Paeds Flashcards
Why are infants more at risk of dehydration from gastro?
Babies weight is 75 - 80% WATER
They can’t reabsorb water as well as adults
Babies have a greater surface area to weight so they can loose water more quickly
Children have a faster Metabolic rate than adults
Pathology of viral gastro..eg rotavirus and noravirus
Transmitted via poo
Virus cells take over the normal cells that line the stomach and intestines
These cells absorb water and nutrients from there
Virus then release toxins that cause death of surrounding cells
Ultimately the intestines can’t absorb nutrients and water well and loose some of the fluid they do have in their tissues
S & s
Vomiting then watery poo
Low fever
Patho of bacterial gastro eg campylobacter, salmonella
Spreads through undercooked food or unpasteurized milk
Mechanism
Release of a toxin which cause gut cells to stop absorbing water and nutrients and instead dump fluid and nutrients into the gut causing diarrhea
Bacteria can get in via mucus membranes. Immune system Causes inflammation and ulceration of intestinal tissue and bleed
S & S
Cramping…..vomiting…diarrhea
High fever
Bloody or mucous filled poo
Complications of gastro in kids
Diarrhea…more than 3 watery poos a day
Dehydration/hypovolemia
Sunken fontanel, dry membrane, sunken eyes no tears
Hyponatremia
Less sodium .. less nervous activity
Apathy, weakness
Low reflexes/twitches
Hypokalaemia
Low potassium…less muscle activity
Pulse bradycardia from Low potassium or tachy from dehydration
Metabolic acidosis
Rapid breathing…blow out the acid
Increase bradycardia
Nursing care
Monitor stool..frequency and characteristics
Assess for blood and mucoumonitor temp
Monitor weight and urine/nappies
Monitor capillary refill
Frequency obs
Test reflexes
EcG
AT HOME
Oral rehydrate
1 litre water, 6 tsp sugar 1/2 tsp salt
Ondansetron
Give ORT with syringe
Hospital
NG fluids with electrolytes
Meds for diarrhea
Nursing care
Monitor stool..frequency and characteristics
Assess for blood and mucoumonitor temp
Monitor weight and urine/nappies
Monitor capillary refill
Frequency obs
Test reflexes
EcG
AT HOME
Oral rehydrate
1 litre water, 6 tsp sugar 1/2 tsp salt
Ondansetron
Give ORT with syringe
Hospital
NG fluids with electrolytes
Meds for diarrhea
Rheumatic fever
Caused by streptococcus group A
Strep throat s & s swollen red throat amd tonsils
Swollen lymph nodes.SWAB THE THROAT
If strep A start ABs
Rheumatic fever
Caused by streptococcus group A
Strep throat s & s swollen red throat amd tonsils
Swollen lymph nodes.SWAB THE THROAT
If strep A start ABs
Acute rheumatic fever (ARF) PATHO
Acute rheumatic fever in children often follows a streptococcal throat infection. The body’s immune response to the infection mistakenly targets its own tissues, particularly in the heart, joints, skin, and brain. This autoimmune reaction leads to inflammation and damage, manifesting as symptoms like fever, joint pain, and heart
inflammation.
ARF S & S
Occurs 2- 4 WEEKS AFTER strep throat
High fever
Joint pain.. migrating polyarthritis…starts lower legs and heads up
Cardioid…chest pain, SOB
Effects endocarditis and valves
Valves can’t close properly so mitral regurgitation, aortic regurgitation
Skin nodules
Erythrma marginata…red non itchy rash
Sydenham chorea… involuntary tics in face or arms
Complications of strep
Heart disease
Dyspnoea SOB
Acute glomerulonrphritis
Complications of strep
Heart disease
Dyspnoea SOB
Acute glomerulonrphritis
Nursing care for ARF
Patient hx…respiratory infections?
Assess for strep A
Listen for left side heart murmur
EcG for rhythm
Skin nodules..hands?
New non itchy rashes?
Tics
Treatment
Swab
Long term ABs
Anti imflamm meds…aspirin, prednisone
H/f…diuretics
ACE or ARB
Beta blockers
Calcium Chanel.blockers
Low sodium diet
O2
Qĺ
