Following a transsphenoidal hypophysectomy, the nurse should assess for which condition?

Following a transsphenoidal hypophysectomy, the nurse should assess for which condition?

• A. Hypocortisolism
• B. Hypoglycemia
• C. Hyperglycemia
• D. Hypercalcemia

Answer: (A)

The key idea is that removing or damaging the pituitary during a transsphenoidal hypophysectomy can stop ACTH production, leading to secondary adrenal insufficiency (hypocortisolism). Without ACTH, the adrenal cortex doesn’t make enough cortisol, and cortisol is essential for maintaining vascular tone, glucose metabolism, and the stress response. So the nurse should monitor for signs of cortisol deficiency such as fatigue, weakness, hypotension, nausea, weight loss, hyponatremia, and hypoglycemia, and be prepared to initiate glucocorticoid replacement if needed. Hyperglycemia and hypercalcemia are not typical immediate concerns from this procedure.

The key idea is that removing or damaging the pituitary during a transsphenoidal hypophysectomy can stop ACTH production, leading to secondary adrenal insufficiency (hypocortisolism). Without ACTH, the adrenal cortex doesn’t make enough cortisol, and cortisol is essential for maintaining vascular tone, glucose metabolism, and the stress response. So the nurse should monitor for signs of cortisol deficiency such as fatigue, weakness, hypotension, nausea, weight loss, hyponatremia, and hypoglycemia, and be prepared to initiate glucocorticoid replacement if needed. Hyperglycemia and hypercalcemia are not typical immediate concerns from this procedure.