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NSG 502 Final Questions with Detailed
Verified Answers (100% Correct Answers)
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Define Growth Hormone Deficiency
Ans: - inadequate production or secretion of GH
What does inadequate production or secretion of GH cause?
Ans: - poor growth
- short stature
Growth Hormone Deficiency Etiology (3)
Ans: Associated with underlying cause
- hypopituitarism
- brain tumor
- cranial irradiation
7 Growth Hormone Deficiency Manifestations
Ans: 1. Short height
2. Growth rate less than 2 SD from mean for age
3. Immature face
4. Delayed puberty
5. Hypoglycemia
6. Diminished Muscle mass
7. Deficiencies in other hormones
3 Growth Hormone Deficiency Diagnostic Studies Components
Ans: - Serial growth measurements using consistent equipment
- bone age evaluation
- complete metabolic lab analysis
What indicates GH deficiency?
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Ans: 2 positive GH levels
GH Deficiency Therapeutic Management
Ans: Biosynthetic replacement GH
- SQ injection: usually specialty pen
- Best administered at bedtime
When does Precocious Puberty occur in females & males?
Ans: Females: puberty before the age of 8
Males: puberty before the age of 9
Precocious Puberty in Caucasian & African American girls
Ans: Caucasian: under 7
African American: under 6
5 Precocious Puberty Etiology
Ans: - more frequent in females
-idiopathic
- CNS lesions or trauma
- adrenal, ovarian, testicular tumors
- Partial effects with some meds
4 Precocious Puberty Manifestations
Ans: 1. Secondary sexual characteristics before the age of 7 or 8 depending on gender &
race
2. Rapid bone growth
3. Early growth plate fusion: short stature
4. Psychological effects
Precocious puberty therapeutic management
Ans: Administration of GbRH agonist (Lupron) injection
- every 4 to 12 weeks
2 Precocious Puberty Therapeutic Management Goals
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Ans: 1. Stop the development of secondary sexual characteristics
2. Maximize adult height (may require GH)
3 Precocious Puberty Nursing Considerations
Ans: 1. Medication education
2. Psychosocial interventions
- mental age vs. age of appearance
- Dress, peer relationship education
3 Neonates & Infants Congenital Hypothyroidism Etiology
Ans: Live births secondary to:
1. thyroid dysgenesis
- absent, underdeveloped, ectopic thyroid gland
- idiopathic
2. biochemical defects in thyroid hormone production
3. hypothalamic-pituitary hypothyroidism
2 Infant Transient Hypothyroidism Etiology
Ans: - Maternal intake of medications such as propylthiouracil (PTU)
- Transfer of maternal antibodies
8 Neonates & Infants: Congenital Hypothyroidism Manifestations
Ans: 1. Skin mottling/coldness to touch
2. Large fontanel
3. Large tongue
4. Hypotonia
5. Slow reflexes
6. Prolonged jaundice
7. Hoarse cry
8. Excessive sleeping
Congenital Hypothyroidism Therapeutic Mangement
Ans: 1. Routine Screening mandatory in all 50 states
2. Lifelong thyroid hormone replacement: levothyroxine
3. Close follow up to adjust for growth
4. Developmental screening
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2 Congenital Hypothyroidism Nursing Considerations
Ans: 1. Detailed medication education
- dose titrated to maintain TSH in normal rage & T4 in the upper half of the normal range
2. Parental education/support
Who has Acquired Hypothyroidism?
Ans: - children
- commonly adolescents
- adults
Acquired Hypothyroidism Pathophysiology
Ans: circulating autoantibodies bind at pituitary TSH receptor sites resulting in decreased
thyroid hormone production
- common cause: hashimoto's thyroiditis
Who is hypothyroidism more common in?
Ans: women > men
10 Acquired Hypothyroidism Manifestations
Ans: 1. Goiter
2. Dry, thick skin
3. Coarse, dull hair
4. Fatigue
5. Cold intolerance
6. Constipation
7. Weight gain
8. Edema of face, eyes & hands
9. Delayed or irregular menses
10. Confusion, lethargy, depression (older adults)
How is primary hypothyroidism diagnosed?
Ans: - elevated TSH
- low T4
How is thyroiditis diagnosed?