CPN Exam Fluid/Elec, Renal, GU Flashcards
Mild Dehydration
Normal tear and urine output
Increased specific gravity
Thirst
Normal heart rate/cap refill
Moderate Dehydration
↓ tear and urine output
↑ heart rate
Irritability or decreased activity
Severe Dehydration
No tears or urine output
Sluggish/decreased capillary refill
Mottled/cool skin
Neuro status depressed
Isotonic Dehydration
No movement of water between intracellular and extracellular spaces
Sodium and water loss equal
Normal sodium levels
Hypotonic Dehydration
Extracellular to intracellular movement of water (earlier signs of dehydration)
Sodium loss greater than water loss
Isotonic Dehydration causes
vomiting
diarrhea
NPO status
burns
Hypotonic Dehydration causes
water intoxication ; watering down/diluting infant formula (one of leading causes of seizures in healthy babies)
Hypertonic Dehydration
Intracellular to extracellular movement of water
Hypertonic Dehydration causes
excessive sweating, ketoacidosis, malnutrition, diabetes insipidus
Fluid Replacement guidelines
Oral: 2-5 mLs every 2-3 minutes, 5-10 mLs every 5 minutes
IV Fluid Resuscitation
20mL/kg IV bolus of isotonic solution
UTI
Microbial invasion of urinary tract, usually caused by E.coli
Cystitis
Bladder Infection
Pyelonephritis
Kidney Infection
Urethritis
Urethra Infection
Nephrotic Syndrome
Increase glomerular permeability to protein, especially albumin - protein loss
Nephrotic Syndrome Assessment
Proteinuria
Hypovolemia
Hematuria
Decreased serum potassium
Dark, foamy, and frothy urine
Edema
Nephrotic Syndrome Treatment
Skin Care
High calorie, high protein meals - no added salt
I&O
Corticosteroids
Acute Glomerulonephritis
Autoimmune complex disorder 1-2 weeks after strep infection. Body produces antibodies that attack the glomerulonephritis, kidney attacked
Acute Glomerulonephritis Process
Glomerulus loses ability to selectively permeable - RBC’s/Protein filters through
Acute Glomerulonephritis Assessment
Hematuria
Cola - Colored (smoky) urine
Increase ESR
Increase ASO titer
Edema
Irritability/Lethargy
Hypospadias
Congenital anomaly of the penis in which the urethral meatus opens on the underside of penis, may cause frequent UTI’s and infertility
Hypospadias Treatment
Surgery between 1-4 years
Avoidance of circumcision - foreskin may be used for repair
Testicular Torsion
Testicle hangs free from vascular structures, results in venous occlusion
Testicular Torsion Assessment
Red Scrotum, warm, swollen, painful
Severe acute pain, nausea/vomiting
Testicular Torsion Management
Manual Detorsion - < 6 hours of pain
Surgical Detorsion - > 6 hours of pain
Pelvic Inflammatory Disease
Infection affecting the uterine tubes, uterus or ovaries
Caused by gonorrhea, trachoma’s, bacteria
PID Assessment
Subacute/Acute pelvic pain
Fever/chills/nausea/vomiting
Vaginal discharge
Increased WBCs in vaginal fluid, Increased ESR
Braden QD Scale
Determines risk for skin breakdown
Impetigo
Most common bacterial infection in children, caused by strep or staph
Impetigo Assessment
Small vesicles or pustules that rupture and become a honey-colored crust with a moist erythematous base
Impetigo Management
Topical antibiotic with or without systemic antibiotic
Scabies
Contagious mite infection, incubation is 1-2 months
Scabies Assessment
Intense itching, worse at night
Rash and skin burrows, papule, vesicles, crusting
Scabies Management
Scabicide below the neck 8-12 hours then wash, repeat 1 week later
Ringworm (Tinea)
Fungal infection
Tinea Capitis
Lesions on scalp
Tinea Corporis
Lesions on body
Tinea Cruris
Jock Itch
Tinea Pedis
Athletes foot
Stevens-Johnson Syndrome
Self-limiting Hypersensitivity complex affecting skin and mucous membranes
More common in males
Precipitated by drugs such as antibiotics
Stevens-Johnson syndrome Assessment
Flu like symptoms
Red/Purple rash - causes skin sloughing
