Peds Exam 2 Study Guide (endocrine, cardiovascular, and oxygen)

What is diabetes?

Characterized by a complete or partial loss of insulin contributing to disease.

What is normal blood sugar?

70-110

Type 1 diabetes

Type 1 diabetes is the destruction of pancreatic beta cells, risk factors are genetics, or family history, toxins, and viruses. Type 1 requires insulin because the body produces none on its own.

Type 2 diabetes

Type 2 diabetes is the most common, the body cannot use insulin properly. Risk factors include obesity, inactivity, and high triglycerides. Manage with insulin and metformin, nutritional and activity teaching.

Managing hypoglycemia (sugar less than 60)

Treat with 10-15g carb snack, OJ, crackers. If needed administer glucagon and monitor every 15 min.

Managing hyperglycemia (sugar above 250)

Administer insulin, encourage hydration, and monitor glucose levels.

Hyperglycemia 3 P’s

Polyphagia: excessive hunger

Polydipsia: excessive thirst

Polyuria: excessive urination

What is DKA?

Diabetic Ketoacidosis: blood sugar above 330, acute and life-threatening, the body starts breaking down fat for energy. Ketones accumulate in the blood, urine, and lungs, caused by metabolic acidosis, insufficient insulin, stress, and poor management.

Treatment of DKA?

Administer IV fluids, insulin administration, cardiac monitoring, hourly glucose monitoring, 2 hr ABG, if untreated can lead to coma and death.

Hyper and hypoglycemia s/s

Hyperglycemia: nausea, vomit, 3 P’s, poor skin turgor, condusion, weakness, fruity breath, kussmauls respirations.

Hypoglycemia: dizzy, shaky, hunger, headache, cool skin, anxiety, sweating, tachycardia, irritable.

What is coarctation of the aorta?

Narrowing of the aorta resulting in obstruction of blood to lower extremities. Upper extremities have hypertension, lower have hypotension. Manage with prostglandin E1, surgical repair at 6mo or less, antihypertensives.

Tetraolgy of fallot (PROV)

Four defects are Pulmonary stenosis, Right ventricular hypertrophy, Overriding aorta, and VSD. Cyanosis, tet spells (sudden cyanosis), and systolic murmur. Manage with knee-chest position, oxygen, morphine, and fluids. Surgical repair with stent before age 1.

Rheumatic fever (JONES)

Post group strep A infection from untreated strep. Jones criteria: 1 major and 2 minor criteria. Major: carditis, subcutaneous nodule, rash. Minor: fever or arthralgia (joint pain). Manage with antibiotics, aspirin, and bed rest.

Kawasaki disease

Acute inflammation of the heart vessels, thought to be autoimmune. Strawberry tongue, erythema, swollen hands and feet, red eyes, and skin rash. Requires early treatment, administer IVIG, high dose aspirin, vitals, and cardiac status.

General cardiovascular management

Monitor O2 status, provide rest to decrease heart demands, daily weights, I and O’s, infection prevention, and emotional support. Digoxin requires apical pulse, hold if HR is less than 60. Furosemide, watch potassium level.

Oxygen acceptable vs expected

Expected is 95-100%, acceptable is 90-100%.