Nur 311 Exam 2 Study Guide with Questions and 100% Correct Answers
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NUR 311
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NUR 311
PKU diet to follow Breast Feeding or PA+ Free Formula. Restricted PA + Intake Throughout Life; No meat, limited fruits & vegetables, limited grains
What happens if people with PKU don't follow their diet Short Attention Span Poor short term memory Visual perception problems Poor motor coordination...
Nur 311 Exam 2 Study Guide with
Questions and 100% Correct Answers
PKU diet to follow ✅Breast Feeding or PA+ Free Formula. Restricted PA + Intake
Throughout Life; No meat, limited fruits & vegetables, limited grains
What happens if people with PKU don't follow their diet ✅Short Attention Span
Poor short term memory
Visual perception problems
Poor motor coordination
Mood disorders
Brain structural changes (reduced grey matter)
Safe PKU level ✅2-6mg/dl
PKU nursing Considerations ✅Assist with testing
Teach parents about diet and need for follow up blood levels throughout life
Child may have trouble adhering to diet as ages
Provide emotional support
Genetic counseling
What kind of diet should a child with Galactosemia Follow ✅lactose free diet; soy
formula
Calcium supplementation.
Dark green leafy green veggies are good
Can galactosemia breastfeed? ✅NO!!! AVOID!!! Need soy formula and calcium
supplementation
Long-term consequences if diet not followed for galactosemia ✅learning disabilities,
lower IQs, short attention span, behavior problems
When should growth hormone be given? ✅NIGHT TIME!!! Sub Q injections given @
night 5x a week. Is stopped once when child is where they are supposed to be height
wise.
Realistic expectations for Growth hormone ✅Growth hormone will only make them
grow to what they were supposed to grow. So giving it to them won't make them a 7'0
Center for UK.
,Nursing considerations for Growth Hormone therapy ✅serial blood draws q 30 minutes
for 3-hours following stimulation with insulin or glycogen.
Treat with chronological age not developmental age
What is considered True or complete precocious puberty ✅When Puberty HAPPENS
EARLY!!!
What drug is for Precocious puberty ✅Lupron. Slows prepubertal growth to normal
rates
Given IM monthly
When to Stop Lupron Treatment ✅Treatment is discontinued at age for normal
pubertal changes to resume
Precocious Puberty ✅a condition in which puberty begins before the age of 8 in girls
and 9 in boys. Testicular enlargement in boys and breast enlargement in girls 1st sign
What drug is used for Treatment of CAH ✅Cortisone to suppress abnormally high
secretion of ACTH for LIFE. Reconstructive surgery as required.
What is something a person with CAH should always be wearing? ✅Medical alert
Bracelet
Detection of CAH in males ✅precocious genital development
Detection of CAH in females ✅-Enlarged clitoris appears as a small phallus
-Fused labia produce saclike structure without testes
-Internal female sexual organs are intact
Diagnostic Evaluation for CAH ✅-Ultrasonography to visualize pelvic organs
-Chromosome typing for positive sex determination and to rule out any other genetic
anomalies
Teaching for CAH ✅Teach parents signs and symptoms of dehydration and salt-losing
crises. Have injectable hydrocortisone available and teach how to use it. MONITOR
FOR HYPONATREMIC DEHYDRATION!!!
Nursing considerations for CAH ✅Hyponatremic dehydration for CAH most at risk,
sodium less than 135, blood sugar drops, do an ultra sound for gender, genetics for
CAH status, always have to have cortisol replacement.
,what medication is for hypothyroidism ✅Levothyroxine (Synthroid) - take in the AM.
Needs to be crushed but can not be given in soy based formula. Keep out of sun. May
administer in increasing amounts over 4 to 8 weeks to reach euthyroidism. Too much
will lead to hyperthyroidism
Goiter ✅Hypertrophy of the thyroid gland. Occurs with hypothyroidism. Congenital
cause harms the airway of newborn and results from maternal ingestion of antithyroid
drugs during pregnancy.
Juvenile Hypothyroidism ✅Congenital hypothyroidism is the major cause of childhood
mental retardation. Everything Slows down!!!
problems with miss diagnosis for hypothyroidism ✅Missed or delayed diagnosis may
lead to mental defects
Clinical Manifestations Hypothyroidism (acquired) ✅EVERYTHING SLOWS DOWN!!!
Decreased growth
Myxedema (dry skin, puffiness around eyes, sparse hair)
Sleepiness
Goiter
Altered body proportions; short stature, legs proportionately short compared to trunk
Hyperthyroidism (Graves Disease) ✅Most common in females 12-14
Everything is sped up*
T3 and T4 increased and TSH is down
CM of Hyperthyroidism (Graves Disease) ✅Everything speeds up- imagine fight or
flight response all the time. Adrenaline rush!! Manifestations develop gradually, often
over 6 to 12 months
When should you stop meds for Hyperthyroidism ✅Stop medication and need to be
put in isolation if allergic such as sore throat and fever
, How long to see results for anti-thyroid drugs for Graves disease ✅2 weeks in order to
see results for anti-thyroid drugs. Propylthiouracil (PTU)
Methimazole (MTZ, Tapazole)
Complete remission for most kids within 1-2 years of medication treatment
Ablation with radioiodine concern ✅result will be hypothyroidism
can kids with graves disease handle extra stress ✅NO!!! Don't add stress to these
kids. Such as physical activity, decrease it
Nursing Considerations (Hyperthyroidism) ✅Identification (bracelet, Necklace)
High calorie, nutritious diet
Drugs to treat thyroid storm ✅Antithyroid drugs
Propranolol
Developmental Issues with Diabetes Management; Toddler (1-3 years) ✅Let toddler
scrub hub with alcohol, or put strip in machine. Toddlers can go days without eating,
Even though not eating still need insulin. Just not using carbs in the equation.
Developmental Issues with Diabetes Management; Preschool (3-6 years) ✅-Reassure
not being punished.
-Let them take part in activities.. They like gadgets and they like to please adults so let
them gather supplies, put the meter together.
-Report to teach lows and what to eat when feel that way
Developmental Issues with Diabetes Management; School Age (6-12 years) ✅-All
Activities must be supervised
-Educate school personnel about diabetes
-Encourage extra-curricular activities and participation in social groups
-11-12 year olds able to perform an occasional injection
-For low BS Don't have to have something with fat in it, avoid chocolate, messes up the
mechanisms of allowing the insulin to spike
Diabetes Med Math ✅Insulin to CHO ratio: 1:10
Correction Factor: 1:50>150mg/dl
BS: 210
CHO: 60
210-150 = 60 . 60 60/50= 1.2 (BS)
60/10=6 (CHO)
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