting Test Results
In children the normal serum growth hormone level is 0 to 20 ng/mL. In cases
of suspected dwarfism, the GH level is less than 10 ng/mL.

Prognosis
Treatment consists of lifelong hormone replacement therapy using certain
medications such as Genotropin or Humatrope.

4 Nursing Diagnosis for
Hypopituitarism Expected Outcomes
Knowledge deficit related to Family will be aware of need for lifelong GH
hormone replacement therapy replacement therapy in the child
Family will understand actions and side
effects of the medications provided

Nursing Interventions
Provide detailed instructions about specific medications.

Emphasize the need for lifelong follow-up care and medical interventions.
Assess status of child’s mental and physical development.