Week 6 - Endocrine Flashcards
Physical assessment - Look (3)
- Skin
- Weight
- Tanner staging
Physical assessment - Listen (2)
- HR
- Bowel sounds
Physical assessment - Palpate (2)
- Abdomen
- Skin
Condition of low or no T4
Congenital Hypothyroidism
S/s of Congenital Hypothyroidism
- bulging fontanelles
- lethargy/fatigue
- brittle hair and nails
- dry skin
- constipation
- umbilical hernia
- protruding tongue
- prolonged jaundice in newborn period
How can you diagnose congenital hypothyroidism?
Newborn screening
-Increased TSH or low/normal T4
Treatment for Congenital Hypothyroidism
Daily Synthroid
What do you need to check for a child on daily synthroid?
Check TSH and T4 at every well-child visit
DM Type 1 definition
Immune-mediated insulin deficiency
DM Type 2 definition
Insulin resistance and failure that results in complete insulin deficiency
S/s of Type 2
- Acanthosis nigricans
- Ketonuria
- recurrent infections
- increase in thirst and urination
Acanthosis Nigricans
- velvety thickening and darkening of skin
- found on back of neck / skin folds
Diagnosis of Type 2
- Fasting glucose
- Random glucose
- Oral glucose tolerance
Fasting glucose > 126
Random glucose > 200 with symptoms
Oral glucose tolerance > 200
General DM diagnosis
- Fasting
- Random glucose
- Hgb A1C
- What is present?
Fasting glucose > 126
Random glucose > 200
Hgb A1c > 6.5
Antibodies present
Treatment for Type 1
INSULIN
- Rotate sites
- SQ
- Goal is to maintain glucose in normal range (90-130)
What should you always do with insulin injection?
Count to 5 after injection to ensure med enters
When do you do urine ketone testing?
- during illness
- glucose > 240
DM nutrition considerations
- timing of consumption needs to be regulated and correspondent to the insulin prescribed
- total cals should be consistent
- extra food with exercise to prevent hypoglycemia
- avoid high sugar and carbs to prevent hyperglycemia
Hypoglycemia blood glucose
< 70
Hypoglycemia treatment
- FLUIDS
- IM Glucagon
- Feed once they’re awake
DKA
Life threatening metabolic acidosis
DKA symptoms
- 3Ps
- abdominal pain
- n/v
- fruity breath
- Kussmaul’s
- mental status change
DKA treatment
- fluids
- insulin
- sugars q hr
