Pituitary Problems
Which hormone is deficient in diabetes insipidus?
Antidiuretic hormone (ADH)
Which thyroid disorder causes intolerance to heat, weight loss, and tachycardia?
Hyperthyroidism (Graves’ disease).
Which hormone is deficient in Addison’s disease?
Cortisol (and often aldosterone).
What is the first nursing action for a child with blood glucose of 48 mg/dL who is awake?
Give a fast-acting carb like juice or glucose tabs
Which disorder is caused by excess growth hormone before growth plate closure?
Gigantism.
A child with SIADH has serum sodium of 124. What’s your priority nursing action?
Restrict fluids and monitor neuro status.
A 10-year-old with hypothyroidism is prescribed levothyroxine. What teaching is most important?
Take it at the same time every morning, before food.
A child with Cushing’s syndrome will likely have what physical characteristics?
Moon face, truncal obesity, thin extremities, and striae.
List three signs of hypoglycemia.
Shakiness, sweating, irritability, headache, hunger.
A child on long-term corticosteroids should be monitored for which three complications?
Infection, hyperglycemia, and growth suppression.
What is the key difference in urine output between SIADH and DI?
SIADH = low urine output; DI = high urine output.
What’s a classic sign of thyroid storm in a child with untreated Graves’ disease?
Very high fever, tachycardia, hypertension, and confusion.
What is the priority concern during an Addisonian crisis?
Severe hypotension and shock from cortisol deficiency.
Which lab test measures long-term glucose control?
Hemoglobin A1C
What’s one similarity and one difference between Type 1 and Type 2 Diabetes?
Both cause high blood sugar; Type 1 requires insulin, Type 2 often linked to obesity/resistance.
A 7-year-old with GH deficiency is starting somatropin. What time of day should it be given?
At bedtime to mimic natural GH release.
Name one lab value that will be high and one that will be low in hypothyroidism.
High TSH, low T4.
A teen with congenital adrenal hyperplasia (CAH) requires which lifelong medication?
Corticosteroid replacement therapy.
A teen with DKA has Kussmaul respirations. Why?
The body is compensating for metabolic acidosis.
Which lab pattern would you expect in SIADH?
Low sodium, low serum osmolality, high urine specific gravity.
What’s the most important nursing assessment after a transsphenoidal surgery for pituitary tumor removal?
Monitor for CSF leak, nasal drainage, and neuro changes.
A child with Hashimoto’s thyroiditis asks if the damage can heal. What’s the best response?
It’s chronic, but medication can manage the hormone levels.
Name two electrolyte changes expected in Addison’s disease.
Hyponatremia and hyperkalemia.
What’s the first IV fluid for a child with DKA?
Normal saline (0.9% NaCl) for volume restoration.
Why must a nurse taper corticosteroids instead of stopping abruptly?
To prevent adrenal crisis from sudden cortisol withdrawal.