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Pediatrics > chapter 48: endocrine disorder > Flashcards

chapter 48: endocrine disorder Flashcards

1
Q
  1. which type of diabetes is more prevalent in pediatrics
  2. what are the manifestations of hyperglycemia and hypoglycemia
  3. what are the diagnostic tests for DM
  4. what assessments are to be done for a patient with DM
  5. what are some nursing considerations for meds used in type 1 diabetes
  6. what would you teach the parents of a child with new diagnosis of type 1 diabetes?
A
  1. type 1

2.

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2
Q

what are organs of endocrine system

A
  1. hypothalamus
  2. pituitary
  3. thyroid
  4. parathyroid
  5. adrenal
  6. gonads
  7. islets in pancreas
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3
Q

what are diagnostic tests used for endocrine

A
  1. CT, MRI, Ultrasound used to determine lesion
  2. Urinalysis for ketones
  3. serum osmolarity
  4. serum sodium
  5. fluid deprivation tests and water deprivation study
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4
Q

Pituitary

  1. what hormones released in anterior
  2. what hormones released in posterior
A
  1. Prolactin, growth hormone, ACTH, LH, FSH, TSH

2. vasopressin and oxytocin

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5
Q

Growth hormone deficiency

  1. aka
  2. maybe caused by
  3. clinical manifestation
  4. diagnosis
  5. therapeutic technique
  6. complication
A
  1. hypopituitarism, dwarfism
  2. tumors, trauma, hereditary, deficiancies in TSH ACTH
  3. poor growth, short stature, delayed epiphyseal closure, increased insulin sensitivity, delayed dentation
  4. hand xray, GH stimulation test, Growth aptterns, IGF binding proteins, CT scans
  5. synthetic growth hormone ( stopped once child grows less than 1 inch a year ), thyroid, cortisone, testosterone, or estrogen, or progesterone.
  6. altered fat metabolism, glucose intolerance, diabetes, leukemia, infection at injection site, sodium retention
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6
Q

hyperpituitarism

  1. symptoms
  2. diagnosis
  3. nursing considerations
A
  1. height of 8 ft or more, increased muscle growth, acromegaly
  2. elevated GH (failure to suppress this when oral glucose level test), bone xray
  3. early identification, emotional support
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7
Q

precocious puberty

  1. patho
  2. treatment
  3. nursing considerations
A
  1. sexual development before 8 in girls and 9 in boys. occurs more frequently in girls. also has accelerated growth.
  2. Treat the cause if known, Lupron.
  3. treatment is halted at age when pubertal changes are to resume, psychological support
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8
Q

Diabetes insipidous

  1. patho
  2. symptoms
  3. treatment
  4. nursing management
A
  1. disorder in posterior pituitary resulting in hyposecretion of antidiuretic hormone resulting in excess urination
  2. polyuria and polydipsia. in infants, they become irritable relieved with water not milk
  3. lifelong adherence: vasopressin,
  4. Monitor I and O, assess fir fluid overload and dehydration, seizure precaution, administer ADH antagonizing meds
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9
Q

SIADH
1. patho
2signs and symptoms

A
  1. excessive release of ADH resulting in fluidoverload

2. fluid retention and hypotonicity, N/V anorexia, irritability

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10
Q

juvenile hypothyroidism

  1. is it common in us
  2. symptoms
  3. treatment
A
  1. no
    2, decelerated growth, thick tongue, constipation, sleepiness, dry skin, sparse hair, periorbital edema
  2. early treatment: hormone replacement therapy, adherence to treatment
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11
Q

Goiter

  1. AKA
  2. results from?
  3. what is this a risk for
  4. nursing management
A
  1. hypertrophy of thyroid gland
  2. maternal ingestion of antithyroid drugs during pregnancy
  3. airway obstruction
  4. this is a lifelong disease, eduate about adherence
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12
Q

lymphocytic thyroiditis

  1. patho
  2. symptoms
  3. treatment?
A
  1. lymphocytic infiltration of the thyroid gland
  2. inflammation, hyperplasia, some symptoms of hyperthyroidism (goiter, large eyes, weight loss, heat intolerance
  3. may resolve within 1 to 2 years, or thyroid hormone replacement which would decrease goiter
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13
Q

Hyperthyroidism

  1. which is most common in children
  2. S and S
  3. management
A
  1. graves disease
  2. develops gradually, over 6 to 12 months usually: enlarged thyroid, T4 and T3 are elevated and TSH decreased.
  3. decrease rate of thyroid hormone secretion through: thyroidecetomy, radiologic iodine, or meds
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14
Q

thyroidtoxicosis

  1. aka
  2. patho
  3. S and S
  4. treatment
  5. nursing consideration
A
  1. thyroid storm, a medical emergency
  2. sudden release of thyroid hormone from discontinuation of antithyroid therapy, surgery
  3. restlessness suddenly with irritability, fever, diaphoresis, severe tachycardia
  4. antithyroid drugs, propranolol
  5. identify early, quite environment with rest periods, help with coping, dietary requirements
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15
Q

how is growth promoted for child with hypothyroidism

A
  1. record growth at regular intervals
  2. measure thyroid levels every 2 to 4 weeks until target range is reached
  3. in first years of life, tests are to be done every 3 to 4 months, then changing to every 6 to 12 months during adolescence
  4. monitor for signs of hypo or hyper thyroidism : Vital signs, temperature, activity.
  5. rest periods
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16
Q

what does parathyroid gland release

A
  1. PTH - maintains serum calcium by increasing release of calcium and phosphate and promotes calcium absorption in GI
17
Q

Hypoparathyroidism

  1. patho
  2. S and S
A
  1. could be deficient PTH, pseudoparathyroidism, or production of PTH but organs are unresponisve
  2. hypocalcemia, dry scaly skin, brittle hair, thin nals, tatany, lockjaw, stridor, spasm, HD, seizure, chvostek (facial nerve stimulation) and trousseau (hand spasm from blood pressure)
18
Q

hyperparathyroidism

  1. caused by
  2. diagnosed through
  3. treatment
  4. nursing consideration:
A
  1. congenital or tumor or anomalies in urinary tract
  2. blood calcium and parathyroid levels
  3. surgical removal or treat underlying cause
  4. monitor vitals, ekg, renal stones, calcium and phosphate levels. Monitor I and O, fluids, diet low in calcium but high in phosphate (watch kidney levels closely)
19
Q

what are released in adrenal glands

A

glucocortocoids (cortisone and corticosterone), aldosteron, androgens, estrogens, pregestins

20
Q

acute adrenal inssuficiency

  1. aka
  2. s and s
A
  1. adrenal crisis is a medical emergency
  2. fatigue, orthostatic hypotension, hyperpigmentation, hyponatremia, hyperkalemia, hypoglycemia, hypovolemia, hyperkalemia
  3. early identification, maintain blood pressure and tissue perfusion, IV therapy, adrenal hormone replacement, VS, cardiac rhythms, monitor I and O and fluid levels.
21
Q

chronic adrenal insufficiency

  1. aka
  2. patho
  3. diagnosis
  4. S and S
A
  1. Addison disease
    2 not enough cortisol and aldosterone, occurs whne 90% of tissue is nonfunctional
  2. corticosteroid and potassium levels
  3. muscle weakness, fatigue, dizziness, dark skin, fast pulse, dark freckles, bluish discoloration in mucus membranes, salt craving, N/V and diarrhea, intolerance to cold
  4. corticosteroid is taken lifelong treatment
22
Q

Cushing syndrome

  1. patho
  2. educate about stopping steroid
  3. S and S
  4. nursing consideration
A
  1. excessive cortisol through use of steroids or excess production
  2. don’t stop using steroid abruptly
  3. moon face, red chicks, poor wound healing and easy bruising, increased hair growth
  4. avoid injury, avoid infection, perp for surgery, encourage rest and moderate activity.
23
Q

congenital adrenal hyperplasia nursing consideration

2. what is this

A
  1. treat parent anxiety and teach parents about about signs and symptoms of dehydration and focus on genetic counseling.
  2. female genitelia is affected
24
Q

hyperaldosteronism

  1. results in
  2. treatment and management
A
  1. hypertension, hypokalemia, polyuria
  2. replace potassium, block effects of aldosterone through spironolactone, assess for signs and symptoms for hypo and hyperkalemia
25
Q

pheochromocytome

  1. patho
  2. therapeutic techniques
A
  1. adrenal tumor that secrete catecholamines

2. surgical removal, lifelong therapy

26
Q

pancreatic hormone function

A
  1. alpha cells prduce glucagon, betacells produce insulin, delta cells produce somatostatin
27
Q

diabetes

  1. patho
  2. diagnosis
A
  1. typ1 has destroyed beta cells, type 2 body doesn’t react to insulin properly
    • 8 hr fasting glucose ( positive if 126 or more)
    • random glucose of 200 or more with manifestation
    • oral glucose tolerance test of 200 or more
    • HbA1C >6
28
Q

hyperglycemia signs and symptoms

A
  1. thirst, polyuria, N/V, abdominal pain
  2. flushed skin
  3. dry mucus membrane
  4. confusion
  5. weak pulse, poor healing
  6. lethargy
  7. rapid respirations
  8. recurrent infection and delayed healing
    9 > 250
29
Q

hypoglycemia signs and symtoms

A
  1. hunger, lightheadedness, shakiness, HD, anxiety, irritability
  2. pallor with cool skin
  3. diaphoresis
  4. irritability
  5. tachycardia, palpitations
  6. decreased LOC, blurred vision, seizures.
  7. < 60
30
Q

complications of diabetes

A
  1. retinopathy, nephropathy, neuropathy, dyslipidemia, celiac disease, hypothyroidism, and diabetic keto acidosis
31
Q

explain diabetic ketoacidosis

  1. S and S
  2. nursing actions
A
  1. medical emergency
  2. ketonuria and acetone breath
  3. leads to ketoacedosis due to ketones released from breakdown of fat due to lack of glucose
  4. anorexia, N/V, lethargy, stupor, altered LOC, kussmaul respiration, air hunger, decreased skin turgor, fruity breath, tachycardia.
  5. monitor BUN, CBC, LOC, IV fluids
32
Q

nursing actions with insulin

A
  1. dont mix lantus with any other insulin
  2. offer instruction as needed
  3. rotate injection site at 90 degree angle
  4. draw up short acting then long acting when mixing.

Pediatrics (15 decks)

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