Other Paeds conditions L2 Flashcards
Clinical presentation of Diabetes Mellitus Type 1?
DM Type 1
polydipsia: increased thirst.
polyuria: frequent urination. polyphagia: increased appetite
* Fatigue
* Weight Loss
* Dry Skin
* Blurred Vision
Signs of DKA: Hyperglycemia, acidosis, glycosuria and ketonuria
Early Hypoglycemia:
Trembling, tachycardia, sweating, anxiety, hunger, pallor, headache
Late Signs:
Loss of coordination, personality and mood changes, slurred speech sleepiness
Clinical presentation of Diabetes Mellitus Type 2? (4)
- Most are overweight
- Velvety hyperpigmented patches In intertriginous area
- Hypertension and lipid disorders
- may have Ketonuria & Ketoacidosis
Assessment of Diabetes Mellitus Type1?
AGE APPROPRIATE BLOOD GLUCOSE LEVEL
Pre-meals (last intake 2hrs before) Post-meals (2hhrs after food)
0-6 years old: 5-12 mmol/L < 12 mmol/L
6-12 years old: 4-10 mmol/L < 10 mmol/L
>12 years old: 4-8 mmol/L < 8 mmol/L
Persistent blood glucose level >10mmol/L results in glycosuria leading to osmotic diuresis with polyuria and polydipsia
Excessive ketone production cause diabetic ketoacidosis (DKA)
- Characterized by marked hyperglycemia, metabolic acidosis, dehydration and altered level of consciousness ranging from lethargy to coma
Nursing intervention of Diabetes Mellitus Type 1 ?
- Assess for signs of hypoglycemia, hyperglycemia and their complications
- Monitor neurologic status, vital signs, blood glucose level
- Monitor level of hypokalemia
- Promote adequate fluid volume by maintaining accurate and careful record of IV
infusion blood glucose level, intake and output and urine specific gravity - Test urine for ketones every 3 hours when child is ill and whenever blood sugar
level >15 mmol/L - Administer insulin - decrease elevated blood glucose level
Nursing Management of Diabetes Mellitus Type2 ? (5)
- Metformin, first line treatment for Type 2 DM, used for children > 8 years old
- Insulin and oral anti-diabetic added to diet and exercise regime to improve blood glucose control
- Calorie-restricted diet
- Behaviour medication if compliance is poor
- Promote lifestyle change
- Increase physical activity to decrease insulin resistance
- Decrease sedentary activity eg. Watching TV, computer games
WHATS Leukaemia?
- blood cancer
- originates in the bone marrow
- affects production and function of WBCs
Clinical manifestation of Leukaemia? (7)
- Fatigue
- Pallor
- Low-grade fever
- Bone and joint pain
- Petechiae, bruising, Purpura - purple discolored spots on the skin caused by bleeding under the skin
- Lymph nodes may be enlarged
Nursing Management of children with leukemia?
- Prevent infection, bleeding and injury
- Reducing pain & anxiety
- Promote normal growth and
development, energy conservation - Infection is the leading cause of death in immunosuppressed child
- Good hand washing is important!
READ & UNDST
Treatment for children with leukemia?
Induction Phase (4 weeks to remission)
* IV Vincristine, L-asparaginase,
Prednisolone
Consolidation
* High-dose chemo, IT/radiation
therapy if CNS is involved
Maintenance
* Chemo agents by oral, IV or IM route
HFMD Causative agent?
Causative agent:
Enteroviruses (EV 71, Coxsackie
A16, A6 and echoviruses)
- Incubation Period: 2-14 days, usually 3-5 days
- Infectious Period: a few days before, continues for 3–4 weeks from saliva
- 6–12 weeks from the faeces
Mode of Transmission: Direct contact
Signs & Symptoms of HFMD?
- Vesiculo-popular rash over palms, soles and
buttocks - Fever
- Pharyngitis
- Mouth Ulcers
Management of HFMD?
- Isolate patient in single room or cohort
patients with same condition - Paracetamol for fever (avoid NSAIDs)
- Strict I/O to maintain hydration
- Monitor for complications: Seizures,
hyper/hypotension, tachycardia - MC for 10 days after onset of illness
- No swimming for next 3 months to decrease transmission
- HFMD is legally notifiable within 24 hours of
diagnosis
Causative agent of dengue?
Causative agent
- Flavirus of four serotypes (DEN-1,
DEN-2, DEN-3, DEN-4
Incubation Period: 3-14 days, usually 5-7 days
Infectious Period: 1 day before till D5
Signs and symptoms of Dengue?
- Maculopapular rash, flushing or petechiae
- Headache
- Retro-orbital Pain = pain behind the eyes
- Myalgia = muscle aches and pain
- Arthralgia = joint stiffness
Nursing Management for dengue?
(Supportive Care)
Paracetamol for fever (avoid NSAIDs)
Strict I/O to maintain hydration
IV Plug
Monitor for complication: Hypovolemia and Bleeding
Prevent and monitor for Dengue
Haemorrhagic Fever
Thrombocytopenia Precaution
- CRIB
- No IM injection
- No brushing of teeth
- Daily platelet count and haematocrit
