Treatment Issues in the Care of Pediatric Patients with Endocrine Conditions

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.