Endocrine - Pancreatic + Gonadal Flashcards

1
Q

Disorders of Pancreatic Function

A

DM 1
»ketoacidosis
»hypo-glycemia
DM 2

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2
Q

DM1

A

autoimmune destruction of pancreatic cells

-inherit susceptibility to disease

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3
Q

DM1

manifestations

A

3P’s

poly - uria, dipsia, phagia

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4
Q

DM1

diagnosis

A
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
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5
Q

HgbA1c

A

> 6.5%

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6
Q

fasting blood sugar

A

> 126 after 8hr

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7
Q

2hr plasma glucose

A

200 during oral glucose tolerance test

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8
Q

random plasma glucose

A

> 200

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9
Q

DM1

treatment

A
  • individualized insulin
  • diet
  • exercise regimens
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10
Q

1 unit of insulin =

A

15 g of carb

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11
Q

children w DM1 can help w care at what age

A

6-8 yo

to test blood glucose, keep records, etc

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12
Q

concerns w adolescents

A

can manage self-care, but desire to be like peers can interfere with treatment adherence

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13
Q

___ is eventual goal for kids + adolescence w DM1

A

self mgmt

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14
Q

___ made be delayed w inadequate DM1 control

A

puberty

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15
Q

concern w children

A

may use condition to get what they want

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16
Q

diabetic ketoacidosis is..

A

fat broken down to create energy
>ketone bodies released into body
»causes acidosis

17
Q

diabetic ketoacidosis primarily occurs with..

A

DM1 who…

  • miss insulin dose,
  • admin insulin incorrectly,
  • experience stressor, or
  • first diagnosis
18
Q

diabetic ketoacidosis

criteria

A

blood glucose >330 mg/dL
serume/urine ketones
pH<7.3, bicarb <15meQ

19
Q

diabetic ketoacidosis

manifestations

A
  • kussmaul respirations

- acetone breath

20
Q

diabetic ketoacidosis

late signs

A
  • altered LOC
  • pupillary changes
  • irregular respirations
21
Q

diabetic ketoacidosis

treatment

A

IV REGULAR INSULIN

  • 0.1unit/kg/hr
  • do not decr gluc faster than 100mg/dL/hr bc risk for cerebral edema
22
Q

diabetic ketoacidosis

nursing mgmt

A

monitor mental stat
assess for hypoglycemia
monitor arrhythmias
assess dehydration

23
Q

why are kids at risk for hypoglycemia

A
  • rapid growth,
  • unpredictable eating,
  • phys activity
  • error in dosage
  • not enough cals
  • exercise
24
Q

parent should have ____ for severe hypoglycemia

A

IM glucagon

25
Q

hypoglycemia

manifestations

A
  • shaky feeling
  • behavior change
  • confusion
26
Q

hypoglycemia

therapy

A

if conscious, give 15g of carb

if unconscious, give glucagon by injection

27
Q

hyperglycemia

manifestations

A
  • lethargy
  • sleepy
  • slowed response
  • confusion
  • deep, rapid breathing
  • acetone breath
28
Q

hyperglycemia

therapy

A
  • additional insulin at usual time

- extra injections if hyperglycemia + mod-large ketones

29
Q

DM2

A

insuline resistance overtime

-usually NOT acute onset

30
Q

DM2

risk factors

A

obesity

low level of physical activity

31
Q

DM2 in pediatrics, focus on…

A

prevention

32
Q

assess kids w _____ for signs of insulin resistance (DM2)

A

BMI>85th percentile

33
Q

signs of DM2

A
  • acanthosis nigricans
  • HTN
  • dyslipidemia
  • fam w DM2
34
Q

Primary Amenorrhea

A

absence of menarche by 14.5 yo + no growth/dvlpt of secondary sex characteristics
-absence of menses by 16 y.o.

35
Q

Secondary Amenorrhea

A

pregnancy is most common reason so obtain sex hx

-cessation after 6 months or 3 cycles of menstruation

36
Q

Dysmenorrhea

A

leading cause of missed school days among adolescent females

37
Q

Primary Dysmenorrhea

A

painful cramps

-from INCREASED PROSTAGLANDINS

38
Q

Secondary Dysmenorrhea

A

painful cramps fr pelvic abnormalities like fibroids or endometriosis

39
Q

Dysmenorrhea happens _______ and lasts ______

A

at beginning or prior to menstrual period

lasts 1-3 days