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
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- Summer '18