Endocrine - Pancreatic + Gonadal

Question 1

Disorders of Pancreatic Function

Answer 1

DM 1
»ketoacidosis
»hypo-glycemia
DM 2

Question 2

DM1

Answer 2

autoimmune destruction of pancreatic cells

-inherit susceptibility to disease

Question 3

DM1

manifestations

Answer 3

3P’s

poly - uria, dipsia, phagia

Question 4

DM1

diagnosis

Answer 4

3P's + one of the following:
>>HgbA1c>6.5%
>>fasting bld sugar> 126 after 8hr
>>2hr plasma glucose >200 during oral gluc tolerance test
>>random plasma gluc >200

Question 5

HgbA1c

Answer 5

> 6.5%

Question 6

fasting blood sugar

Answer 6

> 126 after 8hr

Question 7

2hr plasma glucose

Answer 7

200 during oral glucose tolerance test

Question 8

random plasma glucose

Answer 8

> 200

Question 9

DM1

treatment

Answer 9

• individualized insulin
• diet
• exercise regimens

Question 10

1 unit of insulin =

Answer 10

15 g of carb

Question 11

children w DM1 can help w care at what age

Answer 11

6-8 yo

to test blood glucose, keep records, etc

Question 12

concerns w adolescents

Answer 12

can manage self-care, but desire to be like peers can interfere with treatment adherence

Question 13

___ is eventual goal for kids + adolescence w DM1

Answer 13

self mgmt

Question 14

___ made be delayed w inadequate DM1 control

Answer 14

puberty

Question 15

concern w children

Answer 15

may use condition to get what they want

Question 16

diabetic ketoacidosis is..

Answer 16

fat broken down to create energy
>ketone bodies released into body
»causes acidosis

Question 17

diabetic ketoacidosis primarily occurs with..

Answer 17

DM1 who…

• miss insulin dose,
• admin insulin incorrectly,
• experience stressor, or
• first diagnosis

Question 18

diabetic ketoacidosis

criteria

Answer 18

blood glucose >330 mg/dL
serume/urine ketones
pH<7.3, bicarb <15meQ

Question 19

diabetic ketoacidosis

manifestations

Answer 19

• kussmaul respirations

- acetone breath

Question 20

diabetic ketoacidosis

late signs

Answer 20

• altered LOC
• pupillary changes
• irregular respirations

Question 21

diabetic ketoacidosis

treatment

Answer 21

IV REGULAR INSULIN

• 0.1unit/kg/hr
• do not decr gluc faster than 100mg/dL/hr bc risk for cerebral edema

Question 22

diabetic ketoacidosis

nursing mgmt

Answer 22

monitor mental stat
assess for hypoglycemia
monitor arrhythmias
assess dehydration

Question 23

why are kids at risk for hypoglycemia

Answer 23

• rapid growth,
• unpredictable eating,
• phys activity
• error in dosage
• not enough cals
• exercise

Question 24

parent should have ____ for severe hypoglycemia

Answer 24

IM glucagon

Question 25

hypoglycemia | manifestations

Answer 25

- shaky feeling - behavior change - confusion

Question 26

hypoglycemia | therapy

Answer 26

if conscious, give 15g of carb if unconscious, give glucagon by injection

Question 27

hyperglycemia | manifestations

Answer 27

- lethargy - sleepy - slowed response - confusion - deep, rapid breathing - acetone breath

Question 28

hyperglycemia | therapy

Answer 28

- additional insulin at usual time | - extra injections if hyperglycemia + mod-large ketones

Question 29

DM2

Answer 29

insuline resistance overtime | -usually NOT acute onset

Question 30

DM2 | risk factors

Answer 30

obesity | low level of physical activity

Question 31

DM2 in pediatrics, focus on...

Answer 31

prevention

Question 32

assess kids w _____ for signs of insulin resistance (DM2)

Answer 32

BMI>85th percentile

Question 33

signs of DM2

Answer 33

- acanthosis nigricans - HTN - dyslipidemia - fam w DM2

Question 34

Primary Amenorrhea

Answer 34

absence of menarche by 14.5 yo + no growth/dvlpt of secondary sex characteristics -absence of menses by 16 y.o.

Question 35

Secondary Amenorrhea

Answer 35

pregnancy is most common reason so obtain sex hx -cessation after 6 months or 3 cycles of menstruation

Question 36

Dysmenorrhea

Answer 36

leading cause of missed school days among adolescent females

Question 37

Primary Dysmenorrhea

Answer 37

painful cramps | -from INCREASED PROSTAGLANDINS

Question 38

Secondary Dysmenorrhea

Answer 38

painful cramps fr pelvic abnormalities like fibroids or endometriosis

Question 39

Dysmenorrhea happens _______ and lasts ______

Answer 39

at beginning or prior to menstrual period lasts 1-3 days