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Ch.29 Wong’s Peds Study Guide: Endocrine

43. is transmitted to humans by the saliva of an infected mammal and is introduced through a bite or skin abrasion.

  1. Reye syndrome is a disorder defined as
    What are three clinical manifestations of Reye syndrome? a.

    b. c.

  2. Research has confirmed an association between the use of
  3. Definitive diagnosis of Reye syndrome is established by

Seizure Disorders

associated with other characteristic organ involvement.

and the incidence of Reye syndrome. .

  1. Seizures in children have many different causes. Seizures are classified not only according to but also to .
  2. are a frequent cause of seizures in late infancy and early childhood.
  3. Identify and describe the three major categories of seizures? a.

    b. c.

  4. Seizure activity is believed to be caused by spontaneous electrical discharges initiated by a group of hyperexcitable cells, referred to as the .
  5. Identify 10 clinical entities that mimic seizures in children. a.

    b. c. d.

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e. f. g. h. i. j.

  1. ( ) is obtained for all children with seizures and is the most useful tool for evaluating a seizure disorder. What does this test confirm?
  2. What are the goals of the therapeutic management of seizures? a.

    b. c.

  3. What is the primary therapy for seizure disorders?
  4. How is the dosage of anticonvulsant drugs monitored?
  5. When anticonvulsant drugs are discontinued, what precautions should be taken?
  6. The diet has been shown to be an efficacious and tolerable treatment for difficult-to-control seizures.

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58.

59. 60.

61. 62.

63.

When seizures are determined to be caused by a hematoma, tumor, or other cerebral lesion, is the treatment.

is a continuous seizure that lasts more than 30 minutes or a series of seizures from which the child does not regain a premorbid level of consciousness.

What criteria in an of itself is enough to diagnose epilepsy?

Children taking phenobarbital or phenytoin should receive adequate and , since deficiencies of both have been associated with these drugs.

List various seizure precautions.

seizures are one of the most common neurologic conditions of childhood, affecting approxi- mately 3% to 8% of children.

Cerebral Malformations

64. Match the following time period with the correct statement regarding the normal time all sutures and fontanels are ossified.

  1. 8 weeks
  2. 6 months
  3. 18 months
  4. After 12 years

1. Posterior fontanel closed
2. Anterior fontanel closed
3. Fibrous union of suture lines and interlocking of serrated edges 4. Sutures unable to be separated by increased ICP

  1. The majority of infants with craniosynostosis have brain development.
  2. is a condition caused by an imbalance in the production and absorption of CSF in the ventricu- lar system, usually under increased pressure.
  3. What are the two results of hydrocephalus? a.

    b.

  4. Hydrocephalus is so often associated with that all infants with this condition should be observed for the development of hydrocephalus.
  5. What are the most commonly observed clinical manifestations of hydrocephalus in the infant? a.

    b. c.

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d. e. f. g. h. i.

70. What is the typical treatment of hydrocephalus?

APPLYING CRITICAL THINKING TO NURSING PRACTICE

A. Tommy, age 6 months, was admitted to the pediatric unit after sustaining head trauma in an automobile accident. When admitted, he was conscious, but the nurse noted he had a bulging anterior fontanel, seemed irritable, had a high-pitched cry, and had distended scalp veins.
1. What nursing diagnosis could be formulated from these assessment data?

2. Tommy is becoming sleepy. When the nurse checked his pupils, they appeared fixed and dilated. What does this finding suggest?

B. Heather, age 10, has been unconscious for 2 days after surgery related to the trauma she endured from a motor vehicle accident.
1. List signs of pain that Heather may demonstrate.

a. b. c. d.

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239

e.

f.

  1. A patient goal is that Heather will exhibit no signs of pain. List three nursing interventions that could be used to achieve this goal.
    a.

    b.

    c.

  2. What parameters are assessed to monitor Heather’s neurologic status? a.

    b.

    c.

  3. What nursing measure is taken to protect Heather’s eyes from possible damage?

C. Spend a day in an emergency department for pediatric patients. Answer the following questions and include specifics (examples, responses) to illustrate these concepts.
1. Tara, age 2 years, sustained head trauma when she fell down some stairs. She was just admitted to the pediatric

unit. The nurse notes a watery discharge from her nose. What is this nasal discharge called, and what does it suggest?

2. Sam, age 3 years, comes to the emergency department after being rescued from a swimming pool. What problems should the nurse recognize that could develop as a result of a near-drowning accident?
a.

b. c.

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D. Aden, age 8 months, is admitted to the pediatric unit with possible meningitis. 1. What clinical manifestations would you expect to assess in Aden?

2. What is a major priority of nursing care of a child with suspected meningitis?

E. Zach, age 6 years, was admitted to the pediatric unit for diagnosis and treatment of a possible seizure. 1. What are the two major foci of the process of diagnosis in a child with a seizure disorder?

a.

b.

2. While the nurse is assisting with breakfast, Zach has a brief loss of consciousness. The nurse noted that his eyelids twitched and his hands moved slightly. He then needed to reorient himself to previous activity. How would the nurse keep Zach safe?
a.

b. c. d. e. f.

F. Adam, a newborn, is transferred to the pediatric unit for treatment of hydrocephalus. 1. What are some of the clinical manifestations of hydrocephalus?

a. b. c. d.

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e.

f.

  1. List some of the postoperative nursing interventions for the newborn with hydrocephalus. a.

    b. c. d. e. f. g. h. i. j.

  2. List the evaluative data that would indicate accomplishment of the following goal: The family will receive adequate education and emotional support.

Chapter 28 The Child with Cerebral Dysfunction Copyright © 2013 by Mosby, an imprint of Elsevier Inc. All rights reserved.

29 The Child with Endocrine Dysfunction

Chapter 29 introduces the nursing considerations essential to the care of the child experiencing endocrine dysfunction. The conditions discussed in this chapter interfere with the body’s ability to produce or to respond to the major hormones. After completing this chapter, the student will be able to develop a nursing care plan to help provide family-centered care to the child with endocrine dysfunction.

REVIEW OF ESSENTIAL CONCEPTS

Disorders of Pituitary Function

1. List the disorders that can result from an overproduction of the anterior pituitary hormones. a.

b. c. d.

2. The most common organic cause of pituitary undersecretion is

, especially

3.

4.

5.

6.

7.

craniopharyngiomas, in the pituitary or hypothalamic region.
What is a principal nursing consideration in working with children with hypopituitarism?

Why is it important to assess the parental history in children with constitutional growth delays?

What is the definitive treatment of growth hormone deficiency?

When is the best time to administer growth hormone?

includes typical facial features of the head, lips, nose, tongue, jaw, and paranasal and mastoid sinuses overgrowth; separation and malocclusion of the teeth in the enlarged jaw; disproportion of the

face to the cerebral division of the skull; increased facial hair; thickened, deeply creased skin; and an increased tendency toward hyperglycemia and diabetes mellitus.

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  1. What is the primary nursing responsibility regarding hypopituitarism and hyperpituitarism?
  2. Define precocious puberty.
  3. The principal disorder of the posterior pituitary hypofunction is

    hyposecretion of antidiuretic hormone (ADH), producing a state of uncontrolled

11. Identify the two cardinal signs of diabetes insipidus. a.

b.
12. What is the usual treatment of diabetes insipidus?

13. What causes the syndrome of inappropriate antidiuretic hormone (SIADH)?

14. What is the immediate nursing management goal of SIADH?

Disorders of Thyroid Function

, which causes .

15. 16.

17.

18. 19.

is one of the most common endocrine problems of childhood. What is the main physiologic action of the thyroid hormone?

Growth cessation or retardation in a child whose growth has previously been normal should alert the nurse to the possibility of .
A(n) is an enlargement or “hypertrophy” of the thyroid gland.

(also known as Hashimoto disease or ) is the most common cause of thyroid disease in children and adolescents and accounts for the largest percentage of juvenile

hypothyroidism.

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  1. Most cases of Graves disease in children occur between the ages and , with a peak incidence at to

    years of age. However, the disease may be present at birth in children of thyrotoxic mothers.

  2. The clinical features of Graves disease in children consist of factors related to excessive motion. Identify those factors.

    a. b. c. d. e. f.

  3. Identify the three methods for treating Graves disease. a.

    b.

    c.

  4. The most serious side effect of antithyroid drugs used to treat Graves disease is .

Disorders of Parathyroid Function

24. Identify the most common early symptom of hypoparathyroidism.

25. The diagnosis of hypoparathyroidism is made on the basis of clinical manifestations associated with decreased and increased .

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Wong’s Essentials of Pediatric Nursing- Marilyn Hockenberry

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