Gigantism is a condition of a person that excess growth, with a large height above normal and is caused by the secretion of growth hormone (GH) excessive and occurs before adulthood or before epiphyseal closure process. (Corwin, 2007)
Growth hormone is a hormone produced by the anterior pituitary which works to increase the growth and metabolism in target cells. Hormone target cells are located in almost all parts of the body. Growth hormone also plays a role in synthesizing somatomedin the liver, to stimulate the epiphyseal growth plate. Metabolic impact of GH is the mobilization of free fatty acids in adipose tissue and muscle glucose metabolism barriers and in adipose tissue.
Pituitary gigantism often occurs as a result of excessive GH secretion due to the onset of pituitary tumors in children before epiphyseal closing. Gigantism usually affects children aged 6-15 years.
Gigantism is a protein hormone increases in many tissues, increasing the decomposition of fatty acids and adipose tissue and blood glucose levels. Gigantism occurs in children when the period skeleton still has the potential to grow, or at pre-puberty.
Gigantism is caused by excessive secretion of GH. This condition can be caused by pituitary tumors that secrete GH or because of abnormalities of the hypothalamus which leads to excessive GH secretion. Gigantism can occur when the state of excess growth hormone occurs before epiphyseal bone plates close or still in its infancy. The cause of excess growth hormone production is mainly in the tumor cells somatrotop which produces growth hormone.
The most frequent cause of gigantism is a pituitary adenoma, but gigantism has been observed in boys aged 2.5 years with hypothalamic tumor secreting GHRH which can be complicated, especially in the pancreas that secrete the already large number of GHRH (Arvin, 2000).
Some people have vision problems and behavior. In most cases recorded abnormal growth become apparent at puberty, but this situation has been established as early as the newborn period in a child and at the age of 1 month. In gigantism, soft tissues such as muscle and other continue to grow. Gigantism can be accompanied by visual disturbances when the tumor enlarges to suppress chiasma opticum which is the optic nerve pathways.
The following are symptoms of gigantism caused by excess secretion of GH:
- The signs of glucose intolerance.
- Nose width, enlarged tongue and rough face.
- Excessive growth of the mandible.
- Teeth become separated.
- Finger and thumb to grow thicker.
- Melting and weaknesses.
- Loss of vision in the visual field examination carefully because the optic nerve khiasma depressed eyes.
Nursing Diagnosis for Gigantism: Altered Family Processes related to families with gigantism.
Goal:
- Preparing the family to be able to care for members with gegantisme.
- Families can adapt to the disease.
- Families can cope with problems arising from the presence of signs and symptoms that appear and deliver or provide a suitable environment to the client's condition.
Intervention and rationale:
1. Provide emotional support to families and clients.
R /: Families can receive clients.
2. Encourage parents to express their feelings.
R /: Families can adapt to the client's illness.
3. Encourage clients to share a sense of helplessness, shame, fear associated with disease manifestations.
R /: To solve problems that arise.
4. Acting as an advocate and liaison clients and families, with other health care team members.
R /: Preparing families to care for the client.
5. Encourage clients to socialize with their surroundings.
R /: Motivating clients.
6. Encourage client involvement in recreational and diversionary activities are age-appropriate.
R /: Increase client confidence.