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Pediatrics > Exam 3 Endocrine Disorders > Flashcards

Exam 3 Endocrine Disorders Flashcards

1
Q

Hypothyroidism =

Diagnosed via =

A

= low or no production of T4, involves the thyroid and anterior pituitary gland

= newborn screening (1/40,000)

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2
Q

S/S of Hypothyroidism

A
  • Large Fontanels
  • Protruding tongue
  • Umbilical Hernia
  • Lethargy, Fatigue
  • Constipation
  • Prolonged jaundice (in newborn period)
  • dry skin, brittle hair/nails
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3
Q

Diagnosis/Prevention/Teaching for Hypothyroidism

  • ____ diagnosis to prevent?
  • N___ S____
  • Screen ____/____ in childhood/teens
A
  • Early, prevent cognitive deficits
  • Newborn Screen
  • T4 (low), TSH (high)
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4
Q

Tx for Hypothyroidism

  • Daily ______*
  • Serum ___ and ___ testing at each well visit
A

SYNTHROID*

- T4 (low), TSH (high)

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5
Q

Precocious Puberty =

Girls =
Boys =

A

= Early physical sexual development

= < 9 y
= < 9.5 y

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6
Q

Causes of Precocious Puberty (5)

Why is it important to check for precocious puberty?

A

1) Obesity
2) Heredity
3) Stress
4) Environmental exposure
5) Adrenal, CNS, Gonad tumors

Tumors are major factor

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7
Q

S/S of Precocious Puberty for Girls/Boys?

- Advanced ____ staging

A 
Girls = breast development, pubic hair, axillary hair, growth spurt, early menarche
Boys = voice changes, testicular enlargement, penile growth
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8
Q

Tx for Precocious Puberty = *

Teach parents how to?
Treat child how?*

A

Monthly IM injection of LUPRON*

  • how to administer
  • treat age appropriately**
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9
Q

Precocious Puberty, monitor what hormones (4)

A

FSH, LH, Testosterone, Estrogen

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10
Q

Type I Diabetes Mellitus =

Destruction of pancreatic beta cells ->
Almost always ___ mediated, __ known cause

A

= Autoimmune illness which is caused by insulin deficiency followed by destruction of insulin producing pancreatic beta cells

  • > absolute insulin deficiency
  • immune, no known cause (idiopathic)
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11
Q

Type II Diabetes Mellitus =

  • Ability to -> _____ but inability to -> ____ causing ->
  • Can result in beta cell _____ -> eventually leads to complete ____ _____
A

=combination of insulin resistance due to failure of insulin to act on tissues and relative insulin deficiency

  • Ability to produce insulin but inability to use it correctly -> causing excessive production of insulin
  • exhaustion -> insulin deficiency
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12
Q

Risk Factors for Type II DM

  • Obesity BMI > ___%
  • Family History of? Mother with?
  • Physical ____
  • Races (4)
  • Greater in boys or girls?
A
  • > 85%
  • hx of Type II, Mother with gestational diabetes
  • physical inactivity
  • AA, American Indians, Hispanic, Asian Americans
  • Girls
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13
Q

S/S of Type II DM

  • ____ uria
  • Recurrent _____
  • Increase in ___, ____
  • _____ ______** (early or late sign?)
A
  • Ketonuria
  • Recurrent infections
  • Increase thirst, urination
  • Acanthosis Nigricans (early sign) - velvety thickening and darkening of skin found on back of neck, axillae, medical aspect of thighs or any folds (80%)
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14
Q

Diagnosis of Type II DM

  • Fasting Glucose >/- ____
  • Random Glucose >/- _____, ____ symptoms
  • Oral glucose tolerance test (OGTT) >/- _____
A

> /- 126
/- 200, with
/- 200

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15
Q

Tx of Type II DM * =

- D___ and E____

A

= Metformin* -> increases insulin sensitivity, suppresses appetite, improves lipid profile, and reduces hepatic glucose output
- Diet, Exercise

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16
Q

S/S of Diabetes

A
  • Polyuria, Polydipsia, Polyphagia (excessive hunger)
  • Enuresis (frequent urination)
  • Weight loss
17
Q

Diagnosis of Diabetes

1) Fasting Plasma Glucose >/- _____
2) Random Plasma Glucose >/- _____
3) Hemoglobin A1C >/- _____%
4) Antibodies = presence of circulating _____ specific antibodies
5) Insulin level = __-__

A

1) 126
2) 200
3) 6.5%
4) islet
5) low to zero

18
Q

Tx for Diabetes = *

1) For which DM?
2) Goal is maintain near normal glucose (____-___)
3) 4 types of insulin

A

Insulin*

1) For type 1 DM is treated w insulin dt absolute insulin deficiency; insulin replacement is the key to managing type I
2) 90-130
3) Rapid, Short, Intermediate, Long acting

19
Q

Tx for Diabetes Giving Injections

1) _____ sites
2) Delivered IM or SQ?
3) May use a syringe, injector, or pen
4) Skin doesn’t need to be pinched if?
5) Always count to ___ after injection, before removing needle
6) Age appropriate for administration?

A

1) Rotate
2) SQ
4) small needle
5) 5 seconds
6) No set age

20
Q

Insulin Pump =

Closely imitates =
Pump must be programmed to deliver a bolus dose before each _____

A

= electromechanical device designed to deliver fixed amounts of regular or lispro insulin continuously (basal rate)

= release of hormone by islet cells
meal

21
Q

Diabetes Monitoring: Blood
Take Serum Glucose when? (4)
Urine Ketone Testing when? (2)

A

= before meals, at night, when not feeling well, before physical activity
= during illness, when glucose >/- 240

22
Q

Why do ketones form?

A

When your body doesn’t have enough glucose or insulin to use glucose, your body starts breaking down fat for energy ketones are a byproduct of this breakdown

23
Q

Diabetes Monitoring: Nutrition

1) Timing of consumption must be regulated to correspond to time and action of ____ prescribed
2) Total # of calories should be ____ day to day
3) Provide what w exercise?
4) Avoid what types of food (2) to prevent hyperglycemia

A

1) insulin
2) consistent
3) extra food
4) High sugar, Carbs
instead eat fruits, vegetables, grains, beans, dairy, sugar

24
Q

Diabetes Monitoring: Exercise

1) Maintain ____ fitness
2) Control ___ and help body use insulin more ______
3) Children w diabetes should participate full in

A

1) cardiovascular
2) weight, efficiently
3) physical education classes, sports

25
Q

Hypoglycemia =

Causes (4)

Can lead to -> (2)

A

= low blood sugar < 70 mg/dL

Too little food, Too much insulin, increase in exercise, skipping or delaying meals

Seizures, death

26
Q

S/S of Hypoglycemia

A

Shaking, sweating, dizziness, anxious, hunger, rapid HR, impaired vision, weakness/fatigue, headache, irritability

27
Q

Tx for Hypoglycemia

1) F____
2) Close ____ Monitoring
3) Give IM ______*
4) Feed once ____

A

1) Fluids
2) Blood
3) GLUCAGON*
4) awake

28
Q

15 g of carbs is equal to

1) ____ glucose tabs
2) __ lifesavers
3) ___ butterscotch candies
4) __ small box of raisins
5) ___ oz regular soft drink or juice box
6) ___ oz milk
7) ___ tbsp honey
8) ____ tbsp of sugar

A

1) 3
2) 6
3) 3
4) 1
5) 4
6) 8
7) 1
8) 2

29
Q

Hyperglycemia =

Causes of Hyperglycemia (6)

A

= high blood sugar

Too much food, too little insulin
Illness, infection, stress (more corticoids)
Emotional upset

30
Q

S/S of Hypergylcemia

A

Very thirsty, more urination
Dry skin, Hungry, Sleepy
Blurry vision
Infection/injury heals slower

31
Q

Tx for Hyperglycemia = (2)*

A

= Short acting insulin* , Fluids to prevent dehydration and flush out ketones

32
Q

Diabetic Ketoacidosis =

  • Ketones are produced when body breaks ___ for energy
  • Ketone bodies are strong ___ = ____ serum ph < _____
  • Causes ____ _____
A

= LIFE THREATENING complication resulting from excessive ketone production and lack of insulin

  • fat
  • acids, lowers, 7.35
  • metabolic acidosis
33
Q

S/S of Diabetic Ketoacidosis

1) Poly____, Poly_____, E_____
2) Dehydration -> T_____, or ____, _____ pain, N/V
3) ____ breath, _____ breathing
4) Mental Status changes

A

1) Polyuria, Polydipsia, Enuresis
2) Tachycardia, Orthostatsis, abdominal
3) Fruity, Kussmaul (agonized)
4) Combative, drunk, coma

34
Q

Tx for Diabetic Ketoacidosis (4)

A

Fluids
Insulin
Close blood monitoring at least every hour
CAT scan bc acidotic may lead to brain bleeds

35
Q

Long Term Complications of Diabetes (4)

Diseases (2)

A

1) Retinopathy -> potential vision loss
2) Nephropathy -> renal failure
3) Peripheral neuropathy -> foot ulcers, amputation
4) Autonomic neuropathy -> GI, GU, cardio, sexual dysfunction

Atherosclerotic cardiovascular peripheral, Arterial and cerebrovascular disease/ HTN

36
Q

Early complications are even greater in what type?

- ____ damage is proportional to degree of hyperglycemia and duration of exposure

A

Type II

-Organ

37
Q

Impact on Family and Child

A
  • Fear, Anxiety
  • Continual drainage of emotional, financial resources
  • Feelings of guilt
  • parents lose ability to protect child from harm and suffering
  • Restricted independence
  • Stressful daily planning
  • adolescents have difficulty adjusting, compliance issues

Pediatrics (16 decks)

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