Care of child chapter 51

What is hypothyroidism?

decreased secretion of pituitary hormones

What is the treatment for hypothyroidism?

Levothyroxine (Synthroid)

What is the cause of Pituitary Hyperfunction?

Excess GH before closure of epiphyseal shafts results in overgrowth of long bones.

What is acromegaly?

Rare condition resulting from excess secretion of growth hormone (GH).

Signs of acromegaly

Typical facial features include overgrowth of the following:HeadLips, tongue, jaw, noseNasal, mastoid sinusesMalocclusion of the teeth (bite problems)

Acromegaly treatment

Surgical treatment to remove tumourRadiation and radioactive implantsHormone replacement therapy after surgery in some cases: Thyroid extract, Cortisones and Sex hormones

Diabetes insipidus What are the cardinal signs?

polyuria and polydipsia (excessive urination and thirst)

treatment for diabetes insipidus

Daily hormone replacement of vasopressin (antidiuretic hormone)Either with a IM or subcutaneous injection or a nasal spray

Nursing interventions for diabetes insipidus

Strict I &O, VS, monitor skin tugar, monitor IV fluids, neuro checks, daily weights, urine specific gravity, low NA diet, instruct patient to wear medical alert bracelet

Juvenile Hypothyroidism

A condition involving a deficiency of thyroid hormone secretion in children.

Clinical manifestations on Juvenile Hypothyroidism

* Mental decline * Constipation* Sleepiness* Myxedematous skin changesDry skinSparse hairPuffiness around eyes

Treatment for juvenile hypothroidism

§ Oral TH replacement§ Prompt treatment is needed for brain growth in infant.§ For a child, treated gradually over 4 to 8 weeks to avoid symptoms of hyperthyroidism

What is Goitre ?

enlargement of the thyroid gland

Treatment for goitre

treatment ranges from watchful waiting (no treatment) to surgery.

Hyperthyroidism

excessive activity of the thyroid gland (graves disease)

signs of hyperthyroidism

Enlarged thyroid gland and exophthalmos (bulging eyes)

Treatments for hyperthyroidism

§ Antithyroid drugs§ Partial Thyroidectomy§ Radioiodine: taken pill form and gets to work destroying cancer cells§ Meds may put patient into remission, but relapses may occur.§ Ablation (removal) with radioiodine

Which hormones does the adrenal gland secrete?

§ Glucocorticoids (cortisol, corticosterone)§ Mineralocorticoids (aldosterone)§ Sex steroids (androgens, estrogens, and progestins)

Hypoparathyroidism verses hyperparathyroidism.

hypoparathyroidism, there is a low production of parathyroid hormone. Whereas as in hyperparathyroidism, there is an excessive amount of parathyroid hormone production

Type I Diabetes Mellitus (DM):

§ Characterized by destruction of beta cells, usually leading to absolute insulin deficiency. Typically, onset is in childhood and adolescence but it can occur at any age.§ Most DM of childhood is type 1.§ Incidence among boys is slightly higher than in girls.

What is the cardinal sign of DM

§ Frequent urination Excessive thirst

ketoacidosis

excessive production of ketones, making the blood acidic

Signs of ketoacidosis

Kussmaul's respirations

Kussmaul's respirations:

§ Hyperventilation characteristic of metabolic acidosis, resulting from respiratory system's attempt to eliminate excess CO2 by increased depth and rate

Long term complications of DM

Microvascular complications, especially nephropathy (damage to kidney), neuropathy (damage affecting peripheral nerves of the body), and retinopathy (damage to the retina)Macrovascular disease (disease of large blood vessels in the body; example- coronary arteries)

Therapeutic management of DM?

-Diet-Exercise-Glucose monitoring-Insulin therapy- Metformin PO

Symptoms of hypoglycemia

tachycardia, excessive sweating (diaphoresis), light-headedness, visual disturbances

What is diabetic ketoacidosis?

Pediatric emergencyResults from progressive deterioration with dehydration, electrolyte imbalance, acidosis, coma; may cause death