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Dynamic Investigations and Diagnostic Testing

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Advanced Practice in Endocrinology Nursing

Abstract

The evaluation of pituitary function is complex and critical. Pituitary dysfunction causes a wide range of physical, emotional, social, and potentially spiritual changes, all of which compound the process of evaluation. Patient and family anxieties are heightened given either symptoms of unknown etiology or a new discovery of a “brain tumor,” which can influence testing outcomes and requires nursing expertise in management.

Infants and children are affected by pituitary dysfunction that can present with life-threatening symptoms and parents in need of significant support. Both issues pose a challenge to the endocrine nurse involved in the child’s evaluation. Most testing is not emergent and appropriate patient and parent preparation with attention to factors that can invalidate testing is vital. Explanations and/or literature provided to the patient and family must be age and language appropriate.

There is a broad range of diagnostic techniques that may be employed in diagnosis and ongoing patient management for patients with pituitary diseases. Knowledge of the testing purpose, procedure, and result interpretation is essential for the endocrine nurse performing testing and advance practice nursing for long-term patient management.

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Abbreviations

17KG:

17-ketogenic steroid

17OHCS:

17-hydroxycorticosteroid

17OHP:

17-hydroxyprogesterone

ACTH:

Adrenocorticotropic hormone

ADA:

American Diabetic Association

ADH:

Anti-diuretic hormone

AI:

Adrenal insufficiency

AVP:

Arginine vasopressin

CAH:

Congenital adrenal hyperplasia

Cm:

Centimeter

CRH:

Corticotropin releasing hormone

CSF:

Cerebral spinal fluid

CT:

Computed tomography

DDAVP:

Synthetic desmopressin

DI:

Diabetes insipidus

dL:

Deciliter

EMR:

Electronic Medical Record

FSH:

Follicle stimulating hormone

G:

Gram

GH:

Growth hormone

GHD:

Growth hormone deficiency

GHRH:

Growth hormone releasing hormone

GnRH:

Gonadotropin releasing hormone

GST:

Glucagon stimulation test

HCG:

Human chorionic gonadotropin

HPA:

Hypothalamic pituitary adrenal

HPG:

Hypothalamic pituitary gonadal

HPT:

Hypothalamic–pituitary thyroid

IGF-1:

Insulin-like growth factor 1

IPSS:

Inferior petrosal sinus sampling

ITT:

Insulin tolerance test

IV:

Intravenous

IVP:

Intravenous push

Kg:

Kilogram

LH:

Luteinizing hormone

LNSC:

Late night salivary cortisol

m2:

Meter squared

mL:

Milliliter

mOsm:

Milli-osmolarity

MRI:

Magnetic resonance imaging

Na:

Sodium

Ng:

Nanogram

nmol/L:

Nanamole/liter

PCOS:

Polycystic ovarian syndrome

PET-CT:

Positron emission tomography with computerized tomography

rhGH:

Recombinant growth hormone

SAI:

Secondary adrenal insufficiency

SHBG:

Sex hormone binding globulin

SRS:

Somatostatin receptor scintigraphy

T3:

Triiodothyronine

T4:

Thyroxine

TRH:

Thyrotropin releasing hormone

TSH:

Thyroid stimulating hormone

WDT:

Water deprivation test

μg:

Microgram

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Author information

Authors and Affiliations

  1. Northwest Pituitary Center, Oregon Health and Sciences University, Portland, OR, USA

    Christine Yedinak

  2. Department of Advanced and Integrated Practice, London South Bank University, London, UK

    Kate Davies

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  1. Christine Yedinak
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Correspondence to Christine Yedinak .

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Editors and Affiliations

  1. School of Health Sciences, City, University of London, London, UK

    Sofia Llahana

  2. Department of Oncology, Skåne University Hospital, Lund, Sweden

    Cecilia Follin

  3. Northwest Pituitary Center Oregon Health and Sciences University, Portland, OR, USA

    Christine Yedinak

  4. Churchill Hospital, University of Oxford, Oxford, UK

    Ashley Grossman

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Yedinak, C., Davies, K. (2019). Dynamic Investigations and Diagnostic Testing. In: Llahana, S., Follin, C., Yedinak, C., Grossman, A. (eds) Advanced Practice in Endocrinology Nursing. Springer, Cham. https://doi.org/10.1007/978-3-319-99817-6_15

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  • DOI: https://doi.org/10.1007/978-3-319-99817-6_15

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-99815-2

  • Online ISBN: 978-3-319-99817-6

  • eBook Packages: MedicineMedicine (R0)

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