Peds Exam 2 :( Flashcards
what is enuresis
bedwetting beyond the age of toilet training
what is primary vs secondary enuresis
primary is when the child never reaches a level of continence and secondary is when the child is potty trained but then not, look at physical cues (DM, UTI, constipation)
parent teaching for enuresis
avoid caffeine, no fluids before bed
what is a medication for enuresis and how does it work
desmopressin
works by acting on ADH to produce less urine, make sure to limit fluids with this medicine
What is the main symptoms and patho with nephrotic syndrome
when the basement membrane of the glomerulus is damaged, which allows protein to leak into the urine, which shows up as frothy urine
What does the liver do in response to hypoalbuminemia
produces lipoproteins which causes hyperlipidemia
what is the treatment for nephrotic syndrome
corticosteroids for 4-6 months, can cause weight gain and mood swings
What is hemolytic uremic syndrome
a verotoxin from e coli causes microthrombi which clogs the kidneys and causes hemolysis (death of RBCs), and forms fibrin clots which diminishes platelets causing thrombocytopenia
What is the treatment for hemolytic uremic syndrome
IVIG, contact precautions, manage HTN and fluid balance, give packed red blood cells for active bleeding
What is hypospadias
urethral opening on the bottom of glans penis, VENTRAL
What is episadias
urethral opening on the top of glans penis
What is the treatment of epispadias and hypospadias
urethral stenting, teach hygiene after surgery, will have pressure dressing, double diapering where urine empties to outer diaper and stool in inner diaper
What is a hydrocele
fluid in scrotal sac that is transilluminate with light, painless and may resolve on its own by 12 months
what is a varicocele
varicosed mass on the spermatic cord that can cause infertility or a low sperm count, requires surgery, palpation is WORM LIKE
What causes acute glomerulonephritis
strep infection
acute glomerularnephritis
injures the glomerulus and causes inflammation and an altered GFR
What are the main symptoms of glomerulonephritis?
coca cola colored urine from the hematuria
proteinuria and hypertension from damaged kidneys
What are the nursing management of acute glomerulonephritis
manage hypertension and fluid status
treat strep infection
Phimosis
inability to retract the foreskin which is normal in newborns but not if it persists
how to treat phimosis
topical steroid 2 times per day for a month
what is paraphimosis
fibrotic band behind the glans penis that requires surgery to prevent incarceration
What is different in peds respiratory systems vs adults
less alveoli, funnel shaped trach, shorter airway, more pliable
What is asthma
chronic inflammation of the airway that results in reversible intermittent airway obstruction
what are some triggers for asthma
allergies, smoke, exercise, change in weather
what are signs and symtpoms of asthma
wheezing, hacking non productive cough, crackles, chest tightness
Silent chest
onminous sign of no air movement
What are the tests for asthma
pulmonary function test is not useful during acute exacerbations and a peak expiratory flow rate is done daily at home for management of acute symptoms
Asthma prevention meds
long acting bronchodilators (formoterol)
inhaled corticosteroids (fluticasone)
mast cell stabilizer (cromolyn)
leukotrine antagonist (montelukast)
asthma exacerbation meds
albuterol (short acting bronchodilator)
anticholinergic (ipratropium)
corticosteroid PO (prednisone) or IV (methyl prednisone)
croup patho
inflammation of the larynx, trachea, and bronchi from parainfluezna virus
what are the main signs of croup
barking cough, inspiratory stridor, sudden onset at night and usually goes away on its own in 3-5 days
treatment of croup
home care for mild cases
mild/mod: corticosteroid to decrease inflammation, and racemic epinephrine to open up airways short term
what is epiglottitus
inflammation of the epiglottis from influenza B bacteria
What is the signs of epiglottitus
sudden high fever and toxic appearance, drooling, whispering, dysphagia, tripod pos, cough absent
what does the x ray show with epiglottitis
a thumb apperance
management of epiglottitis
ICU admission for intubation
what should the nurse NOT do with epiglottitis
examine the throat
What should the nurse prepare for suspected epiglottitis
100% oxygen adminstration, emergency airway equipment
Hypoxia priority of care
administer oxygen
pulse ox
chest pt
suctioning
what are the signs of respiratory distress
first is tachypnea
then pallor and cyanosis
then retractions, nasal flaring, head bobbing in infant, restless
What are the respiratory symptoms of CF
thick tenacious secretions that are difficult to clear, clubbing from chronic hypoxia, barrel chest on CT from trapped air
cor pulmonale which is right sided heart failure from backup of the lungs
what are the GI symptoms associated with CF
fatty stools from the lost pancreatic enzyme function, fat soluble vitamin deficiency ADEK
What is the golden diagnosis of cystic fibrosis
sweat chloride test chloride >40 infant <3 mos, >60 all other ages, sodium >90
what aerosol is given for CF
dornase alpha to thin secretions
GI treatment for CF
pancreatic enzymes with all food within 30 minutes
supplementation of fat soluable vitamins ADEK
high protein/high calorie diet
