NURSING CARE OF A FAMILY WHEN A CHILD HAS AN ENDOCRINE OR A METABOLIC DISORDER
THE ENDOCRINE SYSTEM AND ITS - Secretes insulin and glucagon (regulates aerobic and muscle-strengthening
IMPORTANCE blood sugar levels) exercises across all age groups.
Additional points
Glands – endocrine is made up of multiple Reproductive glands
- Parents and age-appropriately children
glands that are responsible for the secretion
- Females: ovaries produce estrogen and should be educated about endocrine
of hormones in the body.
progesterone. disorders to facilitate participation in
Hormones – molecules produced by
- Males: testes produce testosterone. long-term treatment plans.
endocrine glands that regulate the activity
- The passage emphasized the importance
of target cells or organs.
Gland network – consists of ductless of creating accessible community
GLANDS glands, which release hormones directly into programs and initiatives to encourage
the bloodstream. physical activity in all demographics,
Pituitary gland especially children and individuals with
Hormone action – hormones act as
chemical messengers, traveling through the limitations.
- “Master Gland”, located at the base of
brain. blood to target organs and influencing their
NURSING PROCESS
- It also secretes hormones that regulate activities.
growth, reproduction, and the function of Specifity – each gland produces hormones ASSESSMENT
thyroid, adrenal glands, and gonads. with specific functions that regulate various
Growth and development
body processes.
Symptoms:
Thyroid gland Impact of Dysfunction – hormonal - Delayed growth
imbalances or gland malfunctions can lead - Unidentified growth issues
- Located in the neck
to long-term health problems. - Acute weight loss
- Produces hormones that regulate
- Overweight
metabolism, energy production, and HEALTHY PEOPLE 2023 GOALS - Unusually short/tall stature
body temperature. Activity level: assess sleep patterns,
Reduced sugar consumption participation in activities, fatigues levels
Adrenal glands - aims to decrease added sugar intake in Look for extreme thirst, frequent
people aged 2 and above urination
- Located in top of kidneys
- combats a major contributor to metabolic Physical appearance:
- Produces hormones such as cortisol, - Early/late puberty signs
problems
adrenaline, and aldosterone. - Skin changes
Increased physical activity
- Drooping eyelids
Pancreas - promotes meeting recommended
- Bulging eyes
physical activity guidelines for both - Poor muscle tone
Delayed development Signs and symptoms:
NURSING DIAGNOSIS Infantile appearance Excessive growth in height
Delayed puberty Enlarged facial features, jaw, and tongue
Fluid volume deficiency r/t constant High-pitched voice Delayed or incomplete closure of skull
excessive loss of fluid through urination Crowded teeth fontanelles
Malnutrition risk r/t an inability to use Speech difficulties due to tongue
glucose because of diabetes mellitus Diagnosis: enlargement
Altered body image perception r/t abnormal o Growth chart monitoring Potential for exceeding 8ft in height if
height o Physical examination untreated
Health-seeking behaviors r/t the self- o Blood tests
administration of insulin o Imaging tests
Knowledge deficiency r/t long-term Diagnosis
treatment needs Treatment: o X-rays or ultrasounds
Fear r/t the potential and unknown illness o Growth hormone replacement therapy
outcome o Other hormone replacements Treatment option:
Anticipatory grieving r/t presumed losses o Delaying puberty (in some cases) o Surgery (laser surgery or cryosurgery)
associated with diagnosis of long-term o Medications:
illness Treatment benefits and considerations: GH antagonists to slow GH
Impaired family processes r/t the child’s o Improved growth production (e.g., bromocriptine or
chronic illness o Long-term therapy octreotide)
Anxiety r/t financial resources required to o Misuse and safety Potential need for hormone
maintain optimum family health replacements if other hormone
GROWTH HORMONE EXCESS IN CHILDREN production is affected (e.g.,
thyroid, cortisol, gonadotropin)
Causes:
o Radiation therapy
GROWTH HORMONE DEFICIENCY
Usually caused by a benign tumor in the
Nursing considerations:
- Growth Hormone (GH) is a hormone pituitary gland
Psychosocial support: children with
produced by the pituitary gland
Effects on growth: excessive growth may experience social and
- when deficient, children experience stunted
Before epiphyseal closure: emotional challenges due to their size.
growth and may develop other
- If such occurs before bone growth plates Assessing for self-esteem issues and helping
characteristic features.
close, it leads to excessive growth with them adjust to their larger size is crucial.
Causes: weight increasing proportionally to
DIABETES INSIPIDUS IN CHILDREN
pituitary tumors height.
ICP After epiphyseal closure: - is a disorder affecting the body’s ability to
Unknown causes - Once growth plates close, acromegaly regulate water balance.
develops.
Signs and Symptoms: - It is characterized by enlargement of the
Slow growth bones of the head, hands, and feet.
- Unlike the more common type 1 or 2 IV in emergencies Treatment:
diabetes, DI is not related to blood sugar Intranasal spray for long-term use o Fluid restriction
levels. Oral (tablets) o Sodium replacement (IV)
o Medications:
Causes: Nursing considerations:
Demeclocycline – an antibiotic with
Decreased ADH production: DI can Medication education
side effect of blocking ADH action in
occur when the pituitary gland doesn’t Dehydration prevention
kidneys
produce enough ADH (a hormone Emotional support
responsible for water reabsorption in the
kidneys). This can be caused by:
Genetic factors
Lesions, tumors, or injuries to the
pituitary gland
Unknown causes
ADH resistance: in rare cases, the SYNDROME OF INAPPROPRIATE
kidneys may not respond properly to ANTIDIURETIC HORMONE (SIADH) IN THE THYROID GLAND
ADH, even if the pituitary gland produces CHILDREN
enough. - Located at front of neck
- Is a rare disorder where the body produces - Responsible for controlling rate of
Signs and symptoms: too much ADH, leading to decreased urine metabolism in the body through the
Excessive thirst output and water intoxication. hormones thyroxine (T4) and
Excessive urination triiodothyronine (T3) (produced by follicular
Causes:
Irritability cells)
CNS infections like meningitis
Weakness - Controls several body functions: heart rate,
Long-term use of positive pressure
Fever how much you digest your food, muscle
ventilation machines
Headache control, bone health, and brain health.
Pituitary gland compression due to
Seizures
swelling or tumors
Lethargy
Signs and symptoms: THYROID GLAND DISORDERS
Diagnosis:
MILD SIADH
o Monitoring urine output
o Blood tests (1) CONGENITAL HYPOTHYROIDISM
Weight gain
o Imaging tests (MRI, CT scan or Concentrated urine
- Associated with the congenital absence
ultrasound) Nausea
of a thyroid gland or the inability of the
o Vasopressin test Vomiting
thyroid gland to secrete thyroid hormone
Treatment: SEVERE SIADH in the newborn.
o Tumor removal - An indication that infant’s thyroid is not
o Desmopressin (DDAVP): Coma or seizures due to brain swelling functioning well may not be noticeable at
birth because the birthing parent’s metabolic needs AEB hypotonic or
thyroid hormones maintain adequate decreased activity level
levels in fetus during pregnancy. Deficient knowledge r/t lack of exposure to
hypothyroidism and unfamiliarity with
Causes: information sources
Thyroid gland does not develop properly Fatigue r/t impaired metabolic state
May be formed properly but does not
produce hormone in right wat Nursing intervention:
It’s missing the signal from pituitary
gland to produce thyroid hormone Educate the client and family regarding
body weight in hypothyroidism
Physical examination: Educate the client on intake on food lower in
calories and focus on nutrient-rich foods like
Hair: brittle and dry fruits, vegetables, whole grains
Neck: short and thick Encourage patient adequate rest and
Expression: dull and mouth opened schedule activities when client has most
Extremities: short and fat energy
Develops a floppy, ragdoll Provide clear and concise explanations
appearance about congenital hypothyroidism using
language tailored to patient’s understanding
Signs and symptoms: Promote an environment conducive to
Enlarged tongue relieve fatigue
Constipation
Jaundice Therapeutic management:
Sleeping longer or more often than usual
Poor or slow growth Levothyroxine therapy: oral
Skin of extremities is cold, dry, and scale administration of synthetic thyroid hormone
Suck poorly (Sodium levothyroxine)
Supplemental Vitamin D
Diagnostic test:
o Newborn screening
o Radioactive iodine uptake (2) ACQUIRED HYPOTHYDOISM
o X-ray (HASHIMOTO THYROIDITIS)
o T4 levels
o Ultrasonography or scintigraphy - SEDRFYGHBNJ
Nursing diagnosis:
Imbalanced nutrition more than body
requirements r/t greater intake than
