EXAM 2 Flashcards
Retinoblastoma
-An eye tumor
-White eye reflex (no red!)
-Symptoms: Squinting, Strabismus & Swelling
Autism
-No cause
-Deficits in social interactions, communication, & behavior
-Peculiar and bizarre characteristics in specific areas
-Trouble with eye and body contact
-Delayed language
-Behavior modification! and Structured routines!
-Important: Family counseling, support & education!
-Numerous therapies are important for overcoming/dealing with autism
-Parents often express guilt & shame
-Respite care important for tired parents
-Autism Society of America
When pt. has a respiratory problem, it’s important for the nurse to…
-Promote hydration
-Provide rest/comfort
-Prevent spread of infection
-Ease resp effort
-Reduce temp.
-Provide nutrition.
Streptococcal pharyngitis
-Caused by Strep A bacteria
-Can cause kidney and heart problems
-Diagnostics: Throat culture (?)
-Risk for rheumatic fever (affects heart, brain, joints, skin).
-Inflammatory disease
-Can also lead to tonsilitis
Croup/LTB
-Hoarseness, barking cough, inspiratory stridor, & varying degrees of resp distress.
-Affects the BIG 3 (LTB), and epiglottis & laryngitis
-Larynx, trachea, bronchi
-Infections all around!!! (upper and lower resp)
-Caused by bacteria or viruses (like Influenza or RSV)
What to do when you have Croup/LTB
-Maintain airway (RELAX IT!)
-Maintain hydration
-Neb mist with SUPP OXYGEN
-Racemic epi (neb)
-Steroids (prednisone) -> decrease inflammation
RSV
-Upper resp infection/virus
-Can be a risk for asthma (in children)
-Leading cause of child hospitalizations (toddlers/kids)
-Symptoms: runny nose, fever, wheezing, cough/sneeze, tachypnea, refusal to eat
-Can usually be managed at home. If symptoms are severe, then managed in the hospital
-5-10 ml of fluid
can also cause bronchitis
Epiglottitis (acute)
-An emergency!
-Abrupt and rapidly progresses to severe resp. distress
-Tripod position -> child insists on sitting in an upright position LEANING FORWARD
-Symptoms: sore throat, drooling -> trouble swallowing, STRIDOR, hypoxia, distress
What to do?
-Intubation (nasal b/c airway in throat is narrow)
-Prevent progressive resp. obstruction
-Treat with antibiotics
Cystic Fibrosis
Multisystem Issue:
-Increased viscosity of mucous gland secretions.
-Elevation of sweat electrolytes.
-Increase in enzymatic const. of saliva.
-Autonomic nervous system issues.
-Autosomal recessive trait.
-Defective gene from both parents.
*refer back to slides for more info
RSV
-Upper resp infection/virus.
-Can be a risk for asthma (in children).
-Leading cause of child hospitalizations (toddlers/kids).
-Symptoms: runny nose, fever, wheezing, cough/sneeze, tachypnea, refusal to eat.
-Can usually be managed at home. If symptoms are severe, then managed in the hospital.
Dehydration
-Children are more heavily affected by dehydration.
-How to diagnose? Physically assess the child; labs; electrolyte imbalance.
-Check for: skin turgor, fontanelles, mucous membranes, cap refill time, behavior.
-Therapeutic management: correct fluid imbalance/treat underlying cause.
-Oral rehydration solution 2-5mls every 2-3 minutes.
-Pedialyte is the best for dehydration (the right balance of H2O and salt).
-Dehydration is better managed at home.
Appendicitis
-Perumbilical pain to McBurney’s point
-More likely to rupture for little kids because they can’t explain s/s
-Fever, vomiting
-Diagnoses: CT scan & ultrasound
-Management: surgical removal of appendix
Inflammatory Bowel Disease
-Include ulcerative colitis and Crohn’s disease.
-Ulcerative colitis: rectal bleeding, severe diarrhea, less frequent pain, mild anorexia.
-Crohn’s disease: no rectal bleeding, diarrhea, common pain, severe anorexia, severe weight loss.
-Treatment: corticosteroids, immunomodulators, antibiotics
-Nutritional support -> enteral & parental -> high protein & high calorie.
-Emotional support -> calm sources of stress.
Acute Diarrhea
-Cause: usually pathogens spread by fecal/oral route; antibiotic administration.
-USUALLY ROTAVIRUS
-Diagnoses: history, travel, diet, contact w/ animals, fever, character of stool
-How to treat? Be mindful of fluid levels, REHYDRATE THE CHILD; Better treated at home.
-Teach caregivers signs of dehydration.
-Give small doses of liquids (& things of that nature).
-Perianal care because diarreha is irritating to the skin.
Cleft lip and palate
-Facial deformation that occurs during embryonic development.
-Apparent at birth.
-Care: interprofessional management.
-Surgical correction of CLEFT LIP 2-3mo.
-Surgical correction of CLEFT PALATE before 12mo.
-Care: feeding -> special bottle/nipple and breastfeeding support.
-A lot of people are involved in this process.
Pyloric Stenosis
-Projectile vomiting!!!!!!!!!!!!
-Develops first few weeks of life.
-Back -> 1 foot.
-Side-lying -> 3-4 feet.
-Insatiable hunger!!! 🙁
-Visible peristaltic waves.
-Palpable olive-shaped tumor.
-Diagnoses: ultrasound.
-Treat: surgery.
Intussusception
-Red or black Jelly like stools.
-Child screaming and drawing their knees.
-Child is normal and comfy between periods of pain.
-Abdomen tender & distended
-INVAGINATION or TELESCOPING of one intestine portion into another (3mo to 3yrs)
-Cause often unknown.
-Diagnose: ultrasound.
-Treat: surgery, enema, or it goes away.
Sickle cell anemia
-Universal screening of newborns.
-Obstruction caused by sickle RBC’s
-Vascular inflammation (in different areas in the body, very painful, malaise).
-Precipitating factors: physical & emotional distress, infection, fever, hypoxia, anything that increases body’s need for oxygen.
-Management: rest, IV hydration, analgesics for pain, blood replacement for anemia, antibiotics.
Urinary Tract Infections
-One of the most common childhood conditions.
-Impossible to localize the infection.
-Symptoms: foul-smelling urine, incontinence (toilet trained), frequency/urgency, pain with urination.
-Treatment: antibiotics (to get rid of infection, reserve renal function, prevent spread of infection.
-Diagnoses: clean catch/urinalysis.
-Teach appropriate cleaning of private areas, and peeing when the urge is felt.
Acute Glomerulonephritis
-Acute after strep infection (certain strains).
-Symptoms: Oliguria, Edema, Hypertension, Hematuria, Proteinuria
-Diagnosis: Did you have strep; Urinalysis, high BUN, high Creatine.
-Azotemia
-Treatment: manage edema, weight, low sodium diet, prevent infections, vital signs.
-Also: regularly monitor vital signs, fluids, and edema, no salt, fluid restriction
Head Injury
-3 main causes of head injury: motor vehicle, falls, struck by an object.
-Prevention.
-Children have larger heads (in relation to body).
-LOC assessment extremely important for any head injury
-FREQUENTLY assess LOC, vital signs, and neuro status.
Increased intracranial pressure
-Subtle signs and symptoms.
-As pressure increases, signs and symptoms increase.
-Earliest indicator is changes in neuro status.
-Assess: LOC, pupils, vital signs.
-Frequency varies (range from 15 min to 2 hours)
-Posturing -> involuntary abnormal movements.
-General s/s: headache, vomiting, blurred vision, seizures, drowsiness and lethargy.
-Irritability, poor feeding, increased sleeping, bulging & tense fontanelles.
*Skin injury
*Provide analgesia/sedation
Hydrocephalus
-Caused by imbalance in production & absorption of CSF.
-Obstruction through ventricular system.
-Early infancy or neoplasms, infection, and trauma.
-Treatment: often surgical (peritoneal shunt), deal with motor problems, treat complications.
Precocious Puberty
-Sexual development before 8 (girls), 9 (boys).
-Early mat. of gonads and secondary sex characteristics.
-Psychological support for child/fam.
-May be treated with Lupron (slows prepubertal growth).
