Have to eat while drinking alcohol o dm t1 exercise

 **HAVE to EAT while drinking alcohol**
o DM T1: Exercise
 Activity increase insulin absorption
 May need snacks for PE, Recess, Sports
o Hypo/Hyperglycemia
 HYPO
 Pale, weak, dizzy, sweating, shaking, irritable, HA, Stomach ache, change in personality, “feel low”, seizure
 HYPER
 Gradual onset of symptoms
 Might see the symptoms of DKA come on
o Nursing Intervention: HYPOglycemia

 Blood sugar < 70 and symptoms:
 Immediate intake of simple sugars
o Juice
o 2 glucose tablets
 15 minutes later, recheck
 Remains <70 – repeat simple sugars
 >80 – more substantial (fat, protein) snack (or meal within 30 minutes)
 Unable to eat or drink
 Honey or icing under tongue (only if still conscious)
 Glucagon injection
 10-15 minutes recheck glucose
 More substantial snack or meal
 Consider transport to ER
o DM T1: Education
 Patient and family will need to meet with a diabetes educator, nutritionist, if available
 Insulin Administration
 Nutrition
 Illness
 Exercise
 Blood glucose monitoring
 Signs & Symptoms/Treatment
 Hypoglycemia
 Hyperglycemia
 Coping and Support
o DM Complications
 DKA, coma, death
 Microvascular Damage from excess glucose can lead to:
 Heart and blood vessel disease
 Neuropathy
 Kidney damage
 Retinopathy
 Foot injuries
 Pregnancy complications
o Type 2 DM
 Pathophysiology and treatment for children with Type 2 is the same as for adults
 Focus heavily on decreasing weight and increasing physical activity
 Try to manage without medications
 Can use oral hypoglycemic agents (like Metformin ) and insulin
 Will often see acanthosis nigricans

 Disorders of Pituitary Function
o HYPOpituitarism – talking about effects of the ANTERIOR Pituitary
 Diminished or deficient secretion of pituitary hormones
 Growth Hormone
o Stimulates linear growth
o Builds bone mineral density
o Stimulates growth of all body tissues
o Stimulates synthesis of proteins in Liver (including insulin-like growth factor)
 Thyroid-Stimulating Hormone
 Gonadotropins
 Adrenocorticotropic Hormone
 Melanocyte-Stimulating Hormone
 Prolactin
 Oxytocin
 Antidiuretic Hormone
o **BLUE = POSTERIOR Pituitary

 Causes
 Idiopathic (most cases are idiopathic)
 CNS infection
 Infarction of pituitary gland
 CNS disease
 Tumors of pituitary or hypothalamus
 Brain trauma
 Chemotherapy
 S&S
 Classic Symptoms:
o Growth Retardation
o Short Stature
o Delayed bone maturation and muscle mass
 X-rays of the hands can tell us where they are compared to chronological age
 S&S in INFANT
 Normal birth weight
 By 1 year below 3 rd percentile for height
 May be hypoglycemic (increased insulin sensitivity)
 Hyponatremic
 Seizures – low sodium/glucose
 Jaundice - prolonged
 Undescended testes with micro penis
 S&S in the CHILD
 Height below 3 rd percentile
 Overweight - **Still gain weight, just do not grow taller**
 Youthful facial features – cherubic look
 Higher pitched voices
 Delayed dentition
 Decreased muscle mass
 Delayed skeletal and sexual maturation
 Hypoglycemia due to increased insulin sensitivity
 Diagnosis