special education 519

Special Education 519

UNIT FIVE

Other Systems

and Universal PrecautionsKevin Anderson

Minnesota State University Moorhead2006

Metabolic, Protective and Defensive Function and

Dysfunction

Metabolic, Protective and Defensive Function and

Dysfunction Endocrine and exocrine systems Integumentary system - Skin Immune system

Function of Endocrine System


System - network of glands that release secretions into circulatory system

Functions Regulation of heartbeat Maintains fluid and electrolyte balance Maturation of reproduction system

Parts Endocrine cell Target cells or end organ Environment



Glands Pituitary gland - controls growth and

development Thyroid gland - regulates metabolic rate of

body Parathyroid gland - regulates calcium levels in

blood Adrenal glands - affects body’s metabolism

and emotional status Pancreas - produces digestive enzymes and

hormones Gonads - produces and stores gametes - sperm

and eggs

Dysfunction of Endocrine System


Excessive hormone production - such as hyperpituitarism, hyperthyroidism, hypocalcaemia

Insufficient hormone production - such as hypopituitarism, hypothyroidism, hypocalcaemia, or hypoinsulinism or Diabetes, which is the most common form



Diabetes Insipidus - “bland” urine diabetes, less

common in children Mellitus - “sweet” urine diabetes, Type I

Diabetes Mellitus most common Lack of or inadequate insulin production Two types

Type I-(insulin dependent) Type II (non-insulin-dependent) diabetes

ImplicationsImplications

Lack of insulin causes glucose shortage in cells

Blood glucose levels rise Loss of glucose reserves lead to

fatigue Fats and proteins may be used as

energy source


Levels monitoring Glucose testing of blood Ketone testing of urine if blood

glucose is high Prognosis

Controlled by diet, exercise, and insulin therapy

No known cure other than pancreas transplant


Continuum between hypoglycemia and hyperglycemia Hypoglycemia - below normal blood

glucose levelToo much insulin, rapid insulin

absorption, sudden exercise, delayed eating

Too little sugar leads to insulin reactionNeeds sugar


Continuum between hypoglycemia and hyperglycemia Hyperglycemia - above normal blood

glucose levelMissed insulin dosing, not following

recommended diet, lack of physical activity, illness or infection, emotional stress

Too much sugar leads to ketoacidosisNeeds insulin

Educational Considerations


Understanding condition Should not require change in curriculum or

instruction May develop educational needs despite normal

intellectual functioning Consider physical vs. psychosocial factors Be aware of hypo- or hyperglycemia symptoms

Encourage self-sufficiency Using condition as excuse Controlled diet but not different foods Encourage fluid intake and allow access to

bathroom Support groups if necessary Occupational impact



Maintain effective communication Contact with school nurse Share information with family

Collaboration Trained personnel for any necessary

procedures Advocate for exercise with caution

Function of Exocrine System

Function of Exocrine System

System - network of glands that release secretions to outer surface of organs or tissues

Functions Regulates digestive glands Produces digestive enzymes Regulates body temperature

Glands Sweat glands - regulate body heat Sebaceous glands - maintains skin Digestive glands - breaks down food Lymph glands - fights off infection

Dysfunction of Exocrine System


Problems with exocrine glands mostly related to system involved

One disease affects all glands of exocrine system - Cystic Fibrosis Abnormally viscous secretions Secretions with abnormal electrolytes



Cystic Fibrosis - thick secretions may plug ducts and damage gland and surrounding tissues Pancreatic involvement

“Cystic” - cyst-like appearance of pancreas ducts

“Fibrosis” - pancreatic tissue becoming fibrous



Pancreatic involvement “Cystic” - cyst-like appearance of pancreas ducts “Fibrosis” - pancreatic tissue becoming fibrous

Respiratory involvement Abnormal mucus in the bronchioles of the lungs Prevents removal of bacteria and foreign particles Progressively leads to exercise intolerance and

increased fatigue Initially looks like asthma, but is not reversible



Cardiac involvement Respiratory dysfunction leads to decreased oxygenation

of blood to heart Heart compensates by beating harder to circulate blood

through the lungs Right side of heart becomes thicker and larger

Gastrointestinal involvement Decrease pancreatic enzymes to aid in metabolism Increased risk for insulin-dependent diabetes Liver damage Growth deficiencies Bodily odors

Glandular involvement Elevated sodium and chloride levels “salty” kiss


Easily identified through sweat test and detection of CF gene

No known cure, treatment focuses on alleviation of symptoms Improving pulmonary function through

inhalation or chest therapy Enzyme replacement therapy Maintaining adequate nutrition Surgical organ replacement



Does not affect intellectual development Strong communicative and social skills Decreased focus on physical activity Increased interaction with adults through

medical interventions School attendance

Medical appointments or hospitalizations Health-related procedures and medications

during school Prone to respiratory infections and may

have persistent cough in effort to clear airway



Exercise and diet Caution during hot weather Prevent excessive perspiration May need diet high in calories

Access to bathroom Bowel movements Hygiene needs

Social issues Self-esteem and self-image Prognosis increasing Occupational outlook

Function of Integumentary System


Skin - serves as protector from environmental dangers and barrier against invading organisms

Three layers Epidermis - outermost protects from

invading organisms, prevents loss of body fluids, and stores pigment

Dermis - tough, thick inner layer protects body and contains blood vessels, sweat/sebaceous glands, nerves lymphatic vessels, and hair follicles

Hypodermis - innermost layer which “insulates” body



Appendages Nails - hardened skin cells that serve to

protect the soft tips of extremities and aid in grasping

Hair - filament of the protein, keratin which serves primarily as a decorative function

Glands Sweat - produces sweat to fight off

microorganisms and regulate body temperature Sebaceous - attached to hair follicles and

produces sebum for skin lubrication and water-resistence

Dysfunction of Integumentary System


Not typically life-threatening, however can be socially stigmatizing

Can be non-infectious or infectious Can be systemic or localized



Non-infectious skin conditions Not communicable Can become infected Types

Atopic Dermatitis (Eczema ) Itchy, chronic skin condition characterized by

lesions Allergy-related

Allergic contact dermatitis - direct contact with natural or manufactured agent that triggers an allergic response

Psoriasis - recurrent inflammatory skin condition Pigmentation disorders - either change in amount

or dispersement



Non-infectious skin conditions Resulting from injury

Abrasions, lacerations, punctures Thermal injuries - burns and scalds

Depth of injury 1st degree - partial-thickness burn at epidermis

layer 2nd degree - partial-thickness burn at epidermis and

dermis layer 3rd degree - full-thickness burn at all skin layers 4th degree burn - extends beyond skin to muscles,

tendons, and bones Amount of body surface area affected - “rule of nines”

Treatment From minor first aid to extended hospitalization Goals of therapy include prevention of infection, growth

of tissue, and regain functional abilities



Non-infectious skin conditions Affecting skin appendages - congenital or

acquired Disorders of nails Disorders of hair Disorders of glands



School attendance Dependent on severity of injury May require specialized garments

Rehabilitation Long and painful process Intolerance of extreme temperatures

Education Prevention Appropriate and timely treatment response



Infectious skin conditions Typically caused by microorganism

entering body through a break in the skin - such as bacteria, viruses, fungi, or parasites

Contagious either directly or indirectly



Types of infections Bacterial infections - such as impetigo Viral infections - such as cold sores,

warts, and molluscum Fungal infections - such as nail

infections Parasitic infections - such as lice or

scabies



Attendance Most can attend school if Universal Precautions

are followed Treatment

May require treatments at school Apply pressure to itch rather than scratch

Social issues Appearance issues Assumption of poor personal hygiene

Must learn and follow proper hygiene techniques

Function of Immune System


Immune system - collection of organs, glands, cells, and proteins located across body Serve as protection from disease and

microorganisms Discriminate between essential components

of body and foreign bodies or pathogens Protects from excess cellular wastes and

abnormal development of cells



Immunity - the body’s ability to defend itself against foreign substances Natural - born resistant to particular diseases

due to transmission of mother’s antibodies Acquired

Self-producing antibodies due to previous contact with disease

Artificially acquired immunity - by vaccination



Defensive system Made up of primary and secondary organs Serves a defensive reaction if the body’s first line of

defense is compromised Lymph system - the body’s drainage system

Chain of infection “Cause” of condition - pathogen “Host” - source of the pathogen “Means” of transmission - mode of transmission

Communicable diseases Caused by microorganisms not visible to the naked eye Not always pathogenic or disease producing Direct or indirect transmission

Dysfunction of Immune System


Dysfunction can be harmful May occur due to many factors

Genetics Developmental defects, Infection Malignancy Injury Drugs Altered metabolic states



Most common dysfunctionHypersensitivity disorders - asthma,

drug/product/food reactions, rejection of transplanted organs/tissues

Immunodeficiency disordersAutoimmune diseasesCancer



Hypersensitivity disorders - asthma and allergies Types

Immediate - immediate response to allergen

Delayed - may take 1-6 days Characteristics

Localized - specific siteSystemic - found throughout body

Severity - depends on sensitivity and exposure



Attendance - not necessarily related to academic achievement in well supported environments

Symptoms - medication, removal of allergens, response to emergency

Awareness and acceptance Medical response to certain conditions -

emergency plan, auto-injectors



Hyposensitivity or immunodeficiency disorders System underreactive and unable to defend

against disease-producing organisms - immunodeficiency

Most well-known type is Acquired Immunodeficiency Syndrome (AIDS) Results from invasion of retrovirus -

Human immunodeficiency virus (HIV) Spread by exposure to contaminated

blood/blood products or exposure to bodily fluids of infected persons



Communication with parents of child who is immunosuppressed, especially if exposed to communicable diseases

Follow universal precautions Prejudice and isolation



Autoimmune diseases - autosensitivity leading to autoimmune disease Juvenile rheumatoid arthritis Glomerulonephritis Juvenile-onset insulin dependent

diabetes



Malignant tumors Abnormal cell growth and

development Replacement and kill normal cells Kinds

Benign - non-life-threatening and easily removed

Malignant - life-threatening and easily spread or metastasize



Types of cancerous conditions Hematopoietic system - leukemia Central nervous system Lymph system Musculoskeletal system Sympathetic nervous system Urinary system Visual system



Communication with family is crucial Increased awareness and understanding of

impact on student Maintain attendance at school to maintain

“normalcy” Ongoing medical treatments may interfere

in academic progress Susceptibility to infections, bleeding, pain Self-awareness and determination

Communicable DiseasesCommunicable Diseases

Invasion of pathogenic agents which are infectious

Common bacterial infections Pinkeye, pneumonia, Lyme disease,

meningitis, middle-ear infection, rubella, mononucleosis, Fifth disease, hepatitis

Treated with antibiotic medication Common viral infections

adenoviruses, enteroviruses, rhinoviruses, myxoviruses

Treated with antiviral medication

Communicable DiseasesCommunicable Diseases

Common fungal infections Certain types of fungi can be

pathogenic in humans Treated with antifungal medicines

Common parasitic infections Tapeworms, pinworms, lice, and mites Treated with antiparasitic agents



Decreased incidence due to widespread use of vaccines

May need to be remain home until condition is not communicable

Notice of exposure to communicable diseases is required

Enforce proper hygiene in the classroom and proper cleanliness in food preparation

Sexually-Transmitted Diseases

Sexually-Transmitted Diseases

Transmitted primarily through sexual intercourse or contact

Second most common infection; the first is the common cold

Caused by bacterial, viral, and fungal agents

Often non-symptomatic and not treated properly



Awareness of signs of STD’s Formal and informal instruction is

necessary Increasing numbers secondary to better

medical treatment Do not restrict access to education Changes in programming should only be

made amongst collaborative team

Policies and ProceduresPolicies and Procedures

School health services versus medical services

Handling and administration of medications

Provision of special health care procedures Contact with bodily fluids Use of Universal Precautions Do Not Resuscitate (DNR) orders Disagreement with physician orders

Universal PrecautionsUniversal Precautions

Definition - the usual and ordinary steps all school staff need to take in order to reduce their risk of infection with HIV, the virus that causes AIDS, as well as all other blood-borne organisms (such as the Hepatitis B virus)

Universal PrecautionsUniversal Precautions

They are universal because they refer to steps that need to be taken in all cases, not only when a staff member or student is known to be HIV-infected.

They are precautions because they require foresight and planning, and should be integrated into existing safety guidelines.

See document from the Boston Public Schools

special education 519

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