Study Guide Peds Exam 4

8/15/2019 Study Guide Peds Exam 4

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Chapter 15 : have powerpointKey Points from book :

● Middle childhood aka “the school years” a period of life that extends from 6-12years of age

● ltho!gh growth is slower than in previo!s years" there is a steady gain in height

and weight" with mat!ration of #ody systems$#etween the ages of 6 and 12 years"children grow 2 inches per year$ primary teeth are lost and replaced #y permanent teeth

● ma%or task d!ring the middle years is developing a sense of ind!stry oraccomplishment& '(rikson)

● *iaget+s period of concrete operations refers to the school age period whenchildren are a#le to !se their tho!ght processes to experience events and actions andmake %!dgements #ased on reasoning&

● *iaget+s period of concrete operations" children have the a#ility to gro!p and sortand make concept!al decisions

● ,he child develops a conscience and is a#le to !nderstand and adhere to r!lesand standards set #y others

● (ntertaining different points of view" #ecoming sensitive to social norms" andforming peer friendships are important feat!res of social development d!ring the schoolyears

● ooperative play" team activities" and the ac.!isition of skills are prime elementsof play d!ring the school years$ r!les and rit!als ass!me greater importance

● *arental concerns d!ring middle childhood incl!de lying" cheating" stealing andschool achievement& /ying is often a res!lt of not meeting peer expectations set !p #yothers to which they have #een !na#le to meas!re !p&

● *eer-gro!p identification is an important factor in gaining independence fromparents

● ,easing in this age gro!p is common and can have long-lasting effects● 0tress in the school age child may present as stomach pains" " sleep

pro#lems" #ed-wetting" changes in eating ha#its" st!##ornness or aggression" rel!ctanceto participate or regression to earlier #ehaviors&

● ,he availa#ility of %!nk foods" irreg!lar family meals" and sched!les of workingparents often interfere with optimal n!trition

● ental care is important d!ring this time$ potential dental pro#lems incl!decaries" periodontal disease" maloccl!sion" and dental in%!ry& 3 /(4 wants !s to p!tchild+s knocked o!t tooth in cold milk or saliva&

● 5ncreased sociali ation and media expos!re make the school years an ideal timefor sex ed!cation& 0ex sho!ld #e treated as a normal part of growth and development

● *!#erty signals the #eginning of the development of secondary sexcharacteristics& *!#erty !s!ally #egins 2 years earlier in girls than in #oys

● 0chool health programs ideally incl!de health appraisal" emergency care" safetyed!cation" comm!nica#le disease control" co!nseling" g!idance" and health ed!cationwith ad%!stment to individ!al st!dent needs

● in%!ry prevention is directed toward safety ed!cation" provision of safe play areasand e.!ipment" and well-s!pervised sport activities&


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Chapter 17: have powerpoint" paige presented and said to %!st read the #ook chapters andcross reference their notes&Key Points from book:

● lterations in growth and mat!ration may #e manifested as short or tall stat!re"precocio!s p!#erty" or delayed sex!al development

● ,he most fre.!ent health pro#lems related to the female reprod!ctive systeminvolve menstr!al dysf!nction& ,reatment is with 30 5 0● ealth pro#lems related to sex!ality incl!de pregnancy" sex!al assa!lt" and

0,5+s$ prevention incl!des sex ed!cation and contraceptive co!nseling● (ating disorders o#served in middle and late childhood incl!de o#esity" 3 and

73● /actose intolerance is a developmental disorder in which there is red!ced lactase

activity in the intestine" which ca!ses #loating" a#d& distention" and flat!lence shortlyafter the ingestion of lactose& Most persons with lactose mala#sorption are a#le tocons!me approx& 1 milk8day witho!t having these s8s

● 7ehavior pro#lems in middle childhood can res!lt from " en!resis"

encopresis" school pho#ia" childhood depression" conversion reaction" and childhoodschi ophrenia● 0igns of depression in children and adolescents are often s!#tle and re.!ire

ast!te o#servation #y parents and health professionals● ,he s!#stances a#!sed #y children and adolescents incl!de alcohol" mari%!ana"

narcotics" opioids" 30 depressants or stim!lants" inhalants" and mind-altering dr!gs● ,o#acco smoking is a significant pro#lem among teenagers$ reasons for smoking

inc&: social press!res" mass media" a need to develop a self-concept" cigarettes areconsidered a gateway dr!g& 0mokeless to#acco is considered to #e a s!#stit!te forcigarettes #!t pose serio!s health ha ards and is associated with cancer of the mo!thand %aw&

● 0!icide" the deli#erate act of self-in%!ry with intent to kill" is often associated withdepression" s!#stance a#!se" diffic!lties in coping with stress" an affective disorder" or adist!r#ed family environment& 0ocial isolation is a ma%or factor in determining who maykill themselves&

Chapter 185& *erspectives in the are of hildren with 0pecial 3eeds

& 0cope of the *ro#lem● drive to define the children with special needs sit!ation so federal

and state programs can plan more comprehensive sol!tions● decrease in mortality has led to an increase in special needs

children and ad!lts● most common: respiratory diseases" impairments in speech andsensory f!nction" and mental and nervo!s system disorders

55& ,rends in are & evelopmental 9oc!s

● foc!sing on developmental stages vers!schronological aging

● emphasis on the child vers!s their disa#ility7& 9amily evelopment


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● evelopment of the family along with the individ!alis emphasi ed

children with chronic illness canca!se developmental str!ggles within the family" especiallynewlyweds

& 9amily- entered are● n emphasis on getting the family involved 'p!#licpolicy extended age to ; years)

● the health care system for the child needs to #eintegrated with family care

& 3ormali ation● Normalization: esta#lishing a normal pattern of

living(x: daily ro!tine" enco!ragement of

participating in age appropriate activities(& ome are

●


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● emphasis on lang!age and locomotor skills 'thechild needs to learn to walk and talk to #ecome a!tonomo!s

& *reschooler ● start to feel g!ilty" like they ca!sed the illness● initiative: development of social relationships"

learning a#o!t the environment" and developing a sense of p!rpose andself-confidence

& 0chool- ged hild● prepare the class they+re going into for the details

of the child+s disa#ility● more kids with disa#ilities are going #ack to the

classroom than #efore● art" m!sic" poetry" and drama" especially help kids

with disa#ilities(& dolescent

● *@AMA,( 53 (*(3 (3 ( 7B (3 AC@ A/>(M(3, 53 , (5@ ,@( ,M(3,

>& elping the hild ope & oping Mechanisms 'there+s a ta#le" 22-2 in mine so pro#a#ly 1?-

2 on yo!rs)1& 3ormali ation

● foc!s on developing the adolescentsself image" normali e his8her life as m!ch as possi#le

● as a n!rse: acknowledge strengthsand weaknesses of #oth the child and the family !nit

2& opef!lness● #asically worthless section"

enco!rage hopef!lness as a n!rse

=& ealth (d!cation and 0elf- are● teach the child a#o!t changes in the#ody" especially with an illness" and how that affects the #ody 'likein p!#erty)

● ed!cate them on different riskfactors 'especially girls who have menstr!ated and can getpregnant

D& @ealistic 9!t!re 5& ssessing 9amily 0trengths and d%!stment● contin!o!s assessment is important" eval!ate how well the family

is coping and ad%!sting>55& ccepting the hild+s ondition and @eceiving 0!pport at the ,ime of theiagnosis

● manage parents emotional reactions to thediagnosis with acceptance

● 7( 3A3EC


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● maintain privacy and help set !p a plan of care>555& Managing the ondition on an Angoing 7asis

● model appropriate interventions with the children● foc!s on the strengths the child has along with

contin!ing ed!cation on how to take care of their child & 0pecial 5nformation 3eeds

technical information 'how to minister in%ections" how to deal with different medications" how tomanage side effects)

● info on how the condition interferes with /s● @ 0 9(,B● #eing a#le to comm!nicate how to deal with the

child+s condition in the event of an emergency7& 9amily Management 0tyles

● ,hriving F ccommodating- perceive their conditionas “normal”" they feel they can manage their child+s illness"'accommodating only differ as having a slightly more negative view oftheir child+s condition

● (nd!ring- feel their illness is more of a #!rden"foc!sing on the long term conse.!ences and effects on their life" theydescri#e illness management as a #!rden

54& Meeting the hild+s 3ormal evelopmental 3eeds)● emphasi e a#ilities" deemphasi e limitations● foc!s on knowledge of the condition 'child and

si#lings)● effort towards re integrating and normali ing

'especially more in the school setting)4& Meeting evelopmental 3eeds of Ather 9amily Mem#ers

& *arents

1& @oles ● (mphasis of teaching onome care with the

#!rden ass!med primarily #y one parent" the financial#!rden" fear of the child+s dying" press!re from relatives"the hereditary nat!re of the illness" fear of pregnancy

2& Mother 9ather ifferences● recogni e and s!pport differences in

coping #ehaviors=& 9atherGs

● father+s have different challengesthan mothers with the need to strengthen care-taking a#ilities

● have more diffic!lty with sons withchronic illness than da!ghters

● change in time and sched!ling● feelings of g!ilt and fail!re

D& 0ingle-*arent 9amilies● special efforts need to #e taken to

help them gain more s!pport from other o!tlets;& 9oster or doptive 9amilies


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● s!pport may promote long termplacement for kids

7& 0i#lings● ed!cate si#lings to their

developmental and intelligence level" especially with adolescents

'access to the internet) ● prepare si#lings for the physicalchanges of their #rother8sister

● si#lings 'older females or yo!ngermales) may act o!t

● ed!cate them on “catching” theillness" and help deal with their emotions of !n#alanced allocationof time and money to the sick child

& (xtended 9amily Mem#ers and 9riends● grandparents are a primary so!rce of help with

care" foc!s on ed!cating them● grandparents can go thro!gh stages of grief ● parents need to decide how m!ch to tell and who to

tell a#o!t their child+s illness● !se reso!rces like friends or family" #e aware that

some might feel worried a#o!t #efriending a child with a chronic illness'he8she might die" he8she might #e contagio!s)

45& oping with Angoing 0tress and *eriodic rises & onc!rrent 0tresses Hithin the 9amily

● financial stressors are the primary stressors7& oping Mechanisms

● "pproa#h $eha!iors: coping mechanismsres!lting in movement toward ad%!stment and resol!tion of the crisis

● "!oi%an#e $eha!iors: maladaptation of the crisis● 1st long term coping strategy- finding meaningwithin an existing medical- scientific #elief

● 2nd- learn to share #!rdens in the family networkand o!tside of the family network

& *arental (mpowerment● Empo&erment: can #e viewed as a personal

process thro!gh which individ!als develop and !se the necessaryknowledge" confidence" and competence to make there voices heard

455& ssisting 9amily Mem#ers in Managing ,heir 9eelings & 0hock and enial

● manifestations incl!de: 1& physician shopping" 2&attri#!ting symptoms of the act!al illness to a minor condition" =& ref!singto #elieve diagnosis" D& delayed in agreement to treat" ;& acting happyand optimistic despite diagnosis" 6& ref!sing to talk a#o!t it" I& insistingthat no one is telling the tr!th" ?& denying the reason for hospitaladmission" J& asking no .!estions

● denial can #e protective for the child to developnormally 'as normally as possi#le) for as long as possi#le


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● can #ecome maladaptive when it impedesrecognition of treatment

7& d%!stment● open admissionK first sign of ad%!stment● anger and #itterness" feelings of !nfairness" watch

for si#lings passive anger & @eintegration and cknowledgement

● esta#lishment of new goals and reintegration intosocial sit!ations

4555& (sta#lishing a 0!pport 0ystem & 5ntrafamilial @eso!rces

● marital relationship represents primary s!pport● cohesion" adapta#ility" sense of coherence" and

hardiness are key7& 0ocial 0!pport 0ystems

● 00(00 ,B*( A9 0C**A@, 3(( ( 7(9A@(( 5 53< A3 53,(@>(3,5A30

& *arent-to-*arent 0!pport● parent-parent self help gro!ps are extremely helpf!lso people can see they+re not alone and get other help

& *arent- *rofessional *artnerships● working with n!rses and doctors to develop a list of

explicit and implicit responsi#ilities(& omm!nity @eso!rces

● local and national disease oriented organi ationscan help

Chapter 1'( 5mpact of cognitive or sensory impairment on the child and family● 3!rsing care

ed!cate child and familyteach child self-care skillspromote child+s optimal development and self

esteemenco!rage play and exerciseprovide means of comm!nicationesta#lish disciplineenco!rage sociali ationprovide information on sex!alityhelp family ad%!st to f!t!re carecare for child d!ring hospitali ationn!rses need to #e a#le to assist in meas!res to

prevent 5 'cognitive impairment)-(volve says ,he child with 5 needs to#e referred for stim!lation and ed!cational programs as yo!ng aspossi#le& (vidence exists that early intervention programs for childrenwith disa#ilities are val!a#le for cognitively impaired children&

● 0 - !tism 0pectr!m isorders 'review from *sych8M )do not conf!se a!tism spectr!m disorder ' 0 )

with atrial septal defect ' 0 )


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complex ne!rodevelopmental disorders of !nknownetiology

/ang!age 'in social comm!nication)" imaginativeplay and social interaction may show delay #efore = years of age in orderfor diagnosis to #e made&

#ehavioral patterns that are repetitive" restricted"and stereotype are commonly seenimpairments range from mild to severe


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L f!nctional-no lesion occ!rs" oftenseen in conversion hysteria '!nconscio!s a#ility to t!ne someoneo!t d!ring tra!matic event)" infantile a!tism" and childhoodschi ophrenia&

eci#el 'd7) is the !nit of lo!dness meas!red on

a scale #eginning with 'the softest so!nd the normal ear can hear) !p to2 &/ip reading" c!ed speech" sign lang!age and other

methods of comm!nication are helpf!l to the child with hearing pro#lems&with lip reading" speak at an even rate" do not !se a s!rgical mask with apatient who lip readsNNN make s!re there is an interpreter present for thosewho sign& c!ed speech is an ad%!nct to lip reading and !ses hand signalswhen words that look alike are !sed& 'Alive %!ice" 5 /ove Bo!)

5mm!ni ations are important when preventingac.!ired hearing loss via !nimm!ni ed children exposed to MM@&

● ownGs 0yndrome- most common chromosomal a#normality&

trisomy 21-extra chromosome on chromosome 21"common for children to have congenital heart disease s!ch as septaldefects of the heart" respiratory tract infections'!se cool mist vapori er for moist!re)" thyroid dysf!nction" increased incidences of le!kemia"hypotonic m!sc!lat!re&

OOhave child checked for atlantoaxial insta#ility#efore participating in sportsNNNNN 4 ray is done&

,hese children sho!ld have peer experiencessimilar to those of other children" s!ch as gro!p o!tings" iscovery l!#"

!# 0co!ts" and 0pecial Alympics&good prognosis-may live 6 years or longer with

owns&● 9ragile- 4 syndromemost common inherited ca!se of 5 or intellect!al

disa#ility*revalence: 1 in 2 to ; #irths

linical ManifestationsL long face with a prominent %aw" large

protr!ding ears" large testesL developmental delay and lang!age

delay are commonL a!tism like #ehavior L in carrier females" clinical

manifestations are minor" mostly anxiety" withdrawal" anddepression

,herape!tic ManagementL no c!reL !se of serotonin agents ' tegretol"

*ro ac to control violent tempersL 30 stim!lants to improve attention

span


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L Medical ,reatment: m!sc!loskeletalconcerns" mitral valve prolapse" rec!rrent AM" and sei !res

L speech and lang!age therapy*rognosis

L expected to live a normal life span3!rsing are Management

L


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55& 5ntracranial *ress!re & early signs

1& headache" vomiting" personality changes" irrita#ilityand fatig!e

2& older children: headache" na!sea and vomiting=& sei !res may occ!r

7& ssessment1& Hatch for elimination or reappearance of reflexes2& history is very important 'animal enco!nters" fevers"

past illness" ingestion of harmf!l s!#stances& *hysical (xam

1& si e and shape of head2& spontaneo!s activity and post!ral reflexes=& Alder children: !se same methods as ad!ltsD& A C/ @ MA>(M(3,0" *C*5// @B

@(0*A30(0" 9 5 / MA>(M(3,0" and MAC, 9C3 ,5A30555& ltered 0tates of onscio!sness

& "ltere% +tates of Cons#io-sness: !s!ally refers to varyingstates of !nconscio!sness that may #e momentary or may last for ho!rs" days"or indefinitely

7& (tiology1& direct or indirect ca!se

a) direct: encephalitis" indirect:hypoglycemia

& /evel of onscio!sness1& earliest indicator of improvement or deterioration

& oma ssessment1& 4lasgo& Coma +#ale: 'eye opening" ver#al

response" motor response)

a) pediatric version recogni esdevelopmental expectations of the child

#) n!meric val!es of 1-; are assignedto the levels of response in each category& the s!m of these threen!meric val!es provide an o#%ective meas!re of the patientGs /A &a person with an !naltered /A wo!ld score the highest" 1;& thechild who opens eyes spontaneo!sly" o#eys commands" and isoriented is scored at a 1;&

2& 5rreversi#le coma- 7rain death is the total cessationof #rainstem and cortical #rain f!nction that res!lts from any conditionthat ca!ses irreversi#le widespread #rain in%!ry

5>& 3e!rologic (xamination & >ital signs

1& elevated #ody temp" p!lse is varia#le" 7* co!ld #enormal" elevated" or low 'increase is !ncommon in children)" respirationsare slow deep and irreg!lar

7& 0kin1& examine for in%!ry" needle marks" #ites" petechia"

evidence of toxic s!#stances


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& (yes1& p!pil si e and reactivity" '*inpoint p!pils in

poisoning" widely dilated and fixed s!ggest paralysis of 3555'=))2& Cnilateral fixed s!ggest same side lesion=& #ilateral fixed imply #rainstem damageD& dilated nonreactive: ypothermia" anoxia" ischemia"

poisoning with atropine like s!#stances;& @(>5(H A//G0 (B(0 @(9/(4: eyes move in

opposite direction of head 'a#sence s!ggests 3 555)& Motor 9!nction

1& watching the kid walk will help provide cl!es to thelocation and extent of cere#ral dysf!nction&

2& asymmetric movements of the lim#s or a#sence ofof movements s!ggest paralysis

(& *ost!ring1& 9lexion- ecorticate-severe dysf!nction of cere#ral

cortex or lesions a#ove the #rainstem

2& (xtension- ecere#rate-dysf!nction at level ofmid#rain or lesions to #rain stem&

9& @eflexes1& three key reflexes that demonstrate ne!ro health in

yo!ng infants are the Moro" tonic neck and withdrawal reflexes&>& ead 5n%!ry

& (tiology1& falls" motor vehicle in%!ries" and #icycle in%!ries2& #oys 2x as often as girls=& highest rate of mortalityD& physical characteristics '#eing placed on a high

chair" large head si e of infants" etc&)7& *athophysiology

1& acceleration-deceleration ca!ses the most #raindamage 'a head striking a stationary s!rface)

2& inade.!ate perf!sion when 5 * exceeds arterialpress!re

=& shearing forces are ca!sed #y !ne.!al movement"tearing small arteries

D& Mild: < 0 of 1=-1;" Moderate: < 0 J-12" 0evere:< 0 of ? or less

50 Con#-ssion: alteration of mental stat!s with orwitho!t loss of conscio!sness

a hallmark symptoms #onf-sionan% amnesia

6& ont!sion and /acerationa) #r!ising and tearing of cere#ral

tiss!e'1) most commonly in

occipital" frontal and temporal lo#es


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'2) 0 P(3 7 7B0B3 @AM( 3 B5(/ 53,@ @ 35 /0C7 @ 3A5 A@ 0C7 C@ / (MA@@


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>55& ,herape!tic Management & ma%ority if no loss of conscio!sness can #e o#served at home

1& warning a#o!t s8s of worsening: headachesvomiting" change in mental stat!s or #ehavior" !nsteady gait" or sei !res

2& #ring in child after 1 or 2 days=& monitor 5> fl!ids very closelyD& sedating dr!gs !s!ally withheld in ac!te phase

'give tylenol for headache)7& 0!rgical ,herapy

1& sk!ll fract!re depressed more than the thickness ofthe sk!ll or an intracranial hematoma that ca!ses more than ; mmmidline shift is indicated for s!rgery

& *rognosis1& dependent on the extent of the in%!ry and

complications2& generally more favora#le than ad!lts=& more than J Q recover witho!t symptoms

D& oncerns: cognitive" emotional" or mental pro#lems;& ,r!e coma does not !s!ally last more than 2 weeks'if coma happens" o!tcomes have a wide range)

& 3!rsing are Management1& A3,53C / 00(00M(3, '.1;) MA0,

5M*A@, 3,: /A(& 9amily 0!pport

1& ed!cational and emotional s!pport" #e honest9& @eha#ilitation

1& as soon as possi#le2& take care of the whole child: emotional" physical"

cognitive" and social=& *," A," n!trition" speech" special ed" psychiatry"

medical doctors" etc on the team for reha#ilitation555& 0!#mersion 5n%!ry & Ma%or ca!se of in%!ry 1-1D years of age" type of child a#!se7& *athophysiology

1& *C/MA3 @B" @ 5 " and 3(C@A/A


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=& watch for aspiration pne!monia and otherrespiratory complications 'atelectasis" @ 0" #ronchospasm)

(& 3!rsing are Management1& Maintain airway2& enco!rage and reass!re parents=& help parents or caretakers deal with their g!ilt

9& *revention1& 0C*(@>505A32& 9amiliarity with *@

54& 5ntracranial infections & 7acterial Meningitis

1& P3AH , ( > 53(0 9@AM , ( **,2& 0& pne!moniae is the most common ca!se

#etween = mos and 1 years of age=& ( @53< 5M* 5@M(3, 50 , ( MA0, AMMA3

0(RC (/7& *revention

1& vaccines& 3!rsing are

1& proper preca!tions 'isolation droplet)2& side-lying position" pain management=& acetaminophen with codeine is one of the most

commonly !sedD& 0trict 5+s and A+s" clear li.!ids and then progress;& 9amily s!pport- help parents deal with the s!dden

onset and condition of their child& 3on#acterial 'aseptic) meningitis)

1& Manifestations: headaches" fever" malaise" and 5@ / 539432& 040

a) fever" prof!se vomiting" ne!roimpairment" disordered hepatic fxn&

#) >A5 0 'salicylates) for a feverwith viral illness&

'1) liver sh!ts down anddoesn+t filter toxins" hepatic encephalopathy" and cere#raledema may occ!r

9& 0ei !re isorders1& most common ne!ro dysf!nction in children 'more

than half are fe#rile sei !res)2& 0BM*,AM A9 C3 (@/B53< 50( 0(

*@A (00NNNa) ne!rologic" meta#olic" ingestion"

tra!matic" infectio!s=& 0x0


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a) change in /A " invol!ntarymovements" post!ring" changes in perception" #ehaviors" orsensations

D& classification8clinical manifestationsa) partial#) generali edc) !nclassified

;& iagnosis of sei !resa) m!st differentiate epilepsy from

other #rief alterations in conscio!sness or #ehavior #) 4c) description 'can i get a witnessN) of

event'1) d!ration" progression"

postictal #ehavior d) physical exam" la# val!es" ((


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'c) whenthey are going thro!gh p!#erty

'd) thereis there possi#ility of rec!rrent sei !res after firstyear of d8c meds&- %!st fyiT&

c) P(,A


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a) >* sh!nt-prevent infxn" can getclogged w8protein" kid can o!tgrow-Uneed for #igger sh!nt later inlife&

#) n!rse care want to meas!re headcirc!mference daily

;& .!estion: a neonate is #ro!ght to the ( #y hismom& yo! s!spect hydrocephal!s" which o#servation wo!ld indicate thisconditionS

a) #!lging fontanel" eyes rotateddownward “0!nset eyes”

Chapter /'( he Chil% &ith En%o#rine ysf-n#tion● the endocrine system has three components: the cells"" which send chemical

message via hormones$ target cells" which receive the message$ and the environmentthro!gh which the chemical is transported from the site of synthesis to the sites ofcell!lar action&

● pit!itary dysf!nction is manifested primarily #y growth dist!r#ance&● ,he main physiologic action of , is to reg!late the #asal meta#olic rate andcontrol the processes of growth and tiss!e differentiation

● isorders of thyroid fxn incl!de hypothyroidism" a!toimm!ne thyroiditis" goiter"and hyperthyroidism&

● ,herapy for hyperthyroidism is directed at retarding the rate of hormone secretionand may incl!de dr!g therapy" thyroidectomy" or radioiodine therapy&

● lassic forms of hypoparathyroidism is childhood are idiopathic 'deficientprod!ction of *,C) and pse!dohypoparathyroidism 'increased *, prod!ction with end-organ !nresponsiveness to *, )

● ,he adrenal cortex secretes three important gro!ps of hormones:

gl!cocorticoids" mineralocorticoids" and sex steroids● isorders of adrenal fnx incl!de ac!te adrenocortical ins!fficiency" chronicadrenocortical ins!fficiency" !shingGs syndrome" and ' ongenital drenalhyperplasia- 0ymptoms in infants may incl!de am#ig!o!s genitalia in girls and anenlarged penis in #oys)&

● 9ive categories of !shing+s syndrome are pit!itary" adrenal" ectopic" iatrogenicand food dependent 'she didn+t go over these #!t they are in the #ook)

● Management of incl!des assignment of a sex according to genotype$ adminof cortisone and possi#ly" reconstr!ctive s!rgery&

● M-we know diet" exercise" ins!lin therapy" 70 checks" promoting healthylifestyle" ed!cating for sxs of hypoglycemia8hyperglycemia&

( %on2t kno& &hy it is formatting this &ay b-t hopef-lly yo- g-ys #an see &hat &rote0 #an e(mail it to yo- if yo- &ant0


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Study Guide Peds Exam 4