Peds 2 Unit 4

Question 1

UTI TREATMENT

Answer 1

Bactrim, amoxicillin. If first infection, repeat urine culture 15-30 days to verify infection is gone.

If chronic, may use prophylactic tx.
If severe reflux, may need surgery.

Question 2

UTI NURSING CARE

Answer 2

Hydration, antipyretics, frequent diaper change, increase fiber/fluids
(avoid constipation)

Culture q3mos, VCUG (dye to ID reflux) PRN.

Question 3

UTI Patho

Answer 3

E.coli infection
may include stasis
vesicoureteral reflux (d/t congenital structural anomalies)

Question 4

Acute Poststreptococcal Glomerulo-nephritis (APSGN)

Patho

Answer 4

Noninfectious renal disease occuring 10-14 days after a strep infection.
Membranous substance is released into blood after strep infection.

Antibody/antigen complex trapped in capillary loop.

Inflammation, occlusion & vasospasm of arterioles leads to decreased GFR.
LEADS TO: H2O and Sodium retention= HTN & edema

Question 5

UTI signs and symptoms

Answer 5

May be asymptomatic! Fever, poor feeding, V/D, strong urine odor, diaper rash, septicemia

In older kids, may be abd/flank pain, dysuria/frequency.

Question 6

Hypopituitarism

Answer 6

Growth hormone deficiency
Inhibits somatic growth in all cells of body
Short stature, decreased weight after 1st year

Question 7

Hypopituitarism treatment

Answer 7

Injection of bio synthetic growth hormone at night 1/3x week

S/E: hyperglycemia

Question 8

Precocious Puberty (anterior pituitary)

Answer 8

Gonadotropin hormones released prematurely

S/S: boys- Ax/pubic hair before age 9
Girls- breast buds age 6 (African Am)-7
Very tall 100% height growth curve

Treatment: Lupron Depo injections

Question 9

Juvenile hypothyroidism

Answer 9

S/S: decelerated growth, facial edema, hypo/hyper calcemia. At birth could have developmental delays, respiratory distress, Brady cardia.

Treatment: TH replacement with thyroxine

Dd: Thyroid stimulating hormone level will be elevated and T3, T4 will be decreased.

Question 10

Type 1 diabetes triggers

Answer 10

Viral illness

Upper respiratory infection

Question 11

Type 2 Diabetes etiology

Answer 11

Insulin resistance with some deficiency
90% kids have acanthosis nigricans (dirty neck)
Obesity
Family history

Question 12

Blood sugar goals

Infant -preschooler

Answer 12

100-180

Question 13

Blood sugar goals

School age

Answer 13

90-180

Question 14

Blood sugar goals

Adolescents

Answer 14

90-130

Question 15

A1C goals

Less than 6 year old

Answer 15

7.5-8.5%

Question 16

A1C goal

6-12 year old

Answer 16

8%

Question 17

A1C goals

12 year old

Answer 17

7.5%

Question 18

Hypoglycemia
Signs & symptoms
Treatment

Answer 18

Dangerous because child has decreased verbal skills
Sweating, trembling, imbalance, memory, dizziness
Treat: 10-15g CHO, glucose water/breast milk(babies), OJ/Milk, bread, repeat, if severe glucagon injection. D10 injections.

Question 19

Illness and Diabetes
Risks and monitor?
Treatment

Answer 19

Risk for hyperglycemia & ketouria

Monitor blood sugar and ketones in urine q 3 hours

Call provider: when Blood sugar >240, ketones remain high, vomits more than once
Treatment: maintain hydration, juic, flush ketones, continue insulin.

Question 20

Hyperglycemia/ Diabetic Ketonacidosis

Treatment

Answer 20

10-20 ml/kg NS blous
Continuous drip IV
Support metabolic needs-insulin regulation is decreased due to stress so increase CHO intake