52 Questions
Which component of the endocrine system sends chemical messages by means of hormones?
The cells
What is the main function of the endocrine system?
Regulating metabolic processes
In the context of diabetes mellitus, what is the key difference between hypoglycemic and hyperglycemic reactions?
Hypoglycemic reactions involve low blood sugar levels, while hyperglycemic reactions involve high blood sugar levels
What are the manifestations of adrenal hypofunction and hyperfunction primarily related to?
Metabolic processes
Which of the following is a key factor in differentiating GH deficiency from failure to thrive?
Nourished appearance
What is used to assess skeletal maturity and may indicate the reversibility of short stature?
Bone age
What is essential for diagnostic evaluation of growth disorders?
Accurate measurement of height and weight
How is target height determined in pediatric growth evaluation?
Using parental heights
What is used to diagnose GH deficiency?
GH stimulation testing
What is a potential risk for patients on GH replacement therapy?
Hypothyroidism
What may indicate diminished permanent height if left untreated?
Extended growth into adulthood
What is important in growth evaluation for pediatric patients?
Height velocity
What declines in subsequent years of GH replacement therapy?
Growth velocity
What is involved in the diagnostic evaluation of growth disorders?
Radiographic imaging
What is used to assess the reversibility of short stature?
Bone age
What may be indicative of underlying diseases in cases of growth disorders?
Delayed bone age
Which condition is characterized by the loss of all anterior pituitary hormones, leaving only posterior function intact?
Panhypopituitarism
What is the most common organic cause of pituitary undersecretion?
Tumor in the pituitary or hypothalamic region
What is the definition of growth failure in children?
Height below 2 standard deviations for age
What is the term for the diminished or deficient secretion of one or more pituitary hormones?
Hypopituitarism
What inhibits somatic growth in all cells of the body, usually related to growth hormone deficiency?
Idiopathic hypopituitarism
Which gland releases hormones into the bloodstream?
Pituitary gland
What is the term for the condition where not all children with short stature have growth hormone deficiency?
Familial short stature
Which type of hypopituitarism can manifest in newborns with symptoms such as apnea, cyanosis, and seizures?
Congenital hypopituitarism
What is the term for the absolute height of less than 2 standard deviations for age or consistently low linear growth velocity?
Growth failure
What is the term for the condition where children with growth hormone deficiency grow normally in the first year, then follow a slowed growth curve below the third percentile, and may appear overweight or obese?
Idiopathic hypopituitarism
Which type of hypopituitarism usually inhibits somatic growth in all cells of the body?
Idiopathic hypopituitarism
What is the term for the condition where clinical manifestations of pituitary dysfunction depend on the hormones involved and the patient's age?
Hormone-specific clinical manifestations
What is the primary nursing consideration for excessive growth rates?
Early identification
What is the optimum time for administering growth hormone (GH) to achieve optimum dosing?
Bedtime
What is the result of excess GH before closure of the epiphyseal shafts?
Overgrowth of long bones
What is the result of oversecretion of GH after closure of the epiphyseal shafts?
Acromegaly
What is a possible therapeutic management option for acromegaly?
Surgical treatment
What role do nurses play in the care of children with growth deficiencies?
Identifying and providing emotional support
What may children undergoing hormone replacement therapy require in terms of support?
Patient self-management education
What is involved in the diagnostic evaluation of acromegaly?
History of excessive growth, evidence of increased GH levels, MRI, and endocrine studies
What may children with other hormone deficiencies require?
Replacement therapy
At what rate do children undergoing hormone replacement therapy attain their adult height compared to their peers?
Slower
What is the consequence of oversecretion of GH after closure of the epiphyseal shafts?
Acromegaly
What is the role of nurses in supporting children and families undergoing hormone replacement therapy?
Providing education on self-management, injection techniques, and setting realistic expectations
What is the definition of precocious puberty?
Sexual development before age 9 in boys or age 8 in girls
What is the recommended age for precocious puberty evaluation for a pathological cause in girls?
Younger than 7 (White) or 6 (Black)
What percentage of children with precocious puberty have central precocious puberty (CPP)?
Approximately 80%
What stimulates the secretion of gonadotropic hormones from the anterior pituitary at the time of puberty?
Hypothalamic-releasing factors
What is the recommended treatment approach for precocious puberty?
Directed toward the specific cause, when known
What may be the result of central precocious puberty?
Congenital anomalies, CNS insults, or idiopathic causes
What is the potential consequence of early menarche?
Increased risk of future breast cancer
What is the recommended management approach if precocious puberty needs treatment?
Monthly injections of a synthetic analogue of luteinizing hormone-releasing hormone
What should nurses in ambulatory settings do regarding children showing excessive linear growth?
Refer them for medical evaluation
What signs should be observed for a tumor in children showing excessive linear growth?
Headache and evidence of hormonal excess
What is the current trend in the onset of puberty in girls?
Occurring earlier than previously documented
What do children with excessive growth rates need?
Emotional support and an opportunity to express their thoughts
Study Notes
Precocious Puberty and Growth Screening in Ambulatory Settings
- Nurses in ambulatory settings should refer children showing excessive linear growth for medical evaluation
- Signs of a tumor, especially headache and evidence of hormonal excess, should be observed
- Children with excessive growth rates need emotional support and an opportunity to express their thoughts
- Precocious puberty is defined as sexual development before age 9 in boys or age 8 in girls
- Recent studies show the onset of puberty in girls is occurring earlier than previously documented
- It is recommended that precocious puberty evaluation for a pathological cause be performed for girls younger than 7 (White) or 6 (Black)
- Early menarche increases the risk of future breast cancer
- Normally, hypothalamic-releasing factors stimulate secretion of gonadotropic hormones from the anterior pituitary at the time of puberty
- Approximately 80% of children with precocious puberty have central precocious puberty (CPP)
- Treatment of precocious puberty is directed toward the specific cause, when known
- Central precocious puberty may be the result of congenital anomalies, CNS insults, or idiopathic causes
- Precocious puberty may regress or stop advancing without treatment, but if needed, it can be managed with monthly injections of a synthetic analogue of luteinizing hormone-releasing hormone
Test your knowledge on precocious puberty and growth screening in ambulatory settings with this quiz. Learn about the signs, evaluation, and management of precocious puberty, as well as the importance of screening for excessive linear growth in children.
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