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Sophomore 1 Test 6 > Endocrine > Flashcards

Endocrine Flashcards

1
Q

When do most endocrine glands develop?

A

During the first trimester

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2
Q

Growth Hormone Deficiency

A

Also known as hypopituitarism or dwarfism, is characterized by poor growth and short stature

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3
Q

S/Sx of Growth Hormone Deficiency

A
  1. Prominent subcutaneous deposits of abdominal fat
  2. Child-like face with a large, prominent forehead
  3. High-pitched voice
  4. Delayed sexual maturation
  5. Delayed dentition
  6. Delayed skeletal maturation
  7. Decreased muscle mass
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4
Q

When does a Growth Hormone Deficiency becomes apparent?

A

May start with a normal birth weight and length but is less than 3% on the growth chart by 3 years of age

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5
Q

Causes of Growth Hormone Deficiency

A
  1. Tumor
  2. Infection
  3. Infarction
  4. Irradiation in utero
  5. Trauma during or after birth
  6. Genetics
  7. Idiopathic
  8. Emotional or nutritional deprivation which suppresses the production of pituitary hormones (but this is reversible)
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6
Q

Growth Hormone Deficiency Diagnostics

A
  1. Bone age test
  2. CT/MRI to rule out tumors
  3. Pituitary function test
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7
Q

Growth Hormone Deficiency Treatment

A
  1. Tumor removal (if applicable)

2. Supplemental GH

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8
Q

When do we stop administering supplemental GH to a patient with growth hormone deficiency?

A

When the growth plates fuse

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9
Q

Growth Hormone Deficiency Nursing Management

A
  1. F/U appointments with endocrinologist every 3-6 months
  2. Growth plotting every 3-6 months
  3. Assessing adequate nutrition
  4. Evaluate for learning problems
  5. Communicate in an age appropriate manner
  6. Medication compliance
  7. Encourage participation in sports that are not height dependent
  8. Support groups
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10
Q

Precocious Puberty

A

In precocious puberty, the child develops sexual characteristics before the usual age of pubertal onset.

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11
Q

S/Sx of Precocious Puberty

A
  1. Acne
  2. Adult body odor
  3. Accelerated rate of growth
  4. Breast development
  5. Pubic hair
  6. Advanced genitalia maturation, but does not typically display sexual behavior
  7. Emotional lability
  8. Aggressive behavior
  9. Mood swings
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12
Q

When does precocious puberty typically present?

A

In girls: 6-7 years

In boys: younger than 9

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13
Q

Precocious Puberty Causes

A
  1. Tumor
  2. Radiation
  3. Infection
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14
Q

Why is it necessary to treat precocious puberty?

A

Because without treatment, the child may become fertile (girls will start menstruation)

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15
Q

Precocious Puberty Diagnostics

A
  1. Pelvic ultrasound
  2. Serum hormone values
  3. CT/MRI
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16
Q

Precocious Puberty Treatment

A

Aimed at determining and treating the cause and halting sexual development

  • GnRH analog: suppresses gonadotropin release
  • Medroxyprogesterone (depo-provera) prevents menstruation
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17
Q

Precocious Puberty Nursing Interventions

A
  1. Medication compliance
  2. F/U appointments every 6 months
  3. Monitor for behavior changes
  4. Provide sexual education at discontinuation of treatment or if sexual behavior is suspected
  5. Communicate with child at age-appropriate level
  6. Counseling
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18
Q

Delayed Puberty

A
  • Characterized by delayed secondary sexual development

- These children usually end up developing normally, just at a later age

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19
Q

Delayed Puberty (Boys)

A
  • No testicular enlargement by 14

- Pubic hair by 15

20
Q

Delayed Puberty (Girls)

A
  • No breast development by age 12
  • No pubic hair by 14
  • No menarche by 15
21
Q

Delayed Puberty Diagnostics

A
  1. Physical assessment
  2. Genetic testing
  3. Serum hormone level
  4. Growth plotting
  5. MRI/CT to assess for tumors
22
Q

Delayed Puberty Treatment

A

Treating cause and/or Testosterone (males) and Estradiol (females)

23
Q

Delayed Puberty Nursing Intervention

A

Emotional support for possible infertility depending on the cause

24
Q

Polycystic Ovary Syndrome (PCOS)

A

Characterized by excessive testosterone production by the ovaries

25
Q

S/Sx of Polycystic Ovary Syndrome

A
  1. Hirsutism (facial hair growth)
  2. Balding
  3. Acne
  4. Increased muscle mass
  5. Decreased breast size
26
Q

Potential Complications of Polycystic Ovary Syndrome

A
  1. Infertility
  2. Insulin resistance
  3. Hyperinsulinemia (DM)
  4. Increased risk for endometrial carcinoma and CVD
27
Q

Cause of Polycystic Ovary Syndrome

A

Unknown

28
Q

Polycystic Ovary Syndrome Diagnostics

A
  1. Physical assessment
  2. Serum glucose and insulin levels (high insulin level in relation to glucose level)
  3. Serum hormone levels
29
Q

Polycystic Ovary Syndrome Treatment

A
  1. Early recognition!!!
  2. Oral contraceptives
  3. Insulin sensitizing medications (metformin)
30
Q

Polycystic Ovary Syndrome Nursing Management

A
  1. Encourage diet and exercise
  2. Medication compliance
  3. Monitor blood pressure
  4. Support groups
31
Q

Childhood Obesity Nursing Interventions

A
  1. BMI and growth chart plotting
  2. Food exposure
  3. Exercise and/or sports of interest
  4. Positive support group/peers
  5. Assess environmental/financial concerns
32
Q

Type 1 DM

A

Caused by a deficiency of insulin secretion

** Children can have both types of DM

33
Q

Type 2 DM

A

Caused by insulin resistance

** Children can have both types of DM

34
Q

S/Sx of Diabetes Mellitus (hyperglycemia)

A
  1. Weakness
  2. Fatigue
  3. Mood changes
  4. Polydipsia
  5. Polyuria
  6. Polyphagia
  7. Blurred vision
  8. Bed wetting
  9. Headaches
35
Q

Diabetes Mellitus Diagnostics

A
  1. HbA1C (greater than 6.5%)
  2. Random glucose (greater than 200)
  3. Fasting glucose (greater than 120)
  4. 2-hour plasma glucose (greater than 200)
36
Q

Long Term Complications of Diabetes Mellitus

A
  1. Failure to grow
  2. Delayed sexual maturation
  3. Poor wound healing
  4. Recurrent infections
  5. Retinopathy
  6. Neuropathy
  7. Vascular complications
  8. Nephropathy
  9. Cerebrovascular disease
  10. PVD
  11. CVD
37
Q

S/Sx of DKA

A
  1. Anorexia
  2. N/V
  3. Lethargy
  4. Stupor
  5. Altered LOC
  6. Confusion
  7. Decreased skin turgor
  8. Abdominal pain
  9. Kussmaul respirations
  10. Fruity breath
  11. Ketones in urine and blood
  12. Tachycardia
  13. Coma and death (if untreated)
38
Q

Type 1 Glycemic Control

A

Glucose checks with meals and at bedtime

39
Q

Type 2 Glycemic Control

A

Glucose checks less often when on oral diabetic medications

- May also need insulin which increases the frequency of glucose checks

40
Q

Insulins

A
  1. Rapid Acting (aspart)
  2. Short Acting (regular)
  3. Intermediate Acting (NPH)
  4. Long Acting (glargine)
41
Q

Diabetes Mellitus Nursing Management

A
  1. Carb Counting (carb goals)
  2. Diet and Exercise
  3. Educate the patient and the family!
42
Q

Managing Complication of Diabetes Mellitus

A
  1. Routine eye exams (monitor for retinopathy)
  2. Annual microalbuminuria testing (monitor for nephropathy)
  3. Periodic lipid profile (monitor for dyslipidemia)
  4. Every 1-2 years children should be screened for celiac disease and hypothyroidism
43
Q

Hypoglycemia Treatment

A

Severe: glucagon SQ or IM OR dextrose IV

Mild: glucose paste or tablets, or simple carb such as OJ followed by a complex carb such as PB and crackers

44
Q

CFRD

A

Cystic Fibrosis-Related Diabetes

- Thick mucus causes scarring of the pancreas that prevents the pancreas from producing normal amounts of insulin

45
Q

S/Sx of CFRD

A
  1. May be asymptomatic
  2. Polyuria
  3. Polydipsia
  4. Fatigue
  5. Weight loss
  6. Unexplained decline in lung function
46
Q

Treatment for CFRD

A

Treated with insulin

  • Must maintain a high calorie, high protein, high fat diet
  • Must count carbs and give insulin accordingly
  • Glucose checks 4 times a day and increased exercise just like Type 1 diabetics

Sophomore 1 Test 6 (4 decks)

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