Peds Ch. 52 Word Scramble
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Question | Answer |
Hypopituitarism refers to GH deficiency and will be a dysfx where? Caused by? | hypothalamus cause: dev defects, tumors, trauma, surg, hereditary disorders, anorexia nervosa, dwarfism |
Diagnostic studies include? | fam hx, growth patterns, hand xrays to evaluate growth potential vs ossification, endocrine tests Diffinitive dx: GH levels in blood |
Tx for hypopituitarinism | GH injections is tx of choice May need TH, cortisone, test or estrogen/progesterone |
what is Prader-Willi Syndrome | uncommon genetic disorder cause poor muscle tone, low levels of sex hormones, constant hunger, so obesity. Infants floppy(poor muscle tone). Boys undescended testicles |
Late s/s that may appear wtih Prader-Willi Syndrome | short stature, poor motor skills, wt gain, underdev sex organs, mild mental retardation. No cure |
Nsg for hypopituitarianism | help fam w/ body image, prepare child for inj and very exp, give inj at bedtime to resemble normal GH release |
What is consideration of pt getting GH from cadavers that does not occur from biosynthetic GH? | Creutzfeldt-Jakob Disease |
What do you get with hyper pituitary fx? | Giants, up to 8ft, excess long bone growth if give GH before epiphyseal shafts close |
After epiphyseal closure and have excess GH, what do you get? | acromegaly, overgrowth of head, lips, nose, tongue, jaw, mastoid sinuses, malocclusion of teeth, incr facial hair, thick, creased skin |
Tx for hyper pituitary fx? | remove tumor from sella turcica, radiation implants, hormone replacement after |
What is precocious puberty? | sex dev b4 9y/boys, 8y/girls. Girls w/ higher body fat at 5y more likely. Am then mex-Am, then white |
two types of precocious puberty | true: premature activation of hypo-pit-gonadal w/ early maturation pseudopuberty - incomplete: no early secretion of gonadotropin, overproduction of sex hormones caused by tumor |
tx for precocious puberty | Lupron: luteinizing hormone |
What is nephrogenic DI? | unresponsiveness of renal tubules to hormone, rare hereditary disorder and will not respond to DDAVP |
First sign of neruogenic DI? | enuresis, infants are irritable and prefer water to milk. |
Does SIADH lead to edema? | not necessarily bc edema is excess of water and sodium, this is retention of water. s/s: FVE (no edema), seizure from low Na tx: ADH antagonizing meds |
What is most common endocrine disorder for children? s/s? tx? nsg? | juvenile hypothyroidism s/s: decelerated growth, constipation, sleepiness, dry skin, sparse hair, periorbital edema tx: TH replacement, infant need immediate care for brain growth which happens by 2-3y |
What are some antithyroid or iodide meds? SE of PTU? | MTZ methimazole, PTU propylthiouracil SE: sore throat, fever, leukopenia, hypothyroidism |
what is lymphocytic thyroiditis? | Hashimoto disease or juvenile autoimmune thyroiditis. Most common cause of thyroid disease in children/teen |
what are cardinal s/s of Grave's Disease? | emotional liability, restlessness, poor school performance, voracious appetite w/ wt loss. Dx: elevated T3 & T4 tx: PTU, thyroidectomy, radioiodine |
What is tx for thyrotoxicosis or thyroid storm? | antithyroid drugs, propranolol for s/s of hyperthyroidism |
what is fx of PTH? | incr Ca & Phosphate release bone demineralization incr absorption of Ca and excretion os phosphate by kidneys Incr Ca absorption in GI |
With Pseudohypoparathyroidism what r s/s? | PTH is incr, but end organs are unresponsive to hormone s/s: short stature, round face, thick neck, stubby fingers/toes, dimpling skin over knuckles, mental retardation |
s/s? tx for hypoparathyroidism | s/s: muscle cramps(early), numbness, stiffness, tingling in hands/feet, +Chvostek/Trousseau's sign, laryngeal spasms tx: massive Vit. D |
Early s/s of acute adrenocortical insufficiency? Shocklike state s/s? In infants? | early: irritable, HA, abd pain, weak, N/V/D shock: weak, rapid pulse, decr BP, shallow resp, cold/clammy skin, cyanosis, cirulatory collapse Inf: hyperpyrexia, tachypnea, cyanosis, seizures, palpable gland |
what is Waterhouse-Friderichsen Syndrome? | generalized cerebrospinal meningitis with fever, nuchal rigidity, seizures, stupor, coma |
tx for acute adrenocortical indufficiency Nsg? | cortisol, fluids for dehydration/hypovolemia, glucose for hypoglycemia, antibiotics if inf. Nsg: monitor for hypokalemia(weak, paralysis, hyporeflexia, ileus, arrhythmias) |
Addison's disease is chronic adrenocortical insufficiency and is rare in children, what are s/s? | Neuro: muscle weak, mental fatigue, irritable, listless Pigment: palmar creases, dark over elbows/knees/waist GI: dehydration, anorexia, wt loss |
more s/s of Addison's dis | circulatory: hypotension, sm heart size, dizzy, fainting Hypoglycemic: HA, hunger, weak, tremble other: crave salt, acute abd pain, electrolyte imbalance |
tx for Addison's Disease | cortisol, aldosterone |
s/s of Cushing's dx tests? tx? | excessive hair growth, red cheeks, moon face, pendulous abd with red stiae, poor wound healing, ecchymosis dx: fasting blood glucose, serum electrolytes, 24h urine tx: surgery, GH, ADH, TH, donadotropins, steroid replacement. |
Nsg for cushings | If steroid cause, give early morn or every other day. if surgery, watch for shocklike state, like hypotension adn hyperpyrexia |
Waht does hyperaldosteronism casue? nsg? tx? | htn, K imbalances, polyuria that fails to respond to ADH tx: spironolactone nsg: s/s of hypo/hyperkalemia |
what is congenital adrenogenital hyperplasia? | decr enzyme activity req for cortisol production in adrenal cortex, 21-hydroxylase insufficiency so masculination of female fetus. Can't assign sex to female |
tx for congenital adrenogenital hyperplasia | give cortisone to suppress high ACTH, reconstructive surgery. Nsg: can be reason for ambiguous genitalia in newborns. Salt losing type, will tell parents need lifelong meds of aldosterone |
What is nsg considerations for pheochromocytoma? | Can mimic hyperthyroidism and DM Do not palpate mass bc release catecholamines. monitor for hyperglycemia, htn, CHF preop and shock postop |
s/s hypopitutarism | short stature, ht retarded more than wt, inactive, |
What is ht velocity? How calculate project target ht? | observe child's ht over time, 6mos of observe, father ht + mother's ht + 13/2 for boys father + mother -13/2 for girls |
premature thelarche(breast dev), menarche, pubarche r s/s of | incomplete precocious puberty |
best test to dx DI | restrict oral fluids and observe changes in urine. Watch for kids drinking from toilet bowl, flower vases, etc. |
How do you make vasopressin for DI effective? | resuspend in oil under warm water for 10-15m and shake vigorously b4 draw in syringe, want to see brown particles |
With SIADH, what s/s are severe? | disorientation, confusion, coma, seizures r/t hyponatremia |
what are s/s or lymphocytic thyroiditis | enlarged thyroid, hoarseness, dysphagia, possible hyperthyroidism |
Created by:
palmerag
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