Ch 41 Peds Metabolic / Endocrine Flashcards Preview

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Flashcards in Ch 41 Peds Metabolic / Endocrine Deck (20):
1

normal peds temp

36.4 - 37 C / 97.5 - 98.6 F

2

peds fever

38 C / 100.4 F

3

peds dehydration

pds more vulnerable to fluid volume deficit bc more of their body water is in the extracellular fluid compartment
the organs that coserve water are immature

4

phenylketonuria

genetic disorder (auto recessive)
results in CNS damage from toxic levels of phenylalanine in the blood.
blood phenylalanine levels > 20 mg/dL

5

normal phenylalanine level

1.2 - 3.4 mg/dL in newborns
0.8 - 1.8 mg/dL otherwise

6

types of dehydration

isotonic
hypertonic (electrolyte loss < water loss)
hypotonic (electrolyte loss > water loss)

7

phenylalanine containing foods

high protein foods (meats and dairy)
aspartame

8

mild dehydration

3-5% weight loss
normal VS
slight thirst
cap refill > 2 sec

9

moderate dehydraiton

6-9% weight loss
increased pulse, RR
orthostatic BP
irritable
moderate thirst
jugular vein not visible except w supraclavicular pressure
2-4 sec cap refill
decreased turgor

10

severe dehydration

>10% weight loss
very increased pulse, RR
BP orthostatic / shock
intense thirst
sunken eyes
sunken anterior fontanel
jugular vein not visible even w pressure
cap refill > 4 sec
tenting, skin cool, acrocyanotic, mottled
oliguria / anuria

11

Type 1 DM

destruction of pancreatic beta cells

12

ketoacidosis

insulin deficiency: impaired metabolism of fats, pro, carbs
hyperglycemia: fatigue, hunger, wt loss
polyuria, cellular starvation
ketones, produced in resonse to cellular starvation, cannot nourish cell bc of absence of insulin
--> ketoacidosis

13

hypoglycemia

glucose < 70 mg/dL
too much insulin, not enough food, or excessive activity

14

hypoglycemia s/sx

HA, nausea, sweating, tremors, lethargy,hunger, confusion, slurred speech, tingling around mouth, anxiety

15

hyperglycemia

glucose > 250 mg/dL, or as spec. by dr.

16

hyperglycemia s/sx

polydipsia, polyuria, polyphagia, blurred vision, wkns, wt loss, syncope

17

priority nursing actions HYPOGLYCEMIA

1. check glucose level
2. give child 1/2 cup fruit juice or other item
3. take child's vital signs
4. retest the glucose level
5. give child small snack of carb and protein
6. document child's complaints, actions taken, and outcome

18

hypoglycemia interventions

confirm w blood glucose reading
admin glucose immediately: rapid releasing glucose followed by complex carb and protein
extra snack if next meal not for >30 min
unconscious --> cake frosting / glucose paste on gums
remains unconscious --> admin glucagon
in hospital: dextrose IV

19

diabetic ketoacidosis

occurs when a severe insulin deficiency occurs
hyperglycemia that progresses to metabolic acidosis
develops over several hrs - dys
blood glucose > 300 mg/dL

20

diabetic ketoacidosis s/sx

signs of hyperglycemia
kussmaul's respirations
acetone (fruity) breath odor
increasing lethargy
decreasing LOC