Module 14: Care of a Child with an Endocrine System or Metabolic Condition

Question 1

bone age

Answer 1

can reveal childs age

Question 2

thyroid function test

Answer 2

how the thyroid hormones are working in the body

Question 3

growth hormone tests

Answer 3

imbalance causes:- decreased or increased activity of pituitary

• anterior gland
• males more than females
• have normal brith weight and length
• S&S: dwarfism or gigantism

Medical interventions:

- growth hormone replacement injections to control secretions 
- surgery

Question 4

disorder of pituitary function: hypopituitarism

Answer 4

involves the growth hormone and manifests with short stature, dwarfism

Question 5

disorder of pituitary function: hyperpituitarism

Answer 5

involves the growth hormone, before epiphyseal closure, gigantism. After epiphyseal closure, acromegaly sexual precocity (puberty before 8-9 years of age)

Question 6

Cushing’s Disease

Answer 6

• adrenocortical hyperfunction
• causes:
  
  • rare in children
  • more common in females
  • adrenal tumor
• S&S:
  
  • excessive weight gain
  • growth delay
  • takes 5 years to develop cushingoid appearance
    
    • moon face
    • chubby cheeks & double chin
    • fat pads over shoulders and back (buffalo hump)
• Treatment
  
  • medical/surgical interventions
  • radiation
  • drug therapy
  • surgery

Question 7

Addison’s Disease

Answer 7

• Causes:
  
  • adrenal cortical insufficiency
  • occurs in all ages groups
  • results of idiopathic atrophy
  • destruction of both adrenal glands by TB
  • autoimmune process - final infection
• Diagnosis - CT scan and abd x-ray
• S&S
  
  • fatigue: poor stress response
  • decreased BP
  • Wt loss
  • E+ imbalance
  • frequent infections
• Treatment
  
  • medical/surgical interventions
  • Iv fluids to replenish body salt
  • genetic sexual assessment
  • steroids
    
    • hydrocortisone
    • fludrocortisol
  • physiological and psychological n

Question 8

Diabetes Mellitus

Answer 8

• chronic disease of insulin deficiency
• most common childhood endocrine disorder
• can occur any age
• peak incidence between 10-15 years of age
• causes: genetic factors, autoimmune disorders, as a result of viral infection
• S&S: 2 cardinal signs are polyuria, polydipsia, and polyphagia, weakness and fatigue, nocturne, dehydration, weightloss and hunger
• Treatment:
• insulin injection, blood glucose monitoring

Question 9

Diabetes Insipidus

Answer 9

• Causes
  
  • lack of ADH secretion
• S&S
  
  • urine becomes extremely dilute and a great deal of fluid is lost from body
  • polyuria and polydipsia
• Treatment
  
  • DDVAP- desmopressin (nasal spray)
  • medical or surgical interventions

Question 10

juvenile hypothyroidism

Answer 10

may be congenital or acquired
- thyroid controls metabolic activity

S&S:
- sluggish, sleepy, tongue becomes enlarged (snoring resps), hands and feet are cold, hypotonia

Treatment: levothyroxine