405 2 Flashcards
Gestational dm is associated with 3 ___ of pregnancy
hormones
Gestational dm is associated with pregnancy hormones which cause ____ ____
insulin resistance
How does the fetus’ insulin and mother’s insulin work together?
The fetus has its own insulin
Mother’s insulin doesn’t cross the placenta
in gestational dm, the glucose levels return to normal after
delivery
in gestational dm, the baby will be ___glycemic after birth
hypo
Dx of gestational dm: fasting blood sugar of
greater than 126
Dx of gestational dm: Glucose Tolerance Test - GTT
above 200 after 2hrs
Dx of gestational dm: You need an ultrasound to determine
heart rate, activity level, and the size of the fetus (is it appropriate for gestational age?)
Dx of gestational dm: you need an Amniocentesis to
check level of surfactant for lung maturity
What’s a good food group for gestational dm
complex carbs
What’s a good meal plan for gestational dm
3 meals and 3 snacks
With dm, there are diet restrictions but you still need to
have enough calories to support the fetus
Gestational dm: exercise to maintain the weight gain at
2 pounds a week
Bethmethasone is a steroid for
increasing fetal lung development- surfactant production
when is Bethmethasone given
during pregnancy
Gestational dm: treat the Newborn with
PO or IV glucose
Hyperglycemia causes: i___ or i____
illness or injury
Hyperglycemia causes: s____
stress
Hyperglycemia causes: __ too low or ___ too low
insulin or activity
Hyperglycemia causes: too much ___ in the diet
carbs
the ph of someone with Hyperglycemia will be
acidosis
when someone has Hyperglycemia you treat it by giving insulin and
correcting f/e problems
Hyperglycemia: length of time for the onset
gradual
Hyperglycemia: activity level will be
slow
Hyperglycemia: skin will be
Flushed, dry
Hyperglycemia: which sense is affected
vision (blurred)
Hyperglycemia: breathing pattern
deep and rapid
Hyperglycemia: what are the really serious complications
shock and coma
HypOglycemia: length of time for the onset
rapid
HypOglycemia: treatment:
Give 20g carbohydrate check glucose and repeat if below 65-70 mg /dL
HypOglycemia: treatment: Give __ g carbohydrate
20
HypOglycemia: treatment: Give 20g carbohydrate check glucose and repeat if below
65-70 mg /dL
HypOglycemia: HR will be
increased
HypOglycemia: breathing pattern
shallow
HypOglycemia: skin
pale and sweaty
Death and Grief: Anticipate the siblings will
act out, have sleep problems, act differently
Toddlers believe that death is
temporary
Death and Grief: With toddlers, watch out for
regression of development
Death and Grief: Preschoolers view death as temporary and ___, but not ___
temporary and selective (only for bad people), but not universal
Death and Grief: Magical thinking refers to what age group
preschooler
Death and Grief: With preschoolers, the 2 most important things you can do is
help the child understand its not their fault and keep routines
Death and Grief: school-age kid’s routine
allow time to grieve and let them return to the school routine gradually
Iron Deficiency Anemia
A decrease in the number of red blood cells, caused by a lack of iron
A decrease in the number of red blood cells, caused by a lack of iron
Iron Deficiency Anemia
the most common form of anemia
Iron Deficiency Anemia
Iron is an essential part of ____, the oxygen-carrying protein in blood
hemoglobin
Iron comes from the diet and by
recycling iron from old red blood cells
Iron Deficiency Anemia can be caused by poor Absorption rate because of drinking __ __ and ___ birth
cow’s milk and premature birth
one of the strange symptoms of Iron Deficiency Anemia
pica
Iron Deficiency Anemia: the patient’s nails will be
brittle
hypochromic
RBCs are pale
Iron Deficiency Anemia: RBCs will be ___ and ___
low and pale
Iron Deficiency Anemia: hemoglobin will be
low
Hemoglobin Concentration for children
Some between 11 and 17
It’s highest as a newborn
Iron Deficiency Anemia: most common age of onset in children
9 to 12 months (weaning from breast & eating semi-solid foods)
Iron Deficiency Anemia: when do you screen children
9 to 12 months (weaning from breast & eating semi-solid foods)
Iron Deficiency Anemia: Dietary assessment: what should you watch out for in babies
picky eaters, drinks mostly whole milk after 12 mos
Iron Deficiency Anemia: Dietary assessment: what should you watch out for in toddlers
engage in Pica
Iron Deficiency Anemia: Dietary assessment: what should you watch out for in adolescents
rapid growth period. Poor diet. Menstruation in females
Iron supplements: patient teaching
it can stain the teeth
take on an empty stomach
take with Vit C
Sickle cell: genetics
it’s recessive
One cause of sickling: decreased
PO2
One cause of sickling: Increased hydrogen ___ _____
ion concentration (acidemia)
One cause of sickling: Increased plasma
osmolarity/decreased plasma volume (dehydration)
One cause of sickling: Low
temperature
Splenic Sequestion
Sickle cells become trapped and destroyed in the spleen causing Shortage of red blood cells or anemia
Sickle cell: RBC life span decrease from 120 days to
10-20 days
A sickle cell sign that results from elevation of indirect bilirubin because of increased destruction of red blood cells.
Jaundice
Sickle cell complication: __ ulcers
leg ulcers
Sickle cell patients should avoid ___ weather
cold weather
The peak risk of stroke for sickle patients is what ages
2 to 9 y/o
Acute chest syndrome may be treated with abx and
blood transfusion
one of the first complications in sickle cell syndromes with the highest incidence between ages six months and two years
Sickle dactylitis
Sickle dactylitis
sickle red cells cause painful swelling of the hands and feet
Sickle dactylitis is treated with
fluids and pain medication. It usually will go away in a few days without any problems.
Bone pain in sickle cell is treated with
NSAIDS and PT
Treatment for Splenic Sequestion: ___ ___ as necessary
Blood transfusion
Treatment for Splenic Sequestion: ____ after 2 years of age
splenectomy
Routine care of sickle patient: prophylactic
penicillin (reduces strep by 80%)
4 vaccines of sickle cell patients (routine care)
Flu Vaccine; Pneumovax
Hepatitis A
Meningococcal
Routine care of sickle patients: 3 broad things
preventative screening
hydration
balance rest and exercise
antineoplastic drug used to treat sickle cell
Hydroxyurea
Hydroxyurea treats sickle cell anemia by
changing red blood cells so that they are less likely to bend in an abnormal shape
Hydroxyurea dosing regimen
1 daily PO
