School Age Disorders Lecture Review

A comprehensive set of flashcards covering school-age pediatric disorders, including diabetes, cystic fibrosis, ADHD, and musculoskeletal injuries.

What is the primary cause of Type 1 Diabetes (T1D)?

An autoimmune process that destroys insulin-producing islet cells.

How do weight changes typically differ between initial Type 1 and Type 2 Diabetes assessment?

Type 1 is associated with marked weight loss as an initial sign, while Type 2 is associated with obesity.

What is the 'honeymoon period' in Type 1 Diabetes?

A period of remission lasting $1-12$ months generally after the initial diagnosis.

Which human leukocyte antigens (HLAs) on chromosome $6$ are associated with Type 1 Diabetes susceptibility?

$HLA-DR3$ and $HLA-DR4$.

What is the renal threshold for glucose where the kidneys begin to excrete it into the urine?

About $160\,mg/dL$.

Name the three cardinal symptoms of diabetes.

Polyuria, polydipsia, and hyperglycemia.

Why do children with untreated diabetes often remain short in stature and underweight?

Large amounts of protein and fat are being used for energy instead of glucose, depriving the body of components necessary for growth.

What are the three components of the onset, peak, and duration for Lispro (Humalog) insulin?

Onset: Immediate; Peak Effect: $30\text{ minutes}-1\text{ hour}$; Duration: $3-4\text{ hours}$.

What are the duration of effect values for Lantus and Humulin-N?

Lantus has a duration of $24\text{ hours}$; Humulin-N has a duration of $24+\text{ hours}$.

What is an acceptable blood glucose range for a child with Type 1 Diabetes before a meal?

$70-110\,mg/dL$.

What is the Somogyi phenomenon?

A rebound hyperglycemic response caused by insulin overuse and persistent hypoglycemia, suspected when there is nighttime ($2\text{ a.m.}$ or $3\text{ a.m.}$) hypoglycemia followed by high early-morning hyperglycemia.

Contrast the respiratory symptoms of hypoglycemia versus hyperglycemia.

Hypoglycemia does not typically have specific respiratory changes (symptoms include sweating and pallor); Hyperglycemia can present with Kussmaul respirations and sweet (acetone) breath.

What causes precocious puberty in relation to the hypothalamus?

A disease that causes early activation of Gonadotropin-releasing hormone ($GnRH$).

What is the therapy for Diabetes Insipidus?

Administration of $DDAVP$ (an arginine vasopressin).

How does Antidiuretic Hormone ($ADH$) help regulate fluid volume?

It regulates urine output by the kidneys; decreasing urine output increases the volume of extracellular fluid.

What are the typical characteristics of a febrile seizure?

Associated with high fever ($102^{\circ}F$ to $104^{\circ}F$ [$38.9^{\circ}C$ to $40.0^{\circ}C$]), usually a generalized tonic–clonic pattern, and lasts $15\text{ to }20\text{ seconds}$ (total duration usually $1-2\text{ minutes}$ or less).

What monitoring is required for a child taking Carbamazepine (Tegretol)?

Serum drug levels to prevent toxicity, liver function studies, and blood cell counts to detect marrow depression.

Why is there an increased risk of hemorrhage following a tonsillectomy?

Sutures are not usually placed during the removal of tonsillar tissue by laser or ligation.

What is the inheritance pattern of Cystic Fibrosis (CF)?

Autosomal recessive trait (resulting from an abnormality on the long arm of chromosome $7$).

Why do bowel movements in Cystic Fibrosis become large, bulky, and greasy (steatorrhea)?

Absence of pancreatic enzymes ($lipase$, $trypsin$, and $amylase$) in the duodenum results in an inability to digest fat, protein, and some sugars.

What chloride concentration in a sweat test is diagnostic of Cystic Fibrosis?

More than $60\,mEq/L$ of sodium chloride (normal is $20\,mEq/L$).

What is meconium ileus?

A condition where meconium is so thick it obstructs the intestine, occurring in approximately $10\%$ of newborns with Cystic Fibrosis.

What is the classification and action of Pancrelipase?

It is an enzyme replacement used to aid digestion in children with Cystic Fibrosis.

Define the BMI percentiles for 'obese' and 'overweight' in childhood.

Obesity is defined as a BMI at or above the $95^{th}$ percentile; Overweight is at or above the $85^{th}$ percentile.

Why do children's bones tend to bend rather than break (Greenstick variety)?

Bone in childhood is fairly porous and the periosteum is thick.

What is Volkmann ischemic contracture?

A complication occurring when an arm cast is in a bent position, causing the radial artery and nerve to be compressed at the elbow.

What are the three major behaviors characterizing Attention Deficit Hyperactivity Disorder (ADHD)?

Inattention, impulsiveness, and hyperactivity.

How do children with language difficulties typically score on the Wechsler Intelligence Scale for Children (WISC)?

They typically do poorly on the verbal scale but average or greater on the performance scale.

What are specific nursing implications for administering stimulant medication for ADHD?

Administer exactly as prescribed, do not crush extended-release tablets, administer before $6\text{ p.m.}$ to prevent sleep interference, and monitor baseline height and weight.