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27 Cards in this Set
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- Back
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In Hypoglycemia, when Serum glucose under 70, what should you do to bring it up?
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Orange Juice--Give 15 g carbs (or 15-20 gm glucose) and recheck in 15 min. If it is still under 70, contact doctor. If it's ok give snack with 7 gm proteing if meal > 1 hr away.
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What should you do If unsure whether someone is hypo or hyperglycemic?
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Treat them with a little bit of sugar, won't hurt if sugar gets a bit high, but you don't want it low.
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What is Acanthois Nigricans and what is it a sympton of?
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Discolored areas of skin on nick or creases, looks dirty and is a symptom or Type 2 Diabetes.
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What would a radiological assessments show in a person who has hypopituirarism?
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Delayed bone growth
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What will the sodium level be if a patient with Diabetes Insipidus is given the water deprivation test?
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Sodium will be high...over 150. Normal levels are 135-145
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What are the s/s of Hypoglycemia?
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oSerum glucose below - 70
oRapid onset oCommon in children oMood changes, irritability oTachycardia oPale and sweaty oClammy skin oShaky feeling or tremors oSlurred speech oChange in LOC oSeizures |
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What are the s/s of Hyperglycemia?
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oSerum glucose over- 160
oOften gradual oFatigue oBlurred vision oWeight loss oThirst and hunger oHeadache oPolyuria oOliguria |
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What are the s/s of Ketoacidosis?
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oSerum glucose > 300
oUrine and serum ketones oSerum pH < 7.25 oSame symptoms of hyperglycemia plus oAbdominal or chest pain oNausea & vomiting oDry skin and mucous membranes oSudden weight loss oOliguria oAcetone odor to breath oKussmaul respirations oIncreasing lethargy oDecreasing LOC oComa |
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In a child with Type I, what are some of the dietary actions that should be taken?
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Consistent intake
Base meal plan on child’s diet history Allow to help choose foods Balance meals and snacks with insulin |
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What are the some of the causes of Hypopituirarism?
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oInadequate production or secretion of growth hormone by pituitary
oCan occur alone oCan be associated with pituitary malformations, brain tumors, cranial radiation oGH release is stimulated by Sleep Exercise hypoglycemia |
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How do you diagnos Hypopituirarism?
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oSerial measurement of GH after stimulation by drugs
oMeasuring suppressive effect on GH by high dose of glucose oMeasuring plasma insulin-like growth factor- IGF-1 o***Best-Radiologic assessments show delayed bone growth oMRI to look for tumors, other defects |
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What are the clinical manifestations of Hypopituirarism?
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oGrowth less than 5 cm / year
oNormal at - birth and On growth chart below – 5th percentile oMore than 2 standard deviations below the norm oSkeletal proportions are – normal oBone age is- delayed oPuberty - late and Permanent teeth – late and deformed oBoys can have micro-penis oHypoglycemia common oDecreased muscle mass oIncreased adipose tissue |
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What are the treatments for Hypopituirarism?
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oDaily SQ injections of GH (Protropin, somatrem) HS
oSubcutaneous time release GH every 2- 4 weeks o80% respond oTreat until – growth plates have fused at puberty |
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What are some of the nursing implications for Hypopituirarism?
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oProvide encouragement
oMonitor using growth chart and bone age X rays oTreat the child appropriately for age, not size oAssess self-esteem and body image oChildren are mentally normal oTeach – injections techniques |
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What is Precocious Puberty?
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Very, very early puberty
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What are the causes of Precocious Puberty?
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oPremature activation of sex hormones
oHypothalmus releases GnRH oPituitary releases LH and FSH oLH and FSH promote estrogen and testosterone production |
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What are the clinical manifestations of Precocious Puberty?
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oSecondary sexual characteristics develop prematurely
oSexual maturation occurs before 8 years in girls, or 9 years in boys oNo workup needed if only breast and pubic hair develop in black girls ages 6 and up and Caucasian girls ages 7 and older o9 times more common in – girls than boy oMeasure serial LH and FSH levels after administration of GnRH oAssess bone age oCranial CT and MRI R/O tumor oAbdominal & pelvic ultrasound R/O ovarian tumors or cysts Assess changes in the uterus and ovaries |
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What are the treatments for Precocious Puberty?
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oBlock GnRH
oIntranasal spray or monthly injections osecondary sexual characteristics should stabilize or regress within a year oThere will be rapid bone growth oGrowth plates usually close earlier than normal Tend to be short |
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What are the nursing Implications for Precocious Puberty?
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oTeach administration of meds
oStress importance of compliance oTreat appropriately for age, not size oIncreased risk for- sexual abuse, especially in girls |
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What are some of the causes of Diabetes Insipidus?
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oInability to concentrate urine due to lack of vasopressin
o30% idiopathic oCan occur with disorders or diseases, especially of CNS Head trauma, brain tumor, cranial radiation |
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What are some of the clinical manifestations of Diabetes Insipidus?
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oPolyurea
oPolydipsia oPossible nocturia and dehydration oIf fluids withheld, no immediate decrease in concentration or volume of urine oWater deprivation test Sodium is- high > 150 (norm is 135-145) Specific gravity is – low < 1.005 Water goes right thu them |
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What is the treatment for Diabetes Insipidus?
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oBalance fluid intake
oReplace vasopressin with DDAVP once or twice daily oIntranasal through rhinal tube oSubcutaneous injection oOral |
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What are the Nursing implications for Diabetes Insipidus?
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oProper administration
oSupervise use with children oOveruse causes- water intoxications oParents should know symptoms of too much or too little fluid Decreased output, H/A, water retention & seizures Teach to measure specific gravity oWear medic alert bracelets oWork with schools and daycares |
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What are some causes of Congenital Hypothyroidism?
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oDeficiency of thyroid hormone
oFetal thyroid fails to develop or locate to proper area oTSH- Elevated oT4- Low oAll states mandate newborn testing Most accurate between - 2 – 6 days |
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What are some clinical manifestations of Congenital Hypothyroidism?
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oMay be asymptomatic
oMottled skin, large fontanelle, large tongue, slow reflexes,hypotonia, distended abdomen, prolonged jaundice, feeding problems, constipation, cold skin, umbilical hernia, hoarse cry, excessive sleepiness oWithout treatment- retardation, mental |
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What are some of the treatments of Congenital Hypothyroidism?
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oThyroid replacement
Levothyroxin (Synthyroid or Levothyroid) Single daily oral dose Titrate to normalize – TSH & T4 oPrognosis for normal development is excellent oTreatment should be continued for- LIFE |
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What are some of the nursing implications of Congenital Hypothyroidism?
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oMedication administration
Crush tablet for infants Importance of compliance oWatch for signs of – hypo or hyper thyroid monitor pulse and temp |
