Assignment Prompt & Instructions
APA format
minimum 1 paragraph for reply
Use evidence based practice
Total of 2
Due in 7 hours
– 2 years ago
**files (1)**
– ## week5pedsstudentreply.docx
**## week5pedsstudentreply.docx**
Jennifer
Case Scenario 4
**S: Subjective**
Patient: 9-year-old female
c/c: Well-child exam
HPI – Mother reports that the patient was diagnosed with hypothyroidism last month but has not filled the prescription for levothyroxine. She is seeking to explore alternative treatment options and would like to discuss these with the provider. The patient has no current symptoms but the mother is concerned about long-term medication use.
**O: Objective**
All VSS stable, child in no acute distress without visible goiter or mass. New diagnosis of hypothyroidism last month based on laboratory results. TSH elevated, Free T4 low. Newly diagnosed hypothyroidism. The patient has not started the prescribed levothyroxine medication. The most recent lab results support this diagnosis.
**Well-Child Exam** – The patient is here for a routine well-child exam. No acute health concerns.
1.
**Discussing Levothyroxine Medication:**
· Explain to the mother that levothyroxine is the standard treatment for hypothyroidism and is essential for normal growth, development, and metabolic function in children.
· Discuss the potential consequences of untreated hypothyroidism, such as developmental delays, growth issues, fatigue, and cognitive impairment.
· Reassure her that the medication is safe when properly dosed and monitored and emphasize that it can help the child lead a normal, healthy life.
· Offer to answer any questions or concerns the mother may have about the medication.
2.
**Approach to Complementary Therapy:**
· Acknowledge the mother’s interest in exploring complementary therapy and suggest a collaborative approach.
· Explain that while lifestyle changes can support overall well-being, there is currently no strong scientific evidence to support the use of alternative treatments such as herbs, supplements, or acupuncture as a replacement for thyroid hormone therapy in the treatment of hypothyroidism.
· Highlight the importance of consistent medication adherence to ensure the thyroid hormone levels remain in the therapeutic range, which is critical for the child’s growth and cognitive development (Maaks et al., 2019)
· Suggest that any complementary therapies should be discussed with the medical team to ensure they do not interfere with the prescribed treatment. As many therapies have unwanted therapeutic or disruptive effects on medications, such as horseradish or kelp and effects of iodine (Maaks et al, 2019.)
3.
**Evidence on Complementary Therapy:**
· Provide the mother with evidence-based information about complementary therapies for chronic diseases.
· Encourage open communication with the healthcare team if the mother wishes to explore complementary options, ensuring the patient’s thyroid function is adequately managed including and referred endocrinology pediatric specialist.
4.
**Follow-up:**
· Schedule a follow-up appointment in 6 weeks to reassess thyroid function and monitor for any side effects of the medication.
· Ensure that the mother fills the prescription and begins levothyroxine treatment as soon as possible, in line with the child’s best health interests.
**Patient Education:**
· Provide the mother with written information about hypothyroidism, the role of levothyroxine, and a list of reputable resources on thyroid health.
· Provide resources for American Association of Pediatric Endocrinology to join other discussions and have access to resources for parents and patients disease management.
References
_All about thyroid_. (n.d.). American Association of Clinical Endocrinology.
[https://www.aace.com/disease-and-conditions/thyroidLinks to an external site.](https://www.aace.com/disease-and-conditions/thyroid)
Maaks, D.L. G., Starr, N., & Gaylord, N. (2019). Burns' Pediatric Primary Care (7th ed.). Elsevier – Evolve.
Ivette
Case Scenario 3
Carlos is a 15-year-old with type 1 DM, diagnosed one year ago. Carlos is interested in trying out for a soccer team.
· What additional information should you know about Carlos?
Additional information to find out about Carlos includes his insulin regimen, dietary habits, exercise habits blood glucose trends, hgA1C and if any episodes of hyper/hypoglycemia and emergency preparedness. It is also important to assess Carlos and his mothers understanding of his conditions along with the management.
· Which diagnostic tests should you periodically monitor for this condition?
Diagnostics that should be monitored for Carlos include- HgA1C ,Kidney function, cardiovascular health including cholesterols, eye health – for diabetic retinopathy , foot exams for neuropathy , thyroid function.
What anticipatory guidance and instructions will you give Carlos and his parents about his participation in soccer, diet, and insulin management?
Carlos should understand that he will require ongoing blood glucose monitoring (before, during, and after exercise), careful planning of meals and carbohydrates, snacks around the time of exercise, and adjustment of insulin dosing when exercising.Exercise can trigger release of high levels of glucose and ketone bodies, leading to hyperglycemia and even DKA. Carlos should aware that if too much exogenous insulin is administered, hypoglycemia may result.Exercise may affect blood glucose levels for as long as 24 hours after therefore Carlos and his parents need to be aware of the risk of nocturnal hypoglycemia on active days meaning they should monitor blood glucose levels more frequently overnight.Carlos should work with an endocrinologist and nutritionist and it is essential that his coaches/trainers are aware of his condition and s/s to look out for.
Chiang, J. L., Maahs, D. M., Garvey, K. C., Hood, K. K., Laffel, L. M., Weinzimer, S. A., Wolfsdorf, J. I., & Schatz, D. (2018). Type 1 Diabetes in Children and Adolescents: A Position Statement by the American Diabetes Association.
_Diabetes care_,
_41_(9), 2026–2044. https://doi.org/10.2337/dci18-002
Emmanuel M, Bokor BR. Tanner Stages. [Updated 2022 Dec 11]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK470280/
**## week5pedsstudentreply.docx**
Jennifer
Case Scenario 4
**S: Subjective**
Patient: 9-year-old female
c/c: Well-child exam
HPI – Mother reports that the patient was diagnosed with hypothyroidism last month but has not filled the prescription for levothyroxine. She is seeking to explore alternative treatment options and would like to discuss these with the provider. The patient has no current symptoms but the mother is concerned about long-term medication use.
**O: Objective**
All VSS stable, child in no acute distress without visible goiter or mass. New diagnosis of hypothyroidism last month based on laboratory results. TSH elevated, Free T4 low. Newly diagnosed hypothyroidism. The patient has not started the prescribed levothyroxine medication. The most recent lab results support this diagnosis.
**Well-Child Exam** – The patient is here for a routine well-child exam. No acute health concerns.
1.
**Discussing Levothyroxine Medication:**
· Explain to the mother that levothyroxine is the standard treatment for hypothyroidism and is essential for normal growth, development, and metabolic function in children.
· Discuss the potential consequences of untreated hypothyroidism, such as developmental delays, growth issues, fatigue, and cognitive impairment.
· Reassure her that the medication is safe when properly dosed and monitored and emphasize that it can help the child lead a normal, healthy life.
· Offer to answer any questions or concerns the mother may have about the medication.
2.
**Approach to Complementary Therapy:**
· Acknowledge the mother’s interest in exploring complementary therapy and suggest a collaborative approach.
· Explain that while lifestyle changes can support overall well-being, there is currently no strong scientific evidence to support the use of alternative treatments such as herbs, supplements, or acupuncture as a replacement for thyroid hormone therapy in the treatment of hypothyroidism.
· Highlight the importance of consistent medication adherence to ensure the thyroid hormone levels remain in the therapeutic range, which is critical for the child’s growth and cognitive development (Maaks et al., 2019)
· Suggest that any complementary therapies should be discussed with the medical team to ensure they do not interfere with the prescribed treatment. As many therapies have unwanted therapeutic or disruptive effects on medications, such as horseradish or kelp and effects of iodine (Maaks et al, 2019.)
3.
**Evidence on Complementary Therapy:**
· Provide the mother with evidence-based information about complementary therapies for chronic diseases.
· Encourage open communication with the healthcare team if the mother wishes to explore complementary options, ensuring the patient’s thyroid function is adequately managed including and referred endocrinology pediatric specialist.
4.
**Follow-up:**
· Schedule a follow-up appointment in 6 weeks to reassess thyroid function and monitor for any side effects of the medication.
· Ensure that the mother fills the prescription and begins levothyroxine treatment as soon as possible, in line with the child’s best health interests.
**Patient Education:**
· Provide the mother with written information about hypothyroidism, the role of levothyroxine, and a list of reputable resources on thyroid health.
· Provide resources for American Association of Pediatric Endocrinology to join other discussions and have access to resources for parents and patients disease management.
References
_All about thyroid_. (n.d.). American Association of Clinical Endocrinology.
[https://www.aace.com/disease-and-conditions/thyroidLinks to an external site.](https://www.aace.com/disease-and-conditions/thyroid)
Maaks, D.L. G., Starr, N., & Gaylord, N. (2019). Burns' Pediatric Primary Care (7th ed.). Elsevier – Evolve.
Ivette
Case Scenario 3
Carlos is a 15-year-old with type 1 DM, diagnosed one year ago. Carlos is interested in trying out for a soccer team.
· What additional information should you know about Carlos?
Additional information to find out about Carlos includes his insulin regimen, dietary habits, exercise habits blood glucose trends, hgA1C and if any episodes of hyper/hypoglycemia and emergency preparedness. It is also important to assess Carlos and his mothers understanding of his conditions along with the management.
· Which diagnostic tests should you periodically monitor for this condition?
Diagnostics that should be monitored for Carlos include- HgA1C ,Kidney function, cardiovascular health including cholesterols, eye health – for diabetic retinopathy , foot exams for neuropathy , thyroid function.
What anticipatory guidance and instructions will you give Carlos and his parents about his participation in soccer, diet, and insulin management?
Carlos should understand that he will require ongoing blood glucose monitoring (before, during, and after exercise), careful planning of meals and carbohydrates, snacks around the time of exercise, and adjustment of insulin dosing when exercising.Exercise can trigger release of high levels of glucose and ketone bodies, leading to hyperglycemia and even DKA. Carlos should aware that if too much exogenous insulin is administered, hypoglycemia may result.Exercise may affect blood glucose levels for as long as 24 hours after therefore Carlos and his parents need to be aware of the risk of nocturnal hypoglycemia on active days meaning they should monitor blood glucose levels more frequently overnight.Carlos should work with an endocrinologist and nutritionist and it is essential that his coaches/trainers are aware of his condition and s/s to look out for.
Chiang, J. L., Maahs, D. M., Garvey, K. C., Hood, K. K., Laffel, L. M., Weinzimer, S. A., Wolfsdorf, J. I., & Schatz, D. (2018). Type 1 Diabetes in Children and Adolescents: A Position Statement by the American Diabetes Association.
_Diabetes care_,
_41_(9), 2026–2044. https://doi.org/10.2337/dci18-002
Emmanuel M, Bokor BR. Tanner Stages. [Updated 2022 Dec 11]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK470280/