Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
55 Cards in this Set
- Front
- Back
|
Pituitary Gland
|
Secretes tropic hormones which regulate secretion of hormones from other organs. Controlled by the hypothalamus.
|
|
|
Pituitary Hyperfunction
|
Caused by excessive growth hormone or tumor. Results in Giganticism or Acromegaly.
|
|
|
Giganticism
|
Excessive growth hormone prior to puberty.
Can cause: -overgrowth of long bones -increased muscle mass -rapid visceral growth -head enlargement (delayed closure of fontanels |
|
|
Acromegaly
|
Occurs after closure of epiphyseal shafts.
Can cause overgrowth of: -head -lips -nose -tongue/jaw -facial hair -thick deep creased skin |
|
|
Pituitary Hyperfunction: Diagnosis
|
X-rays
Endocrine Studes Bones enlarged (wrist x-ray) |
|
|
Pituitary Hyperfunction: Therapeutics
|
Surgery for lesions
Radiation Radioactive implants Hormone replacement therapy |
|
|
Pituitary Hyperfunction: Nursing Considerations
|
Monitor growth charts at well visits
Assess S&S of tumor Early Tx is important Empathy Support |
|
|
Panhypopituitarism
|
Pituitary gland just doesn't work. Most often caused by tumors. Very serious
|
|
|
Idiopathic Hypopitarism
|
Growth Hormone deficiency. Most common. All growth of body cells is inhibited.
|
|
|
Idiopathic Hypopitarism: Treatment
|
Growth Hormone Replacement
|
|
|
Idiopathic Hypopitarism: Nursing Considerations
|
Identify kids with growth problems.
|
|
|
Precocious Puberty
|
Premature activation of hypothalamus/pituitary/gonadal axis. Caucasian girls <7yrs. African American girls <6yrs. Boys <9yrs
|
|
|
Precocious Puberty: Treatment
|
Monthly injections of leutinizing hormone releasing hormone
|
|
|
Precocious Puberty: Nursing Considerations
|
Psy support for parents and child
Activities and dress should remain normal for age Possible BCP (stunts growth) |
|
|
Diabetes Insipidus
|
Hyposecretion of ADH or vasopressin. Maybe familial/idiopathic or r/t trauma/tumors/infection.
|
|
|
Diabetes Insipidus: Clinical Manifestations
|
Intense polyuria
Polydipsia Enuresis (1st sign) Infants: -irritability is calmed by water vs. formula -dehydration -electrolyte imbalance -hypothermia -azotemia |
|
|
Diabetes Insipidus: Diagnosis
|
Restriction of oral fluids
Observation of urine volume & concentration Observe I&O |
|
|
Diabetes Insipidus: Treatment
|
Hormone replacement-vasopressin
DDAVP |
|
|
Diabetes Insipidus: Nursing Considerations
|
Identification of disorder
Parent teaching Medical alert bracelet |
|
|
SIADH
|
Hypersecretion of ADH resulting in fluid retention and hypotonicity. Caused by CNS disease, trauma, infections, tumors.
|
|
|
SIADH: Clinical Manifestations
|
Nausea
Vomiting Malaise Disorientation Confusion Coma |
|
|
Hypothyroidism
|
Deficiency in thyroid hormone. May be congenital or acquired
|
|
|
Hypothyroidism: Clinical Manifestations
|
Impaired growth & development
Decelerated growth Myxedemaous -cold, dry skin -periorbital edema -constipation -mental decline -sleepiness |
|
|
Hypothyroidism: Treatment
|
TH replacement
|
|
|
Hypothyroidism: Nursing Considerations
|
Teach child to take responsibility for own health (9-10yrs)
|
|
|
Hyperthyroidism
|
Most often caused by graves disease (enlarged thyroid gland, exopthalmous)
|
|
|
Hyperthyroidism: Clinical Manifestations
|
Excessive motion
Gradual weight loss Linear growth and bone age acceleration Heat intolerance Dyspnea Goiter |
|
|
Hyperthyroidism: Treatment
|
Anti-thyroid drugs
-PTU -MTZ Sud-Total thyroidectomy Ablation with radioactive iodine |
|
|
Hyperthyroidism: Nursing Considerations
|
Teach S&S of hypothyroidism
Diet (high cal high fat) Explain drug regiment Teach side effects of drugs |
|
|
Cushing Syndrome
|
Caused by excessive circulating free cortisol. Primarily seen with excessive or prolonged steroid therapy (D/C steroids and condition reverses).
|
|
|
Cushing Syndrome: Clinical Manifestations
|
Moon face
Pendulous abdomen Weight gain Red striae Echymoses Red cheecks Hyperglycemia |
|
|
Cushing Syndrome: Diagnosis
|
Fasting BS
Serum electrolytes 24hr urine X-rays for osteoporosis/enlargement of sella tursica |
|
|
Cushing Syndrome: Treatment
|
Depends on cause
Bilateral adrenalectomy & post-op replacement of cortical hormones Removal or irradiation of pituitary tumor & hormone replacement |
|
|
Cushing Syndrome: Nursing Considerations
|
Monitor med admin
Effects may be less with AM admin of corticosteroids & given on alternating day basis |
|
|
Addison Disease
|
Chronic adrenal insufficiency resulting in decreased levels of cortisol.
|
|
|
Addison Disease: Diagnosis
|
Measure of cortisol reserves
|
|
|
Addison Disease: Treatment
|
Replacement of cortisone and aldosterone
|
|
|
Addison Disease: Nursing Considerations
|
Sudden termination of cortisol replacement will threaten acute adrenal crisis
Cortisone may cause gastric irritation-ingest with food Monitor meds Child needs increased replacement during times of stress, illness or surgery Medical ID bracelet |
|
|
Congenital Adrenal Hyperplasia
|
Autosomal recessive enzyme deficiency
|
|
|
Congenital Adrenal Hyperplasia: Pseudohermaphrodism
|
Overproduction of adrenal androgens
-virilization of female fetus -ambiguous genetalia |
|
|
Diabetes Mellitus
|
Partial or complete deficiency of insulin. Peaks at 10-15yrs.
|
|
|
Diabetes Mellitus: Types
|
Type I:
-Destruction of Beta cells -Absolute insulin deficiency Type II: -Insulin resistance -variable insulin deficiency |
|
|
Diabetes Mellitus: Type I
|
Auto-Immune
Not inherited but heredity may be a factor Trigger causes an autoimmune response to destroy beta cells in genetically susceptible hosts |
|
|
Diabetes Mellitus: Type II
|
May be influenced by genetic factors
Asso. with obesity Can be result of: -sluggish or insensitive secretory response in the pancreas -a defect in body tissues that requires unusual amounts of insulin -insulin secreted is rapidly destroyed, inhibited or inactivated |
|
|
Diabetes Mellitus: Insulin Resistance
|
PCOS
Acanthosis nigricans (perma-dirt) |
|
|
Ketoacidosis
|
Occurs when there is no glucose for the cell to function. Body breaks down fat which is converted to ketones in the liver. Ketones in turn enter the blood stream and increase the pH
|
|
|
Course of Insulin Deficiency
|
Insulin deficiency->fluid deficiency->electrolyte imbalance->acidosis->coma->death
|
|
|
Diabetes Mellitus: Long Term Complications
|
Vascular in nature
neuropathy Retinopathy Nephropathy |
|
|
Diabetes Mellitus: Clinical Manifestations
|
"The Great Imitator"
Polyphagia Polydipsia Polyuria Weight loss (TI) Abdominal discomfort Dry skin Blurred vision Fatigue Enuresis Hyperglycemia, ketotic or DKA at presentation |
|
|
Diabetes Mellitus: Diagnosis
|
8hr fasting BS =/> 126mg/dl
Random BS =/> 200mg/dl Oral glucose tolerance test =/>200mg/dl in 2hr sample |
|
|
Diabetes Mellitus: Management
|
Insulin replacement therapy w/ frequent monitoring
Ped. Endocrinologist Diabetes Nurse Educator Nutritionalist Exercise physiologist (exercise decreases need for insulin) Mental Health Teachers School Guidance Counselors |
|
|
Diabetes Mellitus: Goals of Insulin Replacement Therapy
|
Maintain near normal glucose levels while avoid to frequent episodes of hypoglycemia.
|
|
|
Diabetes Mellitus: Conventional Management with Insulin Therapy
|
Combination of rapid acting (regular insulin) with intermediate acting (NPH or Lente insulin) BID usually 1/2hr before meals.
|
|
|
Diabetes Mellitus: Monitoring
|
Self monitoring of BS
Glycosylated hemoglobin (Hgb A1c) Urine (no longer used for management) |
|
|
Diabetes Mellitus: Nursing Goals
|
Education on disease process
Maintain positive self image Support child and family Medical Alert Bracelet Refer to ADA Teaching about injections and monitoring |
