Wong's Nursing Care of Infants and Children, 11th Ed., Hockenberry, Wilson & Rogers | Registered Nurse (RN) School Study Aid
Peptide Hormones
- Fast-Acting and Short-Lived
- Bind To Cell Membrane Receptors
- Stimulate Secondary Messengers
- Amino Acid-Derived
- Insulin
- Parathyroid Hormone (PTH)
- Vasopressin
- Oxytocin
Steroid Hormones
- Nuclear Membrane
- Long-Lived and Slow-Acting
- Cholesterol-Derived
- Intracellular Receptors
- DNA Transcription
- Testosterone
- Aldosterone
- Estrogen
- Cortisol
Hypothalamus
- Anterior Pituitary Stimulated Through the Hypophyseal Portal
- GHRH
- GnRH
- TRH
- PIF
- CRF Released During Stress
- Posterior Pituitary Stimulated Through Neural Control
Thyroid Gland
- TSH Stimulates T3 and T4 Release
- Metabolism Regulation
- Blood Calcium Sensor
- Calcitonin Release
- Blood Calcium Decreases
- Bone Building
Parathyroid Gland
- Blood Calcium Sensor
- Parathyroid Hormone
- Bone Resorption
- Blood Calcium Increases
- Vitamin D Activation
- Calcium Absorption From The Small Intestine
Adrenal Gland (Basic)
- Adrenal Cortex
- RAAS Stimulates Aldosterone
- CRF (CRH) acts on Anterior Pituitary Gland to Release ACTH
- Cortisol Released
- Androgens Released
- Adrenal Medulla
- Epinephrine & Norepinephrine
Anterior Pituitary
- Hypothalamic Control
- FLAT PeG Mnemonic
- Follicle-Stimulating Hormone (FSH)
- Lutenizing Hormone (LH)
- Adrenocorticotropic Hormone (ACTH)
- Thyroid-Stimulating Hormone (TSH)
- Prolactin (PRL)
- Growth Hormone (GH)
Posterior Pituitary
- Neuroendocrine Reflex Stimulation (By Hypothalamus)
- Vasopressin
- Increased Water Retention (In Kidneys)
- Oxytocin
- Increased Uterine Contraction
- Mammary Glands Contraction
Acromegaly Assessment
- Excess Growth Hormone (GH)
- Protruding Jaw
- Large Lips and Nose
- Hearing Loss
- Enlargement of Hands and Feet
- Vision Changes and Headache
- Joint Pain
- Peripheral Neuropathy
- Hyperglycemia
Diabetes Insipidus Assessment
- Polyuria
- Nocturia
- Low Specific Gravity (USG)
- Polydipsia
- Dehydration
- Hypotension
- Tachycardia
- Confusion
Syndrome Of Inappropriate Antidiuretic Hormone (SIADH)
- Hypersecretion of ADH
- Increased Sensitivity to ADH
- Serum Hypoosmolality
- Coma and Seizure
- Dilutional Hyponatremia
- Cramps and Tremors
- Euvolemia
- Change in LOC
Syndrome of Inappropriate Antidiuretic Hormone (SIADH) Nonpharmacologic Interventions
- Monitor Serum and Urine Osmolality
- IandOs with Daily Weights
- Restrict Fluid Intake
- Monitor Cardiovascular and Neurological Status
- Seizure Precautions
Syndrome of Inappropriate Antidiuretic Hormone (SIADH) Pharmacologic Interventions
- Diuretics
- Hypertonic IV Fluids
- Demeclocycline
- Tolvaptan and Conivaptan
Hypothyroidism Assessment
- Weight Gain - Edema
- Lethargy
- Cold Intolerance
- Bradycardia
- Hypertension
- Brittle Nails and Dry Skin
- Constipation
- Goiter
- Prolonged Menses
- Slowed Thinking
- Decreased Free T4
- Increased TSH
Hashimoto's Thyroiditis
- Hypothyroidism with Bouts of Hyperthyroidism
- Enlarged, Nontender Thyroid
- Autoimmune
- Anti-Thyroid Peroxidase (TPO)
- Anti-Thyroglobulin
- Hurthle Cells
- Lymphoid Follicles
- HLA-DR5 and HLA-DR3
- Increased Risk Of Non-Hodgkin Lymphoma
Hypothyroidism Intervention
- Levothyroxine (Synthroid)
- Liothyronine (Cytomel)
- Myxedema Coma
- Lifelong Replacement Hormone
- Monitor Vital Signs
- Fluids and Fiber
- Low Calorie, Low Fat Diet
- Medication Education
- No Switching Brands
Levothyroxine (Synthroid)
- Synthetic T4
- Hypothyroidism
- Thyrotoxicosis
- Tremors
- Heat Intolerance
- Insomnia
- Tachycardia
- Do Not Use for Obesity
- TSH Monitoring
Hyperthyroidism Assessment
- Heat Intolerance
- Exophthalmos
- Warm, Moist Skin and Silky Hair
- Tremors
- Goiter
- Diarrhea
- Weight Loss
- Tachycardia
- Hypertension
- Amenorrhea
- Decreased TSH with Elevated Free T4
- Radioactive Iodine Uptake (RAIU)
Graves' Disease Characteristics
- Women 20-40 years old
- Anti-TSH Receptor Antibodies
- Ophthalmopathy
- Exophthalmos
- Hyperthyroidism
- Goiter
- Pretibial Myxedema
Graves' Disease Labs and Treatment
- Decreased TSH
- Increased T3
- Increased T4
- Radioactive Iodine Uptake (RAIU)
- Beta blocker
- Methimazole
- Radioiodine Ablation
Hyperthyroidism Interventions
- Propylthiouracil (PTU)
- Methimazole (Tapazole)
- Iodine
- Beta Blockers
- Radioiodine Ablation
- Thyroidectomy
- Thyrotoxicosis
- Post-Surgery Hypocalcemia
Propylthiouracil (PTU) and Methimazole (MMI)
- Hyperthyroidism
- Inhibits Thyroid Peroxidase
- PTU Blocks Peripheral Conversion of T4 to T3
- Agranulocytosis
- Skin Rash
- Hepatotoxicity (PTU)
- Teratogen (MMI)
Primary Hyperparathyroidism
- Hypercalcemia
- Kidney Stones
- Osteoporosis
- Arrhythmias
- Increased Calcium and Decreased Phosphorus
- Prevent Injury
- Medication Education
- Surgery
Hypocalcemia
- Muscle Spasms
- < 8.5 mg/dL Ca2+
- Decreased Bone Density
- Tetany
- Chvostek's Sign
- Trousseau's Sign
- Increased DTR
- ECG Changes
- QT Prolongation
- Oral and IV Replacement of Ca2+
- Seizure Precautions
Hypocalcemia Causes
- Hypoalbuminemia
- Hypomagnesemia (Less Common Hypermagnesemia)
- Hypovitaminosis D
- Hypoparathyroidism
- Medications
- Hyperphosphatemia
- Malnutrition
- Acute Pancreatitis
- Alkalosis
- Sepsis
- Chronic Kidney Disease
Hypoparathyroidism
- Hypocalcemia
- Lethargy
- Tetany
- Arrhythmias
- Decreased Calcium and Increased Phosphorus
- IV Calcium Chloride
- Rebreather Mask
- Lifelong Medications
- Oral Calcium Supplements with Vitamin D
Prednisone (Glucocorticoids)
- Glucocorticoid
- Inflammatory Conditions
- Organ Transplant Rejection
- Cataracts and Glaucoma
- Cushing's Syndrome
- Osteoporosis
- Immunosuppression
- Hyperglycemia
- Ulcers
- Adrenal Insufficiency
- Taper Gradually
Adrenal Gland (Advanced)
- Adrenal Cortex
- Zona Glomerulosa
- Aldosterone
- Zona Fasciculata
- Cortisol
- Zona Reticularis
- Androgens
- Adrenal Medulla
- Chromaffin Cells
- Epinephrine & Norepinephrine
Cushing's Syndrome Assessment
- Increased Cortisol Levels
- Truncal Obesity
- Purple Abdominal Striae
- Buffalo Hump
- Decreased Bone Density
- Moon Face
- Thinning Skin
- Hyperglycemia
- Hypertension
- Long Term Glucocorticoid Use
- Immunosuppression
Diabetes Assessment
- Juvenile Onset
- Absent Insulin Production
- Ketosis Prone
- Adult Onset
- Insulin Resistance
- Obesity
- Onset During Pregnancy
- Glucose Intolerance
- Retinopathy
- Peripheral Vascular Disease
- Nephropathy
- Neuropathy
Pancreas
- Acinar Cells Release Digestive Enzymes
- Ductal Epithelial Cells Release Bicarbonate
- Islets of Langerhans
- Beta Cells Release Insulin
- Alpha Cells Release Glucagon
- Delta Cells Release Somatostatin
- Somatostatin Inhibits Alpha and Beta Cells
Diabetes Education
- Self-Monitoring (Blood Glucose)
- SubQ Injection Technique
- Lifestyle Changes
- Symptoms of Hyperglycemia and Hypoglycemia
- Sick Day Care
- Foot Care
- Exercise Therapy
- Medication
Diabetes Interventions
- Early Diagnosis
- Insulin
- Oral Hypoglycemics
- Glucose Monitoring
- Routine Exercise
- Diabetic Diet
- Monitor for Complications
- Insulin Therapy
- Diabetic Ketoacidosis (DKA)
Insulin
- Rapid Acting
- Insulin Lispro (Humalog)
- Insulin Aspart (Novolog)
- Insulin Glulisine (Apidra)
- Short Acting
- Regular Insulin (Humulin R)
- Intermediate Acting
- Isophane NPH (Humulin N)
- Long Acting
- Detemir (Levemir)
- Glargine (Lantus)
Mixing NPH and Regular Insulin for Injection
- Verify Order
- Roll NPH Insulin
- Alcohol to Multiuse Vials
- Inject Air into NPH Insulin (Cloudy)
- Inject Air into Regular Insulin (Clear)
- Withdraw Regular Insulin Units
- Withdraw NPH Units
- Verify with 2nd Nurse
- Discard if Error
Hypoglycemia Assessment
- Too much insulin
- Decreased glucose
- < 70 mg/dL
- Change in LOC
- Lethargic
- Confusion and Irritability
- Tremors
- Diaphoresis
- Tachycardia
- Vision Changes
- Weakness
- Seizures
Dawn Phenomenon
- Increased Hormone Production
- Hyperglycemia Upon Awakening
- Long-Acting Evening Insulin
- Change Administration Times
- Insulin Pump
- Closely Monitor Glucose Levels
- Between 2-6AM
- Limit Carbohydrates Before Bedtime
Hypoglycemia Intervention
- Mild to Moderate Hypoglycemia
- Simple Carbohydrate (Oral Dextrose, Fruit Juice, Candies)
- Complex Carbohydrate (Whole Grains, Vegetables)
- Severe Hypoglycemia or Unconscious
- 50% Dextrose
- Glucagon
- Monitor Blood Glucose Q 10-15 Minutes
- Give Small Meal After Intervention
- Hypoglycemia Prevention
- Encourage Self-Monitoring
Glucagon (GlucaGen)
- Increases Glucose
- Hypoglycemic Emergency
- Nausea and Vomiting
- Reconstitute Powder
- Consume Oral Carbohydrates
- 50% Dextrose IV (If No Effect)
Needle Sizes and Uses
- Adjust Size Based on Height/Weight
- Subcutaneous Injections
- 3/8 or 5/8 inch
- Intramuscular (IM)
- 1-1.5 inches
Routes of Administration Part Two (Parenteral)
- Intradermal
- Subcutaneous
- Intramuscular (IM)
- Intravenous
- Epidural
- Intrathecal
- Intraosseous
- Intraperitoneal