Chapter 18 | Endocrine Disorders 451
2. What nursing interventions would be appropriate in caring for Mallory? 3. What patient educational topics are warranted for Mallory and her parents?
SAFE AND EFFECTIVE NURSING CARE: Promoting Safety
In 2017 and 2018, 19% of Americans ages 2 to 19 were obese according to the Centers for Disease Control and Prevention (2021). Not only does obesity put children at risk for diabe- tes, but it also increases the risk for heart disease, respiratory problems, joint problems, fatty liver disease, anxiety and de- pression, and low self-esteem (Centers for Disease Control and Prevention, 2021). Reducing the incidence of obesity can help reduce diabetes risk. Obesity is a complex issue that not only involves genetics and behavior but also community and socio- economic factors. Children should be referred to a dietitian to help teach the family and child to make healthy food choices. The goals are to slow weight gain and instill healthy eating habits that will transition to adulthood. Children and families should be encouraged to eat a diet of nutrient-dense foods and beverages that provide the needed vitamins and minerals while avoiding added sugars, saturated fat, and added sodium. It is important to consider cultural vari- ations in dietary preferences and allow children and families to make healthy dietary choices to meet their individual needs (U.S. Department of Agriculture and U.S. Department of Health and Human Services, 2020). Physical inactivity is another behavioral component of obesity. It is recommended that school-aged children and adolescents get at least 60 minutes of moderate activity three times a week. Unless there is a contraindication, children and adolescents should be encouraged to engage in aerobic, mus- cle strengthening, and bone strengthening activities (U.S. Department of Health and Human Services, 2018). Children should be encouraged to participate in recess or organized sports activities in and after school. Case Study Mallory S. is a 15-year-old who was diagnosed with hyperthy- roidism at age 13. Mallory’s hyperthyroidism has been con- trolled with antithyroid medications. However, she has been missing doses of her medication because of being “too busy and forgetting” to take her medication as prescribed. Over the last 2 weeks, she has had an increased appetite, increased per- spiration, and extreme fatigue and has become very irritable and restless. She tells her mother that she is having trouble concentrating in school. She begins to have severe diarrhea and tells her mother that she feels like her heart “is racing.” Mallory’s mother takes her to the emergency department, where she is diagnosed with thyroid storm and hospitalized. During the hospitalization, she is placed on a beta blocking agent. 1. As the nurse taking care of Mallory, what do you think caused the thyroid storm to develop?
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REFERENCES American Diabetes Association (n.d. a). Blood sugar testing and control: Hypo- glycemia . http://www.diabetes.org/living-with-diabetes/treatment-and-care/ blood-glucose-control/hypoglycemia-low-blood.html?loc=lwd-slabnav American Diabetes Association. (n.d. b). Blood sugar testing and control: Hyperglycemia (high blood glucose). https://www.diabetes.org/healthy-living/ medication-treatments/blood-glucose-testing-and-control/hyperglycemia American Diabetes Association (ADA). (2018). Glucagon training for stand- ards for school personnel: Providing emergency medical assistance to pupils with diabetes. https://diabetes.org/resources/know-your-rights/safe-at-school-state- laws/training-resources-school-staff/diabetes-care-tasks- American Diabetes Association. (2021). Standards of medical care in diabetes – 2021. Diabetes Care, 44 (Supplement 1). https://care.diabetesjournals.org/ content/44/Supplement_1 American Diabetes Association. (2021). Standards of Medical Care in Diabetes— 2021.,Diabetes Care, 44(Supplement 1). https://care.diabetesjournals.org/ content/44/Supplement_1 Benzo, S., & Hayes, C. (2019). Pituitary surgery: Nursing implications. In S. Llahana, C. Follin, C. Yedinak, & A. Grossman (Eds.), Advanced practice in endocrinology nursing (pp. 23). Springer. https://doi.org/10.1007/978-3- 319-99817-6 Bosch i Ara, L., Katugampola, H., & Dattani, M. T. (2021). Congenital hypopituitarism during the neonatal period: Epidemiology, pathogenesis, therapeutic options, and outcome. Frontiers in Pediatrics, 8, 1002–1019. https://www.frontiersin.org/articles/10.3389/fped.2020.600962/full Brashers, V., & Huether, S. (2020). Mechanisms of hormonal regulation. In S. Huether, K., McCance, & V. Brashers (Eds.), Understanding pathophysiology (7th ed., pp. 437). Elsevier. Brashers, V., & McCance, K. (2020). Adaptive immunity. In S. Huether, K., McCance, & V. Brashers (Eds.), Understanding pathophysiology (7th ed., pp. 157–158). Elsevier. Brillante, B., & Guthrie, L. (2019). McCune-Albright syndrome. In S. Llahana, C. Follin, C. Yedinak, & A. Grossman (Eds.), Advanced practice in endo- crinology nursing (pp. 207–228). Springer. https://doi.org/10.1007/978-3- 319-99817-6 Castellanos, L. (2021). Sodium, osmolality and antidiuretic hormone. In T. Stanley, & M. Misra (Eds.), Endocrine conditions in pediatrics (pp. 171–172). Springer. https://doi.org/10.1007/978-3-030-52215-5 Centers for Disease Control and Prevention. (2021) Causes of obesity. https:// www.cdc.gov/obesity/childhood/causes.html Chan, Y., & Levitsky, L. (2021). Evaluation of the infant with atypical genitalia (disorder of sex development) . UpToDate. https://www.uptodate.com/contents/ evaluation-of-the-infant-with-atypical-genital-appearance-difference-of-sex- development Donaldson, M., Gregory, W., Van Vliet, G., & Wolfsdorf, J. (2019). Practical endocrinology and diabetes in children. (4th ed., pp. 203–216). John Wiley & Sons Ltd. Elder, C., & Demitri, P. J. (2017). Diabetes insipidus and the use of desmopressin in hospitalized children. Archives of Disease in Childhood Education and Prac- tice Edition, 102 , 100–104. doi: 10.1136/archdischild-2016-31076
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