Pedi Endocrine Flashcards
Growth hormone, TSH, adrenocorticotropic, prolactin, follicle stimulating, lutenizing
Hormones made by Anterior Pituitary
Antidiuretic and oxytocin
Hormones made by posterior pituitary
Thyroxine, triidothyronine, calcitonin
Hormones made by Thyroid
Parathyroid hormone
Hormones made by parathyroid gland
Epinephrine and norepinephrine
Hormones made by adrenal medulla
Cortisol and aldosterone
Hormones made by adrenal cortex
Insulin and glucagon
Hormones made by pancreas
Testosterone
Hormone made by testes
Estrogen and progesterone
Hormones made by ovaries
Thymosin
Hormone made by the thymus
Melatonin
Hormone made by pineal gland
Child is normal size at birth; percentiles decrease with age. Smaller than other children of same age and gender (below 3rd percentile). Delayed puberty. Without treatment, unlikely to meet full growth potential; premature aging. Careful growth monitoring (? more than 2 SD’s below mean?). Labs: hormone levels; GH stim test
Hypopituitarism (Growth Hormone Deficiency)
Treatment: Recombinant Human Growth Hormone (rhGM) IM at bedtime; Somatropin SQ (may also need suppression of luteinizing hormone)
Teaching: Importance of med, self-administration
Treatment and Teaching for Growth Hormone Deficiency (Hypopituitarism)
Inappropriately increased growth. Most common cause: Pituitary adenoma. Careful growth monitoring ( more than 2 SD’s above mean? Excessive foot/finger? Wide facial features?)
Growth Hormone Excess (Hyperpituitarism)
Treatment: Remove pituitary adenoma. Watch for recurrence, diabetes insipidus.
Nursing: Pre and post op care; age-appropriate interaction; self image support
Treatment and Nursing Interventions for Hyperpituitarism (Growth Hormone Excess)
Boys before age 9. Girls before age 8. More common in females and more commonly idiopathic. In males, related to CNS abnormality. Central vs Peripheral. Treatment: Treat the cause. Gonadotropin releasing hormone (GnRH) agonist.
Nursing: education; support mental heath
Precocious puberty
Boys- not occurring by age 14. Girls- not occurring by age 12.
Primary- turner syndrome, klinefelter syndrome; chemo, radiation, autoimmune disease or infection and gonadal injury
Secondary- Decreased secretion of FSH and LH
Treatment: work up for other disorders; short term hormonal therapy
Nursing: Education; support mental health
Delayed Puberty
Kidneys cannot concentrate urine. lack of/decreased sensitivity to Vasopressin (ADH). Nephrogenic (rare) vs Central (lesion, tumor, injury).
Polyuria, polydipsia, nocturia, enuresis, dehydration, increased NA+, increased osmolarity, decreased specific gravity.
Diabetes Insipidus
Treatment: Control dehydration! Vasopressin (oral, intranasal, IV). Low sodium low protein diet.
Teach: prevent dehydration. S/s of dehydration, monitoring I and O. Medical alert bracelet
Treatment and Nursing for Diabetes Insipidus
Excessive secretion of ADH. Continuous ADH, water reabsorbed. Decreased urine output, fluid retention, decreased sodium (dangerous, LOC changes). JVD, increased BP, pulmonary congestion, dark urine; water intoxication
Due to CNS changes: head trauma, tumor, infection.
Can be secondary to CF, asthma.
Syndrome of Inappropriate Antidiuretic Hormone (SIADH)
Treatment: Monitor/restrict fluids (prevent further dilution of blood). Frequent assessment of labs (sodium).
Nursing: teach fluid restriction; high H20 foods. Medical alert bracelet
Treatment and Nursing Interventions for Syndrome of Inappropriate Antidiuretic Hormone (SIADH)
Deficient production of thyroid hormone since birth. Common, 1 in 3000. Autosomal recessive trait. Low levels of triiodothyronine (T3) and thyroxine (T4). If untreated can result in inrreversible intellectual disability, short stature and growth failure.
Congenital hypothyroidism
S/s: Persistent open posterior fontanelle, protuberant tongue, hypotonia, hypoactivity, poor sucking, dull expression, cool skin, bradycardia, protruding abdomen (constipation); elevated TSH
Treatment: Sodium levothyroxine; frequent monitoring of growth and levels
Nursing: Teach families s/s of too much/little TH
S/s, Treatment, and Nursing interventions for Congenital hypothyroidism
Deficient production of thyroid hormone later in life due to autoimmune disorder, throid dysfunction, drug toxicity.
Hashimoto’s thyroiditis
Acquired Hypothyroidism