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48 Cards in this Set
- Front
- Back
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What is another name for pituitary hyperfunction or precocious puberty?
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premature puberty
Boys: before 9 Girls: before 8 typically seen with cerebral palsy patients |
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In DI, is ADH high or low?
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low ADH (too much urine excretion)
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What is typically the first sign in children that indicates something is wrong?
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irritability
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What drug is given to suppress urination?
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DDVAP (desmopressin; synthetic vasopressin)
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What drug is given to reverse the effects of DDVAP if too much is being administered?
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chlorothiazide--> Diuril
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For DI, give a diet low in ____.
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solutes
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What needs to be monitored closely in DI patients?
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urine output
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For nursing care of patient with SIADH what needs to be maintained?
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fluid restriction
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In SIADH what should be given for hyponatremia if neurological disease is present?
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hypertonic sodium chloride solution
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For SIADH, what should be given if adrenal insufficiency is present?
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corticosteroids
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When should medication be given for the treatment of SIADH?
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with meals
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What type of diet should a patient with SIADH be on?
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high in sodium and protein
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What type of precautions should be initiated for SIADH patient?
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seizure precautions
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What are the s/s of hypothyroidism in infants?
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prolonged newborn jaundice, poor feeding, constipation, cool, mottled skin, decreased crying
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What are the s/s of hypothyroidism in children?
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slow heart rate, tiredness, inability to tolerate cold, puffiness in face, impaired memory, depression
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What should be given for hypothyroidism?
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thyroid replacement hormone
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Common signs of hyperthyroidism include:
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goiter, skin that is raised, eyes that bulge (exophthalmos)
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What are some drugs used for hyperthyroidism?
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PTU, MTZ (anti-thyroid medications)
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What are some major treatments for hyperthyroidism?
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radioactive iodine therapy, thyroidectomy, beta-blocking agents (Inderal)
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Weakness, fatigue, dizziness, rapid pulse, dark skin, weight loss, muscle aches, N/V, and cold intolerance are all signs of what adrenal disorder?
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Addison's disease
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When a patient is hospitalized for Addison's disease, what does nursing care include?
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replace fluids and electrolytes, monitor closely for s/s of hypovolemic shock, do not stop steroids suddenly
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Hypokalemia, hypercalcemia, fatigue, muscle wasting, moon face, fragile skin are all signs of what adrenal disorder?
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Cushing's disease
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What is the purpose for giving medication to someone with Cushing's disease?
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inhibit production of cortisol
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How is DM Type I diagnosed?
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elevated BG levels (usually in excess of 200 mg/dL), elevated AIC (greater than 7.0), increased sugar and ketones in urine
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What is the only solution regular insulin can be given IV with?
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Normal saline; provide D51/2 @ TKO to keep BG from falling to quickly
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What is the goal for diet and nutrition in management for DM Type I?
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maintain normal glucose levels
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AIC levels are indicative if the average blood glucose over the past ___ to ____.
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2-3 months
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What is the percentage of CHO a diabetic should consume daily?
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50-60%
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What percentage of protein should be consumed for DM?
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10-20%
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What percentage of fats should be consumed fro diabetic patient?
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20-30%
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When should urine be checked for ketones in a diabetic patient?
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whenever blood glucose readings exceed 240 mg/dL, when the child experiences unexplained weight loss, or if the child is ill
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What is the focus for long-term treatment of diabetes?
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reducing symptoms and preventing complications
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What is the criteria for Type II DM in children?
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BMI >85 percentile for age, and weight plus 2 of the following risk factors: family Hx of type II, race/ethnicity, insulin resistance, maternal history or gestational diabetes
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How is diagnosis confirmed for Type II DM?
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2 fasting glucose results that exceed 125 mg/dL or 2 random readings >200 mg/dL
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In a toddler what is s/s of DKA?
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classic manifestations are often absent
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What are some common s/s of DKA?
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altered mental status, tachycardia, tachypnea, Kussmaul respirations, normal or low blood pressure, poor perfusion, lethargy and weakness
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How is DKA diagnosed?
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blood glucose of >200mg/dL, ketonuria, ketonemia, pH of the blood (acidosis)
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What is nursing care for DKA?
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restore fluid volume, return child to a glucose utilization state by inhibiting lipolysis, replace body electrolytes, correct acidosis and restore acid-base balance
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What is the nursing care for precocious puberty?
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administer gonadotropin-releasing hormone
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What are the abnormal lab values associated with Addison's disease?
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increased potassium, decreased cortisol, decreased sodium
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What medication is administered for Addison's disease?
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Solu-cortef (oral cortisol)
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What are the abnormal lab values associated with Cushing's disease?
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decreased potassium, increased cortisol
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Certain medications are given for Cushing's to inhibit _____.
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cortisol
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What are the 3 p's associated with DM?
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polyuria, polyphagia, polydipsia
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In Type I DM, what is found in the urine?
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increased sugar and ketones
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What should not be restricted in the management of DM?
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exercise
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How often should BG be checked for a child?
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3-6x/day
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What are the four essential physiologic principles for DKA?
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restore fluid volume, return child to glucose utilization state by inhibiting lipolysis, replace body electrolytes, correct acidosis and restore acid-base balance
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