Case study mod 6 Flashcards
How does the nurse describe the pathophysiology of ITP to Dillon’s parents?
Autoimmune destruction of platelets, low platelet count
- What clinical manifestations are associated with ITP?
Petichiae, nosebleeds, gum bleeding, easy bruising
- The provider orders anti-D antibody. The nurse knows that this medication will stop Dillon’s nosebleed immediately.
False
- The most common viral infections associated with acute ITP are:
Upper respiratory diseases, MMR
- ITP can become a chronic condition. What is the best therapy for long-term remission of chronic ITP?
Splenectomy at age 5+
- What is aplastic anemia?
Depression of RBC, WBC, Platelets
- What findings confirm a diagnosis of aplastic anemia?
Bone marrow cellularity: 25% or under, that means 75%+ fat in marrow
- What is the most frequent type of internal bleeding associated with hemophilia?
Hemoarthrosis
- What are some potential management strategies for hemophilia?
FFP, factor replacement therapy, DDAVP, exercise
- List the vital sign changes that are associated with brainstem injury following acute head trauma:
Temp, RR, BP fluctuations, wide pulse pressures
- In contrast, what is a key clinical manifestation of IICP in an infant?
Fontanelle bulging
- You note that Tommy appears to have a runny nose. He has no other respiratory symptoms and is not febrile. What is an important nursing consideration?
Glucose test to see if CSF
- Marshall is a 9-month-old admitted to the pediatric unit for Haemophilus influenzae meningitis. Marshall has not been vaccinated. What clinical findings are expected in an infant with meningitis?
Fever, vomiting, inconsolable, high pitched cry, bulging firm fontanelles
- Could this case of meningitis have been prevented? How?
Hib vaccine
- Callie is a 5-year-old who presents to the clinic because of a palpable painless mass on the left side of her abdomen. Her mother found the mass while bathing her. Why is the diagnosis most likely Wilms tumor rather than neuroblastoma?
Wilms doesn’t cross midline, and it is more common in older toddlers
- Where is Wilms tumor located?
On one of the kidneys
- What is the prognosis associated with Wilms tumor?
Very good prognosis- tumor is encapsulated
- Kimberly, a 2-year-old, is brought to the emergency room for evaluation because of having a headache and vomiting after waking up for the past week. Kimberly is admitted to the hospital and after magnetic resonance imaging (MRI) with contrast is performed, she is diagnosed with a brain tumor. Discuss why the most common presenting symptoms of a brain tumor are headache and vomiting.
Increased pressure from dural stretching, brainstem compression
- The treatment of choice is total removal of the tumor surgically. Discuss some preoperative teaching that should be given to the family.
Symptoms might be worse after surgery due to inflammation
- You arrive home from a long day at clinical and begin scrolling through your social media account. You come across a photo of a friend’s infant, and notice something strange – a whitish “glow” in the infant’s left pupil. You are concerned that the infant may have a retinoblastoma. What is the medical term for this manifestation?
Leukochoria, cat’s eye
- What is the next most common sign that may indicate the presence of a retinoblastoma?
Strabismus
- What is a late sign of retinoblastoma?
Blindness
- When blindness is present, what procedure may be performed?
Enucleation: removal of affected eye
