C - Neurological, GI, Renal & other conditions Flashcards
L2 School Lect
RENAL CONDITIONS - UTI
Causes and symptoms of UTI?
Caused by Ecoli
Symptoms:
Lower tract:
- dysuria (pain when you pee),
- frequent peeing,
- suprapubic pain (lower abdomen)
Upper tract:
- generally <2 yrs old,
- fever,
- loin pain (back of body)
RENAL CONDITIONS
Treatment of UTI? (2)
- Hygiene
- Antibiotics:
- 1st line: ampicillin &/ gentamycin
- 2nd line: ceftriaxone or cefotaxime
RENAL CONDITIONS
Whats Glomerulonephritis and its symptoms (7)?
- inflammation of glomeruli of kidney
SYMPTOMS:
1. Typically caused by Upper resp. tract infection (within 1-2 week) streptococci infection -> antibodies that fought the URTI -> end up in glomeruli -> triggers inflammation
2. Sudden onset of gross hematuria = blood in urine – tea colored, reddish-brown or smoky urine
- Inflammation damages the filtration barrier -> increased permeability -> RBCs that are normally retained in bloodstream leak into the urine.
3. Proteinuria (Total 24 hour urine) > 1gm -> Hypoalbuminemia – losing protein in urine
4. sediment in urine – WBCs epithelial cells hyaline granular and RBC casts
5. hypervolemia -> High BP & edema
6. Oliguria - low urine output
7. May have low grade fever, abdominal pain, vomiting, anorexia or headache
RENAL CONDITIONS
Treatment of Glomerulonephritis? (2)
- depends on symptoms
- strict assessment of intake and output
RENAL CONDITIONS
What’s Nephrotic Syndrome and the 3 forms that occurs in children?
- Damage to the glomerular filtration barrier increases its permeability to proteins
- May be an immune disorder which increases protein permeability
Nephrotic Syndrome in children occurs in 3 forms:
1. Idiopathic/primary NS
– Most common
-
- Secondary
- Occurs due to systemic diseases or other conditions that damage the glomeruli
- like Post-infectious glomerulonephritis, sickle cell anemia or system lupus erythematous - Congenital
- rare but birth condition
- Often due to genetic mutations affecting glomerular structure
RENAL CONDITIONS
What are the 4 Characteristics of nephrotic syndrome?
- MASSSIVE Proteinuria compared to glomerulonephritis
Loss of protein causes:
2. Hypoalbuminemia = decreased albumin levels in plasma
- Reduced plasma oncotic (osmotic) pressure → decreases BVs ability to retain fluid -> fluid shifts from BVs into the interstitial space = tissues -> edema = fluid buildup in tissues
- Hyperlipidemia
(liver compensating protein loss by increase production of lipid)
- lipids & ketones are diff!!!!
Neuro Conditions
What are seizures and the types? (3)
Seizure: abnormal electrical discharge in brain
1. Generalised tonic-clonic
- around the whole brain
- tonic: stiff muscle
- clonic: muscles contract repeatedly to produce jerking movements
- Focal/Partial
- abnormal electrical discharge only in 1 area of the brain
- eg: motor cortex - Febrile
- temp 38.5deg or more
- tonic clonic phases
Neuro Conditions
What are the nursing interventions for seizures? (2)
- Rectal diazepam to stop the seizure!!!
- Prevent Injury!!!
A. seizure precautions
- Bedside padding
- Oxygen
- Suction apparatus
- dont touch pt -> can cause fractures
- Establish baseline developmental level & monitor for changes
B. Administer medication
- treat underlying cause: eg fever -> cold compress, antipyretics
C. Position child
- neck extended for airway patency
- Avoid prone, neck flexion (increases ICP)
- Raise head of bed 35-45 deg to facilitate venous drainage of the brain
- Ensure availability of equipment by
anticipate care needs - eg o2 & suction
During seizure:
- remove harmful objects,
- do not place anything in mouth
- put child on side & extend neck -> allow drainage of secretions & airway patency
Neuro Conditions
Whats meningitis?
Which age group is most susceptible?
- infection of the meninges
- mostly: 1mth - 5 yrs old
- infants < 1yr most susceptible to bacterial meningitis
READ & UNDST
Signs of meningitis in children < 2 yrs & older children?
Children < 2 yrs:
1. Poor feeding, irritable, lethargic
2. High pitched cry, bulging fontanelle
3. Fever or low temp
4. Hyperextension of neck or spine
Older children:
1. Resp/GI problem
2. Stiff neck
3. Headache
4. Tripod posture
5. Kernig sings - pain & resistance to knee extention in supine
6. Brudzinski’s sign - flex knees & hips when neck is flexed in supine
What are the nursing interventions for seizures and meningitis? (3)
- Prevent Infection
* Infection control measures
* Proper technique when caring for drainage tubes, dressing etc - Promote Optimal Growth
* Monitor child’s intake and output
* Nutrition and age appropriate activities - Minimise anxiety
* Encourage family visit
* Explain procedures and tests
Nursing interventions for seizures and meningitis
GI conditions
What’s acute gastroenteritis and its signs?
- diarrhoea disease
Signs:
- diarrhoea, vomiting, fever, dehydration, electrolyte imbalance, URTI, skin integrity
- risk of infection
GI conditions
Whats the nursing management depending on clinical presentation for GI conditions?
- Adequate hydration
- IV fluid and electrolytes replacement/maintenance
- Oral rehydration salt - can be made into ice pops for moderate & severe diarrhoea & dehydration - Adequate food
- tolerates feeds
- reintroduce nutrients - Pain management and pain scales
- Skin care
- change diaper frequently
- rinse with water & cotton balls instead of wet wipes
- apply barrier cream if needed
