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NUR 331 > Endocrine > Flashcards

Endocrine Flashcards

1
Q

phenylketonuria (PKU)

A

Absence of phenoalanine hydroxylase enzyme

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2
Q

dx PKU

A

Newborn screening’s

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3
Q

tx PKU

A

diet free in Meat, Limited fruits/veggies and grains

phenylalanine free formula
breast feed

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4
Q

Galactosemia

A

Lack of enzyme that converts galactose to glucose

Lactose intolerant

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5
Q

tx galactosemia

A

Lactose free diet
Soy formula
Calcium supplements
No breast-feeding

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6
Q

which medication should you be cautious in taking with galactosemia?

A

Penicillin
Some vitamins

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7
Q

what is the number one concern with hypothyroidism

A

Airway protection

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8
Q

tx hypothyroidism

A

Oral thyroid hormone replacement for life
Synthroid

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9
Q

med. Administration precautions.

A

Avoid heat exposure
Don’t mix with soy formula

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10
Q

treatment for hyperthyroidism

A

propylthiouracil
Subtotal thyroidectomy
High calorie diet
Limit activities/stress

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11
Q

what is a complication from PTU

A

agranulocytosis/leukopenia

Sore throat and fever

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12
Q

what should be done with agranulocytosis?

A

Placed in isolation and start antibiotics

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13
Q

where does the growth hormone deficiency condition occur?

A

Anterior pituitary
Hypofunction

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14
Q

sx growth hormone deficiency

A

skeletal proportions are normal for age

Retarded bone age

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15
Q

tx growth hormone deficiency

A

Daily sub Q injection’s
very expensive
Cortisone

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16
Q

when should the injections be taken throughout the day?

A

At night
Mimics natural tendency

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17
Q

Will children be giants after growth hormone injections

A

No, reassure parents

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18
Q

precocious puberty

A

Before nine in boys
Before eight in girls

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19
Q

True precocious puberty

A

normal puberty but earlier

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20
Q

pseudo, precocious puberty

A

Thelarche – early breast
Pubarche – early pubic, under arm hair
Menarche - period

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21
Q

what is the treatment for precocious puberty?

A

Monthly injection of Lupron
Take until normal age of starting puberty

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22
Q

congenital, adrenal hyperplasia

A

Overproduction of adrenal androgens

Decreased production of cortisol and aldosterone

23
Q

sx of CAH in males

A

Precocious genitalia development

24
Q

sx CAH in females

A

Ambiguous genitalia

25
Q

sx of both gender for CAH

A

decrease stress response
Hypoglycemia
Hyponatremic, dehydration
Increased inflammatory response
Hypo tension
Salt tasting skin

26
Q

treatment for CAH

A

Lifelong Cortizone injections
Reconstructive surgery

27
Q

type one diabetes

A

Body doesn’t produce insulin

Auto immune destruction of pancreatic beta cells

28
Q

type 2 DM symptoms in children

A

Weight gain
Fatigue
Frequent infections. – yeast
acanthosis nigrocans – leathery patch in body folds

29
Q

can type one diabetic children eat any type of carbs as long as they replace with insulin?

A

Yes, no restrictions
Try to avoid high sugar

30
Q

carb free sources

A

Meat
Cheese
Sugar, free options

31
Q

Rapid insulin

A

Lispro, aspart

Onset 15 minutes
Peak one hour
Duration 3 to 4 hours

32
Q

Long acting insulin

A

Glargine

onset 4 to 6 hours
No peak
Lasts 24 hours

33
Q

when to monitor blood glucose

A

Before meals
Bedtime
Sick
Before exercise

34
Q

when to monitor urine ketones

A

Blood glucose greater than 240 on two separate occasions

Pump therapy greater than 240 on any occasion

35
Q

DM management with toddlers

A

differentiate between misbehavior
Report funny feeling
Food jags expected/refusal
Give choices

36
Q

DM management with preschoolers

A

Reassure not a punishment
Participate in simple tasks
Report Lows and what to eat then

37
Q

DM management with school-age

A

Educate personnel
Encourage independence and continuation in clubs and exercise
All activities supervised

38
Q

DM management with adolescents

A

Self-care
More willing to inject
Continued parental support

39
Q

what to teach with adolescents drinking alcohol

A

Eat while drinking

40
Q

should you continue to give insulin as scheduled on a sick day?

A

Yes, check glucose before eating

41
Q

hypoglycemia

A

Blood sugar less than 60

Hunger, headache
Confusion, shaky, dizzy
Sweating

42
Q

rule of 15

A

15 g of fast acting carbs recheck in 15 minutes

43
Q

severe hypoglycemia treatment

A

Patient is unable to swallow

Glucagon 1 mg sub Q/IM
Place on side

44
Q

options for rule of 15

A

Honey
Skittles
One half cup juice
One cup milk – white
Cake icing

45
Q

hyperglycemia

A

Blood glucose greater than 180

Increased thirst
Frequent urination

46
Q

should you give diabetic patients caffeinated fluids for hyperglycemia?

A

No

47
Q

DKA

A

access ketone bodies from fat metabolism

Blood glucose greater than 300

48
Q

what is the most serious symptom with DKA?

A

Cerebral edema leads to death

49
Q

treatment for DKA

A

1st hour: Fluids, NS
2nd hour: add electrolytes and start
Insulin drip and continue Observation

50
Q

how to control descent

A

Don’t drop blood sugar lower than 52, 100 per hour

51
Q

What to do after blood glucose reaches 250 to 300

A

Add dextrose, and half normal saline to insulin drip

52
Q

when is the child able to eat throughout this resuscitation?

A

Anytime as long as they are tolerating it

53
Q

how to know when DKA is resolved

A

PH and anion gap are within normal limits

Patient is able to eat and drink

54
Q

When to discontinue insulin drip

A

patient tolerates oral fluids
Sub Q insulin administration

NUR 331 (27 decks)

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