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Pediatrics > GI/GU/Endocrine > Flashcards

GI/GU/Endocrine Flashcards

1
Q

what are major issues with children with cleft lip and palate?

A

Feeding and bonding w parents/family (trust vs. mistrust)

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2
Q

Child w cleft lip and palate have problems later in school age w

A

speech

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3
Q

Every newborn with cleft lip/palate need ________ in the oral cavity for sucking

A

negative pressure

babies with cleft palates need a special bottle with a one way valve

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4
Q

It is hard for babies with cleft l/p to ______ so the mom can pump milk and feed baby w a bottle

A

breast feed

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5
Q

babies w cleft palate need a special bottle with a _____ way valve

A

one

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6
Q

When feeding, a baby with cleft palpate the child should sit

A

sit up-right, burp frequently and small frequent feeds (not too much at once)– aspiration risk

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7
Q

Cleft lip is repaired at ______

A

repaired within the first 6 months of life

ATI: 10 pounds and 10 weeks

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8
Q

Cleft palate surgical repair is done at ________

A

18 months of age

- consider how child’s speech is affective

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9
Q

baby cleft LIP surgical repairs post-op care

A
  • the no-no touch restraints for infants (PRN)
  • Avoid prone positions (cleft palate is okay but not lip)
  • Maintain the airway
  • light suction only if needed
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10
Q

post-op cleft palate repair

A

Prone postion is ok
clear liquid 4 hours and then formula 3-4 days
NOOO pacifiers, NOOO straws (nothing going into the mouth other then liquid)
Child MUST use a cup for feeds (no bottle)

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11
Q

long term effects of cleft palate

A
  • speech impairment

- otitis media (ear infection)– due to positioning of tubes in-ear connecting to the mouth

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12
Q

Hypertrophic Pyloric stenosis (HPS) is

A

a condition of the lower stomach in newborns, where the lower sphincter of the stomach becomes enlarged preventing food from entering the small intensities resulting in vomiting –> leading to dehydration

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13
Q

pyloric stenosis s/s

A

Projectile vomiting after feedings = pyloric stenosis (PS)
constant hunger
abdominal distension
palpable gastric olive shaped mass in the right umbilicus
poor weight fain and dehydration
–compare the current weight to birth weight

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14
Q

palpable gastric olive-shaped mass in the right umbilicus with vomiting is a sign of

A

hypertrophic pyloric stensis

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15
Q

HPS vomiting occurs

A

after feedings

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16
Q

infants stomachs can hold

A

30mL

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17
Q

How do you diagnose AND fix hypertrophic pyloric stenosis

A

Ultrasound

Laparoscopic surgery

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18
Q

Before a baby goes for surgery for HPS the nurse should

A

start IVF bolus NSS

NPO and NG tube to decompress the stomach before operation

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19
Q

Intussusception compare in what age group?

A

9 month-toddlers

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20
Q

Intussusception is when

A

one part of the intestines intestines into another part of the intestines

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21
Q

Intussusception s/s

A
  • stool that is blood/mucus-streaked (currant jelly)
  • sauage shaped abdominal mass
  • vomiting (non-projectile)
  • guarding, crying, DRAWING KNEES TO CHEST
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22
Q

S/S Intussusception is now peritonitis

A

fever
abdominal RIDIDITY
rebound tenderness

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23
Q

Treatment for Intussusception

A

Air enema !!! most effective
enema is given under imaging to reduce the defect
surgery is only needed if enema is not affective

—the goal is the passage of normal brown stool —> surgery won’t be needed

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24
Q

the child has currant jelly stool!!!!!!!! and the cycle of intermittent legs pulled up and the child is screaming!!! then they are relaxed and fine.. then get worst and loses LOC
what is happening?

A

Intussusception —> bowel ruptured (perforated) –> can lead to sepsis

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25
Q

Appendicitis s/s

A 
cramping around the umbilicus
pain at the McBurney's point (right lower quadrant) 
rebound tenderness!!!!!
fever
vomiting
guarding 
rigidity
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26
Q

the appendix is located in the

A

right lower quadrant (McBurney’s point)

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27
Q

tx of appendicitis

A

—–SURGERY before it ruptures, antibodies, fluid replacement, and pain control
NEVER use heating pads
NO laxatives and NO enema

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28
Q

s/s of peritonitis

A 
increased HR
rebound tenderness
feel better and get worst
fever
vomiting 
rigid board-like abdomen
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29
Q

reflux is expected and common during

A

infancy

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30
Q

If an infant is spitting up that’s normal buttttt if they are _____ it is considered GER/GERD

A

failure to gain weight or lose weight

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31
Q

adverse drug reaction for omeprazole _____ and it is in the drug class ____

A

bone lose

proton pump inhibitors (inhibited bone growth)

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32
Q

Feedings interventions to prevent reflex

A

small feedings

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33
Q

constipation is common with kids and is treated with

A

disimpaction, enemas, and laxatives

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34
Q

encopresis is common in

A

adolescence boys

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35
Q

encopresis also know as ______

A

fetal incontinence

36
Q

how do you treat encopresis

A
  • fetal incontinence
  • tx:
    STOOL CLEAN OUT—Miralax
    laxative and still softeners
    fluid and fiber
    schedule regular toilet visits after meals—sit on the toilet with an ipad
    keep a diary for toiler sessions
    parent should reward for EFFORT and do NOT reward for each BM
37
Q

encorpresis is caued by

A

voluntary or involuntary passage of stool

—pt loses feeling in the rectum

38
Q

Hirschsprung’s disease

A

is a chronic constipation disease where the stool is backed up
- large intense is not about to move stool properly

39
Q

s/s of Hirschsprung’s disease and what does the stool looks

A
  • failure to pass meconium within 48 hours
  • distended abdomen
  • consipation
  • ribbon-like
    because the stool is being contracted!
40
Q

What causes hirschsprung’s diease?

A

missing nerve cells in the colon

no movement in the intestines

41
Q

worst-case scenario if Hirschsprung’s disease is untreated

A

Enterocolitis –inflammation of the colon

42
Q

Hirschsprung disease is tx by

A 
surgical correction: 
pull through (surgery)

or

if the colon is too inflamed they will just do a colostomy and wait for surgery

43
Q

celiac diease is

A

auotimmune reation to gluten

44
Q

s/s of celiac disease

A 
present with forth, foul smelling and greasy stool
abdominal distenion
signs of malnurtion
muscle wasting
hypotonia
45
Q

Diagnose Celiac disease

A

tTG-IgA test

small intentional biopsy = villous atrophy on biopsy

46
Q

a child is about to get tested for celiac disease the parent should be educated that the child

A

should continue to eat gluten before the test

47
Q

________ is at risk for celiac diease

A

Type 1 DM

48
Q

What can a pt with celiac NOT eat?

A
  • wheat
  • barley
  • oats
  • rye
49
Q

everytime a patient (with celiacs) eats gluten is causes

A

microscope damage

50
Q

Growth hormone-deficient also known as

A

hypopituiarisum

51
Q

A parent comes in asking for growth hormones bc their child is short what does the nurse do first

A

check the human growth hormones to check the pituitary

- if there is a problem insurance covers if not it costs soooo much

52
Q

In diabetes insipidus
urine output is ________
Na is ________
specific gravity _________

A

high
high (stays in body)
down

53
Q

In SIADH (too much ADH)
urine output is ________
Na is ________
specific gravity _________

A

low
low (too much fluid compared to Na)
high

54
Q

s/s of type 1 DM

A 
weight loss
polydipsia
fatigue
blurred vision
mood change
NOT hunger (change in content)
55
Q

Honeymoon phase for DM type 1

A

the pancreas is still producing insulin on its own (causing hypoglycemia)

Honey moon think HO—hypoglycemia

56
Q

DM type 1 labs we look at

A

Hg-A1C

want this level higher then adults 7-7.5% for kids

57
Q

when are urine tests done for ketones (DM)

A

when a sick is sick (check Q3 hours)

their glucose is over 250

58
Q

giving rapid insulin want

A

breakfast tray ready

59
Q

giving short insulin want

A

meal tray in 30 mintutes

60
Q

giving long insulin want to know it has

A

NO PEAK

61
Q

suspected UTI the nurse should do a

A

urine sample for culture and sensitivity

62
Q

If a patient had pyelonephritis

A

start an antibiotic

63
Q

UTI medication for symptomatic management

A

pyelonephritis

64
Q

Kid comes in with a fever with no other symptoms get a ___

A

urine culture – check for UTI

65
Q

To be considered a UTI the sample must have

A

50,000 units per mL of the SAMEEEE colony forming

e.coli is most common

66
Q

If a child has a 2nd UTI

A

must get voiding cystourethrogram VCUG

67
Q

______ retrograde flow of the urine from the bladder back up to the kidneys
may occur in both ureters

A

Vesicoureteral reflux

68
Q

Vesicoureteral reflux is corrected by

A

antibiotics or surgery

surgery only if high grade 4-5

69
Q

______ bed wetting past the age of toilet training

A

Enuresis

70
Q

How to treat enuresis

A 
fluid restriction before bed
bladder exercises
timed voiding
enuresis alarms 
antidiuretic hormones 
- tricyclic anitdepress
71
Q

Enuresis is most common in children

A

chronically constipated

deep sleepers

72
Q

_________ is when one or both testes fail to descend through inguinal canal into the scrotum

A

Cryptorchidism

73
Q

Cryptorchidism should be tx w surgery within 4 months to prevent

A

infertility and increase risk for cancer

74
Q

Cryptorchidism assessment and surgery should be done in a ____ area

A

warm

75
Q

__________ is an Emergency condition where the testicle rotates and twists the spermatic cord cutting off blood supply to the scrotum

A

Testicular Torsion

76
Q

What is testicular torsion?

A

when the testicles rotates and causes sudden onset of severe pain and swelling

77
Q

how do you treat testicular torsion?

A

Prompt surgical intervention and detersion with orchiopexy

78
Q

Hypospadias and epispadias is surgical corrected between ages

A

6- 12 months

79
Q

Hypospadias and epispadias the child will have a stent and be doubled binder to

A

keep the urine and bacteria away from the surgical site

80
Q

Post-opt Hypospadias and epispadias should never have ____

A

a tub bath

circumcision (they can after surgical repair just not before)

81
Q

Nephrosis is caused by

A

HIGHER PROTEIN LOSS

82
Q

what sign due you report if you have nephrotic syndrome

A 
Report key signs:
• Headache & Mental Status Changes
• Nausea & Vomiting
• Oliguria - NO or low urine output
• New, Sudden, Rapid Weight Gain
83
Q
  • Nasty protein loss in the urine
A
  • Nephrotic Syndrome
84
Q

How do you treat Nephrotic syndrome?

A

prednisone - steroids to stop the immune sys. from attacking the kidneys

85
Q

Nephrotic syndrome goal of tx is to

A

reduce edema, decrease proteinuria, manage symptoms, improve nutrition and prevent infection

86
Q

How do you calculate units need bc of blood sugar

A

(blood glucose- target blood sugar) / (sensitivity)

87
Q

How do you calculate how many units a pt needs of insulin bc of carbs

A

Carbohydrates/ carb ratio #

Pediatrics (5 decks)

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