Care Of Child With Endocrine Disorder Flashcards
How does the hypothalamus & pituitary work together for Endocrine function…
Hypothalamus stimulates the pituitary to Release/ Withhold hormones
Difference between Anterior & Posterior Pituitary…
Releases
Anterior:
Growth & Thyroid Stimulating Hormone
Adrenocorticotropic
Follicle stimulating
Luteinizing
Melanocyte
Prolactin
POSTERIOR:
Antidiurtic
Oxytocin
____ produces humoral factors key to the development of immunity.
Thymus
Thyroid and thyroid hormones deal with…
Metabolism
What is the function of Parathyroid hormones…
Regulates calcium & phosphorus
Releases
Aldosterone
Mineralcorticoids
Androgens
Epinephrine
Norepinephrine
Adrenal
Releases
Insulin
Glucagon
Somatostatin
Pancreas
Antidiuretic hormone is made _____ and secreted from _____
Hypothalamus: Made
Posterior Pituitary Gland: Secreted
ADH aka…
Vasopressin
ADH Affects
Blood osmolality…
Blood volume..
BP…
Osmolality Lowered
Volume Increased
BP Increased
Diabetes Insipidus = Peeing too much / Lack of ADH
2 TYPES
Central DI (Too little ADH is secreted)
Nephrogenic ( Kidneys don’t respond to ADH )
Describe:
UA specific gravity….
Na level….
Serum osmolality….
UA specific gravity <1.005 - decreased osmolality
Hypernatremia >145
Serum osmolality >300 Elevated
Low sodium & protein diet
Promote fluid intake
Administration of Desmopressin acetate
This problem…
DI
DI Nursing Care
Strict I & O - Urine output goal…
Daily weight
Monitor for seizures
1-2 mL /kg/ hr
DDAVP Desmopressin administration
Temp considerations…
Avoid OTC cough med
Watch for overdose….
Keep refriderated
OD = HA, confusion, dizziness, rapid weight gain
Excessive desmopressin in treatment of DI can cause…
Syndrome of
Inappropriate
Anti
Diuretics
Hormone
Fluid retention
Weight gain without edema
HTN
Crackles heard in lungs
Seizure
Decreased urination
This problem…
SIADH
Labs:
Na <135
UA: Concentrated & dark
Specific gravity >1.03
Increased Serum osmolality
Serum osmolality <280
This problem….
Treatment….
SIADH
TREATMENT
fluid restriction
Strict I & O
Correct electrolyte imbalances
Daily weight
DI or SIADH
Fluid overload
Weight gain
Low urine output
Concentrated urine
Hyponatremia
Vs
Poluria
Thirst
Dehydration
Diluted urine
Dry mucos membranes
SIADH
Fluid overload
Weight gain
Low urine output
Concentrated urine
Hyponatremia
Vs
DI
Poluria
Thirst
Dehydration
Diluted urine
Dry mucos membranes
Diagnosis of DM Type I
A1C….
______ antibodies
Fasting glucose….
Random glucose.
2 hr glucose…
Diagnosis of type 2 DM
A1C….
Fasting….
Random…
Elevated…
BP….
Type 1 DM
> =6.5
Islet cell antibodies
=126 fasting
=200 random
= 200 2 hr
Type 1
A1C ,,,
Fasting: >=126
Random <= 200
Elevated LDL and triglycerides
HT
Goal BS
Healthy Child: Before meal & bed…
Type 1 DM: Before meal & bed…
Healthy: 70 - 110
Type 1 90 - 130 (Meal)
90 - 150 (Bed)
of units for food + # of units for blood sugar correction = total insulin dose
Insulin to Carb ratio and correction
- Dose for food
Grams Carbs ÷ Insulin to carb ratio = ___________
- Dose for blood sugar correction
Blood sugar - target/goal = _______÷ correction factor = # of units for correction
- Total insulin dose
- # of units for a meal
Tremors
Sweaty
Palpation
Tachycardia
Confusion
Irritability
Slurred Speech
Unconscious/ Seizures
Hyper/Hypoglycemia…..
Hypoglycemia <70
Blurred vision
GI Symptoms
Dry Flushed Skin
Weakness
Fatigue
Polydipsia, Polyphagia, Polyuria
DKA
HYPO/HYPERGLYCEMIA….
Hyperglycemia
> 130
DKA is associated with a BS this level…
> 250
DKA treatment
Fluid bolus & isotonic IV fluids
IV insulin drip 0.1unit/kg/ hr
Risk for this electrolyte imbalance….
Hypokalemia: Needs cardiac monitor
High blood sugar should be decreased slowly
Not more than 100mg/dl/hour
Rapid decrease in osmolality can lead to….
Cerebral edema
Oral BS meds
Biguanides:
Sulfonylureas:
Alpha-Glucosidase inhibitors:
Stimulates insulin secretion by increasing response of beta cells to glucose
Slow the digestion and Glucose enters blood stream slower
Reduces glucose production in the liver
Biguanides: Reduces glucose production in the liver
Sulfonylureas: Stimulates insulin secretion by increasing response of beta cells to glucose
Alpha-Glucosidase inhibitors: Slow the digestion and Glucose enters blood stream slower
Aspartame
Lispro
Glulisine
Type of insulin….
Onset….
Peak….
Rapid
Within 15 minutes
Peak 1 - 3 hrs
Regular
Tyoe of insulin….
Onset….
Peak….
Short Acting
Onset 0.5 - 1 hr
Peak 2 - 4 hrs
NPH (Humulin N / Novolin N)
Type…
Onset…
Peak…
Type: intermediate acting
Onset: 2 - 4 hrs
Peak: 4 - 12 hrs
Long acting insulin times vary
Glaring
Onset…
Peak….
Onset 2 - 4 hrs
Peak 8 - 12
Long acting insulin times vary
Detemir
Onset…
Peak…
Onset: 1 - 2 hrs
Peak: 4 - 7 hrs
Long acting insulin times vary
Degludec
Onset…
Peak…
Onset .5 - 1.5 hrs
Peak: None
How long daily exercise for diabetic children…
60 min daily
When to monitor glucose in relation to exercise…
Pre & Post
