N410 Peds Ch 33 Endocrine disorders/diabetes Flashcards
Which of the following statements best describes hypopituitarism?
Skeletal proportions are normal for age.
Weight is usually more retarded than height.
Growth is normal during the first 3 years of life.
Most of these children have subnormal intelligence.
Skeletal proportions are normal for age, but these children appear young for their age.
Growth in HEIGHT is usually MORE DELAYED than in weight.
Growth is normal for the 1st YEAR of age, and then these children follow a slowed growth curve.
Most of the children have NORMAL intelligence.
Often they are considered precocious because their educational ability seems to exceed their size. Emotional problems are common because of their small stature.
Which of the following should the nurse include when discussing a child’s precocious puberty with the parents?
The child is not yet fertile.
Heterosexual interest is usually advanced.
Dress and activities should be appropriate to chronologic age.
Appearance of secondary sexual characteristics does not proceed in the usual order.
Engaged in activities according to chronologic age.
Functioning sperm or ova may be produced, thereby making the child fertile at an early age.
Heterosexual interest is usually appropriate to chronologic age.
Development of the secondary sexual characteristics proceeds in the usual order.
Which of the following is the primary clinical manifestation of diabetes insipidus? Oliguria Glycosuria Nausea, vomiting Polyuria, polydipsia
Diabetes insipidus results from the hyposecretion of antidiuretic hormone, excessive amounts of urine are produced. Older children maintain balance with an almost insatiable thirst.
Oliguria is diminished urinary output. Children with diabetes insipidus have increased urinary output. Glycosuria is not a manifestation of diabetes insipidus. It MAY BE a manifestation of diabetes mellitus.
Nausea and vomiting are not manifestations of diabetes insipidus. They can occur with oversecretion of antidiuretic hormone (SIADH).
What is DI?
The principal disorder of posterior pituitary hypofunction is diabetes insipidus (DI)
The nurse is caring for a child hospitalized with acute adrenocortical insufficiency. Because of the sudden, severe nature of the disease, the family needs a great deal of emotional support. The most appropriate nursing action is which of the following?
Prepare the family for the child’s impending death.
Prepare the family for each procedure.
Prepare the family for the long-term consequences of paralysis.
Reassure the family that flaccid paralysis is not problematic.
By preparing the family for each procedure, the nurse is showing sensitivity to the family’s emotional needs.
Acute adrenocortical insufficiency is a reversible condition when associated with adrenocortical insufficiency.
Flaccid paralysis is problematic if not reversible.
S/Sx of hypothyroism?
Decelerated growth from chronic deprivation of thyroid hormone.
Myxedematous skin changes (dry skin, puffiness around the eyes, sparse hair),
Constipation, Sleepiness, and Mental decline.
Which of the following statements best describes Cushing syndrome?
It is caused by excessive production of cortisol.
Treatment involves replacement of cortisol.
The major clinical features are exophthalmia and pigmentary changes.
The diagnosis is suspected with findings of hypotension, hyperkalemia, and polyuria.
Too much circulating cortisol. In children, this is caused by a tumor or excessive and prolonged steroid therapy
The treatment is reduction of circulating cortisol. If the cause is a pituitary tumor, surgery is indicated.
Hypertension and hypokalemia are expected findings.
Exophthalmia is a manifestation of hyperthyroidism, not Cushing syndrome.
The parent of a 10-year-old child with diabetes asks the nurse why home blood glucose monitoring is being recommended. The nurse should base the explanation on which of the following?
It is an easier method of testing.
Parents are better able to manage the diabetes.
Children have a greater sense of control over the diabetes.
Fewer visits to the primary care provider will be necessary.
Blood glucose monitoring affords the child a greater sense of control.
The immediate feedback allows for regulation of insulin doses. Home blood glucose monitoring provides a more accurate assessment of control than urine testing. Although the parents are involved in the management, a 10-year-old child should take responsibility for testing. The same number of visits will be necessary, but the blood glucose monitoring will enable better control.
A school-age child recently diagnosed with type 1 diabetes mellitus asks the nurse if he can still play soccer, play baseball, and swim. The nurse’s response should be based on knowledge that
exercise is contraindicated.
the level of activity depends on the type of insulin required.
exercise is not restricted unless indicated by other health conditions.
soccer and baseball are too strenuous, but swimming is acceptable.
Exercise is encouraged for children with diabetes because it lowers blood glucose levels. Insulin and meal requirements require careful monitoring to ensure that the child has sufficient energy for exercise. Sports are encouraged to help regulate the insulin. Long- and short-acting insulin both may be used to compensate for the effects of training.
The nurse should recognize that when a child develops diabetic ketoacidosis, this is which of the following?
Expected outcome
Best treated at home
A life-threatening situation
Best treated at practitioner’s office or clinic
Diabetic ketoacidosis is the state of complete insulin deficiency. It is a medical emergency that must be diagnosed and treated. The child is usually admitted to an intensive care unit for assessment, insulin administration, and fluid and electrolyte replacement. Diabetic ketoacidosis is a medical emergency needing prompt assessment and intervention, usually in an intensive care environment.
