Final Blueprint Pt. 3 Flashcards
what are the congenital problems?
cerebral palsy, neural tube defects, spina bifida, hydrocephalus, and hypotonia
what is important to know about hydrocephalus?
Cause: primary (Arnold Chiari Syndrome) and secondary (acquired).
S/S: sunset sign, increased head circumference, high-pitched cry, poor feeding if ICP is too high
Surgical treatment with shunt placement/biggest complication is infection
Nursing care: support child and family, teach signs of infection, and skin care.
what is hypotonia?
floppy infant syndrome, when supine is frog legged. Head lag, poor suck, and EMG key diagnostic test. Management by the cause.
convex curve, secondary to disease such as TB, chronic arthritis, compression FX, postural: noted when skeletal growth outpaces muscle, and treated with exercises (shoulder and abd) and bracing
Kyphosis
lateral curvature, spiral rotation, thoracic hypokyphosis, classified by age on onset: infantile, juvenile, adolescent, usually no cause, but may be in association with neuromuscular conditions, and observed undressed-shoulder height, scapular or flank shape or hip height and alignment
scoliosis
cervical or lumbar curve beyond physiologic limits, secondary to disease, the result of trauma, or idiopathic, associated with contracture of hip, scoliosis, obesity, DDH and SCFE, and treated with wt loss if contributing exercises and bracing.
lordosis
what is important to know about scoliosis?
Bracing = Gold Standard treatment
Compliance difficult: body image
Boston or Wilmington: plastic – underarm
Milwaukee: with neck brace
Charleston nighttime: prevents walking
what is hypoglycemia and its S/S?
monitor often and treat with 15 gm carbohydrate or glucagon. Recheck BG 15 M. Repeat the cycle until glucose >70 and continue to monitor for 2 H.
S/S:
Clammy skin
Irritability
Decreased LOC
Stroke like S/S
Slurred speech
Hungry
Grouchy
Sleepy
Sweating
Shakey
Pallor
Confusion
what are the S/S and important to know for hyperglycemia?
S/S:
Polydipsia
Polyuria
Polyphagia
Type 1 DM: your body does not make insulin, so you take insulin. Typically, not diagnosed until they are teens.
Exercise burns up extra glucose. So, if you have a kid who has T1DM, and he goes to PE pat should have snack b4 exercise. In order to prevent hypoglycemia attack. That is also why they get a 9pm snack like PB and crackers.
what is the NIPS pain scale?
maximal score of 7 points, considering pain > 4
Facial expression (relaxed = 0 pts, contracted = 1 pt, (–) = 2 pts)
Cry (absent = 0 pts, mumbling = 1 pt, vigorous = 2 pts)
Breathing (relaxed = 0 pts, different than basal = 1 pt, (–) = 2)
Arms (relaxed = 0 pts, flexed/stretched = 1 pt, (–) = 2 pts)
Legs (relaxed = 0 pts, flexed/stretched = 1 pt, (–) = 2 pts)
Alertness (sleeping/calm = 0 pts, uncomfortable = 1 pt, (–) = 2 pts)
what is the FLACC pain scale?
(2 months – 7 years): behaviors are scored 0-2 for each of 5 behaviors for a total of 0 (no pain) to 10 (worst pain)
Face: no expression or smile = 0, occasional grimace or frown, withdrawn, disinterested = 1, frequent to constant quivering chin, clenched jaw = 2
Legs: normal position/relaxed = 0, uneasy, restless, tense = 1, kicking or legs drawn up = 2
Activity: lying quietly, normal position, moves easy = 0, squirming, shifting back and forth, tense = 1, arched, rigid or jerking = 2
Cry: no cry (awake or asleep) = 0, moans or whimpers, occasional complaint = 1, crying steadily, screams or sobs, frequent complaints = 2
Consolability: content, relaxed = 0, reassured by occasional touch, hug or being talked to, distractible = 1, difficult to console or comfort = 2
what is the FACES pain scale?
(3 years and older): rating scales uses drawings of happy and sad faces to depict levels of pain
what is the HUS triad?
anemia, thrombocytopenia, and renal failure
what is the patho and treatment for HUS?
Patho: primary site endothelial lining of the small glomerular arterioles-swell and occluded with deposits of platelets and fibrin clots. RBC are damaged moving through partially occluded blood vessels. Damaged cells removed by spleen causing acute hemolytic anemia = thrombocytopenia
Treat: hemodialysis or peritoneal dialysis (for those anuric for 24 H, or oliguria with uremia or HTN and seizures), FFP and plasmapheresis, fresh/washed packed cells, and emergency support for family and child.
what are the CM for HUS?
primarily in infant 6 mos to 5 yo, acquired hemolytic anemia, thrombocytopenia, renal injury, and CNS symptoms, associated with e.coli (undercooked ground beef), unpasteurized milk or fruit juice (apple), sprouts, lettuce, salami or drinking – swimming in sewage-contaminated H2O, and begins with gastro or URI.
what is the patho and etiology of nephrotic syndrome?
Patho: predominately 2-7 yo (rare under 6 mos, uncommon under 1 yo, usually after 8 yo), may be metabolic, biochemical, physiochemical, or immune-mediated disturbance: basement membrane increasingly permeable to protein- albumin leaks and is lost in urine (reduces serum albumin level), fluid accumulates in interstitial spaces (edema) and body cavities (ascites).
Etiology: massive proteinuria, hypoalbuminemia, hyperlipidemia, and edema, primary (idiopathic nephrosis, childhood nephrosis, or minimal change nephrotic syndrome), secondary (after glomerular damage), and congenital (autosomal recessive).
what are the CM, therapy goals, and TX for nephrotic syndrome?
CM: wt gain, edema around eyes, scrotum, labia, ankles – especially in the AM, ascites, poor appetite, elevated BP, tired, and urine is frothy and decreased in volume.
Therapy goals: reduce excretion of urinary protein and fluid retention in tissues and prevent infection and minimize therapy complications.
Treatment: low salt diet, severe cases fluid restriction, edema (diuretics), 25% albumin, and corticosteroids.
what is important to know about reflexes?
Absent corneal reflex and presence of tonic neck reflex associated with severe brain damage. Neuro “health” in young infants: presence of Moro, tonic neck, and withdrawal reflexes.
