Peds Test 3 Ch 48 Endocrine/Metabolic Disorders PrepU
The neonatal nurse is caring for children with inborn errors of metabolism. Which treatment is recommended for these conditions?
Replacing deficient enzymes through intravenous administration
A nurse is preparing a presentation for a group of parents with children diagnosed with diabetes type 1. The children are all adolescents. What issues would the nurse address related to their developmental level?
Deficient decision-making skills Body image conflicts Struggle for independence
The nurse is developing a plan of care for a 7-year-old boy with diabetes insipidus. What is the priority nursing diagnosis?
Deficient fluid volume related to dehydration
Eve, 2 years old, and her parents are at the office for a follow-up visit. She has had excessive hormone levels in her recent bloodwork and her parents question why this was not found sooner. What is the best response of the nurse?
"As endocrine functions become more stable throughout childhood, alterations become more apparent."
The nurse is taking a history on a 10-year-old child who has a diagnosis of hypopituitarism. Which question is important for the nurse to ask the parents?
"What time each day does your child take his growth hormone?"
A young couple seeks pregnancy counseling in the women's health clinic. They tell the nurse performing a focused health history that they are of Jewish descent and are worried about conceiving a baby with Tay-Sachs disease. No known metabolic disorders exist in the family medical history. What is the nurse's best response to this couple's concerns?
"Carrier testing is warranted for couples who have an elevated risk for Tay-Sachs disease due to their ethnic origin."
The nurse is doing teaching with a group of caregivers of children diagnosed with diabetes mellitus. The nurse is explaining insulin shock and the caregivers make the following statements. Which statement indicates the best understanding of a reason an insulin reaction might occur?
"He measures his own medication but we watch closely to make sure he gets the correct amount so he doesn't have an insulin reaction."
A 13-year-old adolescent with hyperthyroidism who takes antithyroid medication has a sore throat and a fever. The parent calls the nurse and asks what to do. Which is the best response from the nurse?
"Please take your child straight to the emergency department." A side effect of antithyroid medications is leukopenia. Signs and symptoms that include fever and sore throat need to be seen immediately. These instructions should be reviewed with parents upon discharge
A nurse is educating the family of a small child with phenylketonuria about meal choices. Which of the following meal choices by the parents indicate to the nurse that they understand the dietary management of this disease?
A bowl of dry cereal with strawberries and apple juice
The parents of a child who was diagnosed with diabetes insipidus ask the nurse, "How does this disorder occur?" When responding to the parents, the nurse integrates knowledge that a deficiency of which hormone is involved?
Antidiuretic hormone
A woman in her first trimester of pregnancy has just been diagnosed with acquired hypothyroidism. The nurse is alarmed because this condition can lead to which pregnancy complication?
Decreased cognitive development of the fetus
A 9-year-old girl has just been diagnosed with Grave's disease. Which symptom should the nurse expect in this child? Select all that apply.
Exophthalmos (protruding eyes) Moist skin Nervousness Increased basal metabolic rate
A nurse is preparing to discharge Josephine, a neonate diagnosed with maple syrup urine disease. Which one of the following is recommended teaching for home care of Josephine?
Focus on reinforcing the need for the prescribed lifelong dietary regimen
A child with diabetes reports that he is feeling a little shaky. Further assessment reveals that the child is coherent but with some slight tremors and sweating. A fingerstick blood glucose level is 70 mg/dL. What would the nurse do next?
Give 10 to 15 grams of a simple carbohydrate
The nurse is obtaining a health history from parents whose 4-month-old boy has congenital hypothyroidism. What would the nurse most likely assess?
It is difficult to keep the child awake. Physical examination would reveal that the child is below weight and height, that his skin is pale and mottled, and that he is lethargic and irritable.
The child is diagnosed with hypocalcemia. The nurse should assess the child for which possible complication?
Neurologic deficiencies Hypocalcemia (insufficient calcium) causes neurologic damage, including intellectual disability. Calcium is necessary for bone and tooth formation, and is also needed for proper nerve and muscle function. Hypokalemia can cause cardiac issues. Kidney a
A 12-year-old boy arrives at the emergency room experiencing nausea, vomiting, headache, and seizures. He is diagnosed with bacterial meningitis. Other findings include a decrease in urine production, hyponatremia, and water intoxication. Which pituitary gland disorder would be most associated with these symptoms?
Syndrome of inappropriate antidiuretic hormone
A child with diabetes insipidus is being treated with vasopressin. The nurse would assess the child closely for signs and symptoms of which condition?
Syndrome of inappropriate antidiuretic hormone (SIADH)
The nurse is assessing a 13-year-old boy with type 2 diabetes mellitus. What would the nurse correlate with disorder?
The parents report that their son "can't drink enough water."
A 6-year-old boy has a moon-faced, stocky appearance but with thin arms and legs. His cheeks are unusually ruddy. He is diagnosed with Cushing syndrome. What is the most likely cause of this condition in this child?
Tumor of the adrenal cortex
A child presents to the primary care setting with enuresis, nocturia, increased hunger, weight loss, and increased thirst. What does the nurse suspect?
Type 1 diabetes mellitus
A child with a history of diabetes insipidus is admitted with polyuria, polydipsia, and mental confusion. The priority intervention for this client is to:
check vital signs.
The nurse is teaching the mother of a child with phenylketonuria (PKU) about diet and realizes the mother needs further instruction when she makes which of the following statements?
Lots of fish and meat will help him. Patients with PKU need to avoid high-protein foods including meats, fish, poultry, eggs, cheese, milk, nuts, beans, peas, and flour. The food exchange list includes vegetables, fruits, breads, cereals, fats, and miscellaneous "free foods" allowed on the diet.
A 7-year-old child who has type 1 diabetes mellitus is at school reportin a headache and dizziness. The school nurse notices sweat on the child's face. What should the nurse do first?
Offer the child 8 ounces of juice or soda
The nurse is interviewing the caregivers of a child admitted with a diagnosis of type 1 diabetes mellitus. The caregiver states, "She is hungry all the time and eats everything, but she is losing weight." The caregiver's statement indicates the child most likely has:
Polyphagia
A nurse who is caring for a 7-year-old is providing patient teaching to the child and caregiver. Which response by the caregiver demonstrates to the nurse that the caregiver understands the diagnosis of type 1 DM?
"Her body doesn't have any insulin." Type 1 DM is a disorder in which the child's body has a deficiency of insulin because children with type 1 DM cannot produce insulin. Type 2 DM is controlled through diet, medicine, and exercise. Type 2 DM can be prevented through diet and exercise, but type 1 DM cannot.
The nurse is caring for a 3-year-old diagnosed with diabetes mellitus. The child's eating patterns are unpredictable. One day the child will eat almost nothing, the next day the child eats everything on her tray. The nurse recognizes that this type of insulin would most likely be used in treating this
Rapid-acting insulin
A child who has type 1 diabetes mellitus is brought to the emergency department and diagnosed with diabetic ketoacidosis. What treatment would the nurse expect to administer?
Regular insulin
A 12-year-old is being seen in the office and has hyperthyroidism; the nurse knows that the most common cause of hyperthyroidism is:
Graves disease
A child is diagnosed with hyperthyroidism. What finding would the nurse expect to assess?
Heat intolerance nervousness or anxiety diarrhea weight loss smooth, velvety skin
A 2-day-old infant is diagnosed with galactosemia. Which of the following interventions should the nurse prepare the parents to do?
Remove all milk and lactose-containing foods.
An infant on the pediatric floor has diabetes insipidus. Which assessment data are important for the nurse to monitor while the infant is on strict fluid precautions?
Urine output
The school nurse notes that a child diagnosed with diabetes mellitus is experiencing an insulin reaction and is unable to eat or drink. Which action would be the most appropriate for the school nurse to take?
Administer subcutaneous glucagon
A pediatric nurse is discharging a 1-month-old infant. The infant was diagnosed with congenital hypothyroidism on this admission and will be treated with levothyroxine. The nurse knows it is important to teach the parent about medication administration. Which process will the nurse include in the teaching?
Give the crushed medication in a syringe mixed with a small amount of formula.
A nurse is reinforcing the diagnosis of constitutional delay by the health provider to a 13-year-old male adolescent. Which is the best approach for this teen?
"You will not need medication because your hormone levels are normal. I would be glad to discuss these findings with you." This diagnosis of "short stature" or constitutional delay may cause self-esteem issues with male teens. The nurse should explore the teen's feelings. Teens with a delay in puberty usually experience puberty late, so there is no need for a second opinion. Hormone therapy is not given until after age 14.
The nurse knows that disorders of the pituitary gland depend on the location of the physiologic abnormality. Caring for a child that has issues with the anterior pituitary, the child has issues with which hormone?
Growth hormone
A child is diagnosed with hyperthyroidism. What finding would the nurse expect to assess?
Heat intolerance
What should be included in the teaching plan for a child with type 1 diabetes mellitus who is going home on insulin therapy?
It is absolutely normal for the growing child to require an increase in insulin; this does not mean his/her condition is getting worse.
The nurse working with the child diagnosed with type 2 diabetes mellitus recognizes that most often the disorder can be managed by:
Taking oral hypoglycemic agents If the child presents with diabetic ketoacidosis, initial treatment is insulin administration, but then oral hypoglycemic agents such as metformin are often effective for controlling blood glucose levels. Lifestyle changes such as weight loss and increased exercise are important aspects of treatment for the child.
A 9-year-old child with Graves' disease is seen at the pediatrician's office with a complaint of sore throat and fever. The nurse notes in the history that the child is taking propylthiouracil. Which of the following would concern the nurse?
The child may have developed leukopenia.
As a nurse, you know that which condition is caused by excessive levels of circulating cortisol
Cushing syndrome
An elementary school child takes metformin (Glucophage) three times each day. Which of the following disorders would the school nurse expect the child to have?
Type 2 DM
