Pediatric - Metabolic, Endocrine, GI Flashcards
Fever
Temperature over 100.4
Phenylketonuria
Genetic disorder resulting in CNS damage from toxic levels of phenylalanine in the blood.
Normal phenylalanine levels in newborn
1.2-3.4 mg/dL
Normal phenylalanine levels in child
0.8-1.8 mg/dL
Adult blood phenylalanine level
20 mg/dL
Signs and symptoms of Phenylketonuria
- Digestive problems & vomiting
- Seizures
- Urine has musty odor
- Mental retardation
Interventions for Phenylketonuria
- Two positive tests to diagnose
- Restrict intake of phenylalaine containing foods (meat and dairy products)
- Monitor physical, neurological and intellectual development
- arrange for follow up treatment
Normal blood glucose level
70-100 mg/dL
Insulin and illness
Insulin needs increase during illness, infection and stress.
Hypoglycemia
Blood glucose below 70.
Hyperglycemia
Blood glucose above 200
Signs of Hypoglycemia
- Fatigue
- Tremors
- Hunger
- Headache
- Nausea
- Slurred speech
- Confusion
- Anxiety
Signs of Hyperglycemia
- Polyuria
- Polydipsia
- Polyphagia
- Blurred vision
- Weakness
- Weight loss
- Syncope
Interventions for cleft palate
- Assess ability to suck, swallow, and breathe without distress
- Assess intake
- Monitor daily weight
- Modified feeding technique –> feed slowly with periods of rest, place food to the back and side of the mouth
Gastroesophageal Reflux Disease
Back flow of the gastric contents into the esophagus as a result of incompetence of the lower esophageal sphincter.
Hypertrophic Pyloric Stenosis
Hypertrophy of the circular muscles of the pylorus causing narrowing of the pyloric canal between the stomach and duodenum.
Symptoms of Hypertrophic Pyloric Stenosis
- Vomiting which progresses from mild to forceful
2. Vomitus contains stomach contents with no bile.
Intervention for Hypertrophic Pyloric Stenosis
Pylormyotomy - incision through the muscle of the pylorus which may be done laparoscopically.
People with Celiac disease must avoid
- Wheat
- Rye
- Barley
- Oats
Hitchsprung’s Disease
Absence of ganglion cells in the rectum resulting in obstruction of the bowel due to ineffective mobility.
Symptoms of Hitchsprung’s disease
- failure of newborns to pass myconium stool
- children fail to gain weight
- abdo distention
- diarrhea constipation
- pellet like or ribbon like foul smelling stools
Intussusception
Telescoping of one part of the bowel into another resulting in the inability to pass intestinal contents.
Symptoms of intussusception
- Abdo pain
- Vomiting gastric contents and bile stained fecal emesis.
- Passing currant jelly-like stools containing blood and mucous
Intervention for Intussusception
Hydrostatic reduction - Fluid or air is used to exert pressure on the area to lessen or eliminate the prolapse.
Hydrostatic reduction
Used to treat intussusception. Fluid or air is used to exert pressure on the area to lessen or eliminate the prolapse.
Omphalocele
Birth defect. Herniation of the abdominal contents through the umbilical rink usually with an intact peritoneal sac.
Gastroschisis
Birth defect. Herniation of the intestine laterally into the umbilical ring. Bowel is exposed, not contained within a sac.
Interventions for Omphalocele and Gastroschisis
Area is covered with a sterile saline soaked swab. Covered with plastic wrap tightly in Omphalocele and loosely with Gastroschisis so as not to cause pressure damage if area expands.
Inguinal hernia
In the groin area, protrudes when coughing.
Incarcerated Hernia
a loop of intestine becomes trapped in the weak point in the abdominal wall, it can obstruct the bowel, leading to severe pain, nausea, vomiting, and the inability to have a bowel movement or pass gas. This is a medical emergency.
Hydrocele
Painless, watery build up of fluid around or in the testicles causing the groin area to swell.
Noncommunicating hydrocele
Residual peritoneal fluid is trapped in the testicles with no route to the peritoneal cavity. Usually reabsorbed by the body within the first year.
Communicating hydrocele
Hernia that remains open from the scrotum to the abdominal cavity allowing fluid to flow back and forth. This causes changes in scrotal size.
Encopresis
Encopresis occurs when your child resists having bowel movements, causing impacted stool to collect in the colon and rectum. When the child’s colon is full of impacted stool, liquid stool can leak around the impacted stool and out of the anus.
Irritable bowel syndrome
Increased bowel motility can lead to spasm and pain. Treated with anticholinergenics to reduce spasm.
Imperforate anus
Incomplete development of or absence of the anus in the normal position.
Hepatitis
Acute or chronic inflammation of the liver cause day a virus, medication reaction or another disease process.
Treatments for hepatitis
- Immunoglobulin - effective for pre-exposure or to prevent
- Hepatitis B immunoglobulin - effective for single exposure (needlestick injury)
- Hep A and B vaccines
Lead poisoning
Treated with Chelation therapy to remove circulating lead from the blood, and some organs and tissues.
Acetaminophen poisoning
Treated with antidote N-acetylcystiene. Do not use activated charcoal with this as it will inactivate the antidote.
Aspirin poisoning
Administer activated charcoal, induce vomiting, IV fluids +/- sodium bicarbonate to correct metabolic acidosis)
Corrosive poisoning
- Dilute with warm water or milk
- DO NOT induce vomiting as this may cause further damage
- DO NOT neutralize corrosive as this can cause chemical reaction resulting in release of heat and burns.
Giadiasis
Intestinal parasite caused by protozoa. Symptoms include D&V, anorexia, abdo cramps, diarrheaconstipation. Treated with Metronidazole, tinidizole, and nitazoxanide.
Where are the best places to assess for jaundice?
Sclera, nail beds, and mucous membranes
