exam 2 Flashcards
what lab cue would be expected for a patient with tetralogy of fallot?
increased H and H (RBCs) due to the kidneys trying to compensate
what are the expected findings for a VSD (ventricular septal defect)?
- L to R shunting
- palpable thrill
- holosystolic murmur
- Pulmonary artery hypertension
what are the expected findings of a PDA (patent ductus arteriosus)?
-low Dbp
- machine murmur
- wide pulse pressure
- bounding pulses
what are the cues of coarctation?
- rib notching
- unequal pulses (upper extremities bounding, lower extremities weak)
- frequent epistaxis
- high BP in upper extremities
what are the cues for tetralogy of fallot?
- boot shaped heart
- TET spells
what should you do if your patient vomits 5 mins after receiving digoxin?
- check dig level
- notify provider
what should you do if your patient is prescribed lasix but has muscle weakness and cramps?
check potassium level
if a 6-yr-old has fever, tachycardia and subQ nodules, what history should the nurse suspect?
recent pharyngitis (strep throat that is causing the child to have acute rheumatic fever)
what labs are expected with nephrotic syndrome?
- proteinuria
- decreased serum albumin
- increased lipids and cholesterol
what antidiuretic medication is used for children experiencing enuresis?
desmopressin
what are the physical cues related to nephrotic syndrome?
- recent, sudden weight gain
- frothy urine
- ## periorbital edema/anasarca
what medications are utilized in the treatment of nephrotic syndrome?
- corticosteroids (prednisone)
- diuretics
what medication used in the treatment of nephrotic syndrome may cause the child to have cushings features/wt gain/increased appetite?
corticosteroids (prednisone)
how may the urine look for children with acute poststreptococcal glomerulonephritis?
- gross hematuria
- tea color
- cola color
- dirty green color
what recent social history may be the culprit for the development of HUS (hemolytic uremic syndrome)?
- ingestion of ground beef
- visit to waterpark
- public pool
- petting zoo
what should the nurse suspect if a patient vomits 5 minutes after giving digoxin?
dig toxicity
what action should the nurse take for a patient who has been prescribed lasix and has muscle weakness and ST depression on EKG?
check potassium level
what are the s/s of left sided heart failure?
- increased WOB
- tachypnea
- wheezing, rails
- feeding difficulties
- dyspnea on exertion
what are the s/s of r sided heart failure?
- hepatomegaly
- edema
- JVD
- periorbital edema
- weight gain
what medication is appropriate to manage the joint pain for a child with acute rheumatic fever?
aspirin
which cardiac condition may result in a widened pulse pressure?
patent ductus arteriosus
where is the murmur of a ventricular septal defect best heard?
left sternal border
a nurse is caring for a child who has tetralogy of fallot and is experiencing a hypercyanotic spell, what is the best action for the nurse to take?
place child in the knee to chest position (pushes blood into the pulmonary artery)
what is the purpose of an ASO titer test for a child with glomerulonephritis?
to determine if the child has had a recent strep infection, a likely culprit for glomerulonephritis
why is skin care important for a child with nephrotic syndrome?
edema and the increased risk for infection
what findings are seen with poststreptococcal glomerulonephritis?
- hematuria
- elevated BP
- positive ASO titer
- decreased UOP
how much ORS should be provided to a 32 kg child with mild dehydration?
1600 mL
kg x 50 mL for mild dehydration ORS
how much ORS should be provided to a 24 kg child with moderate dehydration?
2400 mL
kg x 100 mL for moderate dehydration ORS
how much ORS should be provided to a 22 kg child w/moderate dehydration and has had 2 loose stools?
2640 mL
moderate = kg x 100 mL
+
stools = kg x 10 mL/stool
after starting the ORS for a 42 kg child, the child has vomited, what rehydration action is suspected next?
IV rehydration bolus
kg x 20 mL = 840 mL
what is total IVF amount for a 24 hr period for a 28 kg child with dehydration?
1660 mL/24 hrs
