A child with growth hormone deficiency (hypopituitarism) is being started on growth hormone therapy. Nursing considerations should be based on knowledge of which of the following:
Replacement therapy may require daily subcutaneous injections
Lifelong replacement therapy will be required
Treatment is most successful if started during adolescence.
Treatment is considered successful if children attain full stature by adulthood
The Correct Answer is A
A. Replacement therapy may require daily subcutaneous injections.
Explanation: Growth hormone deficiency (hypopituitarism) often requires treatment with growth hormone therapy. One common method of administering growth hormone is through daily subcutaneous injections. Subcutaneous injections involve injecting the medication under the skin into the fatty tissue. This is a routine part of growth hormone therapy, and nursing considerations would include educating the child and their family about proper injection techniques, site rotation, and adherence to the treatment schedule.
Explanation for the other choices:
B. Lifelong replacement therapy will be required:
This statement is generally true. Growth hormone deficiency often requires long-term treatment, which may extend throughout childhood and adolescence. However, in some cases, the need for growth hormone therapy might change based on the individual's response to treatment and growth patterns.
C. Treatment is most successful if started during adolescence:
The optimal timing for starting growth hormone therapy can vary depending on the specific circumstances and the underlying cause of growth hormone deficiency. While treatment during adolescence can be effective, growth hormone therapy can also be successful if started earlier in childhood or later in adolescence. The key is identifying and treating the deficiency as soon as possible to promote healthy growth.
D. Treatment is considered successful if children attain full stature by adulthood:
While growth hormone therapy aims to support growth, achieving "full stature" might not always be possible. The goal of treatment is to help the child reach a more typical height based on their genetic potential and individual response to therapy. The success of treatment is determined by improvements in growth velocity and height, rather than necessarily achieving "full stature," which can vary greatly among individuals.
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Related Questions
Correct Answer is A
Explanation
Type 1 diabetes mellitus is a condition where the body's immune system mistakenly attacks and destroys the insulin-producing cells in the pancreas. Individuals with type 1 diabetes require insulin therapy to manage their blood sugar levels. Since the question is about teaching an adolescent with type 1 diabetes, let's analyze each option:
A) Obtain an influenza vaccine annually:
This is a crucial recommendation. People with diabetes, including type 1 diabetes, have a higher risk of complications from infections, including influenza (the flu). The flu can lead to elevated blood sugar levels and potentially worsen diabetes control. Getting an annual influenza vaccine helps reduce the risk of getting the flu and its associated complications.
B) Take glyburide with breakfast:
Glyburide is a medication used to treat type 2 diabetes, not type 1 diabetes. It stimulates the pancreas to produce more insulin. Type 1 diabetes is characterized by a lack of insulin production, so taking glyburide would not be appropriate.
C) Administer glucagon for hyperglycemia:
Glucagon is a hormone used to raise blood sugar levels, typically in cases of severe hypoglycemia (low blood sugar). It is not used to treat hyperglycemia (high blood sugar) in type 1 diabetes. Instead, insulin administration is the primary method for managing high blood sugar levels.
D) Inject insulin in the deltoid muscle:
Insulin injections for individuals with type 1 diabetes are typically given in the subcutaneous fat, which is found just beneath the skin. The deltoid muscle is not a recommended site for insulin injections due to inconsistent absorption. The abdomen, thighs, and buttocks are commonly recommended injection sites.
Correct Answer is D
Explanation
A) Absence of proteinuria:
Chronic glomerulonephritis often involves damage to the glomeruli in the kidneys, which can lead to the leakage of protein into the urine, resulting in proteinuria. The absence of proteinuria would be an unexpected finding in a patient with chronic glomerulonephritis. Therefore, this choice is incorrect.
B) Serum phosphorus 4.0 mg/dL (within expected reference range):
Serum phosphorus levels within the expected reference range are not directly related to chronic glomerulonephritis. While abnormalities in electrolyte levels might occur due to kidney dysfunction, serum phosphorus within the normal range is not a hallmark finding of glomerulonephritis. Therefore, this choice is incorrect.
C) Serum potassium 3.8 mEq/L (within the expected reference range):
Similar to serum phosphorus, serum potassium levels within the normal range are not specific to chronic glomerulonephritis. Kidney dysfunction can indeed affect electrolyte levels, but a serum potassium level within the normal range doesn't provide specific information about glomerulonephritis. Therefore, this choice is incorrect.
D) BUN 50 mg/dL (elevated):
Blood Urea Nitrogen (BUN) is a waste product that is filtered by the kidneys. Elevated BUN levels indicate impaired kidney function, as the kidneys are less efficient at filtering and excreting waste products. Chronic glomerulonephritis can lead to progressive kidney damage, which can result in elevated BUN levels due to decreased filtration and clearance. Therefore, an elevated BUN level is an expected finding in a patient with chronic glomerulonephritis.
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