Nursing Care of the Child with an Endocrine Disorder

insulin is developed and secreted by beta cells, located in the islets of ___ in the pancreas.

langerhans

list signs and symptoms of hyperthyroidism .

nervousness/anxiety diarrhea heat intolerance weight loss smooth velvet like skin

Cells within the ____ secrete glucagon and somatostatin.

pancreas

the ____ regulates calcium and phosphorus concentration

parathyroid

the most common initial symptoms of diabetes mellitus reported are ___ and polydipsia.

polyuria

the young child has been diagnosed with a secondary growth hormone deficiency. the child weighs 58 pounds. the physician orders the child to receive 0.2 mg of growth hormone for each kilogram of body weight per week, divided into daily doses. how many milligrams of hormone would the child receive with each dose? Round to thousandths place.

0.075 milligrams per day

put the following insulin in order of their onset times 1. Lispro 2. NPH 3. Regular 4. ultralente

1,3,2,4

what are the nursing implications when teaching, discussing, and caring for children with diabetes mellitus in the following age groups (a) infants and toddlers (b) preschoolers (c) school age (d) adolescent?

1. infants and toddlers; attempt to achieve consistent dietary intake. give the toddler foods to choose from. help the toddler to find and use a word or phrase to describe feelings when hypoglycemic symptoms occur. establish rituals/routines with home management. 2. preschoolers: use simple explanations and play therapy when instructing or preparing for a procedure or situation related to the disorder. 3. school age: use concise and concrete terms when instructing. allow children to proceed at their won rate. assist ithe family to incorporate the testing and injections into the school day and plan for field trips. use the school nurse's assistance and help with the school plan. 4. adolescents: care can be slowly turned over to an adolescent with minor supervision from family. watch for depression in this age group.

the child has developed hypothyroidism and has been prescribed sodium L-thyroxine. the starting dose is 12mg/kg of body weight each day. the child weighs 72 pounds. calculate the child's dose in micrograms and round to nearest whole number.

393 micrograms

the nurse is assessing a 16yr old boy who has had long term corticosteroid therapy. which of the following findings, along with the use of the corticosteroids, would indicate Cushing's Disease? A. history of rapid weight gain B. observing a round, child like face C. observing high weight to height ratio D. observing delayed dentition

A

the nurse is assessing a 7 yr old girl who complains of headache, is irritable, and vomiting. her health history reveals she has had meningitis. which of the following is the priority intervention? A. Notifying the physician of the neurologic findings B. setting up safety precautions to prevent injury C. monitoring urine volume and specific gravity D. restoring fluid balance with IV sodium chloride

A

the nurse is caring for an obese 15yr old girl who missed two periods and is afraid she is pregnant. which of the following findings would indicate polycystic ovary syndrome? A. observation of acanthuses nigricans B. complains of blurred vision and headaches. C. auscultation reveals increased respiratory rate D. palpitation reveals hypertrophy and weakness

A

the child may have developed thyroid storm. which of the following are clinical manifestations of thyroid storm? select all that apply. A. the child's temp is 103.2F B. the child's linen is wet and the child com pains of feeling sweaty C. the child's apical heart rate is 172 BPM D. the child states he feels very tired and wants to take a nap E. the child has been mild-mannered and copliant

A,B,C

which of the following male/female may have delayed puberty? select all that apply. A. the 14 yr old female has not developed breast B. the 13 yr old female has no pubic hair C. the 15 yr old male has had no changes to the size of testicles D. the 13 yr old male has no changes in the appearance of his scrotum

A,C

the nurse is assessing a 1 month old girl who, according to the mother, doesn't eat well. which of the following assessments would suggest the child has congenital hypothyroidism? A. mother reports frequent diarrhea B. observation of an enlarged tongue C. auscultation reveals tachycardia D. palpation reveals warm, moist skin

B

the nurse is assessing a 4yr old girl with ambiguous genitalia. which of the following findings would be consistent with congenital adrenal hyperplasia? A. auscultation reveals irregular heartbeat B. observing pubic hair and hirsutism C. palpation elicits pain from constipation D. observing hyper pigmentation of the skin

B

the ruse is teaching an 11 yr old boy and his family how to manage his diabetes. which of the following does not focus on glucose management? A. teaching that 50% of daily calories should be carbs B. instructing the child to rotate injection sites to decrease scar formation C. encouraging the child to maintain the proper injection schedule D. promoting higher levels of exercise than previously maintained.

B

rank the different types of insulin based on their duration of action beginning with the shortest to longest duration. A. humulin N B. lispro C. lantus D. humulin R

B,D,A,C

the nurse is caring for a 10yr old girl with hyperparathyroidism. which of the following would be a primary nursing diagnosis for this child? A. disturbed body image related to hormone dysfunction B. imbalanced nutrition: more than body requirements C. deficient fluid volume related to electrolyte imbalance D. deficient knowledge related to treatment of the disease

C

the nurse is caring for a 4yr old boy during a growth hormone stimulation test. which of the following is a priority task for the care of this child? A. providing a wet washcloth to suck on B. educating family about side effects C. monitoring blood glucose levels D. monitoring intake and output

C

the nurse is caring for a 12yr old girl with hypothyroidism which of the following will be part of the nurse's teaching plan for the child and family? A. educating how to recognize vitamine D toxicity B. teaching how to maintain fluid intake regiments C. teaching to administer methimazole with meals D. instructing to report irritability or anxiety

D

the nurse is providing acute care for an 11yr old boy with hypoparathyroidism. which of the following is the priority intervention? A. providing administration of calcium and vitamin D B. ensuring potency of the IV site to prevent tissue damage C. Monitoring fluid intake and urinary calcium output D. administering intravenous calcium gluconate as ordered

D

mineralocorticoids are related to what gland?

adrenal gland

dwarfism is due to a growth hormone ___.

deficiency

what are the teaching topics needed to educate parents of children with diabetes mellitus?

diet should be low in fats and concentrated carbs. list of foods high in carbs, protein, and fat should be provided. the parents need to understand the need to plan for periods of rapid growth, travel, school parties,and holidays. referring the parents t a nutritionist with diabetes expertise will be helpful. there should be a plan for three meals and two snacks per day in order to maintain blood glucose levels. regular exercise should be encouraged, as well as participation in age appropriate sports. the parents should be reminded of the importance of monitoring the insulin dose, food and fluid intake, and hypoglycemic reactions when exercising.

ophthalmic changes, due to hyperthyroidism, include ____, which is less pronounced in children.

exophthalmos

the thymus has ____factors

humoral

the presence of a goiter is typically associated with ____.

hyperthyroidism

slow, deep ____ respirations are characteristic of air hunger during metabolic acidosis.

kussmaul

discuss how healthy people 2020 suggests addressing the goal of reducing the annual number of new cases of diagnosed diabetes in the population.

recommends screening all children periodically to identify early signs of overweight and obesity based on CDC guidelines. in addition, families should receive education regarding appropriate diet and exercise early during the toddler years in an attempt to prevent obesity, thus decreasing the likelihood of diabetes.

twitching of the extremities, referred to as ___ is related to hypocalcemia in children with hypoparathyroidism.

tetany

what teaching points should the nurse discuss with the parents of a child receiving growth hormone in regards to possible adverse reactions?

the nurse should instruct the family to report headaches, rapid weight gain, increased thirst or ruination, or painful hip or knee joint as possible adverse reactions.

the ___ regulates calcium and phosphorus homeostasis

thyroid

list signs and symptoms of hypothyroidism

tiredness/fatigue constipation cold intolerance weight gain dry, thick skin, edema on the face eyes and hands decreased growth