Module%207%20Caring%20for%20Children%20with%20Alterations%20in%20Metabolism%20-%20Endocrine - PowerPoint PPT Presentation

View by Category
About This Presentation
Title:

Module%207%20Caring%20for%20Children%20with%20Alterations%20in%20Metabolism%20-%20Endocrine

Description:

Module 7 Caring for Children with Alterations in Metabolism - Endocrine Chapter 29 – PowerPoint PPT presentation

Number of Views:108
Avg rating:3.0/5.0
Slides: 25
Provided by: BethA194
Learn more at: http://pediatrics.yolasite.com
Category:

less

Write a Comment
User Comments (0)
Transcript and Presenter's Notes

Title: Module%207%20Caring%20for%20Children%20with%20Alterations%20in%20Metabolism%20-%20Endocrine


1
Module 7 Caring for Children with Alterations in
Metabolism - Endocrine
  • Chapter 29

2
Diabetes Mellitus
  • Definition metabolic disorder characterized by
    hyperglycemia because of lack of insulin or a
    resistance to insulin
  • Classifications
  • Type 1 Diabetes
  • destruction on pancreatic beta cells
  • Type 2 Diabetes
  • insulin resistance

3
Impact of Diabetes
  • leading cause of renal failure
  • major cause of blindness
  • most frequent cause of non-trauma amputations
  • affects 17 million
  • increasing prevalence of type 2 in children and
    adults
  • gt1/3 of all newly diagnosed diabetes in children

4
Historical Facts
  • Diabetes is from the Greek word to siphon
    Mellitus is from Latin word sweet
  • Usually died within 2-3 years from starvation
  • 1921 - Insulin discovery
  • increased life span
  • experiencing long term effects of diabetes
  • 1979 - self glucometers

5
Diabetes Type 1
  • Beta cells no longer produce insulin
  • hyperglycemia
  • fats and protein are broken down
  • development of ketosis
  • accounts for 10-15 of all cases
  • occurs in childhood or adolescence

6
Diagnostic Tests
  • 1. Symptoms of diabetes and random b.s.
    gt200mg/dL
  • 2. fasting glucose gt126mg/dL
  • 3. Oral glucose tolerance test - OGTT
  • after 2 hrs glucose is gt200mg/dL
  • 4. Glycosylated hemoglobin - Hemoglobin A1C
  • average glucose over 2-3 months
  • Routine accu checks for management
  • Type 1 3x/day

7
Hyperglycemia
  • Hyperglycemia leads to
  • polyuria
  • glycosuria
  • polydipsia
  • polyphagia
  • weight loss
  • malaise and fatigue
  • blurred vision

8
Diabetic Ketoacidosis DKA
  • Results from a breakdown of fat
  • occurs when undiagnosed or known diabetic has an
    increased energy need
  • blood sugar gt250mg/dL
  • pH lt 7.3
  • ketones and glucose in the blood and urine

9
DKA - Treatment
  • Regular insulin - sub q or IV
  • Restore fluid balance - .9NS IV
  • Correct electrolyte imbalances - K

10
Hypoglycemia verses Hyperglycemia
11
Long Term Complications of Diabetes
  • Coronary Artery Disease
  • Hypertension
  • Stroke
  • Peripheral Vascular Disease
  • Diabetic Retinopathy
  • retinal ischemia
  • leading cause of blindness ages 25-74

12
Complications of Diabetes
  • Diabetic nephropathy
  • glomerular changes in kidneys leading to impaired
    renal function
  • microalbuminuria
  • most common cause ESRD in America

13
Therapeutic Management
  • Monitoring
  • keeping blood glucose levels close to normal
  • Insulin
  • Dietary management
  • Exercise
  • Future
  • pancreatic transplant, beta cell transplant

14
Medications
  • Insulin
  • all type 1
  • Terms describing insulin
  • onset, peak, duration
  • Types
  • rapid acting, short acting, intermediate, long
    and combinations

15
Injection sites
16
Nutrition
  • Need consistent meal times
  • Goals
  • near-normal glucose levels
  • optimal lipid levels
  • adequate calories to maintain growth
  • Meal planning
  • eat less fat and saturated fat
  • sugars and sweets in moderation

17
Diet Management
  • Type 1
  • correlate eating with insulin onset
  • Carb counting is main diet plan for children with
    diabetes
  • Illness Management Plan
  • change in insulin dosage
  • attention to fluid balance

18
The Nursing Process
  • Working together
  • child/family
  • individualized plan
  • follow-up support
  • community support

19
Growth Hormone Deficiency
  • Decreased activity of pituitary gland
  • Diagnosed in males earlier than females
  • Short stature is noticed more often in males
  • Causes of deficiency
  • Infarct of pituitary gland (sickle cell)
  • Central nervous system infection
  • Tumors
  • Brain trauma
  • Chemotherapy
  • Emotional deprevation

20
Signs and Symptoms
  • Below the 3rd percentile on growth chart in
    height by 1 year of age
  • Overweight
  • Higher pitched voices
  • Delayed dentition
  • Decreased muscle mass
  • Delayed sexual maturation
  • hypoglycemia

21
Treatment
  • Treat underlying cause
  • Growth hormone replacement
  • Daily injections of hormone
  • Possible delay of puberty to allow more time for
    growth hormone therapy to work

22
Precocious Puberty
  • Appearance of any secondary sexual
    characteristics before 8 years of age in females
    and 9 years of age in males
  • Hypothalamus is activated to secrete
    gonadtropin-releasing hormone
  • In males is usually result of intracranial tumor
  • Females is usually idiopathic

23
  • Children will have advanced bone age
  • Stop growing prematurely
  • Hormones stimulate early closure of epiphyseal
    plates
  • Mood swings
  • Emotional labilty

24
Treatment
About PowerShow.com