ASSIGNMENT WK 5

The paper must include a cover page and references. ***Do NOT use internet sources for your assignment. A student will receive a zero (0) if he or she use internet sources for the assignment. Use your text book Only***  BOOK: Ward Susan, L., & Hisley Shelton, M. (2009). Maternal-Child Nursing Care Optimizing Outcomes for Mothers. Children, and Families. Philadelphia, FA Davis

Write a 4-to-5 page summary paper (Not including the cover & Reference pages) that discusses a summary of

1. Growth hormone deficiency (GHD) in children (include the clinical manifestations, management and nursing care)

2. Hypo and hyperthyroidism & Hypo and hyperparathyroidism (include the clinical manifestations, management and nursing care)

3. Diabetes mellitus type 1 & 2 (include the clinical manifestations, management and nursing care)

4. Seizure disorders (include the clinical manifestations, management and nursing care)

Remember, write your paper as a word document AND USE THE BOOK ONLY: Ward Susan, L., & Hisley Shelton, M. (2009). Maternal-Child Nursing Care Optimizing Outcomes for Mothers. Children, and Families. Philadelphia, FA Davis

ASSIGNMENT WK 5-Solution

Growth Hormone Deficiency (GHD) in Children

GHD is an endocrine condition that develops when the anterior pituitary produces decreased growth hormone. GHD is common in children with short stature and is marked by delayed skeletal growth and development in the neonatal period. The affected children experience delayed or absent growth of less than 4 to 5cm in the first two years of life and weight plateaus between assessments (Ward & Hisley, 2009). Nursing care involves helping the child achieve average growth rate and height by administering human recombinants, a replacement therapy including regular subcutaneous injections. However, when administering treatment, nurses should consider potential side effects, including gynecomastia, arthralgia, increased intracranial pressure (ICP), or edema.(Hypo and Hyperthyroidism Essay Sample)

Hypo and Hyperthyroidism Essay Sample

Hypo and Hyperthyroidism

Hypothyroidism is a condition in which the thyroid gland secrets too little thyroid hormone for the body to function normally. Clinical manifestations include prolonged jaundice in new-born, sleepiness, mottled and cool skin, poor feeding habits, constipation, umbilical hernia, large tongue, and abnormal soft spots on the skull at infancy (Ward & Hisley, 2009). For grown and mature children, clinical manifestations include short stature, delays in crucial development milestones, delayed development of baby teeth, puffy facial features, mental retardation, sparse skin hair, dry skin, and protruding umbilical hernia and abdomen (Ward & Hisley, 2009). Older children with this condition experience symptoms such as slow heart rate, fatigue, cold intolerance, flaky and dry skin, difficulty thinking, drowsiness, irregular or heavy menstrual period, constipation, impaired memory, and face puffiness.(Hypo and Hyperthyroidism Essay Sample)

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Nursing care involves early diagnosis and normalization of thyroid hormone in the blood using Synthroid (low-dose levothyroxine) for twelve months. Thyroid replacement hormone can be given daily with an initial dose ranging between 25 and 50mg for infants, q.d. Iodine supplements are also appropriate with weekly visits to the physician for blood tests and dose adjustments (Ward & Hisley, 2009). Nursing care also involves educating the parents on the signs and symptoms of the condition, proper administration of medication and monitoring a child’s growth, developmental milestones, and weight gain, and when to seek further evaluation and interventions for any problem (Ward & Hisley, 2009). In addition, laboratory tests of TSH and T4 are recommended to monitor a child’s hormone levels.

On the other hand, hyperthyroidism is a condition in which the thyroid gland secrets excessive thyroid. The clinical manifestations include goiter, raised, swollen, reddened, thickened skin at the back of feet, face, hands, back and over the shins, and bulging eyes (Ward & Hisley, 2009). Children also present faster heart rates, moist skin, palpitations, increased perspiration, tremor and shakiness, confusion and nervousness, weight loss and increased appetite, troubled sleep, eye sensitivity to lights, constant stare, and altered menstrual period in puberty (Ward & Hisley, 2009).(Hypo and Hyperthyroidism Essay Sample)

Nursing care requires appropriate diagnosis and education of the child and the family on treatment regimens. Treatment includes antithyroid medications that block and lower thyroid hormones, radioactive iodine therapy to lower thyroid hormone productions, subtotal thyroidectomy, and beta-blocking agents to block thyroid hormone actions (Ward & Hisley 2009). The parents are educated and given information on the importance of medication adherence and continuing medication regimen, medication side effects, routine blood tests, signs and symptoms, and emergency referrals (Ward & Hisley, 2009). The nurse should reinforce the importance of low blood pressure and stress environment, discussing with the child about their feelings, and notifying the school of the child’s condition.(Hypo and Hyperthyroidism Essay Sample)

Hypo and Hyperparathyroidism

Hypoparathyroidism is a condition associated with low production of the parathyroid hormone or the inability of the kidney or the body to use the hormone, and the bones do not respond to its production (Ward & Hisley, 2009). As a result, the body’s calcium levels decrease, and phosphate levels increase. The clinical manifestations of hypoparathyroidism include mental impairment, painful and uncontrollable spasms, poor tooth development, vomiting, headaches, seizures, apnea episodes, irritability, and rigid muscles (Ward & Hisley, 2009). Nursing care includes educating the family about eh condition, clinical presentations, and available treatment options. Lifelong diets or supplements with vitamin D and calcium are recommended. Intravenous calcium is administered with acute hypoparathyroidism. Diuretics are recommended to prevent calcium over-excretion.(Hypo and Hyperthyroidism Essay Sample)

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Hyperparathyroidism is associated with increased calcium serum, leading to osteomalacia and osteoporosis. Unfortunately, about 50% of affected children do not present symptoms, and about 1% of cases remain undiagnosed (Ward & Hisley, 2009). The clinical manifestations include joint and bone pain, bone loss and fractures, muscle weakness, abdominal discomfort, constipation, nausea and vomiting, poor appetite, fatigue or drowsiness, memory loss, kidney stones, excessive thirst and urination, depression and anxiety, peptic ulcers, abdominal discomfort, and pancreatic heartburn.

Nursing care involves parathyroidectomy, which restores calcium levels in the blood. Late diagnosis limits the effectiveness of parathyroidectomy. Parathyroidectomy accompanies postoperative care, including airway management, respiratory assessments for distress or obstruction, and fluid management (Ward & Hisley, 2009). Continuous monitoring of the child’s electrolyte balance, intake, output, and signs of infection and hematoma is recommended. The child and family should be educated on the signs and symptoms of hypocalcemia, the administration of calcium supplements and vitamins K and C, and the need for frequent blood draws to monitor phosphorus and calcium levels.(Hypo and Hyperthyroidism Essay Sample)

Diabetes Mellitus Type 1 & 2

Diabetes mellitus type 1 is a condition associated with low insulin production in the body. Clinical manifestations include decreased insulin production, polyuria, loss of bladder control, polydipsia and polyphagia, weight loss, and high hyperglycemia and glycosuria (Ward & Hisley, 2009). In addition, nausea and vomiting, excessive fatigue and weakness, abdominal discomfort and pain,  dehydration, urinary tract infections, respiratory and skin infections, blurred vision, restlessness, and irritability. Nursing care involves considerations for the type of insulin, nutrition and diet, physical activity, stress management, and ketone and blood glucose monitoring, as many factors influence them. The primary aim of nursing care is to reduce symptoms and prevent complications.(Hypo and Hyperthyroidism Essay Sample)

Diabetes mellitus type 2 results from the body’s inability to recognize and use insulin. Usually, children experiencing type 2 diabetes mellitus do not show signs. However, the condition can be detected through routine blood sugar exams. Symptoms include burning sensation and numbness in the feet, legs, and ankles, blurred vision, fatigue, impotence, and poor wound healing (Ward & Hisley, 2009). Nursing care varies and includes nutritional education on reducing calories, behavioral changes, and increased activity. Families are taught lifestyle modification and the need for compliance for all family members. Oral hypoglycemic agents are recommended to elevate blood A1C levels in combination with lifestyle changes (Ward & Hisley, 2009). Intravenous or subcutaneous insulin is recommended with a severe presentation. Increased awareness of escalating conditions is crucial for determining effective treatment. Healthy eating habits and an active lifestyle are primarily recommended.

Seizure Disorders 

Seizure disorders result from an electrical disturbance in the brain, altering sensation, cognition, and motor function. As such, seizures are classified based on the part of the brain affected and the psychogenic and neuromuscular sensory alteration (Ward & Hisley, 2009). The clinical manifestations of seizure disorders include altered sensation, impaired cognition, and motor function. Seizures have unknown causes, and symptoms result from the process associated with a known disease or injury (Ward & Hisley, 2009). Brain tumors, head injury, infection, and hypoxic or anoxic events are related to the development of seizures. This requires neurological testing to ascertain the diagnosis.(Hypo and Hyperthyroidism Essay Sample)

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Nursing care involves collaborative management efforts to determine the type of seizure and manage it medically if the etiology is known. For brain tumors, it is recommended that the mass be excised (Ward & Hisley, 2009). For infection, it is recommended that appropriate antibiotic therapy is initiated. Anticonvulsant therapy is recommended for unknown causes without structural abnormality (Ward & Hisley, 2009). A comprehensive patient history, including a review of systems and neurological exam to ascertain the etiology. Airway management, supportive oxygen ventilation, and removal of obstructions are necessary for effective nursing outcomes (Ward & Hisley, 2009). Anticonvulsant therapy is recommended for seizure management and other pharmacological interventions (Valium, Atvin, Luminal Sodium, Dilantin, and Cerebyx) based on a specific patient case (Ward & Hisley, 2009). Caregivers should be educated on seizure precautions, CPR techniques, medication dose, route, frequency, and side effects. Lastly, the school should be informed of the patient’s condition and the measures to be taken.(Hypo and Hyperthyroidism Essay Sample)

 

 

Reference

Ward, S.L., & Hisley S.M. (2009). Maternal-Child Nursing Care Optimizing Outcomes for Mothers. Children, and Families. Philadelphia, FA Davis

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