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Treatment Issues in the Care of Pediatric Patients with Endocrine Conditions

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Advanced Practice in Endocrinology Nursing

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Abstract

Treatment issues commonly encountered in pediatric endocrine practice include: preparing children for painful procedures, care of transgender youth, and pubertal issues of girls with developmental disabilities. This chapter provides an overview of these topics.

Pediatric endocrine nurses frequently request blood testing of their patients. Also, nurses teach parents to provide blood sugar testing or injections to their children. Selection of the correct needle length is important to ensure correct distribution of medication. Injections and finger sticks are painful or anxiety producing for infants, children, adolescents, and their parents. Many people develop long-term fear or avoidance of needles because of negative childhood experiences. As patient advocates, nurses can ensure that parents and children are prepared for potentially painful experiences by utilizing evidence-based strategies to decrease pain and anxiety. Recognizing that memories of painful experiences can impact current treatment or future experiences allows nurses to intervene to improve upon these. Knowing the guidelines for reducing pain from procedures and practicing these can significantly impact a child’s life.

Children who present as gender creative or transgender may be diagnosed with gender dysphoria and require treatment in a pediatric endocrine environment. Following a diagnosis of gender dysphoria by a qualified mental health practitioner, pediatric endocrine nurses can assist with education and support as well as treatment for the youth. Endocrine treatments should be provided following guidelines and standards of care and may include the use of puberty blocking pharmacologic agents or prescribing cross hormone therapy to support transition. Pediatric endocrine nurses can advocate for the best possible hormone treatment for transgender youth to encourage optimal outcomes.

Providing gynecologic care for young women affected with physical or developmental disability during puberty can be complex. Parents of these youth are very concerned as their young person starts to grow and change. This chapter reviews the complex needs of this group of children/adolescents and reviews available medical treatment options. We will also review a number of strategies that nurses can implement to help families to improve quality of life and patient reported outcomes.

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Abbreviations

ADHD:

Attention deficit hyperactivity disorder

ASD:

Autism spectrum disorder

cm:

Centimeter

CP:

Cerebral palsy

DD:

Developmental disabilities

DSM-5:

American Psychiatric Association Diagnostic and Statistical Manual Version 5

FSH:

Follicle stimulating hormone

GAT:

Growth attenuation therapy

GD:

Gender dysphoria

GnRH:

Gonadotropin releasing hormone

HELP-in KIDS:

Help Eliminate Pain in KIDS Team

IM:

Intramuscular

IUD:

Intrauterine device

kg:

Kilogram

LARC:

Levonorgestrel IUD implants

LGBTQ:

Lesbian, gay, bisexual, transgender, queer

LH:

Luteinizing hormone

mm:

Millimeter

NSAIDS:

Non-steroidal anti-inflammatory drugs

OCP:

Oral contraceptive pills

PENS:

Pediatric Endocrinology Nursing Society

SC:

Subcutaneous

SOC:

Standards of care

TG:

Transgender

WPATH:

World Professional Association for Transgender Health

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Author information

Authors and Affiliations

  1. Clinical Resource, Pediatric Endocrine and Gynecology Clinics, Alberta Children’s Hospital, Calgary, AB, Canada

    Peggy Kalancha

  2. St. Amant Inc., Winnipeg, MB, Canada

    Nicole Kirouac

  3. Pediatric Endocrine Clinic, Alberta Children’s Hospital, Calgary, AB, Canada

    Eileen Pyra

Authors
  1. Peggy Kalancha
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  2. Nicole Kirouac
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  3. Eileen Pyra
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Corresponding author

Correspondence to Eileen Pyra .

Editor information

Editors and Affiliations

  1. School of Health Sciences, City, University of London, London, UK

    Sofia Llahana

  2. Department of Oncology, Skåne University Hospital, Lund, Sweden

    Cecilia Follin

  3. Northwest Pituitary Center Oregon Health and Sciences University, Portland, OR, USA

    Christine Yedinak

  4. Churchill Hospital, University of Oxford, Oxford, UK

    Ashley Grossman

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Kalancha, P., Kirouac, N., Pyra, E. (2019). Treatment Issues in the Care of Pediatric Patients with Endocrine Conditions. In: Llahana, S., Follin, C., Yedinak, C., Grossman, A. (eds) Advanced Practice in Endocrinology Nursing. Springer, Cham. https://doi.org/10.1007/978-3-319-99817-6_5

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  • DOI: https://doi.org/10.1007/978-3-319-99817-6_5

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-99815-2

  • Online ISBN: 978-3-319-99817-6

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