Chapter 30: Metabolic and Endocrine Disorders

The chapter then addresses dehydration in the pediatric population, detailing the pathophysiology, assessment indicators such as weight loss and capillary refill time, and evidence-based rehydration approaches using both oral and intravenous fluid replacement. Phenylketonuria, an inherited metabolic disorder, is presented with emphasis on newborn screening protocols, the necessity of early dietary intervention through phenylalanine restriction, and long-term developmental monitoring to prevent cognitive impairment. The diabetes mellitus section contrasts Type 1 and Type 2 presentations, focusing on pathophysiology, insulin therapy requirements, blood glucose monitoring techniques, nutritional planning with carbohydrate consistency, and exercise considerations specific to pediatric patients. Acute complications including hypoglycemia and hyperglycemia are examined with their clinical manifestations and appropriate emergency interventions. Diabetic ketoacidosis is presented as a life-threatening emergency, with detailed attention to pathophysiology, characteristic clinical signs such as Kussmaul respirations, and critical nursing interventions including fluid resuscitation, insulin administration, and electrolyte monitoring. Throughout the chapter, developmental appropriateness in patient and family education is emphasized, along with safety considerations in medication administration, use of glucose monitoring devices, application of sick-day management rules, and psychological support for children managing chronic endocrine conditions and their families.