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Peds Exam 2 > Peds Exam 2 > Flashcards

Peds Exam 2 Flashcards

1
Q

What is the purpose of the duodenum?

A

where digestion takes place

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2
Q

What are the 2 enzymes that aid in digestion?

A

amylase (saliva, digests carbs)
lipase (enhances fat absorption)
trypsin (breaks down protein into polypeptides and some amino acids)

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3
Q

What are some differences in A&P in the GI system?

A

GI is immature at birth
Liver function is immature at birth and for next few weeks
GI structure becomes more mature in life in second yr

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4
Q

What is the function of the stomach?

A

secretes hydrochloric acid and digestive enzymes to break down fats (gastric lipase) and proteins (pepsin)- little absorption

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5
Q

What is the function of the small intestine?

A

digestion is completed here by pancreatic enzymes, bile, and small intestine enzymes

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6
Q

What is the function of the large intestine?

A

water absorption

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7
Q

What is the function of the liver?

A

bile production, detoxification, glycogen storage and breakdown, vitamin storage

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8
Q

What is the function of the gallbladder?

A

stores bile

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9
Q

What are subjective items to ask about in the GI assessment?

A 
lifestyle and family factors 
diet
elimination patterns 
mental status 
auscultation 
percussion and palpation
Labs
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10
Q

What are some of the physiologic differences of pediatric patients?

A 
minimal saliva
decreased stomach capacity 
reverse peristalsis
increased gastric emptying time
large intestine is relatively short (=decreased water absorption, stools softer with greater water loss during diarrhea meaning they are at a higher risk of dehydration)
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11
Q

What are the important numeric values we need to know for stomach capacity of pediatric patients?

A

newborn - 10-20ml
1 yr - 210-360ml
adolescent - 1500ml

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12
Q

What is a cleft lip and cleft palate?

A 
congenital malformation (failure of maxillary processes to fuse) occurring during weeks 6-12 gestation
varying degrees of severity
most common craniofacial deformities overall in US
multifactoral causes
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13
Q

What is the first sign of a possible cleft lip/palate?

A

formula coming from the nose

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14
Q

How do you treat a cleft palate/lip?

A

surgical correction (early correction to stimulate pleasure when sucking)
lip repair usually by 12 weeks
palate repair usually by 6-24 mo to maximize speech

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15
Q

What are some complications of cleft lip/palate?

A 
cosmetic
speech and hearing 
feeding
orthodontic
otolaryngology
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16
Q

Explain a cleft lip

A

opening between the nose and lip
apparent at birth
should be documented during a newborn assessment
assess a child’s ability to suck and swallow
cleft lip repair is done in first month of life
special feeding techniques is surgery is delayed

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17
Q

What is some pre-operative nursing care for a cleft lip/palate?

A

feeding
facilitate bonding
growth and monitoring
logan bar (protects surgical repair)

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18
Q

How should feeding be done on a cleft lip/palate?

A

upright position (to prevent aspiration)
breastfeeding if possible
haberman nipple
frequent burping

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19
Q

What are some post-operative aspects of cleft lip/palate?

A

restraint
feeding
suture care
referrals

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20
Q

Explain the post-operative aspects of cleft lip/palate regarding restraints?

A

“no,no” for at least 6-8 days, longer with palate repair, remove one at a time every two hours for 15min, for babies– swaddling is perfect

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21
Q

Explain the post-operative aspects of cleft lip/palate regarding feeding?

A

no straws, pacifiers, spoons, fingers by mouth for 7-10 days, use shorter nipple, can feed with side of spoon for older children, advance diet as tolerated

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22
Q

Explain the post-operative aspects of cleft lip/palate regarding suture care?

A

lip protective device (Logan Bar) to prevent tension of suture site
no brushing for 1-2 weeks, clean suture line with water after each feed
do not place on stomach
no oral temps, no tongue depressants

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23
Q

What is some nursing management for cleft lip/palate ?

A

prevent injury to the suture line
promote adequate nutrition
encourage infant-parent bonding
providing emotional support

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24
Q

Explain esophageal atresia and tracheoesophageal fistula?

A

they are congenital malformations in which the esophagus terminates before it reaches the stomach and or a fistula is present that forms an unnatural connection with the trachea

foregut fails to lengthen, separate and fuse into 2 parallel tubes (at 4-5 weeks gestation)

assc with maternal polyhydraminos (fetus can not swallow and absorb amniotic fluid in utero)

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25
Q

What are the 3 C’s of EA and TF?

A

coughing, choking, cyanosis

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26
Q

What are manifestations of EA/TF?

A

coughing, choking, cyanosis
excessive oral secretions
respiratory distress
NG tube cannot be passed into the stomach
child needs NG tube to suction oral secretions which might land in a blind pouch

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27
Q

What are some nursing management techniques of TEF?

A

initiate NPO
elevate HOB
monitor hydration status
assess and maintain orogastric tube/prevent aspiration
O2 and suctioning equipment readily available

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28
Q

What is a pyloric stenosis?

A

results from hypertrophy of circular muscle that surrounds pylorus causing obstruction of gastric emptying

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29
Q

What are some of the manifestations of pyloric stenosis?

A

projectile vomiting 30-60 min after feeding at about 2 weeks of age
movable, palpable, olive-shaped mass
dehydration with metabolic alkalosis

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30
Q

What is a big sign of pyloric stenosis?

A

Vomiting after feeding

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31
Q

What are some preoperative nursing interventions for pyloric stenosis?

A

Assess for dehydration and acid/base imbalance
examine/listen to abdomen
Is/Os
Oral care
TREAT DEHYDRATION AND ELECTROLYTE STATUS BEFORE SURGERY

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32
Q

What are some postoperative nursing interventions for pyloric stenosis?

A

feeding according to OR protocol
pedialyte normally 4-6 hours after then advancing to full strength breast milk or formula
teach parents the signs of problems post surgery

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33
Q

What is gastroschisis?

A

a congenital defect of the ventral abdominal wall, characterized by herniation of abdominal viscera outside the abdominal wall (usually to the right of the umbilicus)

the organs are not contained by a membrane
occurs in week 11 of gestation
multifactoral causes

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34
Q

What is omphalocele?

A

protrusion of abdominal contents through the abdominal wall at the function of the umbilical cord
may include intestines, stomach, liver
organs covered by a thin transparent layer of amnion
occurs at 11 weeks of gestation
multifactoral causes

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35
Q

How do you overall manage omphalocele and gastroschesis?

A

must return bowel to abdomen
if defect is large, will be done with silastic pouch or silo
TPN dependent
large potential for infection

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36
Q

What is the nursing management of newborn omphalocele and gastroschisis?

A

minimize fluid loss
protect the exposed abdomen contents from trauma/infection
postoperative care
surgical repair for both are done in stages

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37
Q

What is intussusception?

A

the invagination of one portion of the intestine into another causing obstruction – ischmia — puss – bleeding etc

most common cause of intestinal obstruction in children under the age of 2

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38
Q

S/s of intussusception

A

severe pain
lethargy
currant-jelly stools, gross blood (pussy, red, stool)
sudden onset of intermittent cramps or abdominal pain (paroxysml)

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39
Q

Manifestations of intussusception

A

sudden onset of pain, draw up their lets, vomit
currant jelly stools
sausage shaped abdominal mass that can be palpated
extreme paroxysmal pain
assess for shock

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40
Q

Treatment of intussusception

A

US guided saline, barium, air enema to reduce
no response? surgical emergency to avoid bowel necrosis
laparoscopy

(if burst - will feel better for a moment then go into hypovolemic shock)

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41
Q

What is malrotation/volvulus ?

A

twisting of intestine
obstruction of feces
occurs d/t intestinal malrotation

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42
Q

What are the manifestations of malrotation/volvulus?

A

pain, vomiting, signs of obstruction

SURGICAL EMERGENCY

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43
Q

What is Hirschprung’s Disease?

A

aganglionic (without nerves in your colon) megacolon
absence of ganglion cells in the rectum and upward to the colon
absence of ganglionic innervation leading to no peristalsis waves

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44
Q

What are the manifesations of Hirschprungs?

A

delayed passage of meconium
signs of obstruction
ribbon-like stool

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45
Q

What is the treatment for Hirschprungs?

A 
stool softeners
surgical removal of the aganglionic segment
assess for enterocolitis 
complete bowel cleansing
bowel sterilization
IV abx
pain management, Is/Os VS, colostomy care
its a two stage surgery
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46
Q

What is an anal stenosis?

A

a thickened and constricted anal wall
s/sx = characteristic ribbon-like stools
can have stool in urine or stool in vagina

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47
Q

What is anal atresia?

A

imperforated anus
physical exam reveals absent opening
failure to pass meconium
can have stool in urine or stool in vagina

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48
Q

What is Meckle’s Diverticulum?

A

most common congenital malformation of GI tract
like a fecal duct
is a pouch on the lower part of the intestine that is present at birth
may contain tissue that is identical to tissue of stomach or pancreas (secreting stomach acid= pain)

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49
Q

What is an umbilical hernia?

A

protrusion or projection of an organ or a part of an organ through the muscle wall of the cavity that normally contains it
imperfect closure of the umbilical muscle ring
is reduceable and resolves by 3-4 yrs
surgery if s/sx of strangulation or increased protrusion

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50
Q

What is encopresis?

A

the soiling of fecal contents into the underwear beyond the age of expected toilet training (4-5 years of age)
can be secondary to other disorders

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51
Q

What is the most important determinant of the percent of total body fluid loss in infants and children?

A

weight

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52
Q

What is the best plan of action for oral rehydration?

A

rehydration of 75-90meq of sodium per liter
give 40-50 ml/kg over 1st four hours
maintain hydration with sol of 40-60 meq sodium per liter
keep daily vol maintenance hydration less than 150 ml/kg/day

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53
Q

What is oral candidiasis?

A

fungal infection of the oral mucosa

children at risk include
immune disorders using corticosteroid inhalers, chemo for cancer
antibiotic use
may get from breastfeeding mom

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54
Q

How do you treat oral candidiasis?

A

nystatin

fluconazole

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55
Q

What is GER?

A

the backward flow of stomach contents up into the esophagus or the mouth
happens to everyone
babies get small amts of GER and is normal and almost always goes away by 18 months

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56
Q

What is GERD?

A

occurs when complications from GER arise like failure to gain weight, bleeding, resp problems, or esophagitis

immaturity of the cardiac sphincter

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57
Q

What are the manifestations of GERD?

A

fussiness 30-60 min after a meal, poor growth

< 2 months have it, peaks at 4 months when LES matures and resolves by one year

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58
Q

What is the treatment for GERD?

A 
smaller feeding 
thickening of formula 
keep upright before and after feedings
burping
find a nipple that makes a good seal to prevent air in mouth
59
Q

What are some pharmacologic treatments for GERD?

A

prokinetics (given with meds that inhibit acid = metoclopramide)
antacids
H2blockers - 1st line (tidine) - turns off 70% of acid producing
PPIs - 2nd line (prazole) - turns off 100% of acid producing

60
Q

What are some malabsorption disorders?

A

lactose intolerance
short bowel syndrome
celiac disease

61
Q

What is lactose intolerance?

A

absence or deficiency of lactose leads to inability to digest lactose

more common in asians, native americans, african americans

frothy diarrhea with abdominal pain and distention

avoid milk based products, soy,

needs Calcium and Vit D supplementation

62
Q

What is short bowel syndrome?

A

results from decreased mucosal surface area, usually resulting from a small bowel resection

prognosis has advance with TPN and nutrition

administer and monitor nutritional therapy

63
Q

What is celiac disease?

A

gluten-induced enteropathy and celiac sprue - immunologic disorder in which gluten causes damage to the small intestine

64
Q

What are the four characteristics of celiac disease?

A

steatorrhea
general malnutrition
abdominal distention
secondary vitamin deficiencies

65
Q

Where are RBCs produced?

A

in bone marrow of long bones, that increase with age,

also produced in vertebrae, sternum, ribs

66
Q

What is the RBC’s function?

A

to transport oxygen to the tissue

67
Q

What stimulates RBC production?

A

a decrease in circulating 02 which causes kidneys to produce erythropoietin

68
Q

What is avg live span of RBC?

A

120 days

69
Q

What does the spleen do?

A

removes damaged or aging RBCs

70
Q

How is the pediatric hematological system different than adults?

A

life span of erythrocytes in neonates is shorter
by 2 months, erythropoiesis increases leading to rise in hgb
fetus has higher O2 carrying capacity
reach adult hgb by puberty

71
Q

What is the pathophysiology of IDA?

A

Iron is necessary for synthesis of hgb

low iron = low hgb = low O2 ability - low O2 to cells

72
Q

How long can maternal hgb last?

A

up to nine months in a newborn

AAP recommends iron supplementation for all preterm infants

73
Q

What are some manifestations of IDA?

A 
pale (especially mucous membranes and conjunctiva)
tachycardia
tachypnea
fatigue
irritability
74
Q

Things to know about administration of iron

A

give in 3 doses between meals with vitamin c rich foods to facilitate absorption
give through a straw to avoid staining teeth
brush teeth/rinse
avoid with milk (inhibits absorption)
will turn stool green/tarry
cont for 3 mon after H&H is normal

75
Q

What is sickle cell disease?

A

inherited autosomal recessive disease
in 1st 5 yrs is the time highest for mortality
mostly african american, mediterranean, indian, middle eastern decent

76
Q

What is the pathophysiology of sickle cell disease?

A

during increased metabolic needs or decreased O2, the cells sickle and cannot move freely through vessels causing stasis and sticking causing halts of blood flow

tissue distal to blockage becomes ischemic resulting in acute pain and cell destruction, vascular occlusion

77
Q

What are manifestations of sickle cell disease?

A 
sickling of RBC
delayed growth and puberty
pallor
jaundice
fatigue
acute splenic sequesrtation
priapism - painful erection doesnt go away

no symptoms in early infancy due to fetal hgb stores which have higher O2 carrying capacity

78
Q

What is acute splenic sequestration?

A

large amts of blood pool in the spleen causing signs of hypovolemic shock

79
Q

What is the treatment for sickle cell disease?

A

immunizations, penicillin prophy for children less than 6, flu vaccine

transfusions if necessary

gene therapy/ stem cell therapy

80
Q

What should you do in a sickle cell crisis?

A

pain mgmt - narcotis like morphine
adequate hydration
oxygenation to prevent further sickling

MONITOR FOR FEVER - 1st sign of bacteremia

81
Q

What are the types of sickle cell crisis?

A

vaso-occlusive
acute sequestration
aplastic

82
Q

What is a vaso-occlusive sickle cell crisis?

A

severe pain in extremities, chest, and abdomen, CVA

give fl, O2, pain mgmt

83
Q

What is acute sequestration sickle cell crisis?

A

spleen enlarges and blood pools in it causing lower bl vol and shock

common around 2-3 yr old

84
Q

What is aplastic sickle cell crisis?

A

profound anemia requiring transfusion, normally brought on by an illness such as cancer

85
Q

What is the pathophysiology behind hemophilia?

A

sex-linked recessive trait causing a decrease in factor 8 coagulation activity (mom carries the trait)

86
Q

What are the manifestations of hemophilia?

A

dx at circumcision shortly after birth w prolong PTT and decrease in factor 8

bleeding or bruising easily at injection site

hemarthrosis - bleeding at joints causing swelling, pain, and joint limitation (get arthritis in your 20s)

87
Q

How do you treat and what are the nursing considerations with hemophilia?

A

infuse factor 8

prevent injury with pads
non-contact sports
no aspirin 
immunization to avoid infection
regular exercise to avoid joint immobilization
88
Q

What is the purpose of the lymphatic system?

A

to drain fluid and cellular waste products, filter and strain out invading organisms, and cancerous cells

89
Q

What is the purpose of lymph nodes?

A

they produce WBCs called lymphocytes which protect against bacteria and viruses

90
Q

What are s/sx of childhood cancer?

A 
may be subtle and look like childhood illness
dx may be delayed
unusual mass or swelling
pallor
fatigue
localized pain or limping 
prolonged unexplained fever
frequent vomiting
eye or vision changes
excessive weight loss
91
Q

What are the different stages of cancer?

A

one - tumor not extented to surrounding tissue
two - local spread
three - spread to local lymph nodes
four - spread systemically

92
Q

What are the effects of chemo?

A 
depends on med
hair loss, n/v/d
stomatitis/dermatitis
renal and neurotoxicity
immunosuppresion 
anaphylaxis 
extravasation 
give IV benedryl
93
Q

What is chemo based on?

A

chemo is based on body mass, kids can tolerate chemo much better than adults

94
Q

Nursing things to recognize in kids with cancer

A

fever is normally only indication
monitor bleeding- platelets less than 20000
asses for anemia
assess for absolute nuetrophil count - normally less than 500 (neutrophils make up 70% of WBCs
wipe down toys
assess for tumor lysis syndrome

95
Q

Goals of teaching for kids with cancer?

A

avoid live virus vaccines
EMLA for veinipunctures
prevent infection
prevent and recognize hemorrhage
admin platelets (no rectal temps and skin punctures)
conserve energy
need hydration
prevent food aversion and or constipation
monitor for neurotoxic signs (weakness, numbness, walking difficulties, jaw pain)
manage body concerns like alopecia
GROUP NURSING ACTIVITES

96
Q

What is the pathphysiology of leukemia?

A

alteration in genetic make up of WBC that prevents maturation, these immature cells (blasts) crowd out all normal cells

most common cancer in childhood

97
Q

What is ALL?

A

Acute lymphoid leukemia that affects cells in the lymphatic system (lymphoblasts) 75% of all leukemias

better prognosis

98
Q

What is AML?

A

acute myelocytic leukemia and affects the myoblasts, less common, worse prognosis

99
Q

What are some s/sx of leukemia?

A

insidious onset
persistent fever
increased bruising (thrombocytopenia)
anemia from low RBCs (usually 1st symptom)
infection from increase in bands (leukopenia)
bleeding from decreased platelets

the blast baby cells have no function
cause hyperplastic of the bone marrow

100
Q

What is the treatment for leukemia?

A

allopurinol and IVF to flush WBC and decrease in uric acid
chemo over first month
CSN prphy therapy with intrathecal methotrexate, cytarabine, and hydrocortisone
maintenance for 2-3 yrs
bone marrow transplants

101
Q

What is lymphoma?

A

Hodgkins Disease
neoplasm of lymphoid cells in lymph glands
only a group of lymph nodes
dx lymph node biopsy

102
Q

What are s/sx of lymphoma?

A

large multinucleated cells - reed/sternberg cells
paianless, firm lymphadenopathy in supraclavicular region
fever
night sweats
weight loss

103
Q

What is non-Hodgkin’s lymphoma?

A

similiar to hodgkins except spread is viz blood strem and not lymph blood
malignant disorder of the lymphocytes either B or T
dx with bone marror biopsy

104
Q

What are the s/sx of an infant brain tumor?

A 
irritable 
enlarged HC
bulging fontanel 
vomiting 
lethargy 
FTT and loss of milestones
105
Q

What are the s/sx of a child brain tumor?

A 
vague headache
personality change
change in school performance
fatigue clumsiness 
HALLMARK SIGN IS HA AND MORNING VOMITING
106
Q

What is the pathophysiology of osteosarcoma?

A

epiphysis of a bone is a common site normally during growth spurt (towards the ends of the bone)

most common in males between 15-19

secondary neoplasm (cancer later in life)

turn about surgical procedure

107
Q

What is Ewing sarcoma?

A

tumor sites in diaphysis (midshaft)
peak between 10-20 yrs
pain with increasing intensity
soft tissue swelling

108
Q

What is Wilm’s tumor?

A

nephroblastoma
embryonic tumor affecting the kidney that originates between renoblasts

btw 2-5

109
Q

What are the s/sx of nephroblastoma?

A 
large, non-tender abdominal mass CROSSES MIDLINE
hematuria
swelling/pain in abdomen
fever
DO NO PALPATE
(most curable solid tumor in children)
110
Q

What is rhabdomyosarcoma?

A

malignancy of striated muscle
occurs most often periorbitally, sinuses or bladder
sysmtoms assc with site

111
Q

What is Von Willebrand disease?

A

deficiency in VW factor
problem with platelet coagulation
ddavp is used for treatment of hemophilia and VW disease as it increases both factors

112
Q

What are functions of the urinary system?

A 
maintains balance 
hormonal functions 
stimulates production of erythropoietin
production of renin (that reg BP)
metabolism of vit D in active form 
excretes waste
functionally immature until puberty
113
Q

What are the differences between adult and peds GU with regards to kidney, urethra, GFR, bladder capacity, reproductive organs?

A

kindney - large in relation to stomach
urethra - shorter (higher chance of UTI)
GFR - slower in infant, risk for dehydration
bladder - 30ml in newborn, increases to adult size by 1 yr

114
Q

What is GFR?

A

the process of filtering blood as it flows through the kidneys

115
Q

What is tubular resorption?

A

necessary fluids, electrolytes, proteins, and blood cells are retained

116
Q

What is tubular secretion?

A

waste products and fl filtered out

117
Q

What do the kidneys need to work properly?

A

unimpaired renal blood flow
adequate GFR
normal tubular function
unobstructed urine flow

118
Q

What is bladder exstrophy?

A

extrusion of bladder outside of body
failure of abdominal wall to close during fetal dev.
surgery in several stages
COVER W/WET STERILE GAUZE POST-DELIVERY AND PREPARE FOR SURGERY

119
Q

What is hydrocele?

A

painless swelling of scrotum d/t collection of fluid

120
Q

What is phimosis?

A

inability to retract prepuce at an age when it should retract (3yrs)

121
Q

What is testicular torsion?

A

rotation of the testicle that interrupts its blood supply

122
Q

What is cryptorchidism?

A

undescended or hidden testes
one or both fail to descend through inguinal canal into the scrotal sac
observe and surgery b/f 15mon (orchidopexy)

123
Q

What is hypospadias?

A

often occurs in conjunction with congenital inguinal hernias, undescended testes, chordee

the urethral meatus may be located anywhere along the course of the ventral surface of the penile shaft

124
Q

What is epispadias?

A

often occurs with bladder exstrophy

the meatal opening is located on the dorsal surface of the penile shaft and may be at the level of the bladder neck

125
Q

What is hydronephrosis?

A

obstruction of the ureteropelvic junction of other parts of the ureter causes dilation of the kidney
the pelvis and calyces of kidney are dilated
can occur as a congenital defect, result of obstructive uropathy or secondary to VUR

126
Q

What are the s/sx of hydronephrosis?

A

in mild-mod cases, there may be none and can resolve in first yr of life
abdominal mass
s and sx similiar to UTI
can be assc with vesicoureteral reflux
severe? extreme pain, bleeding, infrections
need surgery

127
Q

What is VUR?

A

vesicoureteral reflux

backflow of urine from bladder into the kidneys
a valvelike like mechanism at the junction of the ureter and bladder prevents urine reflux into the ureters… when there is a defect at the vesicoureteral junction = VUR results
prevents complete emptying and creates reservoir for bacterial growth

128
Q

What is a VCUG

A

voiding cystourethrogram is an x-ray examination of a child’s bladder and lower urinary tract that uses fluroscopy and a contrast material

VUR can cause infected urine to cause pylonephrities

129
Q

What are disorders of urinary elimination?

A

UTIs (most common GU disorder of children)

Enuresis

130
Q

What is the patho behind a UTI?

A

bacteria enter urethra and ascends the urinary tract

E. coli (Gram neg) causes approx most all UTIs in females

131
Q

What causes a UTI?

A 
incomplete bladder emptying
irritation by bubble baths
poor hygiene 
VUR
urinary tract obstruction
132
Q

What are the s/sx of a UTI for children under 2?

A 
V/D
irritability
poor PO intake
malodorous urine
oliguira
constipation
133
Q

What are complications of a UTI?

A

risk of renal failure

  • UTI under age 1
  • delay in dx
  • anatomic or neurologic obstruction
  • recurrent episodes of upper UTI
134
Q

What are the s/sx normally of a UTI?

A 
abdominal pain
enuresis
freq/urgency
pain/buring with urination (dysuria)
hematuria
lethargy or irritability 
poor feeding patterns
cloudy, foul-smelling uring
135
Q

What is enuresis?

A

repeated involuntary voiding by a child who has reached an age which bladder control is expected (5-6yr old)
nocturnal vs diurnal

136
Q

What is the difference between primary, intermittent, and secondary enuresis?

A

primary- child has never had a dry night, attributed to maturational delay and small functional bladder

intermittent- child has occasional nights or periods of dryness

secondary- child begins bedwetting who has been reliably dry for 6-12 months, assc with stress, infections, and sleed disorders

137
Q

How do you treat enuresis?

A

multitreatment approach is best

limit drinks before bed, void before bed
1/3 of nocturnal treated with meds
behavior interventions

138
Q

What is nephrotic syndrome?

A

kidneys lose a significant amt of protein in the urine resulting in low blood levels of protein

139
Q

What are s/sx of nephortic syndrome?

A 
proteinuria
hypoalbuminemia
hyperlipidemia (from activation of clotting factors and lipids in the liver b/c of low serum albumin levels)
edema
excessive clotting factors
low serum sodium
140
Q

Who does primary nephrotic syndrome effect?

A 
MCNS
peaks btw ages 2-3
syndrome rare after 8
more common in boys
some forms may progress to ESRD
141
Q

What are clinical manifestations of nephrotic syndrome?

A 
oliguira, dark frothy urine
normo to hypertensive
thrombosis
anorexia, abd pain, n/v/d
pallor, shiny skin w prominent veins, brittle hair, edema, skin breakdown
resp distress and pulmonary congestion
142
Q

How do you treat nephrotic syndrome?

A 
PREDNISONE 
depends on cause of disease 
corticosteriods 
diuretics
ACE inhibitors
antithrombolitics
NSAIDS
143
Q

What do you teach parents about nephrotic syndrome?

A

monitor daily protein in urine with daily dipsticks
understand relapses do occur
no added salt
monitor weight
no s/sx of disease for 2 yrs = disease free

144
Q

What is acute poststrep glomerulonephritis?

A

GABHS infection response

body responds to strep bacteria by formin antibodies which combine w. bacterial antigens to form antigen-antibody complexes

complexes get trapped in the glomerulus and cause inflammatory response

Peds Exam 2 (1 decks)

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