Endocrine - Pancreatic + Gonadal Flashcards
Disorders of Pancreatic Function
DM 1
»ketoacidosis
»hypo-glycemia
DM 2
DM1
autoimmune destruction of pancreatic cells
-inherit susceptibility to disease
DM1
manifestations
3P’s
poly - uria, dipsia, phagia
DM1
diagnosis
3P's + one of the following: >>HgbA1c>6.5% >>fasting bld sugar> 126 after 8hr >>2hr plasma glucose >200 during oral gluc tolerance test >>random plasma gluc >200
HgbA1c
> 6.5%
fasting blood sugar
> 126 after 8hr
2hr plasma glucose
200 during oral glucose tolerance test
random plasma glucose
> 200
DM1
treatment
- individualized insulin
- diet
- exercise regimens
1 unit of insulin =
15 g of carb
children w DM1 can help w care at what age
6-8 yo
to test blood glucose, keep records, etc
concerns w adolescents
can manage self-care, but desire to be like peers can interfere with treatment adherence
___ is eventual goal for kids + adolescence w DM1
self mgmt
___ made be delayed w inadequate DM1 control
puberty
concern w children
may use condition to get what they want
diabetic ketoacidosis is..
fat broken down to create energy
>ketone bodies released into body
»causes acidosis
diabetic ketoacidosis primarily occurs with..
DM1 who…
- miss insulin dose,
- admin insulin incorrectly,
- experience stressor, or
- first diagnosis
diabetic ketoacidosis
criteria
blood glucose >330 mg/dL
serume/urine ketones
pH<7.3, bicarb <15meQ
diabetic ketoacidosis
manifestations
- kussmaul respirations
- acetone breath
diabetic ketoacidosis
late signs
- altered LOC
- pupillary changes
- irregular respirations
diabetic ketoacidosis
treatment
IV REGULAR INSULIN
- 0.1unit/kg/hr
- do not decr gluc faster than 100mg/dL/hr bc risk for cerebral edema
diabetic ketoacidosis
nursing mgmt
monitor mental stat
assess for hypoglycemia
monitor arrhythmias
assess dehydration
why are kids at risk for hypoglycemia
- rapid growth,
- unpredictable eating,
- phys activity
- error in dosage
- not enough cals
- exercise
parent should have ____ for severe hypoglycemia
IM glucagon
hypoglycemia
manifestations
- shaky feeling
- behavior change
- confusion
hypoglycemia
therapy
if conscious, give 15g of carb
if unconscious, give glucagon by injection
hyperglycemia
manifestations
- lethargy
- sleepy
- slowed response
- confusion
- deep, rapid breathing
- acetone breath
hyperglycemia
therapy
- additional insulin at usual time
- extra injections if hyperglycemia + mod-large ketones
DM2
insuline resistance overtime
-usually NOT acute onset
DM2
risk factors
obesity
low level of physical activity
DM2 in pediatrics, focus on…
prevention
assess kids w _____ for signs of insulin resistance (DM2)
BMI>85th percentile
signs of DM2
- acanthosis nigricans
- HTN
- dyslipidemia
- fam w DM2
Primary Amenorrhea
absence of menarche by 14.5 yo + no growth/dvlpt of secondary sex characteristics
-absence of menses by 16 y.o.
Secondary Amenorrhea
pregnancy is most common reason so obtain sex hx
-cessation after 6 months or 3 cycles of menstruation
Dysmenorrhea
leading cause of missed school days among adolescent females
Primary Dysmenorrhea
painful cramps
-from INCREASED PROSTAGLANDINS
Secondary Dysmenorrhea
painful cramps fr pelvic abnormalities like fibroids or endometriosis
Dysmenorrhea happens _______ and lasts ______
at beginning or prior to menstrual period
lasts 1-3 days
