CHAPTER 51- FINAL STUDY GUIDE 2026
CARE OF THE PATIENT WITH AN ENDOCRINE
DISORDER EXAM
QUESTIONS WITH DETAILED ANSWERS
Acromegaly - ANSWER-* Overproduction of somatotropin (GH) causing enlargement of
extremities.
* Caused by (1. idiopathic hyperplasia or (2. tumor growth
* growth changes are irreversible
* produces enlarged cranium, lower jaw, separated and maloccluded teeth, bulging forehead,
bulbous nose, thick lips, enlarged tongue, and generalized coarsening of the facial features.
* voice deepens due to hypertrophy of vocal cords
* fingetips develop tufted or clubbed appearance.
* Enlargement of heart, liver and spleen.
* Muscle weakness
* Males may become impotent, females may have increased facial hair and amenorrhea.
DX for Acromegaly - ANSWER-CT, MRI, X-Ray
Eye exam to determine tumor
Lab tests to check GH levels are elevated
Definitive test is Oral Glucose Challenge Test (normal GH levels fall in this test but in
Acromegaly they do not)
Medical Management of Acromegaly - ANSWER-Dostinex
Sandostatin (which inhibit GH)
Attempts to suppress GH secretion
Transspheniodal surgery to remove tumor
Proton beam treatment
Nursing Interventions for Acromegaly - ANSWER-soft, easy to chew diet
allow adequate time during meals
encourage frequent fluid intake
, nonopioid analgesics given
take care to prevent stumbling into things from vision impairment
Gigantism - ANSWER-* Results from oversecretion of GH as a result of hyperplasia of the
anterior pituitary; may develop into a tumor
* May also be a defect in the hypothalamus
* Overgrowth of long bones can occur when overproduction of GH occurs in a child before the
epiphyses closes
*Great height/ weight increases but body proportions are usually normal
* Usually weak despite size
DX for Gigantism - ANSWER-GH-suppression test (or glucose-loading test)
baseline levels of GH are high in Gigantism
Medical Management of Gigantism - ANSWER-Surgical removal or irradiation of anterior
pituitary gland with replacement hormone therapy
Dwarfism - ANSWER-*Deficiency in GH
*Idiopathic/small number related to an autosomal recessive trait/can also lack ACTH, TSH and
gonadotropins
* Usually appear well proportioned and well nourished but appear younger than their
chronological age
*May have problems with dentition since jaws are underdeveloped
* Sexual development is usually normal but delayed
*Able to reproduce normal offspring
DX for Dwarfism - ANSWER-X-Ray of wrist for bone age
MRI/CT
Definitive diagnosis is based on GH levels (decreased levels)
Medical Management for Dwarfism - ANSWER-Replacement GH by injection and addition of
other hormones as needed
Removal of tumor if cause
Diabetes Insipidus - ANSWER-*Deficient ADH (either secretion or action of ADH goes awry)
of the posterior pitutary
CARE OF THE PATIENT WITH AN ENDOCRINE
DISORDER EXAM
QUESTIONS WITH DETAILED ANSWERS
Acromegaly - ANSWER-* Overproduction of somatotropin (GH) causing enlargement of
extremities.
* Caused by (1. idiopathic hyperplasia or (2. tumor growth
* growth changes are irreversible
* produces enlarged cranium, lower jaw, separated and maloccluded teeth, bulging forehead,
bulbous nose, thick lips, enlarged tongue, and generalized coarsening of the facial features.
* voice deepens due to hypertrophy of vocal cords
* fingetips develop tufted or clubbed appearance.
* Enlargement of heart, liver and spleen.
* Muscle weakness
* Males may become impotent, females may have increased facial hair and amenorrhea.
DX for Acromegaly - ANSWER-CT, MRI, X-Ray
Eye exam to determine tumor
Lab tests to check GH levels are elevated
Definitive test is Oral Glucose Challenge Test (normal GH levels fall in this test but in
Acromegaly they do not)
Medical Management of Acromegaly - ANSWER-Dostinex
Sandostatin (which inhibit GH)
Attempts to suppress GH secretion
Transspheniodal surgery to remove tumor
Proton beam treatment
Nursing Interventions for Acromegaly - ANSWER-soft, easy to chew diet
allow adequate time during meals
encourage frequent fluid intake
, nonopioid analgesics given
take care to prevent stumbling into things from vision impairment
Gigantism - ANSWER-* Results from oversecretion of GH as a result of hyperplasia of the
anterior pituitary; may develop into a tumor
* May also be a defect in the hypothalamus
* Overgrowth of long bones can occur when overproduction of GH occurs in a child before the
epiphyses closes
*Great height/ weight increases but body proportions are usually normal
* Usually weak despite size
DX for Gigantism - ANSWER-GH-suppression test (or glucose-loading test)
baseline levels of GH are high in Gigantism
Medical Management of Gigantism - ANSWER-Surgical removal or irradiation of anterior
pituitary gland with replacement hormone therapy
Dwarfism - ANSWER-*Deficiency in GH
*Idiopathic/small number related to an autosomal recessive trait/can also lack ACTH, TSH and
gonadotropins
* Usually appear well proportioned and well nourished but appear younger than their
chronological age
*May have problems with dentition since jaws are underdeveloped
* Sexual development is usually normal but delayed
*Able to reproduce normal offspring
DX for Dwarfism - ANSWER-X-Ray of wrist for bone age
MRI/CT
Definitive diagnosis is based on GH levels (decreased levels)
Medical Management for Dwarfism - ANSWER-Replacement GH by injection and addition of
other hormones as needed
Removal of tumor if cause
Diabetes Insipidus - ANSWER-*Deficient ADH (either secretion or action of ADH goes awry)
of the posterior pitutary
