Metabolic

Growth Hormone Injections

Growth Hormone helps process proteins and fat breakdown to provide the energy needed for growth. Injections can cause alterations in insulin responds- monitor glucose --especially if diabetic

Low GH include: Anxiety/depression, short stature, chubby especially around the midline, tiredness, weak muscles,

Usually daily shots necessary for several years

​GnRH (gonadotropin releasing hormone) analogue therapy is the treatment - Usually monthly injections (Lupron) which delays further puberty development

Removal of tumor if warranted

​Precocious Puberty

​Head Pain

cramping

N/V

Drowsiness

Fatigue

Seizures

Water Intoxication

​DKA

​Fluid Infusions for DKA

​Cerebral edema is the leading cause of death in children presenting in diabetic ketoacidosis and occurs in 0.2 to 1% of cases.

The osmolar gradient caused by the high blood glucose results in water shift from the intracelluar fluid (ICF) to the extracellular fluid (ECF) space and contraction of cell volume.

Correction with insulin and intravenous fluids can result in a rapid reduction in effective osmolarity, reversal of the fluid shift and the development of cerebral edema.

The goals for treatment should be a combination of intravenous fluid and insulin that results in a gradual reduction of the effective osmolarity over a 36- to 48-hour period, thereby avoiding rapid expansion of the ICF compartment and brain swelling.

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Regular insulin is the only type given IV!​

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