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Cardiomyopathy VII: Pre and Post Operative Nursing Management01:28

Cardiomyopathy VII: Pre and Post Operative Nursing Management

Patients with hypertrophic cardiomyopathy (HCM) and left ventricular outflow tract (LVOT) obstruction who remain symptomatic despite optimal medical therapy may undergo a septal myectomy (Morrow procedure). This procedure involves excising a portion of the hypertrophied septum below the aortic valve using a heart-lung machine to improve blood flow through the LVOT. Effective preoperative and postoperative nursing management ensures successful patient outcomes, minimizes complications, and...
Aneurysm IV: Nursing Management01:22

Aneurysm IV: Nursing Management

Vigilant monitoring for aneurysm rupture is essential for patients undergoing aortic surgery.Preoperative Nursing ManagementContinuously monitor the patient for manifestations of aneurysm rupture, such as pallor, weakness, tachycardia, hypotension, abdominal, back, groin, or periumbilical pain, changes in consciousness, and a pulsating abdominal mass. Regularly assess the patient's peripheral pulses.Instruct the patient to consume a clear liquid diet the day before surgery and administer...
The Pituitary Gland01:17

The Pituitary Gland

The pituitary is a small endocrine organ in the sphenoid bone under the hypothalamus. Primarily, the pituitary in adults has two distinct anatomical and functional regions— the anterior and posterior lobes. During human fetal development, a third pituitary gland region called the pars intermedia atrophies and disappears. However, some of its cells migrate and exist adjacent to the anterior pituitary in adults.
Hormones of the Pituitary Gland01:27

Hormones of the Pituitary Gland

The small, pea-sized pituitary gland is located at the base of the brain. It is crucial in regulating various bodily functions, from growth to reproduction. The gland is divided into the anterior lobe and the posterior lobe. The secretory cell clusters in the pars distalis of the anterior pituitary lobe are controlled by hypothalamic regulators and synthesize six primary hormones.
The most abundantly secreted hormone from the anterior lobe is the growth hormone, which controls overall growth by...
Kidney Transplant II: Surgical Procedure01:26

Kidney Transplant II: Surgical Procedure

Preoperative ManagementThe primary goals of preoperative management in kidney transplantation are to optimize the patient’s metabolic state and prepare them for surgery through diet adjustments, necessary dialysis, and tailored medical treatment. This phase also involves comprehensive infection screening and patient education about the surgical procedure and postoperative care to improve outcomes and adherence.Medical ManagementA comprehensive evaluation is required for both the living donor...
Peripheral Artery Disease V: Postoperative Nursing Management01:23

Peripheral Artery Disease V: Postoperative Nursing Management

During the postoperative period, it is crucial to focus on maintaining circulation, identifying and managing potential complications, and planning for discharge.Nursing AssessmentVital signs monitoring: Regularly monitor vital signs, including blood pressure, heart rate, respiratory rate, and temperature, to detect early signs of complications such as bleeding and infection.Circulation assessment: Monitor pulses, perform Doppler assessments, and check capillary refill, color, temperature, and...

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Related Experiment Video

Updated: Jul 6, 2026

Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas
07:43

Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas

Published on: January 17, 2018

Preoperative assessment for pituitary surgery.

Olivia Pereira1, John S Bevan

  • 1Department of Endocrinology, Aberdeen Royal Infirmary, Foresterhill, Aberdeen, Scotland, UK.

Pituitary
|March 14, 2008
PubMed
Summary

Pre-operative pituitary function tests are crucial for pituitary surgery. Key tests include prolactin, cortisol, and thyroid hormones to guide peri-operative management and hormone replacement therapy.

Area of Science:

  • Endocrinology
  • Neurosurgery

Background:

  • Pituitary function evaluation is critical before pituitary surgery.
  • Distinguishing tumoral hyperprolactinemia from 'disconnection' hyperprolactinemia is essential.

Purpose of the Study:

  • To outline essential pre-operative endocrine tests for pituitary surgery.
  • To guide peri-operative management based on pituitary function tests.

Main Methods:

  • Recommended pre-operative tests: electrolytes, cortisol, free-T4, TSH, prolactin, sex hormones, LH, FSH, IGF-1.
  • Consideration of Synacthen or insulin tolerance testing for ACTH reserve.
  • Assessment of prolactin levels to differentiate macroprolactinoma from 'disconnection' hyperprolactinemia, excluding the hook effect.

Main Results:

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Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas
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  • Specific prolactin level thresholds aid in diagnosing macroprolactinoma versus 'disconnection' hyperprolactinemia.
  • Abnormal cortisol or ACTH reserve necessitates steroid supplementation post-surgery.
  • Management strategies differ for patients with basal cortisol <100 nmol/l versus >450 nmol/l.

Conclusions:

  • Comprehensive pre-operative endocrine assessment optimizes patient management and outcomes.
  • Close collaboration between anesthetic, endocrine, and surgical teams is vital for successful pituitary surgery.