Podcast
Questions and Answers
Which of the following is NOT a sign or symptom of hypoglycemia?
What is the recommended macronutrient distribution for a diabetic child's diet?
What adjustment should be made to insulin dosage when a child is experiencing an infection?
Which of the following is a chronic complication associated with diabetes?
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What is the purpose of having all diabetic children eat together?
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What should be included in the urine analysis process for children with diabetes?
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Which symptom is characteristic of diabetic coma?
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Why is it important for a child with diabetes to express their feelings about their disease?
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Which clinical manifestation is NOT typically associated with babies who suffered from maternal hyperthyroidism?
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What is the correct thyroid function diagnostic finding in infants exposed to maternal hyperthyroidism?
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What is an important nursing responsibility when managing a child undergoing thyroid therapy?
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Which of the following interventions is essential for promoting healthy development in infants affected by maternal hyperthyroidism?
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What potential complication should be observed for when administering L-thyroxin to infants?
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When should treatment for congenital hyperthyroidism ideally be initiated to ensure excellent mental development?
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Which nursing diagnosis pertains to the infant's inability to show proper growth milestones due to the disease process?
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What is a peculiar physical characteristic often observed in infants with congenital hypothyroidism due to maternal hyperthyroidism?
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What is a key factor in managing diabetes in children?
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Which of the following is NOT a clinical manifestation of diabetes mellitus?
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What is a significant laboratory finding in diabetic ketoacidosis?
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What is a major complication of frequently missed medication doses in infants?
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What indicates that a child might have diabetes mellitus based on diagnostic criteria?
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Which dietary change can help manage diabetes effectively?
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What role do parents play in managing their infant's medication regimen?
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What is a common misconception about the onset of juvenile diabetes?
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Study Notes
Diabetes Mellitus
- Chronic metabolic syndrome characterized by hyperglycemia and glycosuria associated with abnormal metabolism of carbohydrate, protein and fat, caused by partial or complete deficiency of insulin.
- Called "Juvenile Diabetes" if it occurs, before 15 years of age.
- Hereditary disease: siblings of clients with diabetes have 10 times risk to develop diabetes.
- Infections: virus and organism may attack islet cells of the pancreases and affect insulin secretion.
- Clinical manifestations include:
- Polyuria (frequent urination) due to water not absorbed from renal tubules because of osmotic activity of glucose in the tubules
- Polydipsia (excessive thirst)
- Polyphagia (excessive hunger)
- Weight loss
- Enuresis.
- Diagnostic Evaluation includes:
- Glucosuria and ketonuria plus Fasting blood glucose level ≥ 126 mg/dl or random blood glucose ≥ 200 mg/ dl or two hours plasma glucose during oral glucose tolerance test ≥ 200 mg/dl
- Laboratory features of diabetic ketoacidosis include:
- Blood glucose level more than 300mg/dl
- PH level less than 7.3
- Serum bicarbonate less than 15 mmol/l
Hypoglycemia
- Signs and symptoms of hypoglycemia include:
- nervousness, pallor, tremors, palpitation, numbness, sweeting, hunger, weakness, dizziness, irritability, dilated pupils, loss of coordination, seizure and coma.
Diabetic Coma
- Signs and symptoms of diabetic coma include:
- polyuria, polydipsia
- nausea, vomiting, abdominal pain
- increased pulse, slow blood pressure
- dehydration, oliguria
- acetone odor in mouth, ketone body in urine
- Coma and death
Chronic Complications
- Chronic complications include: Retinopathy, nephropathy, neuropathy, dwarfism, infection gangrene, cataracts, atherosclerosis
Therapeutic Management
- Diet
- Should be attractive and varied according to limits.
- All restricted food should be kept as far as possible.
- Child should understand that if he reports breaks in dietary rules, he will not be punished, but unreported breaks may cause sudden sickness.
- Three meals + 2-3 snacks (55% carbohydrates, 15% fat, 30% protein), high fiber content
- Have all diabetic children eat together as they encourage each other.
- Insulin
- Regimen should be adapted according to lifestyle, diet, age, general health, self-management, social and financial circumstances.
- Dosage:
- 0.5-1 units/kg/day
- 1.5 units/kg/day during puberty
- During infection insulin should be increased by 10-15% of the calculated dose
- With exercise, insulin should be decreased by 10-15% of the calculated dose
- Child should be encouraged to express his feelings towards disease and treatment.
- Teach child self-administration of insulin (7-10 years).
- Use rotating sites of injection (thigh, upper arm and abdomen).
- Teach also urine analysis (when and how) e.g.pre-meal and bed time urine testing.
- Keep a chart in the child's room to record:
- site of injection
- time given
- date
- dosage
- nurse's signature
- urine testing results
- Exercise
- Foot care
- Regular eye and dental checkup
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Description
This quiz covers the essentials of Diabetes Mellitus, including its characteristics, causes, and clinical manifestations. Explore the importance of insulin in metabolism and the diagnostic evaluations used to identify this chronic condition. Understand the implications of hereditary factors and the symptoms associated with different forms of diabetes.