Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

NU 374 > Ch. 31 > Flashcards

Ch. 31 Flashcards

(62 cards)

Start Studying
1
Q

which type of diabetes is more common

A

type I is more common than type II in children

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

covid and diabetes

A

since covid, the amount of children with diabetes has increased
- having covid increased the risk of diabetes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

symptomatology of diabetes

A

regressing in developmental milestones
- secondary enuresis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

mixing insulins

A

don’t do with children
- do multiple daily injections rather than mixing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

___ and ___ alter insulin requirements

A

illness and exercise

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

calorie vs food restriction if child is overweight

A

limit calories not food if child is overweight

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

hypo v hyperglycemic episodes

A

hard to differentiate
- ok to assume hypo if personality changes and they don’t have a glucometer
- if they have a glucometer, test before assuming

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

blood glucose lab values: toddlers/preschoolers (<6 years)

A

before meals: 100-180 mg/dL
bedtime: 100-200 mg/dL
A1C: </= 7.5%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

blood glucose lab values: school age (6-12 years)

A

before meals: 90-130 mg/dL
bedtime: 90-150 mg/dL
A1C: < 7%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

blood glucose lab values: adolescents and young adults (>12 years)

A

before meals: 90-130 mg/dL
bedtime: 90-150 mg/dL
A1C: < 7%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

toddlers and preschoolers < 6 years: blood glucose implications

A

high risk and vulnerability to hypoglycemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

school age 6-12 years: blood glucose implications

A

risks of hypoglycemia and relatively low risk of complications before puberty

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

adolescents and young adults > 12 years: blood glucose implications

A

risk of hypoglycemia
developmental and psychological issues

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

rapid acting insulin

A

names: lispro, aspart, glulisine
onset: < 15 min
peak: 30-90 min
duration: 3-4 hr (up to 5)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

short-acting insulin

A

names: regular
onset: 30 min
peak: 2-4 hr
duration: 4-8 hr

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

intermediate insulin

A

names: NPH
onset: 2-6 hr
peak: 4-14 hr
duration: 14-20 hr

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

long-acting insulin

A

names: glargine, detemir
onset: 6-14 hr
peak: none or small peak after 10-16 hr
duration: 20-24 hr

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

insulin injection sites: fastest absorption site

A

abdomen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

insulin injection sites: a little slower (2nd fastest)

A

the back of the arms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

insulin injection sites: even slower (2nd slowest)

A

the legs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

insulin injection sites: slowest absorption site

A

the buttocks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

injection sites of insulin should

A

rotate/change every week or two to get the most out of your insulin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

what happens if you choose the same injection site each time you inject?

A

hard lumps (fat tissue swells) can develop under the skin; insulin is absorbed slowly
- this is called lipohypertrophy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

lipohypertrophy can be prevented by

A

rotating injection sites
- horizontal pattern
- curve pattern
- crisscross pattern
- zig zag pattern

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
injection sites for infants
no abdomen!
26
injection sites for children
abdomen ONLY if child has at least 1/2" of pinchable skin otherwise no abdomen
27
injection sites for adolescents
abdomen (1/2" of pinchable skin)
28
why can't we inject insulin into a site that will be exercised?
exercise can increase blood flow; makes insulin absorbed at a faster rate *may have to give a snack with extra carbohydrates for every 45-60min of exercise
29
type II DM: acanthosis nigricans
thicker hyperpigmented skin especially seen in the back of the neck, axilla, and groin resolves overtime when blood sugars are under better control
30
DM: nursing care goals
1. restore euglycemia 2. reduce urinary ketones 3. maintain hydration
31
DM: illness management
- Monitor BS q 3 hrs. - Monitor urinary ketones q 3 hrs. - Continue the usual insulin regimen. - Supplemental insulin based on BS. - Encourage fluids (force if needed) - Call provider if multiple emesis episodes, BS >240 continuously or urine ketones remain high (>3+)
32
DKA: nursing care goals
1. rapid assessment 2. adequate insulin coverage 3. reverse dehydration 4. electrolyte replacement (esp. K+) to correct hydration and acidosis
33
DKA: management
- Cardiopulmonary monitoring - Admission weight - Serial vitals and labs at bedside - CBC with diff, BMP, ABG - Strict I/O (Foley) - IVF (1.5-2 days) with K+ - Regular insulin IV (0.1 units/kg/hr.) - Decrease BS by 50-100 mg/dL/hr - Add dextrose to IVF when BS falls <300
34
hypoglycemia: mild reaction (how to treat)
(adrenergic symptoms) - give child 10-15g of a simple, high-carbohydrate substance (pref. liquid- ie OJ) - follow with starch-protein snack
35
hypoglycemia: moderate reaction
(neuroglycopenic symptoms) - give child 10-15g of a simple, high-carbohydrate substance (pref. liquid- ie OJ) - repeat in 10-15 min if symptoms persist - follow with larger snack - watch child closely
36
hypoglycemia: severe reaction (how to treat)
(unresponsive, unconscious, or seizures) - administer glucagon as prescribed - follow with planned meal or snack when child is able to eat, or add snack of 10% of daily calories - consult team re: dosing change
37
hypoglycemia nocturnal reaction: nursing interventions
(magic number is 10*) - give child 10-15g of a simple carbohydrate - follow with snack of 10% of daily calories
38
central precocious puberty (CPP)
type of early onset puberty - before age of 7 in females with lighter skin or white skin - before 6 in females of darker skin - before age 9 in males
39
CPP clinical features
- Begins before age 7 in white girls, before 6 in AA girls and before age 9 in boys - Usual progression of puberty - Advanced ht., wt., and osseous maturation - Early closure of growth plate resulting in less than normal height for age - Elevated GH levels (includes FSH and LH) - Idiopathic (girls)/ pathologic: ie tumor (boys)
40
growth hormone deficiency (GHD)
- Stunted somatic growth - Familial but can be linked with other causes
41
GHD clinical features
- Weight percentile exceeds height - Immature facial appearance - Frontal bossing - Truncal obesity - Hypoplastic genitalia - High pitched voice - Delayed bone maturation - Low GH level and possibly others - Short stature, but HT and WT are proportional - Delayed epiphyseal closure - Retarded bone age compared with height - Premature aging (later in life) - Increased insulin sensitivity - Normal intelligence - Emotional problems (common)
42
causes of precocious puberty
girls: 90-95% are idiopathic- no cause boys: underlying pathologic cause, ie tumor
43
(goal of) treatment of precocious puberty
goal of treatment is to stop and possibly reverse the onset of puberty - treatment will depend on the type and underlying cause, if known
44
central/idiopathic precocious puberty: s/sx
onset of puberty (usual pattern) gonadotropin levels increase
45
central/idiopathic precocious puberty: treatment
- CT or MRI to r/o tumor. Will x-ray bone growth to evaluate bone maturity and premature epiphyseal plate closure. Blood work. Treatment of any underlying cause if known (ex. Tumor removal). - Pharmacology: Lupron Depot (synthetic luteinizing hormone-releasing hormone) injections.
46
peripheral precocious puberty: s/sx
some puberty s/sx but not all; out of order estrogen or testosterone levels increase (not gonadotropin)
47
peripheral precocious puberty: treatment
- Depends on cause of increase in estrogen or testosterone levels. (ex. Tumor removal). - Diagnostics to evaluate cause. - Blood work.
48
incomplete precocious puberty: s/sx
partial development ie unilateral breast development
49
incomplete precocious puberty: treatment
- Wait and see. Usually resolves on its own. - Blood work to confirm no activation of GnRH or hormones.
50
advanced bone age
the child's bone structure is that of an older age
51
lupron depot
an injection administered monthly or q3months or GnRH analog histrelin implant (placed SQ in arm) - to treat CPP
52
why would dose changes be necessary with lupron depot
- hormone and clinical suppression are not achieved with the starting dose - the child's body weight changes
53
if lupron depot is effective
females: breast development will stop and may regress males: the penis and testicles may shrink back to a size that is normal for their age
54
is missing a dose of lupron depot a problem?
yes- can precipitate return of CPP s/sx
55
treatment of GHD
Biosynthetic GH subcutaneous injections daily at bedtime - 80% success rate - Greatest results in year 1 - Likely to attain less than normal height even with treatment - May have additional hormone deficiencies
56
when to stop GHD treatment
- Velocity < 1 inch - Bone age of 14 (females) and 16 (males)
57
before/during/after treatment of GHD, assess for
- Socioemotional concerns pre-treatment - Realistic expectations - Effective coping during/post-treatment
58
intramuscular injections: sites and volume amounts
- Vastus Lateralis and Ventrogluteal Sites: 0.5-2 mL volume - Deltoid: up to 1 mL
59
intramuscular injections
- Traditional hormone replacement therapy - Vaccines - Other medications (rabies vaccine, antibiotics etc.)
60
subcutaneous injections: sites
Numerous sites (kids usually rotate between 4-8 sites) - anywhere you can pinch at least an 1/2-1in of skin in the abdomen - legs (thigh) - upper outer triceps
61
subcutaneous injections
- hormone replacement (pen) - insulin - vaccines
62
if the volume of an injections exceeds the warranted amount per injection,
divide into multiple injections

NU 374 (18 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions