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Pediatrics > Endocrine Disorder > Flashcards

Endocrine Disorder Flashcards

1
Q

What is the endocrine system composed of?

A

glands, tissues, or clusters of cells that produce and release hormones

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2
Q

What is the gold standard for making the diagnosis of GH excess?

A

Failure to suppress serum GH levels after an oral glucose challenge test

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3
Q

Lab/Diagnostic Studies for Diabetes Insipidus

A
  • Radiographic studies
  • Urinalysis
  • Serum Osmolarity
  • Serum Sodium
  • Fluid Deprivation
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4
Q

What are the two types of pituitary disorders?

A

Anterior and Posterior

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5
Q

Anterior Pituitary Disorders

A
  • Growth Hormone Deficiency
  • Hyperpituitarism
  • Precocious Puberty
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6
Q

Posterior Pituitary Disorders

A
  • Diabetes Insipidus

- Syndrome of Inappropriate Antidiuretic Hormone Secretion

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7
Q

When is Growth Hormone typically released?

A

-throughout the day, mostly secreted during sleep

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8
Q

What is growth hormone deficiency usually a result of?

A

Failure of the anterior pituitary or hypothalamic stimulation on the pituitary to produce sufficient GH

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9
Q

GH Deficiency is also known as what?

A

Hypopituitarism or Dwarfism

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10
Q

What is GH Deficiency characterized by?

A

poor growth and short stature

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11
Q

Complications for GH Deficiency Include?

A

unable to metabolize protein, fat, and carbohydrates effectively

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12
Q

What is the primary cause of GH Deficiency?

A

Injury to pituitary gland or hypothalamus

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13
Q

What may cause injury to the pituitary gland or hypothalamus resulting in GHD?

A
  • tumor
  • infection/infarction
  • CNS irradiation
  • abnormal formation in utero
  • birth trauma
  • Genetics (Prader-Willi or Turner)
  • Psychosocial
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14
Q

Therapeutic Management for GHD

A
  • supplement GH
  • removal of tumors
  • continue treatment until near final height
  • physical exam
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15
Q

What would you see on a Physical Exam for a child w/ GHD?

A
  • height at or < 3rd percentile
  • higher weight to height ratio
  • prominent abdominal fat
  • large forehead
  • high pitched voice
  • delayed sexual maturity, dentition, skeletal maturation
  • decreased muscle mass
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16
Q

Teaching Plan for GHD

A
  • promoting growth
  • enhancing the child’s self esteem
  • providing appropriate education on disorder
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17
Q

When does treatment stop for GHD?

A

With fusion of growth plates

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18
Q

How often should you measure a child’s height w/ GHD?

A

q 3-6 months

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19
Q

What should the child notify the physician about during treatment?

A
  • headaches
  • rapid weight gain
  • increased thirst/urination
  • joint pain
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20
Q

Complications of GHD

A
  • altered carbohydrate, protein, fat metabolism
  • hypoglycemia
  • glucose intolerance/diabetes
  • slipped capital femoral epiphysis
  • pseudotumor cerebri
  • leukemia
  • recurrence of CNS tumors
  • Infection at injection site
  • edema and sodium retention
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21
Q

Precocious Puberty

A

Development of sexual characteristics before the usual age of pubertal onset

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22
Q

When does Precocious Puberty begin for boys and girls?

A

Younger than 8 for girls and 9 for boys

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23
Q

What is the most common form of Precocious Puberty?

A

Central Precocious Puberty

24
Q

Central Precocious Puberty develops as a result of what?

A

Increase in hormones w/ development of sexual characteristics, increased growth, and reproductive capability

25
Q

What happens if Precocious Puberty is left untreated?

A

The child may become fertile

26
Q

S/S of Precocious Puberty?

A
  • headaches
  • vision probs
  • behavior changes/mood swings
  • acne, body odor
  • accelerated growth
  • bone age is advanced
  • size of uterus increased
27
Q

Goals of Nursing Management of Precocious Puberty

A
  • educating about physical changes
  • teaching on meds
  • self esteem issues
  • promoting age appropriate physical dev and pubertal progression
28
Q

Delayed Puberty for Girls

A
  • breasts not developed by 12
  • pubic hair not produced by 14
  • menarche not occurred by 15
29
Q

Delayed Puberty for Boys

A
  • no testicular enlargement or scrotal changes by 14

- no pubic hair by 15

30
Q

What is the most common cause of Delayed Puberty?

A

Constitutional Delay-“Late Bloomer”

31
Q

What are the 2 types of Diabetes Insipidus?

A

Nephrogenic and Central

32
Q

How does Nephrogenic occur?

A
  • transmitted genetically

- acquired from renal disease, hypercalcemia, hypokalemia, drugs-lithium, rifampin

33
Q

Therapeutic Management for Nephrogenic DI

A
  • diuretics
  • high fluid intake
  • restricted sodium
  • high-protein diet
34
Q

What is the most common form of Diabetes Insipidus?

A

Central

35
Q

Central DI is a disorder of what?

A

the pituitary gland

36
Q

Central DI is characterized by what?

A

Polydipsia and polyuria

37
Q

When does SIADH occur?

A

when the feedback mechanism that regulates ADH does not function properly

38
Q

Diabetes Insipidus

A
  • “high and dry”
  • increased urination
  • Hypernatremia
  • serum osmolarity > 300
  • decreased urine osmolarity
  • dehydration, thirst
39
Q

Syndrome of Inappropriate ADH

A
  • “low and wet”
  • decreased urination
  • hyponatremia
  • serum osmolarity <280
  • increased urine osmolarity
  • fluid retention
  • weight gain
  • HTN
40
Q

Graves Disease

A

autoimmune disorder that causes excessive amounts of thyroid hormone to be released in response to human thyroid stimulator immunoglobin

41
Q

Congenital Hypothyroidism

A

“Cretinism”

  • failure of the thyroid gland to migrate during fetal development which causes malfunction/malformation of thyroid gland
  • insufficient production of thyroid hormone
42
Q

What happens if Congenital Hypothyroidism is left untreated?

A
  • intellectual disability
  • short stature
  • growth failure
  • delayed physical maturity
43
Q

What is the most common cause of preventable intellectual disability?

A

Congenital Hypothyroidism

44
Q

How often should you measure thyroid levels until target is reached on stabilized dose of meds?

A

q 2-4 weeks

45
Q

Hyperthyroidism

A
  • nervousness/anxiety
  • diarrhea
  • heat intolerance
  • weight loss
  • smooth, velvety skin
46
Q

Hypothyroidism

A
  • tiredness, fatigue
  • constipation
  • cold intolerance
  • weight gain
  • dry, thick skin, edema of face, eyes and hands
  • decreased growth
47
Q

Signs of Thyroid Storm

A
  • sudden onset of severe restlessness and irritability
  • fever
  • diaphoresis
  • severe tachycardia
  • increased BP, HR, body temp to dangerous levels
48
Q

Thyroid Storm

A

life-threatening health condition of untreated or undertreated hyperthyroidism

49
Q

Addison’s Disease

A

deficiency in the adrenal steroids, glucocorticoids-cortisol, and mineralcorticoids,-aldosterone

50
Q

S/S of Addison’s Disease

A
  • hyponatremia
  • hyperkalemia
  • water loss
  • hypoglycemia
  • hypotension
  • hyperpigmentation
  • adrenal crisis
51
Q

Cushing Syndrome

A

excess levels of one or all hormones, but most commonly glucocorticoid excess

52
Q

S/S of Cushing Syndrome

A
  • rapid weight game
  • decreased linear growth
  • weakness/fatigue
  • irritability
  • sleep problems
  • HTN
  • missed menstrual period
53
Q

Congenital Adrenal Hyperplasia

A

autosomal recessive disorder in which there is an inefficient supply of the enzymes required for the synthesis of cortisol and aldosterone

54
Q

What is the most common type of adrenocortical insufficiency?

A

Congenital Adrenal Hyperplasia

55
Q

What is the obvious sign of Congenital Adrenal Hyperplasia?

A

Ambiguous genitalia

Pediatrics (24 decks)

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