Ch 41 Peds Metabolic / Endocrine

Question 1

normal peds temp

Answer 1

36.4 - 37 C / 97.5 - 98.6 F

Question 2

peds fever

Answer 2

38 C / 100.4 F

Question 3

peds dehydration

Answer 3

pds more vulnerable to fluid volume deficit bc more of their body water is in the extracellular fluid compartment
the organs that coserve water are immature

Question 4

phenylketonuria

Answer 4

genetic disorder (auto recessive)
results in CNS damage from toxic levels of phenylalanine in the blood.
blood phenylalanine levels > 20 mg/dL

Question 5

normal phenylalanine level

Answer 5

1. 2 - 3.4 mg/dL in newborns

0. 8 - 1.8 mg/dL otherwise

Question 6

types of dehydration

Answer 6

isotonic
hypertonic (electrolyte loss < water loss)
hypotonic (electrolyte loss > water loss)

Question 7

phenylalanine containing foods

Answer 7

high protein foods (meats and dairy)

aspartame

Question 8

mild dehydration

Answer 8

3-5% weight loss
normal VS
slight thirst
cap refill > 2 sec

Question 9

moderate dehydraiton

Answer 9

6-9% weight loss
increased pulse, RR
orthostatic BP
irritable
moderate thirst
jugular vein not visible except w supraclavicular pressure
2-4 sec cap refill
decreased turgor

Question 10

severe dehydration

Answer 10

>10% weight loss
very increased pulse, RR
BP orthostatic / shock
intense thirst
sunken eyes
sunken anterior fontanel
jugular vein not visible even w pressure
cap refill > 4 sec
tenting, skin cool, acrocyanotic, mottled
oliguria / anuria

Question 11

Type 1 DM

Answer 11

destruction of pancreatic beta cells

Question 12

ketoacidosis

Answer 12

insulin deficiency: impaired metabolism of fats, pro, carbs
hyperglycemia: fatigue, hunger, wt loss
polyuria, cellular starvation
ketones, produced in resonse to cellular starvation, cannot nourish cell bc of absence of insulin
–> ketoacidosis

Question 13

hypoglycemia

Answer 13

glucose < 70 mg/dL

too much insulin, not enough food, or excessive activity

Question 14

hypoglycemia s/sx

Answer 14

HA, nausea, sweating, tremors, lethargy,hunger, confusion, slurred speech, tingling around mouth, anxiety

Question 15

hyperglycemia

Answer 15

glucose > 250 mg/dL, or as spec. by dr.

Question 16

hyperglycemia s/sx

Answer 16

polydipsia, polyuria, polyphagia, blurred vision, wkns, wt loss, syncope

Question 17

priority nursing actions HYPOGLYCEMIA

Answer 17

1. check glucose level
2. give child 1/2 cup fruit juice or other item
3. take child’s vital signs
4. retest the glucose level
5. give child small snack of carb and protein
6. document child’s complaints, actions taken, and outcome

Question 18

hypoglycemia interventions

Answer 18

confirm w blood glucose reading
admin glucose immediately: rapid releasing glucose followed by complex carb and protein
extra snack if next meal not for >30 min
unconscious –> cake frosting / glucose paste on gums
remains unconscious –> admin glucagon
in hospital: dextrose IV

Question 19

diabetic ketoacidosis

Answer 19

occurs when a severe insulin deficiency occurs
hyperglycemia that progresses to metabolic acidosis
develops over several hrs - dys
blood glucose > 300 mg/dL

Question 20

diabetic ketoacidosis s/sx

Answer 20

signs of hyperglycemia
kussmaul's respirations
acetone (fruity) breath odor
increasing lethargy
decreasing LOC