CPN Exam Fluid/Elec, Renal, GU

Question 1

Mild Dehydration

Answer 1

Normal tear and urine output
Increased specific gravity
Thirst
Normal heart rate/cap refill

Question 2

Moderate Dehydration

Answer 2

↓ tear and urine output
↑ heart rate
Irritability or decreased activity

Question 3

Severe Dehydration

Answer 3

No tears or urine output
Sluggish/decreased capillary refill
Mottled/cool skin
Neuro status depressed

Question 4

Isotonic Dehydration

Answer 4

No movement of water between intracellular and extracellular spaces
Sodium and water loss equal
Normal sodium levels

Question 5

Hypotonic Dehydration

Answer 5

Extracellular to intracellular movement of water (earlier signs of dehydration)
Sodium loss greater than water loss

Question 6

Isotonic Dehydration causes

Answer 6

vomiting
diarrhea
NPO status
burns

Question 7

Hypotonic Dehydration causes

Answer 7

water intoxication ; watering down/diluting infant formula (one of leading causes of seizures in healthy babies)

Question 8

Hypertonic Dehydration

Answer 8

Intracellular to extracellular movement of water

Question 9

Hypertonic Dehydration causes

Answer 9

excessive sweating, ketoacidosis, malnutrition, diabetes insipidus

Question 10

Fluid Replacement guidelines

Answer 10

Oral: 2-5 mLs every 2-3 minutes, 5-10 mLs every 5 minutes

Question 11

IV Fluid Resuscitation

Answer 11

20mL/kg IV bolus of isotonic solution

Question 12

UTI

Answer 12

Microbial invasion of urinary tract, usually caused by E.coli

Question 13

Cystitis

Answer 13

Bladder Infection

Question 14

Pyelonephritis

Answer 14

Kidney Infection

Question 15

Urethritis

Answer 15

Urethra Infection

Question 16

Nephrotic Syndrome

Answer 16

Increase glomerular permeability to protein, especially albumin - protein loss

Question 17

Nephrotic Syndrome Assessment

Answer 17

Proteinuria
Hypovolemia
Hematuria
Decreased serum potassium
Dark, foamy, and frothy urine
Edema

Question 18

Nephrotic Syndrome Treatment

Answer 18

Skin Care
High calorie, high protein meals - no added salt
I&O
Corticosteroids

Question 19

Acute Glomerulonephritis

Answer 19

Autoimmune complex disorder 1-2 weeks after strep infection. Body produces antibodies that attack the glomerulonephritis, kidney attacked

Question 20

Acute Glomerulonephritis Process

Answer 20

Glomerulus loses ability to selectively permeable - RBC’s/Protein filters through

Question 21

Acute Glomerulonephritis Assessment

Answer 21

Hematuria
Cola - Colored (smoky) urine
Increase ESR
Increase ASO titer
Edema
Irritability/Lethargy

Question 22

Hypospadias

Answer 22

Congenital anomaly of the penis in which the urethral meatus opens on the underside of penis, may cause frequent UTI’s and infertility

Question 23

Hypospadias Treatment

Answer 23

Surgery between 1-4 years
Avoidance of circumcision - foreskin may be used for repair

Question 24

Testicular Torsion

Answer 24

Testicle hangs free from vascular structures, results in venous occlusion

Question 25

Testicular Torsion Assessment

Answer 25

Red Scrotum, warm, swollen, painful Severe acute pain, nausea/vomiting

Question 26

Testicular Torsion Management

Answer 26

Manual Detorsion - < 6 hours of pain Surgical Detorsion - > 6 hours of pain

Question 27

Pelvic Inflammatory Disease

Answer 27

Infection affecting the uterine tubes, uterus or ovaries Caused by gonorrhea, trachoma's, bacteria

Question 28

PID Assessment

Answer 28

Subacute/Acute pelvic pain Fever/chills/nausea/vomiting Vaginal discharge Increased WBCs in vaginal fluid, Increased ESR

Question 29

Braden QD Scale

Answer 29

Determines risk for skin breakdown

Question 30

Impetigo

Answer 30

Most common bacterial infection in children, caused by strep or staph

Question 31

Impetigo Assessment

Answer 31

Small vesicles or pustules that rupture and become a honey-colored crust with a moist erythematous base

Question 32

Impetigo Management

Answer 32

Topical antibiotic with or without systemic antibiotic

Question 33

Scabies

Answer 33

Contagious mite infection, incubation is 1-2 months

Question 34

Scabies Assessment

Answer 34

Intense itching, worse at night Rash and skin burrows, papule, vesicles, crusting

Question 35

Scabies Management

Answer 35

Scabicide below the neck 8-12 hours then wash, repeat 1 week later

Question 36

Ringworm (Tinea)

Answer 36

Fungal infection

Question 37

Tinea Capitis

Answer 37

Lesions on scalp

Question 38

Tinea Corporis

Answer 38

Lesions on body

Question 39

Tinea Cruris

Answer 39

Jock Itch

Question 40

Tinea Pedis

Answer 40

Athletes foot

Question 41

Stevens-Johnson Syndrome

Answer 41

Self-limiting Hypersensitivity complex affecting skin and mucous membranes More common in males Precipitated by drugs such as antibiotics

Question 42

Stevens-Johnson syndrome Assessment

Answer 42

Flu like symptoms Red/Purple rash - causes skin sloughing