Universal ethical orientation principles are source of rules 17 Universal

Universal ethical orientation principles are source of rules 17+ Universal ethical principle  Death  #1 – Unintentional Accidents, or is it #2? (on test is number 1, but in reality, is probably suicides)  #2 – Suicide (ask abt accessibility to guns during well child visit, espec if depressed)  #3 – Homicide  #4 – Cancer  #5 – Heart disease  Graphs on slides (don't need to know)  Compared with other age groups:  Gender differences:  Race makes a Difference:  Modifiable Safety Issues  Depression ( 3.1 million teens have had at least 1 depressive episode in the last year IPV)  Bullying  Sexual exploitation  Drug/alcohol use  Depression Screening  PHQ9 (another is the Beck test – don't need to know)  Diagnosis  Case Study  Alexei is a 15y.o. male, presents with concerns about his growth :  What can you tell him ? Hes not done growing, ask how tall are your parents  Upon further questioning, you realize he is depressed .:  How did you figure this out, what are you going to do now ?: Endocrine & Metabolic Disorders  Your reading’s objectives  Describe the structure and function of the endocrine glands and why metabolic illnesses occur.  Assess a child with a disorder of endocrine or metabolic function.  Formulate nursing diagnoses for a child with altered endocrine or metabolic function.  Establish expected outcomes for a child with endocrine or metabolic dysfunction as well as help parents manage seamless transitions across differing health care settings.  Evaluate expected outcomes for achievement and effectiveness of care.  Review  Endocrine d/o often detected in kids with  Growth curves  HGH is used to  treat short stature  An ideal A1c in a child is  6.5-8%  For an adult is: under 5.5  Higher A1c in a child  A1c is a 3 month number  If asked about spot random blood sugar, the right answer would be it depends 2

 Diabetic children who are ill require:  Closer monitoring of blood sugars  Usually more insulin  Our Learning Objects  Incorporate unique developmental considerations into what you already know about care of the patient with diabetes.  Identify 1 condition that may appear in a child with a Growth Hormone imbalance.  Articulate normal and abnormal conditions in Tanner staging (tanner staging is sexual development)  Diabetes  Partial or complete metabolic deficiency of insulin  Contributing factor to development of CVD, HTN, Renal Failure, blindness & stroke.  Risk factors: genetic, toxins, viruses, obesity  Labs  8-hrs fasting BS Level of 126 mg/dL or >  Random blood glucose >200mg/dL w/ other classic signs  Oral glucose tolerance 200mg > 2-hr sample  HbA1c is different for children* (expected range is 4-6, but acceptable range for kids is 6.5-7)  Self monitoring  Assess before meals & bedtime  Developmental considerations –  Infant  Toddler  Preschooler  School-Age Child  Adolescents  Growth Hormone Deficiency 