Peds quiz 2?? Flashcards
S/S indicative of ketoacidosis?
kussmauls resp, lethargy, acetone breath, increased urinary output, excessive thirst, and dry mucous membranes.
LABS: decrease in pH and HCO3 (metabolic acidosis), hyponatremia, hypokalemia, hyperglycemia, ketonuria, glycosuria
TX of ketoacidosis
Emergent situation- act rapid
IV insulin then subQ insulin
Frequent blood sugar and urine(for ketones) tests
Cardiac montior - hypokalemia can result in cardiac arrest
IV fluids - plasma expanders (initially) and lactated ringers
Once hes recovering- passed acute phase - diet increased from clear liquid to regular (diabetic). And less urine test and insulin given.
Nursing diagnosis for someone not complying with DM tx?
disturbance in self concept: different than others related to chronic illness
non-compliance: poor diet control related to peer pressue
Growth and development of a 14 year old boywith DM?
He can test glucose, give his injections, make correct food substitions/adjustments and contribute to decisions in his tx.
He wil be rebellious towards his restriictions, deny he has diabetes, and be non-compliant at this age. hes trying to find his indentity and wont want that to be that he as DM.
Can end with depression, discouragement and role confusion
How can parents help a 14 yr old boy with DM meet his development needs ?
Let him not he is accepted and loved.
Keep open lines of communication so he has less reason to hide or den his disease.
Allow him to make decisions, whenever possible, so he feels he has control over his future.
He wil benefit from discussion of disease related problems with other diabetics his age - group rap sessions, diabetic camps.
What to tell a parent about PKU when they ask what it as and how its diagnosised when they first fidn out their baby has it?
PKU is caused by and absence of an enzyme needed for protein digestion. And amino acid- protein(phenylalanine) remains in the blood. States require that newborns be tested for this enzyme. Parents sign a statement that they will bring the infant in within a few days to be tested. A sample of blood from their heel is taken to test for the enzyme, if high levels, further investigation needed. The protein starts to accumulated a few days after full milk feedings. The test is usually done on 3 -4 days after birth.
What to tell parents concerned about the risk of mental retardation with PKU?
The accumulation of protein in the blood arrests brain development. The sooner the child is treated, the less risk of any impairment.
nursing diagnosis for concerned parents with newly diagnosis infant of PKU
altered health maintence related to knowledge deficit of care of child with PKU
What to tell parents they can do the help their child with PKU?
Diet is the treatment. Their is a special formula, lofenalac, a milk substiture low in phenylaline that also has vitamins and minerals neccessary for optical growth and development, that can be used in infancy.
asthe child gets older there are many suggestions regarding food selections and prepartions to give them.
Frequent urine or blood testing for phenylaline will help determine the effectiveness of the diet.
S/S expected from acute glomerulonephritis
Periorbital edmea, anorexia, oliguria, urine cloudy or smokey brown, vomiting, pallor, irritability and letharyg; mild to moderate HTN.
Goals of tx of acute glomerulonephritis
prevention of infection
prevention or control of edema and hyerkalemia
reduction of BP
provision of nourishment and stimulate appetite
promote comfort, normal growth and development
nursing diagnosis for newly diagnosised acute glomerulonephritis pt?
high risk for impaired skin integrity: edema.
prognosis of acute glomerulonephritis?
Almost all children recover completely and specific immunity is conferred so that subsequent recurrences are rare. A few children may develop chronic disease.
Develpoment task of a 4 year old boyand way to help him with these tasks?
initiative vs guilt
At this age he has a strong imagination, likes ot explore the physicla world with all senses and poweres, but has many fears still.
starting to develop a conscience.
Do’s and do not’s of expected behaviors are important but will rebel if too much is expected.
Play is very important to help them understand, adjust to, and work out his life experiences.
The nurse can help him explore within limits of his condition, be aware and tolerate mood swings, reassure him of any fears. provide guidelines for his activitirs but allow freedom within limits.
