Test Results
Guthrie screening test: Increased level in blood of phenylalanine 4 days
after birth.
Chromatography: Increased level in blood of phenylalanine 4 days after birth.Treatment
Maintain blood levels of phenylalanine between 3 mg/dL and 9 mg/dL
by restricting dietary phenylalanine (protein-rich foods).
Administer enzymatic hydrolysate of casein (Lofenalac, Pregestimil) in
place of milk.Nursing Intervention
Explain to the family that the child should avoid eggs, meat, fish,
poultry, breads, aspartame, and cheese for the child’s entire life.
The blood level of phenylalanine must be tested throughout the child’s
life to ensure that it remains within the desired level.Nursing alertBe alert for signs of phenylalanine deficiency (anorexia, skin
rashes, anemia, diarrhea, lethargy) that might occur from too little phenylalanine
in the diet.Conclusion
The endocrine system is comprised of glands that release chemical messages
called hormones that regulate activities of target cells and organs using a feed-
back mechanism. A high level of a hormone causes a gland to decrease secretion
of that hormone, and a low level causes the hormone’s secretion to increase
in an effort to maintain homeostasis.
There are times when a disorder results in an abnormal increase or decrease
in a hormone causing the body out of homeostasis. Once such disorder is con-
genital hypothyroidism where the thyroid gland is not secreting sufficient lev-
els of thyroid hormones, resulting in a decrease in the body’s metabolism.
Too much thyroid hormones causes hyperthyroidism, commonly called
Graves disease, which increases metabolism and causes the patient to become
hyperactive, irritable, and lose weight. This condition is characterized by pro-
trusion of the eyeballs (exophthalmos) and an enlarged thyroid gland (goiter).
Abnormal tissue growth can also increase hormonal secretion as in the case
of Cushing syndrome where excess glucocorticoids are secreted by the adre-
nal gland or the pituitary gland secretes excess ACTH. This results in weight
gain, moon face, and delayed wound healing.
A very common endocrine disorder is diabetes mellitus. Diabetes mellitus
is the absences (type 1) of or low production (type 2) of insulin by the pancreas,
resulting in the inability of glucose to enter cells for metabolism.7CHAPTER 9/ Endocrine and Metabolic Conditions^193