Metabolic and Endocrine Disorders

Question 1

How is congenital hypothyroidism diagnosed?

Answer 1

Newborn screening revealing a low T4 and a high TSH

Question 2

What are the symptoms of congenital hypothyroidism in early infancy?

Answer 2

Large, protruding tongue; course hair; lethargy; sleepiness; and constipation

Question 3

What are the outcomes of untreated congenital hypothyroidism?

Answer 3

Mental retardation and growth failure

Question 4

What are the metabolic effects of PKU?

Answer 4

CNS damage, mental retardation, and decreased melanin

Question 5

What two formulas are prescribed for infants with PKU?

Answer 5

Lofenalac and Phenex-I

Question 6

List foods high in phenylalanine content.

Answer 6

Meat, milk, dairy products, and eggs

Question 7

What are the three classic signs of diabetes?

Answer 7

Polydipsia, polyphagia, polyuria

Question 8

Differentiate the signs of hypoglycemia and hyperglycemia.

Answer 8

• Hypoglycemia: tremors, sweating, headache, hunger, nausea, lethargy, confusion, slurred speech, anxiety, tingling around mouth, nightmares.
• Hyperglycemia: polydipsia, polyuria, polyphagia, blurred vision, weakness, weight loss, and syncope

Question 9

Describe the nursing care of a child with ketoacidosis.

Answer 9

Provide care for an unconscious child, administer regular insulin IV in normal saline, monitor blood gas values, and maintain strict I&O

Question 10

Describe developmental factors that would impact the school-age child with diabetes.

Answer 10

Need to be like peers; assuming responsibility for own care; modification of diet; snacks and exercise in school

Question 11

What is the relationship between hypoglycemia and exercise?

Answer 11

During exercise, insulin uptake is increased and the risk for hypoglycemia occurs.