The nurse is preparing teaching materials for a family whose child is prescribed somatropin for a growth hormone deficiency. What should the nurse instruct the parents about the administration of this medication?
A home health nurse will be coming to administer the injection once a week.
Urine should be monitored for protein.
This medication must be given by injection.
This medication must be given in the morning before school.
The Correct Answer is C
A. Growth hormone therapy is typically administered daily, not weekly. Parents or caregivers are usually trained to give the injections at home, which encourages adherence and consistent growth hormone levels. Reliance on a home health nurse for weekly administration would be inadequate and inconsistent with standard therapy.
B. Routine urine monitoring is not a standard requirement for somatropin therapy. Monitoring is more focused on growth parameters (height, weight), blood glucose, thyroid function, and potential side effects like edema or joint pain. Proteinuria is not a common concern unless other renal complications exist.
C. Somatropin is a peptide hormone, which is degraded in the gastrointestinal tract if taken orally. Therefore, it must be administered via subcutaneous or sometimes intramuscular injection to ensure proper absorption and therapeutic effect. Parents should be taught proper injection technique, site rotation, needle disposal, and storage of the medication (usually refrigerated).
D. While growth hormone is naturally secreted in a pulsatile manner, and some clinicians may schedule injections in the evening to mimic normal secretion, there is no strict requirement for morning administration before school. Timing is flexible as long as injections are consistent daily, and some children may benefit from evening dosing.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Hyposecretion of somatotropin (growth hormone) results in growth retardation or short stature over time, but does not cause acute changes in urine output, sodium balance, or water retention. It is unrelated to the acute presentation described.
B. Hypersecretion of somatotropin leads to gigantism in children or acromegaly in adults. This condition affects growth and skeletal development, not fluid balance or electrolyte disturbances, so it does not explain the current findings.
C. Diabetes Insipidus (DI) involves hyposecretion or resistance to antidiuretic hormone (ADH), leading to polyuria, polydipsia, hypernatremia, and dehydration. The child’s decreased urine output and water retention are opposite of DI manifestations, so DI is inconsistent with this presentation.
D. Syndrome of inappropriate antidiuretic hormone (SIADH) involves excessive release of ADH, leading to water retention, decreased urine output (oliguria), dilutional hyponatremia, and signs of water intoxication. In the context of bacterial meningitis, SIADH is a recognized complication due to stress on the hypothalamic-pituitary axis or CNS irritation. The child’s nausea, headache, and hyponatremia fit the clinical pattern of SIADH, making it the most likely pituitary-related disorder in this scenario.
Correct Answer is A
Explanation
A. Hydration is essential because dehydration increases blood viscosity, promoting sickling of red blood cells and vaso-occlusion. Parents should be instructed to encourage regular fluid intake throughout the day, even when the child does not feel thirsty. Proper hydration helps prevent painful crises and reduces the risk of organ damage.
B. Children with SCA are at increased risk for infections due to functional asplenia. Immunizations are essential to prevent serious infections, such as pneumococcal and meningococcal disease. Avoiding vaccines would increase infection risk.
C. Physical activity should be encouraged but with caution. Children should avoid extreme exertion or high-altitude activities that could lead to hypoxia, dehydration, or fatigue, which can precipitate sickle-cell crises.
D. While mild symptomatic relief may be appropriate, children with SCA require prompt evaluation for infections, particularly fevers, because even minor infections can trigger complications. Self-treatment without medical guidance may delay critical interventions.
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