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Child Health > Block #3 - Renal, Reproductive, Respiratory, and Cardiac > Flashcards

Block #3 - Renal, Reproductive, Respiratory, and Cardiac Flashcards

1
Q

Anatomy of the Kidney

A

Large in relation to stomach; prone to injury

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2
Q

Anatomy of the Urethra

A

Shorter; increased risk for UTI

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3
Q

Glomerular Filtration Rate

A

Slower in infants; increased risk for dehydration

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4
Q

Bladder Capacity

A

30 mL in newborns; reaches adult size by 1 year

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5
Q

Reproductive Organs

A

Immature at birth until adolescence

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6
Q

Fluid and Electrolyte Balance

A

Greater risk for imbalance

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7
Q

Why are kids at increased risk for dehydration?

A

GFR; greater BSA and a higher percentage of total body water

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8
Q

Metabolic Rate in Pediatrics

A

greater than in adults

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9
Q

What conditions is there an increased of incidence of?

A

Fever, URI, and gastroenteritis

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10
Q

What is the O2 saturation goal for kids?

A

> 98%

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11
Q

What is the most common ABG imbalance?

A

Metabolic Acidosis

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12
Q

What is the normal UOP for pediatrics?

A

1-2 mL/kg/hr

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13
Q

Sodium Levels in Pediatrics

A

130-150

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14
Q

Isotonic Dehydration: Description and Cause

A

Na loss = H2O loss

Cause: excessive sweating

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15
Q

Hypotonic Dehydration: Description and Causes

A

Na loss (low sodium) > H2O loss

Causes: Burns, diuretics, N/V, and diarrhea

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16
Q

Hypertonic Dehydration: Description and Causes

A

Na loss (high sodium) < H2O loss

Causes: Salt water ingestion, rheumatic fever, heat stroke

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17
Q

Top 3 S/S of Dehydration** in Pediatrics

A
  • Prolonged cap refill
  • Decreased turgor
  • RR change
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18
Q

S/S of Dehydeation in Pediatrics

A
  • Loss of skin elasticity (“tenting”)
  • Dry mucosa
  • Decreased UOP
  • Sunken fontanelles
  • Tachycardia
  • Decreased cap refill
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19
Q

Nursing Care for Dehydration

A

1 - obtain daily weights

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20
Q

Classifications of Dehydration (% fluid loss)

A
  • Mild: 0-5%
  • Moderate: 6-10%
  • Severe: >10%
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21
Q

What is the #1 cause of UTI in young girls?

A

Urinary stasis

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22
Q

What is the most common pathogen for UTIs in young girls?

A

E. Coli

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23
Q

UTIs are often _______ infections

A

Nosocomial

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24
Q

UTI: Diagnostics Process

A
  • Clean catch (if potty trained)

- U bag if untrained

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25
Q

What is a Nosocomial Infection?

A

Hospital acquired

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26
Q

What is the abx drug of choice to treat UTIs?

A

Gentamycin

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27
Q

What is vesicoureteral reflux (VUR)?

A

The valve b/w the ureters and bladder isn’t working right –> leads to urinary stasis (#1 cause of UTIs)

Should be 1-way valve, works 2-way

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28
Q

Vesicoureteral Reflux (VUR): S/S

A
  • Recurrent UTI
  • Flank pain
  • Abdominal pain
  • Enuresis (unable to control peeing)
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29
Q

Glomerulonephritis (post-strep)

A

-Limited filtration causes protein and blood to spill in urine

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30
Q

Glomerulonephritis: S/S

A
  • Hematuria
  • Tea colored urine
  • Periorbital edema
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31
Q

Glomerulonephritis: Care

A
  • Daily weights/ Input and Output
  • Daily abd girth
  • If severe: dialysis
  • Assess for URI
  • Monitor for HTN
  • Steroids increase infection risk
  • Don’t bed rest
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32
Q

Whic type of dialysis is most recommended for pedaitrics?

A

Peritoneal dialysis

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33
Q

Risks fo Steroids

A
  • Increased chance of infection

- Increased BG

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34
Q

What is CPT?

A

Chest Physiotherapy - patting on chest/back to break up secretions

35
Q

Which condition is CPT a treatment of?

A

Cystic fibrosis

36
Q

CPT: timing

A

QID (Before meals/Before bedtime)

37
Q

Sutioning for Pediatrics

A
  • Each pass <5 seconds

- Suction only on the way out

38
Q

Respiratory Distress: S/S

A
  • Nasal flaring
  • Retractions
  • Stridor
  • Restlessness
39
Q

What is the earliest sign of respiratory distress?

A

restlessness

40
Q

Treatment for Allergic Rhinitis

A

Administer antihistamines, identify and remove trigger

41
Q

Quick Relief for astham/allergic reaction

A

Epinepherine (for antiphylaxis)

42
Q

Long-term Relief for asthma/allergic reaction

A

Albuterol, MDI

43
Q

Acute Streptoccocal Pharyngitis: major risk

A

Sequelae

  • Rheumatic fever/heart disease (cardiac)
  • Glomerulonephritis (renal)
44
Q

Strep. Pharyngitis: S/S

A
  • Fever/chills
  • Foul breath
  • Dry thoat
  • Dysphagia
  • Otalgia
  • HA
  • Malaise
  • Muscle pain
  • Enlarged cervical nodes
  • Mouth breathing
45
Q

Which condition leads to tonsillitis and a possible tonsillectomy?

A

Acute strep. pharyngitis

46
Q

Pharyngitis: nursing care

A
  • Give abx
  • Bed rest
  • Apply warm/cold compresses to neck
  • Warm saline gargle
  • Foods and liquids as tolerated
  • Teach hand washing
47
Q

Pharyngitis: S/S

A
  • Abrupt illness
  • HA, fever, and abd pain
  • Tonsils amnd pharynx (inflamed, red, covered in yellow exudate)
  • Inflammed painful lymph nodes
  • Pain on swallowing
48
Q

Tonsillectomy Post-op Care

A

Assess for post-op bleeding: frequent swallowing

49
Q

Croup: Nursing Care

A
  • Maintain airway
  • Cool mist vaporizer
  • Corticosteroids
  • Nebulized Epi
  • Monitor respiratory and cardiac systems
  • **Never assess with tongue blade
50
Q

Croup: S/S

A
  • Hoarseness
  • Barking cough, inspiratory stridor
  • Respiratory distress
  • Respiratory infection
  • Effects on the larynx, trachea, and bronchi
51
Q

Which retractions indicates the most severe distress?

A

Clavicular

52
Q

What is the most lethal genetic illness in white children?

A

Cystic Fibrosis

53
Q

Cystic Fibrosis: Patho

A
  • Increased production and viscosity of mucus
  • Mucus forms concretions in glands and ducts
  • Elevation of sweat electrolytes

Mainly affects the respiratory tract and the pancreas

54
Q

Cystic Fibrosis: Diagnostics

A
  • Sweat chloride test
  • Chest X Ray
  • Stool fat and/or enzyme analysis
  • Barium enema
55
Q

Cystic Fibrosis: GI Effects

A
  • Impaired fat/protein digestion = steatorrhea, azotorrhea
  • Clubbing
  • Sterility in males
  • Delayed puberty in females
  • Rectal prolapse
  • **Children “taste salty”
  • Dehydration
56
Q

Epiglottitis (croup exacerbation): S/S

A
  • Sore throat
  • Pain
  • Tripod sitting
  • Retractions
  • Stridor
  • Mild hypoxia
  • Distress
57
Q

Epiglottitis: prevention

A

Hib Vaccine

58
Q

Epiglottitis: Nursing care

A

Trach kit at bedside

59
Q

Apnea

A

Defined: >20 seconds without breathing

Stimulate child to breathe before calling a code

60
Q

Hypoxemia

A
  • Chronic can cause clubbing

- Keep O2 >98%

61
Q

Esophageal Atresia

A

EMERGENCY

S/S: frothing/bubbling at the mouth/nose, excessive drooling, coughing, cyanosis, respiratory distress

62
Q

Tetralogy of Fallot (TOF) 4 conditions in 1

A
  • VSD (Ventricular septal defect)
  • Pulmonic Stenosis
  • Overriding Aorta (shifted)
  • Right Ventricular Hypertrophy
63
Q

TOF: S/S

A
  • Cyanosis with crying or playing

- TET spells

64
Q

TOF: Care

A
  • Requires surgical repair
  • Post op management
  • Subacute Bacterial Endocarditis Prophylaxis (SBE)
65
Q

Congenital Heart Defects

A
  • Increases respiratory infection risk
  • Impaired myocardial function
  • Pulmonary congestion
66
Q

CHD: Causes

A

-Maternal drug use
-Teratogenic conditions during pregnancy
Rubella (german measles), Chickenpox, 5th disease
-Infant to diabetic mother (IDM)

67
Q

Systemic Venous Congestion: S/S

A
  • Pleural effusions
  • Hepatic enlargement
  • Ascites
  • Edema
  • JVD
68
Q

Rheumatic Fever: S/S

A
  • Carditis
  • Polyarthritis (>5 joints)
  • Erythema marginatum (rash)
  • Subcutaneous Nodes (non-tender nodes over bony prominence)
69
Q

Activity Recommendations for CHD kids

A
  • Activity is fine

- Recommend frequent rests as needed

70
Q

Ventricular Septal Defect (SVD)

A

A hole b/w the ventricles, causing oxygenated and deoxygenated blood to mix

May need surgical repair

71
Q

SVD: S/S

A
  • SOB
  • Feeding difficulties
  • Poor growth
  • Easily fatigued
  • Heart murmur with thrill
72
Q

Coarctation of the Aorta (CoA)

A

Narrowing of the aorta (may be from ductus arteriosus closure scarring)

73
Q

CoA: S/S

A
  • Rapid RR
  • Heavy breathing
  • CHF
  • Poor weight gain
  • BP difference b/w arms and legs
  • Lower extremities = cool
  • Upper extremities = warm
74
Q

Aortic Stenosis (AS or AVS)

A

Abnormality in development of the aortic valve; progressively worsens = blood flow alterations

Frequently missed diagnosis

75
Q

Aortic Stenosis: S/S

A
  • Fatigue
  • SOB
  • Tachycardia
  • Chest pain
  • Decreased CO
  • Possible sudden death
  • Clubbing (10-11 yr)
76
Q

Pulmonic Stenosis (PS or PVS)

A

Narrowing of the opening of the pulmonic valve. RV must push harder to get blood through = dysrythmia

77
Q

Pulmonic Stenosis: S/S

A
  • Skin pale, cool, clammy
  • Unable to exercise
  • Fatigue
  • Heavy/rapid breathing
  • Whooshing breaths
78
Q

Pulmonic Stenosis: tx

A

Balloon valvuloplasty or open heart surgery

79
Q

Patent Ductus Arteriosus (PDA)

A

Ductus arteriosus fails to close = blood flow from the left side of the heart into the lungs

80
Q

PDA: S/S

A
  • Murmur
  • Frequent colds
  • Susceptible to RSV
  • Fatigue
  • Poor feeding
  • Poor growth pattern
81
Q

PDA: Care

A
  • Closed surgically

- Indomethacin (Indocin)

82
Q

Blood Flow

A 
Vena Cava
RA--> tricuspid
RV--> pulmonary valve --> pulmonary arteries
Lungs--> pulmonary veins
LA--> bicuspid (mitral) valve
LV--> aortic semilunar valve
Aorta
Body
83
Q

CPR Guidelines for Peds

A

Unwitnessed: CPR 2 mins, then call for help
Witnessed: Call for help and begin CPR immediately

1- 30:2
2- 15:2

Child Health (9 decks)

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