Endocrine System Overview
43 Questions
0 Views

Endocrine System Overview

Created by
@DexterousLongBeach

Podcast Beta

Play an AI-generated podcast conversation about this lesson

Questions and Answers

What is a significant limitation of using BMI as a measure of obesity in clinical settings?

  • It loses predictability when applied on the individual level. (correct)
  • It can only be used for adults, not children.
  • It does not account for height.
  • It requires more than two measurements.

    • Which measurement is suggested to be used in conjunction with BMI?

  • Heart rate variability
  • Blood pressure readings
  • Body Roundness Index (BRI) (correct)
  • Flexibility assessments

    • What does the Waist to Hip Ratio (WHR) indicate for males?

  • Obesity is defined as greater than 0.75
  • Obesity is defined as greater than 0.8
  • Obesity is defined as greater than 0.9 (correct)
  • Obesity is defined as greater than 1.0

    • Which of the following factors is NOT considered when using Body Roundness Index (BRI)?

    <p>Muscle mass</p> Signup and view all the answers

    What is the purpose of using Motivational Interviewing in patient care?

    <p>To set patient-centered goals and find personalized solutions</p> Signup and view all the answers

    What is a recommended method for administering oral medication to infants?

    <p>Squirting a small amount in the cheek while sitting upright</p> Signup and view all the answers

    What common condition should nurses be vigilant about identifying early in children?

    <p>Hypothyroidism</p> Signup and view all the answers

    What condition is primarily associated with high familial incidence and often occurs in females?

    <p>Hyperthyroidism</p> Signup and view all the answers

    Which of the following is NOT a clinical manifestation of hyperthyroidism?

    <p>Weight gain</p> Signup and view all the answers

    What laboratory findings are typical for diagnosing hyperthyroidism?

    <p>Decreased TSH, elevated T3 and T4</p> Signup and view all the answers

    Which medication is NOT recommended for use in children with hyperthyroidism due to concerns about liver disease?

    <p>Propylthiouracil (PTU)</p> Signup and view all the answers

    Which symptom might indicate that a child is experiencing school difficulties due to hyperthyroidism?

    <p>Difficulty concentrating</p> Signup and view all the answers

    What is a common outcome of congenital hyperthyroidism in infants of mothers with Graves Disease?

    <p>Resolution by 12 weeks of age</p> Signup and view all the answers

    What is the primary role of hormones in the body?

    <p>To act as messengers affecting cellular functions</p> Signup and view all the answers

    Which type of gland secretes hormones directly into the bloodstream?

    <p>Endocrine gland</p> Signup and view all the answers

    Which system is primarily responsible for maintaining homeostasis in the body?

    <p>Endocrine system and autonomic nervous system</p> Signup and view all the answers

    What does the hypothalamus do in the hypothalamic-pituitary axis?

    <p>Triggers the release of trophic releasing hormones</p> Signup and view all the answers

    Which hormone is vital for stimulating growth and development during childhood?

    <p>Growth Hormone</p> Signup and view all the answers

    What is a key function of the adrenal hormones in children?

    <p>Aid in metabolism and stress response</p> Signup and view all the answers

    At what stage of fetal development does the male embryo begin to secrete testosterone?

    <p>7-8 weeks gestation</p> Signup and view all the answers

    How can skeletal maturity be assessed in children?

    <p>By evaluating bone age based on ossification stages</p> Signup and view all the answers

    What is the primary purpose of insulin in managing type 2 diabetes?

    <p>To assist glucose entry into cells</p> Signup and view all the answers

    Which dietary recommendation is NOT encouraged for children with type 2 diabetes?

    <p>Consume more fatty foods</p> Signup and view all the answers

    What is a significant barrier to lifestyle changes in teenagers as per the context provided?

    <p>The influence of peer pressure</p> Signup and view all the answers

    What is the recommended daily exercise time for children with type 2 diabetes?

    <p>60 minutes</p> Signup and view all the answers

    When screening for weight gain, what should nurses closely monitor?

    <p>BMI and waist circumference</p> Signup and view all the answers

    How should glucose levels be communicated to patients to promote a nonjudgmental environment?

    <p>Describing them as 'target' or 'out of target'</p> Signup and view all the answers

    What lifestyle modification is advocated for families to support children with type 2 diabetes?

    <p>Regular family meals with healthier choices</p> Signup and view all the answers

    What factor increases the risk of obesity in children related to their family history?

    <p>Parents who struggle with weight</p> Signup and view all the answers

    What is the primary cause of Congenital Adrenal Hyperplasia (CAH)?

    <p>Decreased enzyme activity required for cortisol production</p> Signup and view all the answers

    Which clinical manifestation is associated with low cortisol levels in CAH?

    <p>Frequent infections</p> Signup and view all the answers

    What distinguishes precocious puberty in boys?

    <p>Sexual development before age 9</p> Signup and view all the answers

    What is a potential treatment for precocious puberty?

    <p>Gonadotropin-releasing hormone agonists</p> Signup and view all the answers

    In Type 1 Diabetes, what triggers beta cell failure?

    <p>Autoimmune destruction of pancreatic islet cells</p> Signup and view all the answers

    What is the common diagnostic criterion for diabetes?

    <p>Fasting glucose ≥ 126 mg/dL</p> Signup and view all the answers

    What is a common characteristic of Type 2 Diabetes?

    <p>High association with obesity</p> Signup and view all the answers

    Which clinical feature is often seen in females with Type 2 Diabetes?

    <p>Irregular menses</p> Signup and view all the answers

    What does the term 'hirsutism' refer to in clinical manifestations of CAH?

    <p>Excessive hair growth in females</p> Signup and view all the answers

    What laboratory tests are necessary to confirm CAH?

    <p>Cortisol, ACTH, and testosterone levels</p> Signup and view all the answers

    What is the recommended management for a child with CAH who experiences salt wasting?

    <p>Aldosterone replacement therapy</p> Signup and view all the answers

    Which condition may be caused by overproduction of adrenal androgens in CAH?

    <p>Ambiguous genitalia in females</p> Signup and view all the answers

    Which of the following describes a significant factor in diagnosing Pre-Diabetes?

    <p>Fasting glucose ≥ 100 mg/dL</p> Signup and view all the answers

    What is a possible manifestation of adrenal insufficiency due to CAH?

    <p>Severe hypotension</p> Signup and view all the answers

    Study Notes

    Hormones

    • Complex chemical substances produced and secreted into the body fluids by cells that exert a controlling effect on other cells.
    • Can be local or systemic.

    Glands

    • Exocrine: Their secretions reach target cells and may pass through a duct.
    • Endocrine: Secrete directly into the blood.

    Major Endocrine Organs

    • Hypothalamus
    • Pituitary gland
    • Thyroid gland
    • Parathyroid gland
    • Adrenal glands
    • Pancreas
    • Ovaries (female)
    • Testes (male)

    Endocrine System Function

    • Maintains homeostasis with the nervous system.
    • Controls pace of growth and development, including bodily systems like the brain and reproductive organs.

    Hypothalamic Pituitary Axis

    • Hypothalamus secretes trophic releasing hormones which stimulate the Anterior pituitary gland (Master gland).
    • Anterior Pituitary gland releases stimulating hormones to activate other organs and glands.
    • Controlled by a Negative Feedback Loop mechanism, when body receives sufficient hormone release, further release is reduced.

    Pediatric Differences

    • Responsible for sexual differentiation during fetal development.
    • Stimulates growth and development during childhood and adolescence.
    • Skeletal maturation can be determined by bone age, which illustrates a stage of bone ossification.

    Medication Administration Safety for Pediatric Patients

    • Dosage specific to weight (kg/body weight).
    • Determination of drug dosage.
    • Narrow therapeutic range.
    • Different metabolic abilities.
    • Infants and toddlers may need oral medications mixed with sweet foods (applesauce, pudding).
    • Do not add medication to bottles or use a household spoon.
    • For infants, squirt small amount in the cheek while sitting upright.
    • Give medication while the child is calm.
    • Crush pills or offer them in liquid form.

    Nursing Considerations

    • Early identification of children with hypothyroidism.
    • Watch for signs and symptoms of dosage adjustments.
    • Follow laboratory results.

    Congenital Hyperthyroidism

    • Infants of mothers with Graves disease may have congenital hyperthyroidism.
    • Transplacental transfer of immunoglobulins can occur.
    • Usually resolves by 12 weeks of age.

    Hyperthyroidism

    • Increased thyroid levels.
    • Graves disease is caused by immunoglobulins stimulating thyroid hormone oversecretion.
    • Most often in females.
    • High familial incidence.

    Hyperthyroidism Clinical Manifestations

    • Enlarged, tender thyroid (goiter).
    • Prominent or bulging eyes (exophthalmos).
    • Eyelid lag.
    • Tachycardia.
    • Increased appetite with weight loss.
    • Moodiness.
    • Heat intolerance.
    • Irregular menses.
    • Insomnia.

    Hyperthyroidism Potential School Challenges

    • Difficulty concentrating.
    • Behavioral problems.
    • Declining school performance.
    • Easy frustration.
    • Overheated and fatigued during physical education class.
    • Tiredness due to insomnia.

    Hyperthyroidism Diagnosis and Treatment

    • Serum TSH decreased, T3 and T4 levels elevated.
    • Thyroid scan.
    • Medication therapy:
      • Methimazole (Tapazole)
      • Propylthiouracil (PTU)- not recommended for children due to liver disease concerns.
      • Radiation.
      • Surgery (thyroidectomy) - results in hypothyroidism.

    Congenital Adrenal Hyperplasia (CAH)

    • Autosomal recessive disorder.
    • May be detected at birth or later in life.
    • Caused by decreased enzyme activity required for cortisol production, leading to low cortisol levels.
    • Elevated ACTH levels lead to increased androgen release.
    • Results in excess testosterone.

    CAH Clinical Manifestations

    • Low cortisol levels (adrenal insufficiency).
    • Weakness, fatigue, poor growth, frequent infections.
    • Nausea & vomiting, salt craving.
    • Hypotension, hypoglycemia, dehydration, hyponatremia.
    • Overexpression of adrenal androgens and virilization.

    CAH Clinical Manifestations in Males

    • Precocious genital development.

    CAH Clinical Manifestations in Females

    • Born with varying degrees of ambiguous genitalia.
      • Enlarged clitoris appearing as a small phallus.
      • Fused labia.
      • Internal female sexual organs are intact.
    • Hirsutism and delayed menses.

    CAH General Clinical Manifestations

    • Both males and females may have: acne, tall stature, and precocious puberty.

    CAH Diagnosis

    • Ultrasonography to visualize pelvic organs.
    • Chromosome typing for positive sex determination and to rule out other genetic anomalies.
    • Labs: Cortisol levels, ACTH Levels, Testosterone levels.

    CAH Therapeutic Management

    • Confirm diagnosis and assign sex based on genotype.
    • Lifelong Cortisone Replacement (glucocorticoid)
      • To suppress ACTH and reduce androgen release.
      • Oral dosing when healthy, injections as needed.
      • Given in the morning, with meals.
      • Higher doses may be needed during illness or stress.
    • Aldosterone replacement if salt wasting.
    • Reconstructive surgery as required.

    Precocious Puberty

    • Defined as sexual development before age 9 in boys or before age 7-8 in girls.
      • Thelarche: breast development.
      • Adrenarche: pubic or axillary hair development.
    • More common in girls.
    • Potential causes:
      • Disorder of the gonads, adrenal glands, or hypothalamic-pituitary gonadal axis.
      • No causative factor in 80% to 90% of girls and 50% of boys.

    Precocious Puberty Therapeutic Management

    • Treatment of the underlying cause if known.
      • Overproduction of hormones.
      • Tumor (brain, ovarian).
      • Creams/chemicals in the environment.
    • Gonadotropin-releasing hormone agonists (GRHA) such as Lupron or Supprelin LA can be used to treat cases without specific causes.
      • Supprelin LA: Implantable, lasts up to 12 months.
      • Lupron: IM injections monthly.
    • Slows prepubertal growth to normal rates, preventing premature closure of epiphyseal plates and short stature.
    • Treatment is discontinued when the child reaches the "normal" age for pubertal changes to resume.

    Precocious Puberty Therapeutic Management: Psychological Support

    • Psychological support for the child and family.
      • May see mood swings and body image issues.
      • Role play potential responses to bullying.
      • Age-appropriate dress and expectations.

    Diabetes

    • Type 1
      • Insulin dependent diabetes.
      • Autoimmune destruction of pancreatic islet cells leading to beta cell failure and a lack of insulin.
      • Symptoms develop when 80% of beta cells are lost.
      • Less than 10% have family history.
      • Acanthosis nigricans rare.
      • Diabetic ketoacidosis (DKA) seen in 35-40% of patients.
      • Same rate of obesity as the general population.
    • Type 2
      • Insulin resistance.
      • Decreased insulin sensitivity.
      • Highly associated with obesity.
      • Reversal possible with weight loss.
      • More prevalent in ethnic minority populations.

    Type 2 Diabetes Differences

    • More common in females.
      • Irregular menses.
      • Hirsutism in girls (PCOS).
    • Acanthosis nigricans common.
    • Family history is seen in 90% of cases.
    • Lower socioeconomic status more likely.
    • DKA is seen in a small percentage of patients.

    Diabetes Diagnostic Criteria

    • Fasting glucose ≥ 126 mg/dL.
    • Random glucose ≥ 200 mg/dL.
    • 2hr glucose during an OGTT ≥ 200 mg/dL.
    • HA1C ≥ 6.5 - Most commonly used nowadays.

    Diabetes Diagnostic Tests

    • HA1c (captures BS values over previous 3 months).
    • Blood Glucose.
    • Urinalysis:
      • Glycosuria (when blood sugar >180).
      • Ketonuria (if metabolizing fat/protein).
    • BMI vs BMI percentile.
      • Overweight (adults): BMI>25.
      • Obese (adults): BMI>30.
      • At risk (kids): BMI > 85th percentile.
      • Overweight (kids): BMI>95th percentile.

    Body Mass Index (BMI)

    • BMI is an imperfect measure because it does not directly account for body fat composition.
    • Use it in conjunction with other measures.

    Prediabetes

    • Fasting ≥ 100 = Impaired Fasting Glucose (IFG).
    • 2 hour PP> 140 = Impaired Glucose Tolerance (IGT).
    • HA1C 5.7- 6.4 %.

    Prediabetes Recommendations

    • Insulin therapy used to achieve optimal glycemic control (HA1c <8).
    • Insulin therapy coupled with metformin to reduce insulin resistance.
    • Blood glucose monitoring at home.
    • Lifestyle modifications (nutrition and activity).

    Nursing Management of Type 2 Diabetes

    • Educate and support self-care.
    • Encourage dietary changes:
      • Eliminate sugary drinks.
      • Portion control.
      • Encourage weight loss/maintenance.
        • Stabilize growth curve velocity if still growing.
      • Encourage eating breakfast.
      • Encourage reduced fat and high fiber foods.

    Nursing Management of Type 2 Diabetes: Lifestyle Changes

    • Support and encourage lifestyle changes:
      • Limit screen time to 2 hours.
      • Encourage 60 minutes of exercise per day.
      • Encourage regular family meals and healthy choices for all family members.

    Nursing Management of Type 2 Diabetes: Advocacy

    • Advocate for changes in schools and communities that encourage healthy options.

    Type 2 Diabetes: Roadblocks

    • Teenagers:
      • Seeking independence and fitting in.
      • Susceptible to peer influence.
      • Enjoy fast food and sedentary activities.
    • High-risk populations: minorities, low income.
    • Family history of non-adherence to healthy lifestyle recommendations.
    • Mental health issues.

    Obesity Prevention Nursing Implications

    • Screen for increasing weight gain at all primary care visits.
    • Monitor growth curve and intervene early to reduce risk if velocity increases.
    • Plot BMI and follow percentile.
    • Remember, a child with obese parents are at a greater risk of becoming obese.

    Nursing Implications: Language

    • Use nonjudgmental language:
      • Glucose "in target/out of target" range NOT "good/bad."
    • Focus on BMI and waist circumference instead of just weight (less emotionally charged):
      • BMI is an imperfect measure and should be used in conjunction with other measures.
    • Use motivational interviewing to set patient-centered goals and find solutions that work for each individual.
    • Establish good rapport.

    Body Roundness Index (BRI)

    • BRI incorporates hip and waist circumferences to estimate total body fat and visceral fat.
    • May be more precise than BMI to estimate obesity.
    • Waist to hip ratio (WHR) is calculated by dividing the waist circumference by the hip circumference.
      • WHR (males): obesity defined as greater than 0.9.
      • WHR (females): obesity defined as greater than 0.85.
    • BRI doesn't account for muscle mass.

    Studying That Suits You

    Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

    Quiz Team

    Related Documents

    Pediatric Endocrine Disorders - Student Summer 2024 (PDF)

    Description

    Test your knowledge on the endocrine system, including hormones, glands, and their functions. This quiz covers major endocrine organs, the hypothalamic-pituitary axis, and the role of hormones in maintaining homeostasis. Perfect for students studying biology or health sciences.

    More Like This

    Use Quizgecko on...
    Browser
    Open
    Browser
    Browser