Endocrine Flashcards
(46 cards)
When do most endocrine glands develop?
During the first trimester
Growth Hormone Deficiency
Also known as hypopituitarism or dwarfism, is characterized by poor growth and short stature
S/Sx of Growth Hormone Deficiency
- Prominent subcutaneous deposits of abdominal fat
- Child-like face with a large, prominent forehead
- High-pitched voice
- Delayed sexual maturation
- Delayed dentition
- Delayed skeletal maturation
- Decreased muscle mass
When does a Growth Hormone Deficiency becomes apparent?
May start with a normal birth weight and length but is less than 3% on the growth chart by 3 years of age
Causes of Growth Hormone Deficiency
- Tumor
- Infection
- Infarction
- Irradiation in utero
- Trauma during or after birth
- Genetics
- Idiopathic
- Emotional or nutritional deprivation which suppresses the production of pituitary hormones (but this is reversible)
Growth Hormone Deficiency Diagnostics
- Bone age test
- CT/MRI to rule out tumors
- Pituitary function test
Growth Hormone Deficiency Treatment
- Tumor removal (if applicable)
2. Supplemental GH
When do we stop administering supplemental GH to a patient with growth hormone deficiency?
When the growth plates fuse
Growth Hormone Deficiency Nursing Management
- F/U appointments with endocrinologist every 3-6 months
- Growth plotting every 3-6 months
- Assessing adequate nutrition
- Evaluate for learning problems
- Communicate in an age appropriate manner
- Medication compliance
- Encourage participation in sports that are not height dependent
- Support groups
Precocious Puberty
In precocious puberty, the child develops sexual characteristics before the usual age of pubertal onset.
S/Sx of Precocious Puberty
- Acne
- Adult body odor
- Accelerated rate of growth
- Breast development
- Pubic hair
- Advanced genitalia maturation, but does not typically display sexual behavior
- Emotional lability
- Aggressive behavior
- Mood swings
When does precocious puberty typically present?
In girls: 6-7 years
In boys: younger than 9
Precocious Puberty Causes
- Tumor
- Radiation
- Infection
Why is it necessary to treat precocious puberty?
Because without treatment, the child may become fertile (girls will start menstruation)
Precocious Puberty Diagnostics
- Pelvic ultrasound
- Serum hormone values
- CT/MRI
Precocious Puberty Treatment
Aimed at determining and treating the cause and halting sexual development
- GnRH analog: suppresses gonadotropin release
- Medroxyprogesterone (depo-provera) prevents menstruation
Precocious Puberty Nursing Interventions
- Medication compliance
- F/U appointments every 6 months
- Monitor for behavior changes
- Provide sexual education at discontinuation of treatment or if sexual behavior is suspected
- Communicate with child at age-appropriate level
- Counseling
Delayed Puberty
- Characterized by delayed secondary sexual development
- These children usually end up developing normally, just at a later age
Delayed Puberty (Boys)
- No testicular enlargement by 14
- Pubic hair by 15
Delayed Puberty (Girls)
- No breast development by age 12
- No pubic hair by 14
- No menarche by 15
Delayed Puberty Diagnostics
- Physical assessment
- Genetic testing
- Serum hormone level
- Growth plotting
- MRI/CT to assess for tumors
Delayed Puberty Treatment
Treating cause and/or Testosterone (males) and Estradiol (females)
Delayed Puberty Nursing Intervention
Emotional support for possible infertility depending on the cause
Polycystic Ovary Syndrome (PCOS)
Characterized by excessive testosterone production by the ovaries