Chapter 28 Review: Endocrine Dysfunction Flashcards

1
Q

What is hypopituitarism?

A

growth hormone deficiency where growth of all cells in the body is inhibited proportionately (shorter stature with proportional H&W)

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2
Q

How is hypopituitarism diagnosed?

3 diagnoses

A
  • observation of familial growth patterns for comparison
    – look at H&W growth trends – these children tend to fall off growth charts
  • definitive diagnosis = absence of or subnormal reserves of pituitary GH
  • skeletal survey in children < 3 y.o. – look for ossification of bones
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3
Q

How is hypopituitarism treated?

2 treatments

A
  • biosynthetic growth hormone injections
  • other hormone replacements as needed
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4
Q

What are some nursing considerations for hypopituitarism?

5 considerations

A
  • early identification is key – better chance that treatments will help them mimic normal growth pathways
  • familial growth trends compared to child’s growth trends
  • child’s body image
  • daily injections
  • expensive treatment
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5
Q

What is syndrome of inappropriate antidiuretic hormone secretion (SIADH)?

A

hypersecretion of posterior pituitary, resulting in excessive ADH production

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6
Q

How do children with SIADH usually present?

9 manifestations

A
  • fluid retention, usually in belly
  • hypotonicity
  • anorexia d/t feeling full
  • N/V
  • irritability
  • personality changes
  • peripheral edema
  • coarse breath sounds
  • low urine output less than 1 mL/kg/hr – low volume, high concentration (high specific gravity)
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7
Q

How is SIADH managed?

4 treatments

A
  • I&Os
  • observe for signs of fluid overload
  • seizure precautions – d/t build-up of toxins in body
  • ADH-antagonizing medications
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8
Q

What s/s is common in both DI and SIADH?

A

excessive thirst

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9
Q

What do the 3 cells of the pancreas produce?

A
  • alpha cells – glucagon
  • beta cells – insulin
  • delta cells – somatostatin
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10
Q

What is diabetes mellitus?

A
  • total or partial deficiency of insulin
  • most common endocrine disorder of childhood
  • peak incidence is early adolescence – 10 - 15 y.o.
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11
Q

What is type 1 diabetes?

A

destruction of beta cells, causing an absolute insulin deficiency

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12
Q

What is type 2 diabetes?

A

arises d/t insulin resistance

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13
Q

What is ketoacidosis?

A
  • when glucose is unavailable for cellular metabolism, the body begins to break down alternate sources for energy
  • breakdown of protein creates ketones
  • excess ketones are elimintated in the urine or by respiratrion
  • ketones are strong acids and lower blood pH –> ketoacidosis
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14
Q

What are Kussmal respirations?

A

hyperventilation characteristic of metabolic acidosis – it is the body’s attempt to eliminate excess CO2

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15
Q

What is diabetic ketoacidosis?

A
  • progressive deterioration with dehydration, electrolyte imbalance, acidosis, and coma
  • may cause death
  • pediatric emergency
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16
Q

How is diabetic ketoacidosis treated?

6 treatments

A
  • administer fluids first – blood is viscous, so fluids dilute it down; 20 mL/kg
  • administer insulin – don’t want to change blood sugar too rapidly; no more than 100 mg/dL/hr
  • administer glucose and other electrolytes (K+ mostly)
  • glucose monitoring – goal = less than 126 mg/dL
  • urine test for ketones
  • labs for A1c
17
Q

What are some education topics for children with type 1 DM?

A
  • nutrition
  • exercise
  • management of hypoglycemic episodes
  • illness management
  • management of DKA
  • glucose monitoring
18
Q

What are the types of rapid acting insulin, when do they start working, and what is their peak?

A

– Novolog & Humalog
* starts working in 15 min
* peak = 30 - 90 min
* take immediately prior to meals – make sure sugar/meal is in front of pt prior to administering

19
Q

What are the types of intermediate acting insulin, when should it be administered, and when does it peak?

A

– NPH & Humalin
* administer in the AM
* peak = 6 - 8 hours

20
Q

What is the name for long acting insulin, when should it be taken, and when does it peak?

A

– Lantus
* administer at dinner
* peak = no peak