Chapter 28: Child with Endocrine Dysfunction

You are working with a nurse who is new to your endocrine unit and has never worked with an infant born with congenital adrenal hyperplasia. You want to make sure he has a full understanding of this dx. Which statement by the nurse indicates a need for further teaching

Blood studies to identify elevated calcium and decreased phosphorus levels are routinely performed

What is the most common cause of secondary hyperparathyroidism

CKD

The newborn dx with PKU will require long term follow up to assess for the development of

Cognitive impairment

What statement should the nurse include when discussing a child's precocious puberty with the parent's

Dress and activities should be appropriate to the chronologic age

A nurse working on a pediatric unit is assigned to an infant with hypothyroidism. She knows that the assessment may include

Dry skin, puffiness around the eyes, sparse hair, constipation, sleepiness, lethargy and mental decline

What is the most important nursing consideration r/t congenital hypothyroidism

Early identification of the disorder

A father calls the pediatrician's office concerned about his 5 year old type I DM child who has been ill. He reports that upon checking the child's urine, it was positive for ketones. What is the nurse's best response to this father

Encourage the child to drink calorie-free liquids

The nurse is planning care for a child recently diagnosed with DI. which nursing intervention should be planned

Encourage the child to wear medical identification

A school age child recently diagnosed with type 1 DM asks the nurse if playing soccer, baseball and swimming are still possible. The nurse's response should be based on knowledge that

Exercise is not restricted unless indicated by other health conditions

An infant is born with ambiguous genitalia. Tests are being done to assist in gender assignment. The parents tell the nurse that family and friends are asking what caused the baby to be this way. What should the nurse's explanation include

Explain the disorder so that the parents can explain it to others

You are working in the ED and a 10 year old child with type I DM has just been admitted. He has been diagnosed with diabetic ketoacidosis. Which assessment data will you expect to note in this child

Fruity breath odor and decreased LOC

A nurse is caring for a child who presents with normal growth during the first year of life and then a slowed growth curve below the third percentile. What do these findings suggest

GH deficinecy

A neonate with a goiter has just been admitted to the newborn nursery. A priority nursing intervention is to

Have a tracheostomy set at bedside

A 13 year old girl is brought to the clinic with the c/o emotional lability and restlessness. Other symptoms include gradual weight loss despite good appetite; warm moist skin; heat intolerance and unusually fine hair. These manifestations ar most suggestive of which of the following

Hyperthyroidism

A child with type I DM presents to the ED with sweating, hunger, weakness, dizziness, headache, drowsiness, irritability and loss of coordination. What do these clinical manifestations suggest

Hypoglycemia

The nurse should recognize that when a child develops DKA, treatment will be instituted as described in which of the following statements

Immediate treatment is required because DKA is a life threatening situation

Diabetes is a great imitator of what condition

Influenza, gastroenteritis, appendicitis

Which statement best describes cushing syndrome

It is c/b excessive production of cortisol

Identify the three principal microvascular complications of diabetes

Nephropathy, retinopathy, neuropathy

Test results reveal elevated growth hormone levels in an adolescent male. Based On this finding, the nurse suspects that the child by have

Pituitary adenoma

The nurse is caring for a child hospitalized with acute adrenocortical insufficiency. The acute phase seems to be over when ascending flaccid paralysis occurs. What is the most appropriate nursing action

Reassure the family that this condition is temporary

A breastfed newborn has just been diagnosed with galactosemia. The therapeutic mgmt for this newborn is to

Stop breastfeeding

A 17 year old with type I DM tells the school about recently starting to drink alcohol with friends on weekends. The most appropriate intervention by the nurse is to

Teach the adolescent about the effects of alcohol on type I DM and to prevent problems associated with alcohol intake

The mother of a child with type I DM asks why her child cannot avoid all those "shots" and take pills as an uncle does. The most appropriate response by the nurse is

Your child needs to have insulin replaced and the oral hypoglycemics only add to an existing supply of insulin

A pt diagnosed with hypoparathyroidism would most likely exhibit signs of hypocalcemia. Which findings would reflect this type of electrolyte imbalance SATA a) Tetany b) Chovsetk's sign c) Trousseau sign d) Tongue twitching e) Spontaneous fractures

a, b, c

The nurse is teaching an adolescent, newly diagnosed with type I DM, ways to minimize discomfort with insulin injections. Which interventions are helpful in minimizing injection discomfort SATA a) Do not reuse needles b) Inject insulin when it is cold c) Flex or tense the muscle during injection d) Remove all bubbles from the syringe prior to injection e) do not move the direction of the need/syringe during insertion or withdrawal

a, d, e

Discharge teaching for parents of a school-age patient with DI should include which of the following SATA a) Education and support regarding the rationale for fluid restrictions b) Information for school personnel regarding the dx so that they can grant children unrestricted use of the bathroom c) A thorough explanation regarding the condition with specific clarification that DI is different than DM d) Understanding that treatment will only be needed until the child reaches puberty e) Knowing that school age children may assume full responsibility for their care

b, c, e

In patients who develop thyroid storm for which medical interventions are not successful may proceed to

coma

What is the most common cause of hyperthyroidism in children

graves disease

_________is a complex chemical substance produced and secreted into the body fluids by a cell or group of cells that exerts a physiologic controlling effect on other cells

hormone

_____________is one of the most common endocrine problems of childhood

hypothyroidism

During the summer, many children are more physically active. What changes in the mgmt of the child with type I DM should be expected as a result of more exercised

increased food intake

Identify the most common early symptoms of hypoparathyroidism

muscle cramps

In the diagnostic work up of a child for central precocious puberty, one of the etiologies associated with this disease is

neoplasm

Which lab finding would reflect a critical assessment in a child who has been diagnosed with SIADH

serum sodium 120

The most common organic cause of pituitary under secretion is

tumor

What physiologic alteration is characterized by destruction of pancreatic beta cells that produce insulin

type I DM