Endo & Metabolic

Question 1

fever

Answer 1

assess temp 30min to 1hr after antipyretic
sponge bath for 20 to 30min then reassess temp after 30min
❌no alcohol: peripheral vasoconstriction
✅ ibu
❌ aspirin-risk for Reye’s syndrome

Question 2

dehydration

Answer 2

MILD to MOD: ORS or pedialyte
SEVERE: NPO and fluid replacement thru IV

if K is prescribed for IV, ensure the child has voided before admininstration

Question 3

phenylketonuria

Answer 3

genetic disorder
-toxic levels of phenylalanine in blood damages the CNS

All children:
digestive problems
seizures
musty odor of urine
mental retardation

older children
eczema
hypertonia
hypopigmentation
hyperactive behavior

newborn screening:
if + before age 48hrs,
rescrewb at age 14days

Question 4

foods rich in phenylalanine

Answer 4

high protein foods (meat, dairy)
aspartame (diet drinks, chewing gum, gelatin, ice cream, breakfast cereal, toothpaste and medications such as cough drops and chewable vitamins)

Question 5

food items to treat hypoglycemia

Answer 5

▪ ½ cup of orange juice or sugar-sweetened carbonated beverage
▪ 8 oz of milk
▪ 1 small box of raisins
▪ 3 or 4 hard candies
▪ 4 sugar cubes (1 Tbsp of sugar)
▪ 3 or 4 Life savers candies
▪ 1 candy bar
▪ 1 tsp honey
▪ 2 or 3 glucose tablets

Question 6

interventions for hypoglycemiag

Answer 6

▪ If possible, confirm hypoglycemia with a blood glucose reading.
▪ Administer glucose immediately; rapid-releasing glucose is followed by a complex carbohydrate and protein, such as a slice of bread or a peanut butter cracker.
▪ Give an extra snack if the next meal is not planned for more than 30 minutes or if activity is planned.
▪ If the child becomes unconscious, squeeze cake frosting or glucose paste onto the gums and retest the blood glucose level in 15 minutes (monitor the child closely); if the reading remains low, administer additional glucose.
▪ If the child remains unconscious, the administration of glucagon may be necessary.
▪ In the hospital, prepare to administer dextrose intravenously if the child is unable to consume an oral glucose product.

Question 7

blood glucose ________
urine glucose ________

Answer 7

reliable
only for ketones leading DKA

Question 8

Sick Day Rules for a Diabetic Child

Answer 8

▪ Always give insulin, even if the child does not have an appetite.
▪ Test blood glucose levels at least every 4 hours.
▪ Test for urinary ketones with each voiding.
▪ Notify the PHCP if moderate or large amounts of urinary ketones are present.
▪ Follow the child’s usual meal plan.
▪ Encourage liquids to aid in clearing ketones.
▪ Encourage rest, especially if urinary ketones are present.
▪ Notify the PHCP if vomiting, fruity odor to the breath, deep rapid respirations, decreasing level of consciousness, or persistent hyperglycemia occurs.

Question 9

hypopituitarism vs hyperpituitarism

Answer 9

hypo
-GH & Gonadotropic Hormones (LH, FSH)

hyper
-GH
stereotactic radiosurgery/ hypophysectomy