405 2 Flashcards by Richard smith

Gestational dm is associated with 3 ___ of pregnancy

hormones

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Gestational dm is associated with pregnancy hormones which cause ____ ____

insulin resistance

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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

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in gestational dm, the glucose levels return to normal after

delivery

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in gestational dm, the baby will be ___glycemic after birth

hypo

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Dx of gestational dm: fasting blood sugar of

greater than 126

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Dx of gestational dm: Glucose Tolerance Test - GTT

above 200 after 2hrs

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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?)

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Dx of gestational dm: you need an Amniocentesis to

check level of surfactant for lung maturity

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What’s a good food group for gestational dm

complex carbs

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What’s a good meal plan for gestational dm

3 meals and 3 snacks

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With dm, there are diet restrictions but you still need to

have enough calories to support the fetus

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Gestational dm: exercise to maintain the weight gain at

2 pounds a week

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Bethmethasone is a steroid for

increasing fetal lung development- surfactant production

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when is Bethmethasone given

during pregnancy

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Gestational dm: treat the Newborn with

PO or IV glucose

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Hyperglycemia causes: i___ or i____

illness or injury

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Hyperglycemia causes: s____

stress

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Hyperglycemia causes: __ too low or ___ too low

insulin or activity

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Hyperglycemia causes: too much ___ in the diet

carbs

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the ph of someone with Hyperglycemia will be

acidosis

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when someone has Hyperglycemia you treat it by giving insulin and

correcting f/e problems

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Hyperglycemia: length of time for the onset

gradual

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Hyperglycemia: activity level will be

slow

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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

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

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 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