Mod 7 and 8

Notes

  • FOCUS Growth Hormone, Precocious Puberty, Type 1 Diabetes

Powerpoint

  • Endocrine glands

  • Key tal away:

    • Chuldsren endocrine system focusues on gorwth, development and puberty

    • Adults endocrine system stabilzes

    • Some glands shrink GH, sex homrones

  • Feedback control in hormone production

    • Hypothalamus secretes TRH causing pituitary to relase TSH

    • TSH causes thyroid to secrete t3 and t4

    • Then when baby has enough T3 and T4 are relased feedback to halt the stop

  • Growth Hormone Defiency

    • Occurs whenthe pituatary doesnt receive enoguh

    • Clincal Manifestation: At or below 3rd percentile in height

      • Delayed epiphyseal closure

      • Prominent subcutaneous deposit on abdomen

      • Child like face with large prominent forehead

      • High pitch voice

      • Delay sexyalt matuerity, altered dentition, skeltal matuiion

      • Underdeveloped jaw

      • Decrease muscel mass

      • Increase insulin sensitivity

    • Treatment: Growth hormone repalcement therapy is the primary treaemtn and has to eb carefully manage

      • Subq injection and take home

        • Monitoring and adjustment

        • Supportive care

          • Physcial therapy, dietary consult

        • Psychosocial support

      • Treatment usualy stops when the growht plate is closed

  • Diabetes

    • Type 1: Deficency in inuslin

    • Type 2: Insulin resistance

    • Diabetes can be secondary to certain conidtions such as CF, glucostieord

    • Gestational Diabetes

  • Type 1 Diabetes Mellitus

    • S/S Polydipsia, polyuria, polyphagia, unexplained weight loss, fatigue, blurred vision, slow healing of wounds or infection, fruity scented breath ( ketoacidiosis)

    • Goals

      • Achieve nomral growth adn devloeplet

      • Promote optimal serum glucose control including fuild and electroyles and near normal hemoglobin A1C

      • Prevent complication

      • Promoting positve adjsutment to teh disease with abulty to self manage in the home

    • VERY IMPORTANT: Medication managment diabetes → Insulin

      • Type

        • Rapid acting

          • Aspart Novolog

          • Lispro HUmlog

          • Glulisin Aprida

        • Short acting

          • Regular

    • Complication of Diabetes

      • Faulure to grow, delay sexual maturation, poor wound healing, recurrent infection, vascular complicaiton, peripheral bascualr disease, neuropathy, nephropathy, retinopathy, cerebrovacualr dsiease, caridovasuclar disease

  • Diabeteic Acidosis

    • Clincal Manifestation   

      • Anorexia, nausea, vomiting, lethary, stupor, altereed level of consiousness, confusion, Kusssmaul respiration, decrease skin tuorgor, abdominal pain, fruity smell, presnece of ketones in urine and blood, tahcycardia, if left untreated will go into coma and die

  • Education for Diabetes

    • Self measurement of blood glucose

    • Urine ketone testing

    • Medication use

    • S/S and treatment of hypo/hyperglycemia

    • monitroing and managing complication such as a wound

    • Sick Day instructions

    • Laboratory testing and follow up care

    • Diet and excercise as part of DM maangmenet

    • Create a log/diary

  • Precocious Puberty: Fast onset of pubertiy; chuld develops sexual cahcteristic before hte usual age of pubertal onset whihc can occur when the gonads. produce an increased amount of sex hormone

    • Goals of Managing Precocios Puberty

      • Education: Physical changes the child is experiencing

      • Teaching: how to correcly use the prescibed medication

      • Helping: Help child deal with self esteem issues realred to rate of grwoth

      • Promoting: Age appropriate physical development adn pubertal progression