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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
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
Function of Endocrine System
Function of Endocrine System
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
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
Dysfunction of Endocrine System
Dysfunction of Endocrine System
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
ImplicationsImplications
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
ImplicationsImplications
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
ImplicationsImplications
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
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
Educational Considerations
Educational Considerations
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
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
Dysfunction of Exocrine System
Dysfunction of Exocrine System
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
Dysfunction of Exocrine System
Dysfunction of Exocrine System
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
Dysfunction of Exocrine System
Dysfunction of Exocrine System
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
ImplicationsImplications
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
Educational Considerations
Educational Considerations
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
Educational Considerations
Educational Considerations
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
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
Function of Integumentary System
Function of Integumentary System
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
Dysfunction of Integumentary System
Not typically life-threatening, however can be socially stigmatizing
Can be non-infectious or infectious Can be systemic or localized
Dysfunction of Integumentary System
Dysfunction of Integumentary System
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
Dysfunction of Integumentary System
Dysfunction of Integumentary System
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
Dysfunction of Integumentary System
Dysfunction of Integumentary System
Non-infectious skin conditions Affecting skin appendages - congenital or
acquired Disorders of nails Disorders of hair Disorders of glands
Educational Considerations
Educational Considerations
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
Dysfunction of Integumentary System
Dysfunction of Integumentary System
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
Dysfunction of Integumentary System
Dysfunction of Integumentary System
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
Educational Considerations
Educational Considerations
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
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
Function of Immune System
Function of Immune System
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
Function of Immune System
Function of Immune System
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 of Immune System
Dysfunction can be harmful May occur due to many factors
Genetics Developmental defects, Infection Malignancy Injury Drugs Altered metabolic states
Dysfunction of Immune System
Dysfunction of Immune System
Most common dysfunctionHypersensitivity disorders - asthma,
drug/product/food reactions, rejection of transplanted organs/tissues
Immunodeficiency disordersAutoimmune diseasesCancer
Dysfunction of Immune System
Dysfunction of Immune System
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
Educational Considerations
Educational Considerations
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
Dysfunction of Immune System
Dysfunction of Immune System
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
Educational Considerations
Educational Considerations
Communication with parents of child who is immunosuppressed, especially if exposed to communicable diseases
Follow universal precautions Prejudice and isolation
Dysfunction of Immune System
Dysfunction of Immune System
Autoimmune diseases - autosensitivity leading to autoimmune disease Juvenile rheumatoid arthritis Glomerulonephritis Juvenile-onset insulin dependent
diabetes
Dysfunction of Immune System
Dysfunction of Immune System
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
Dysfunction of Immune System
Dysfunction of Immune System
Types of cancerous conditions Hematopoietic system - leukemia Central nervous system Lymph system Musculoskeletal system Sympathetic nervous system Urinary system Visual system
Educational Considerations
Educational Considerations
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
Educational Considerations
Educational Considerations
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
Educational Considerations
Educational Considerations
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