PNP endocrine

Card Set Information

Author:
MBitting
ID:
104228
Filename:
PNP endocrine
Updated:
2011-09-25 18:42:53
Tags:
PNP Pediatric Nurse Practitioner Endocrine via Burns book
Folders:

Description:
Study questions for PNP endocrine exam
Show Answers:

Home > Flashcards > Print Preview

The flashcards below were created by user MBitting on FreezingBlue Flashcards. What would you like to do?


  1. What labs are needed for Type I diabetes?
    1. Urine testing and blood glucose measurement are generally all that are required to make the diagnosis

    2. Metabolic screen: For acid-base status to exclude diabetic ketoacidosis

    • 3. Blood sugar:
    • - Fasting plasma glucose equal to or greater than 126 mg/dL
    • - Random plasma glucose equal to or greater than 200 mg/dL
    • - Postprandial (2 hours after eating) plasma glucose level equal to or greater than 200 mg/dL

    4. Urine: For glucose and ketones

    5. Screen for concomitant associated autoimmune conditions (primary hypothyroidism and celiac disease [if symptomatic])

    Capillary blood samples, reagent sticks, and glucose meters should only be used for monitoring diabetes control
  2. What lab tests should one obtain for Type II Diabetes?
    Screening should be conducted in high-risk children even without symptoms

    1. Initial urine glucose screen can be done in the office

    2. A glycosylated hemoglobin, lipid panel, TSH and free T4, and fasting insulin level should be taken

    • 3. Symptomatic plus:
    • - Fasting plasma glucose equal to or greater than 126 mg/dL
    • - Random plasma glucose equal to or greater than 200 mg/dL
    • - Postprandial (2 hours after eating) plasma glucose level equal to or greater than 200 mg/dL

    4. Depending on results and differential diagnosis, further laboratory studies to evaluate thyroid dysfunction, female hyperandrogenism, and sleep apnea may be indicated
  3. What lab testing needs to be done for primary hypothyroidism?
    Congenital hypothyroidism is usually tested via newborn screening occurs usually before leaving the hospital. It includes either a Free T4 or a TSH. If abnormal, primary care clinician is contacted to obtain a confirmatory free T4 and TSH serum sample. Sample is also obtain if clinical features of CH are detected
  4. How often are children with Down Syndrome tested for hypothyroidism?
    6 and 12 months old and then annually
  5. What is testing results are considered abnormal and indicate primary hypothyroidism in older children?
    TSH is abnormally elevated while the free T4 is in the normal range or low
  6. What is testing results are considered abnormal and indicate central hypothyroidism?
    Free serum T4 is low, TSH is normal (typically TSH is measurable, but there has not been enough TSH secretion to bring the free T4 into normal range)
  7. What is testing results are considered abnormal and indicate thyroid-binding globulin deficiency?
    Total T4 will be low, but free T4 will be normal as will TSH (this condition does not require treatment)
  8. What testing results would you see on children with hyperthyroidism?
    1. Free T4 and total T4 levels will be elevated and the TSH suppressed below the sensitivity of the assay

    2. Measuring a T3 levels may be helpful because it may be more dramatically elevated than the T4 and be a better marker to follow
  9. What is the normal TSH value?
    In a newborn the normal is 3 - 18 microunits/ml
  10. What would be high and low for hypothyroidism and physical exam findings of a newborn?
    • Newborn may look completely normal but may have some neonatal signs:
    • Prolonged jaundice
    • Constipation
    • Umbilical hernia
  11. What would be high and low for hypothyroidism and physical exam findings of a infant?
    • Large anterior and posterior fontanelle
    • Large tongue
    • Decreased muscle tone
    • Respiratory distress
    • Poor peripheral circulation with cool, cyanotic skin in the extremities
  12. What would be high and low for hypothyroidism and physical exam findings for older children?
    • -Delayed growth such as small stature for their family or subnormal growth velocity
    • -May be overweight for height and have delayed dentition or puberty
    • -Bradycardia
    • -Delayed return of the DTR
    • -With central hypothyroidism may show slow growth, increased weight for height, and features suggestive of hypopituitarism including midline facial or eye abn.
  13. What years are the most crucial for hypothyroidism in children and why?
    0 - 3 y/o is most crucial for normal cognitive development to occur.
  14. What are the monitoring guidelines for hypothyroidism?
    If TSH is elevated or if T4 is depressed than the medication needs to be increased and blood testing to be done in 6 weeks
  15. What are the PE findings for hyperthyroidism?
    • Goiter
    • Tachycardia
    • Wide pulse pressure
    • Underweight for height
    • Eyelid lag or exophthalmos; approximately 50% of children with Graves’ disease have exophthalmos
    • Hyperfunctioning nodule in the thyroid may be present
    • Warm, smooth skin
    • Tremor or hyperreflexia

What would you like to do?

Home > Flashcards > Print Preview