Endocrine Flashcards
Poor growth and short stature caused by the failure of the pituitary to produce sufficient growth hormone
Growth hormone deficiency
When is the growth hormone mostly secreted?
During sleep
What causes a growth hormone deficiency?
Injury Brain tumors Infection Radiation Idiopathic
Growth hormone deficiency sx
Deteriorating/absent rate of growth High wt to ht ratio and a delayed bone age ^ fat in trunk area Childlike face w/ large prominent forehead ^ pitched voice Hypoglycemia Small penis/testes Delayed sexual maturation Delayed dentition
Growth hormone deficiency tx
Administer growth hormone SQ 6-7 days per week or IM depot injection every 2-4 weeks
Cretinism
Congenital hypothyroidism
Causes of Congenital hypothyroidism
Low levels of T3, T4
Congenital hypothyroidism sx
Pallor Hypothermia Enlarged tongue Hypotonia/Large underactive baby Feeding difficulties/ Poor suck Delayed mental responsiveness Cool, dry scaly skin Swollen eyelids
What is essential for the growth and development of the CNS?
Thyroid hormone
Thyroid hormone tx
Synthroid for life
Bl. test q2-3 weeks until dose is established (based on wt)
The Islets of Langerhans fail to produce adequate insulin
Diabetes Mellitus
What is impaired with diabetes mellitus?
Carb and lipid metabolism
Type 1 diabetes
Common in children
Type 2 diabetes
Use to only occur in adults, not its common in children
Diabetes sx
Polyuria Polydipsia Polyphagia Weight Loss Dehydration
Diabetes diagnosis
Sx
Bl. glucose levels
Diabetes tx
Insulin therapy
Bl. glucose monitoring
Monitor hg A1C
Hg A1C
Reflects average bl. glucose control over the past 8-12 weeks
Ms. the amt. of glucose that attaches to protein in the RBC
The greater the amount of glucose in the blood…
The ^ the hg A1C will be
Hg A1C values
8-8.5% in children < 7
< 8% in older children/adults
What do high A1C levels prevent?
Eye, kidney and nerve disease
Diabetes nutrition
No longer excludes foods
Exercise potentiates the hypoglycemic effects of insulin
Regular exercise may help w/ glucose control
Blood glucose below 60
Hypoglycemia
What causes hypoglycemia?
Too much insulin
Too little food
Too much exercise
Hypoglycemia tx
Carbs
Primary reason for rehospitalization or emergency care in diabetes
Diabetic ketoacidosis
Diabetic ketoacidosis sx
Fruity breath
Alert-> coma
pH < 7.30
Glucose > 200
Diabetic ketoacidosis tx
Fl. deficit
El. imbalances
Acid-base disturbances
Insulin deficiency
Type of fluids for diabetic ketoacidosis
PRIORITY (hypovolemic shock could happen)
Isotonic
Diabetic ketoacidosis electrolyte replacement
Correct imbalances
Potassium is depleted
Once evidence of renal output, can add potassium to IV
Diabetic ketoacidosis acid base balance
May infuse bicarb to correct acid-base balance
Diabetic ketoacidosis insulin deficiency
Insulin given by infusion
Usually regular insulin
Diabetic ketoacidosis consequences
Cerebral edema Confusion HA Tach/Brady Dif. arousing child Widening pulse pressure
