I.

Diagnostic Tests
Stimulating and suppression tests
Stimulation testing
• Stimulus may be provided to determine whether the gland is capable of
normal hormone production.
Suppression test
• Used when hormones levels are high or in the upper range of normal.
II. Radioactive iodine uptake
• This thyroid function test measures the absorption of the iodine isotope
to determine how the thyroid gland id functioning.
• Elevated values indicate hyperthyroidism, decreased iodine intake or
increased iodine excretion
• Decrease values indicate a low T4 level, the use of antithyroid
medications, thyroiditis, myxedema or hypothyroidism.
III. T3 and T4 resin uptake test
• Blood tests are used to diagnose thyroid disorders.
IV. Thyroid-stimulating hormone
• Blood test is used to differentiate the diagnosis of primary
hypothyroidism.
V. Thyroid Scan
• Thyroid scan is performed to identify nodules or growths in the thyroid
VI. Needle aspiration of thyroid tissue
• Aspiration of thyroid tissue
VII. Glucose Tolerance Test
• The glucose tolerance test aids to the diagnosis of Diabetes Millitus
VIII. Glycosylated Hemoglobin
• Indicated how well blood glucose levels have been controlled for the
prior 3 to 4 months.
IX. Glycoserated Serum Albumin
• More sensitive to recent changes that the HbA1c
Pituitary Gland Disorder
A. Hypopituitarism
• Hyposecretion of one or more pituitary hormones.
Assessment
• Mild to moderate obesity
• Reduced cardiac output
• Infertility, sexual dysfunction
• Tumors of the pituitary also may cause head aches and visual changes.
Intervention
• Provide emotional support
• Encourage client and family to express feelings related to deficient
hormones.
• Client education needed regarding signs and symptoms of hypofunction
and the hyperfunction related to insufficient or excess hormone
replacement.
B. Hyperpituitarism
• Hypersecretion of groth hormones by the anterior pituitary gland in an
adult; caused primarily by pituitary tumors.
Assessment
• Large hands and feet
• Thickening and protrusion of the jaw
• Arthristic changes
• Visual disturbances
• Diaphoresis
• Oily, rough skin
• Organomegaly
 • Hypertension
• Dysphagia
• Deepening of voice
Intervention
• Provide emotional support to client and family and encourage client and
family to express feelings related to disturbed body image.
• Provide frequent skin care
• Provide pharmacological and nonphramacological interventions for join
pain.
• Prepare the client for radiation of the pituitary gland if prescribed
• Prepare the client for Hypophysectomy if planned

C. Hypophysectomy (pituitary adenectomy, transsphenoidal pituitary surgery)

• Removal of pituitary tumor via craniotomy or transphenoidal approach
Postoperative Interventions
• Initiate postoperative care similar to craniotomy care
• Monitor vital signs,neurological status, and level of consciousness
• Elevate head of the bed
• Monitor for increase ICP
• Monitor bleeding
• Monitor for any post nasal Drip or nasal drainage
• Instruct the client to avoid sneezing, coughing and and blowing of the
nose
• Monitor electrolytes values
• Monitor intake and output and avoid water intoxication
• Administer glucocorticoids and other hormone replacement as
prescribed
D. Diabetes Insipidus
• Hyposecretion of ADH
Assessment
• Polyuria 4 to 24l/day
• Polydipsia
• Dehydration
• Inability to concentrate urine
• Low urinary specific gravity 1.006 or lower
• Fatigue
• Headaches
• Postural hypotension that may progress to vascular collapse without
rehydration
• Tachycardia
Intervention
• Monitor v/s and neurological and cardio vascular status
• Provide a safe environment
• Monitor electrolytes
• Maintain intake of adequate fluids
• Monitor intake and output, weight serum osmolality
• Chlorpropamide (Diabinese) may be prescribed for mild diabetes
insipidus
• Vassopressin tannate (DDAVP,Stimate)
• Instruct the client in the administration of medication of medications
• Instruct client to wear medic bracelet.
E. Syndrome of inappropriate antidiuretic hormone(SIADH)
• Excess ADH is released, but not in response to the body’s need for it.
Assessment
• Signs of fluid volume overload
 • Changes in level of consciousness and mental status
• Weigh gain
• Hypertension
• Tachycardia
• Anorexia, nausea vomiting
• Hyponatremia
Intervention
• Monitor vital signs and cardiac and neurological status
• Provide a safe environment, particularly for the client with changes in
the level of consciousness and mental status
• Monitor intake and output and obtain weight daily
• Monitor fluid and electrolyte balance
• Monitor serum and urine osmolality
• Restrict fluid intake as prescribes
• Administer antidiuretics and IV fluids
• Demeclocycline (delomycin)

Adrenal Gland Disorders

A. Addison’s Disease
• Hyposecretion of adrenal cortex hormones
Assessment
• Lethargy, fatigue
• Muscle weakness
• Gastrointestinal disturbances
• Weight loss
• Menstrual changes in women; impotence in men
• Hypoglycemia
• Hyponatremia
• Hypoglycemia
• Hypercalcemia
• Postural hypertension
• hyperpigmentaion
Intervention
• Monitor v/s particularly blood pressure weight and intake and outout
• Monitor blood glucose and potassium
• Administer glucocorticoids or mineralocorticoaid meds
• Observe for addisonian crisis caused by stress infection and trauma,
surgery
Client education
• Avoid individual with glucocorticoid therapy
• Diet: high in protein and high in carbohydrate normal sodium intake
• Avoid stress
• Need for life long glucocorticoid therapy
• Avoid over the counter medications
• Wear medic balcelet
• Sign and symptoms related to underrplacement and overplacement of
hormones.