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Nursing School Pt 4 > Peds_Exam 2 > Flashcards

Peds_Exam 2 Flashcards

1
Q
  1. 4 wk old biliary atresia sx
  2. Hirschsprung’s Disease
  3. GER, plan of care
A
  1. ab distention, enlarged liver, enlarged speen, clay colored stool, tea colored urine
  2. lack of peristalsis in lg intestine, accumulation of bowel content leading to ab distention
  3. encourage parents- infant upright 30 min after feeding
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2
Q
  1. What age group for swallowing reflex
  2. Why do children need small frequent feedings
  3. What offers the most informtion for dehydration
A
  1. 6 weeks
  2. small stomach capacity and rapid movement of fluid through digestive system
  3. Analysis of serum electrolytes
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3
Q
  1. How is dehyration corrected
  2. what is contraindicated if child has not urinated
  3. How does breastfeeding alleviate villi?
A
  1. Isotonic Solution, NS, LR
  2. Potassium
  3. prevents death of villi and malabsopriotn
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4
Q
  1. What is common for a child to have when resuming a reg diet
  2. How can hirschsprung disease transmitted
  3. What cells are lacking in hirschprung syndrome
A
  1. diarrhea
  2. Genetic, future sibling are also at risk
  3. ganglion cells
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5
Q
  1. If child has enterocolitis, how would you evalute circulatory system
  2. What needs to be assessed first with enteroclitis
  3. What does nissen fundoplication involve
A
  1. quick head to toe assessment
  2. Vital signs, risk for shock
  3. wrapping the fundus of the stomach around the inferior esophagus, creating a lower edophageal sphincter or cardiac
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6
Q
  1. What does reglan do
  2. What could be indicative of a perforated appendix
  3. Prior to 6 weeks of age what should be assumed about infants swallowing
A
  1. Increased gastric emptying
  2. Sudden change or loss of pain, notify HCP
  3. will swallow anything hot or cold. Wont spit anything out.
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7
Q
  1. Major concerns when child is having diarrhea
  2. Complications of gastroesophageal reflux disease include
  3. A child with lactose intolerance can develop
A
  1. dehydration, the loss of fluid and electrolytes, and the development of metabolic acidosis.
  2. esophagitis, esophageal strictures, aspiration of gastric contents, and aspiration pneumonia.
  3. Calcium and vitamin D deficiency
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8
Q
  1. precautions to prevent viral hepatitis
  2. Left Sided HF characteristics
  3. coarctation of the aorta,
A
  1. proper hand washing, enteric, standard precuations
  2. crackles, grunting, orthopnea, nasal flaring, head bobbing, tachypnea
  3. blood pressure is higher in the upper extremities than in the lower extremities. In addition, bounding pulses in the arms, weak or absent femoral pulses, and cool lower extremities may be present.
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9
Q
  1. Clubbing
  2. Priority Actions if hypercyanotic spells occur
A
  1. symptomatic of chronic hypoxia. Peripheral circulation is diminished and oxygenation of vital organs and tissues is compromised
  2. place infant in knee chest posotion, admin 100% o2, admin morphine sulfate, IV fluids, document
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10
Q
  1. Assessment for rheumatic fever
A
  1. inquiring about a recent sore throat because rheumatic fever manifests 2 to 6 weeks after an untreated or partially treated group A β-hemolytic streptococcal infection of the upper respiratory tract.
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11
Q
  1. What can EKG detect x4
  2. A neborn is diagnosed with CHD. the test results reveeal the lumen of the duct between tha orta na dpulmonary artery remains opne. This defect is known as
  3. The parent of an infant diagnosed with TOF, which defects are involved? x4
A
  1. ischemia, injury, dysrhythmias, conduction delay (SATA)
  2. PDA
  3. VSD, Right eventricular hypertophy, P. Stenosis, overriding aorta (SATA)
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12
Q
  1. Major criteris of RF
  2. Minor criteria of RF
  3. RF is an
A
  1. carditis, subcutaneous nodules, erythema marginatum, chorea, and arthritis.
  2. fever and previous hx
  3. inflammatory disease caused by group A hemolytic strep
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13
Q
  1. What should nurse assess prior to administering digoxin?
  2. What finding might delay procedure cardiac cath
  3. First priority if child is bleeding after cardiac cath
A
  1. apical pulse rate, dig decreases HR. If <60 do not administer
  2. if standard groin approach then severe diaper rash,
  3. apply pressure 1 inch above puncture site will localize pressure over the vessel site.
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14
Q
  1. Interventions to decrease cardiac demands on child with CHF
A
  1. allow parents to hold anr rock child, keep child uncovered to promote low body temperature, make frequent position changes, fed child when sucking the fists, change bed linenes only when necessary, organize nursing activitis (SATA)
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15
Q
  1. Indomethacin may be given to close what CHD in newborn?
  2. Child with hypoplastic left heart syndrome, what drug may the PDA be given to allow PDA to remain open until surger?
  3. What can a fever do in relation to a murmur
A
  1. PDA
  2. Prostaglandin E
  3. increase CO, increase intensity of murmur
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16
Q
  1. Hall mark sign of PDA
  2. Outcome of KD
  3. KD medications
A
  1. Machine Like Murmur
  2. coronary thrombosis (hypercoagulability), cornorary stenosis, coronorary artery aneurysm (SATA)
  3. IgG and Aspirin
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17
Q
  1. CHD classification
  2. Hypoxic Spells with CHD can cause
  3. the 6 month who ha a tet spell could have the CHD defect of decreased pulmonary blood flow called
A
  1. defects w/ increased pulmonary blood flow, defeced with decreased pulmonary blood flow, mixed defects, obstructive (SATA)
  2. polycythemica, blood clots, CVA, developmental delays, brain damage (SATA)
  3. TOF (tet spell is the nickname)
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18
Q
  1. Characteristics of Supraventricular tachycardia
  2. BP screening to detec end organ damage begin at what age?
  3. Associated manifestation of Wilms Tumor
A
  1. above 200 bpm, result of dehydration, low CO, low BP, and prolonged cap refill
  2. 3 years to establish baseline
  3. Hypertension Secondary
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19
Q
  1. Where is Wilms tumor located
A
  1. sits on the kidney
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20
Q
  1. Mother with secondary hypertension, what drug should NOT be used
  2. Beta blockers are used in cautions with
  3. The (blank) serves as a septal opening between atria of the fetal
A
  1. ACE inhibitors, can cause birth defects.
  2. patient with hyperlipidemia, hyperglycemia , and impotence
  3. Foramen Ovale
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21
Q
  1. What lab finding would you find with CHD of decreased pulmonary blood flow
  2. Assessment reveals HR of 160, cap refill of 4 sec, bilateral crackes, sweat on scaple. signs of..
  3. Examples of Acquired Hear disease x4
A
  1. Polycythemia, body is attempting to increase oxygen supply w/ presence of hypoxia by increasing total RBC’s to carry o2
  2. CHF
  3. infective endocarditis, RF, Cardiomyopathy, KD (SATA)
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22
Q
  1. Signs of dig toxicity
  2. Positioning for CHF
  3. What is happenining in COA
A
  1. rubbing eyes, seeing halos, bradycardia, hypokalemia (w/ furosemide can increase the risk)
  2. Semi-Fowlers, fluid in lung can go to the base, allowig better expansion
  3. narrowing of the aorta
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23
Q
  1. First assessment after cardiac catheterization
  2. Medication for RF
  3. Valvular involvement with RF
A
  1. Check pulses
  2. aspirin drug of choice
  3. indicates significant damage, antibiotics for life
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24
Q
  1. What cardiac defect should child w/ down syndrome be evaluated for?
  2. What is norwood procedure used for
  3. What might suggest ingestion of cardiac medication
A
  1. CHD
  2. correct hypoplastic left heart syndrome
  3. lower hr and BP, hypoglycemia (Beta Blockers)
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25
Q
  1. When should you discontineu aspirin therapy in KD
  2. What illness is associated with spastic movements of extremities, facial grimace and speech disturbance?
  3. What is the most common dysrhytmia in pediatrics
A
  1. if child has chickenpox or influenza (viral) b/c danger of Reye Syndrome
  2. RF, (Sx of Chorea)
  3. suprventricular tachycardia
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26
Q
  1. What nursing action promotes ideal nutrition in an infnat with CHF
  2. What allergy can be associated with Spina Bifida (myelomeningocele)
  3. Normal pediatric urin output
A
  1. Formula additional w/ extra calories
  2. Latex allergy, cardiac cath balloon made of latex
  3. ImL/kg/hr
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27
Q
  1. Flow of blood in VSD
  2. Why may surgery for VSD not be recommended
  3. ASD blood flow?
A
  1. Right to left
  2. VSD usually will close within first year of life
  3. Left to right (left side of heart pressure is greature)
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28
Q
  1. An infant dx with ASD/ AVC defect flow of blood
  2. A 6r old with chest pain and exercise intolerance, what does she have?
  3. Manifestations of COA in older chid
A
  1. either direction (gen left to right)
  2. AS (Aortic Stenosis)
  3. dizziness, headache, fainting, elevated BP, and bounding radial pulses
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29
Q
  1. Medication for patient with transposition of great vessels
  2. How shoud mother treat sibling of RF patient
  3. What type of feeding does a CHF patient require?
A
  1. Prostaglandin E, inhibits closing of PDA which connects th aorta and pulmonary artery
  2. if one gets a sore throat treat with antibiotics
  3. gavage, may experience increase cardaic demand while feeding
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30
Q
  1. 2 Physiological changes occur as a result of hypoxemia and CHF
  2. What does aspirin do for RF
  3. Which vaccines need to be delayed after KD pt received IGG
A
  1. Clubbing, polycythemia
  2. reduce joint inflmmation and pain
  3. MMR, Varicella (might not produce appropriate number of antibodies)
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31
Q
  1. What are current recommendation for a lipid profile in children
  2. during play, a toddler with a hx of TOF might assume which position?
  3. What does increasing SVR (systemic vascular resistance) in squatting position do?
A
  1. over 2 yrs with 1st or 2nd degree relative with stroke, MI, angina or sudden cardiac death. or if relative has >240mg/dL cholesterol
  2. Squatting, dec preload by occluding venous flow from lower extremities, and incr after load.
  3. increase pulmonary blood flow
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32
Q
  1. Heart transplant may be indicated in a child with which symptoms?
  2. How is hypoplastic left heart syndrome treated?
  3. How long can children be irritable after symptoms of KD start?
A
  1. hypoplastic left heart syndrome
  2. Heart transplant, allow chid to tie, norwood procedure
  3. 2 months
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33
Q
  1. What can be indicative of good growth and development of a child with CHF?
A
  1. 50th percentile for height and weight for age
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34
Q
  1. Why does a newborn have to be fed more frequently?
  2. How to get child to take pedialyte
  3. What should be taught with child w/ rotavirus at discharge
A
  1. small stomach capacity and persistalsis is more rapid than in older children
  2. allow choices, small amounts in a spoon, medicine cup or syringe
  3. continue breastfeeding, promotes death of villi, & malabsorption
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35
Q
  1. When can a child with diarrhea be discharged?
  2. What to give child that is thirsty after vomiting severqal times?
  3. How can a parent manage child’s constipation?
A
  1. relapse of diarrhea after resuming reg diet.
  2. sm amt of pediatlye. wait half hour and give half of what you gave previously (small gradual amounts)
  3. more fluids
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36
Q
  1. A child with chronic constipation what medication is appropriate?
  2. What should parent NOT do for a child with encoperesis?
  3. Manifestation of enterocolitis associated with Hirschsprung disease?
A
  1. stool softener
  2. provid positive reinforment for toileting habits,
  3. mucous stool and bloody diarrhea, iriitable, distended abdomen
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37
Q
  1. What needs to be done first with enterocolitis symptoms?
  2. What should parents expect with child that has Hirschsprung disease?
  3. When should reglan be administerd for a child with GER?
A
  1. Vital signs, head to toe
  2. require surgery, different ways to manage, depending on how child’s bowels are involved
  3. 30 mintues before feeding
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38
Q
  1. How does prilosec work for GER?
  2. What is a positive sign of Rovsing
  3. Best position for a child with after appendectomy of ruptured appendix?
A
  1. decreases stomach acid will be irritating when child spits up
  2. LLQ palpated and pain is felt in the right lower quadrant
  3. Right side lying, allows peritoneal cavity to drain
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39
Q
  1. post op appendectomy
  2. How is morphine administered for appendectomry?
  3. If child has a fever post op
A
  1. child will be sleepy, IV line in hand, pain meds thru IV
  2. PCA pump
  3. TCDB, blow bubbles
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40
Q
  1. How long should pt wait post op appendectomy to resume sports?
  2. What to expect early stages of hepatitis
  3. Child with hepatitis what to eat?
A
  1. 6 weeks
  2. N/V, malaise (anicteris phase)
  3. high protein, tuna, whole wheat bread skim milk
41
Q
  1. What is approiate for a 2+ year old on bed rest?
  2. Why would child with biliary atresia be given cholestyramine?
  3. What is a Kasai Procedure for biliary atresia?
A
  1. playing with puzzles
  2. to relieve itching
  3. palliative bile duct is attached to a loop of bowel to assis with bile drainage
42
Q
  1. When is a surgery procedure done with a child who has cleft lip/palate?
  2. Can you breastfeed with cleft lip/palate?
  3. Post op cleft lip repair positioning?
A
  1. within first weeks of life, but palate is not repaired until 18 months
  2. sometimes
  3. supine, dec risk of infant rubbing suture line
43
Q
  1. Post op cleft lip how to administer pain med
  2. What would you expect in an infant with esophaeal atresia during mother’s pregnancy?
  3. Immediate action if baby is cyanotic or choking?
A
  1. regularly to avoid crying which stresses suture line
  2. polyhydramnios
  3. take infant fro mother and administer blow by oxygen while obtaining o2 saturation, obtain vital signs
44
Q
  1. Preop tracheosophageal atresia
  2. How should the area around a GT be cleaned?
  3. When do umbilical hernia occur most often?
A
  1. IV fluids and antibiotics, because infant will be NPO, prevention of pneumonia (due to aspiratin)
  2. with soap and water everyday
  3. in premature infants
45
Q
  1. When should HCP be notified with umbilical hernia
  2. pyloric stenosis and genetics
  3. manifestation of pyloric stenosis
A
  1. If it appears more swollen or tender (intestine may be trapped surg emergency)
  2. can run in families is more common among males
  3. baby is always hungry appear malnourished
46
Q
  1. Preop pyloromyotomy?
  2. Signa of intussusception
  3. What should mother do in this situation?
A
  1. infant is NPO, maintenance IV fluids, NGT low wall suction (decompress stomach)
  2. sleepy, fussy, vomiting, diarrhea, mucous and blood in stool.
  3. will need tests in ER if anything serious is going on- to prevent ischeia or perforation
47
Q
  1. Evaluation for intussesception?
  2. Purpose of enema for intussesception?
  3. Pt with rigid abdomen and intussescpetion
A
  1. irritability when knees are brought to chest. Vital signs are stable
  2. will confirm diagnoses and change of fixing the problem
  3. ER surgican correction TOP priority
48
Q
  1. Discharge teaching for imperforate anus
  2. What is indicative of anorectal malformation
  3. What should parent NOT to if colostomy is place
A
  1. Call doc of stool changes in consistency (could indicate stenosis of rectum)
  2. presence of stool in urine
  3. keep bag attached to avoid cotens of small instestine comin in contact with baby’s skin
49
Q
  1. Why to make dietary changes in child with celiac’s disease?
  2. Examples of diet with celiacs
  3. How do they evaluate for celiacs disease
A
  1. damages mucosal cells in intestine leading to absorption problems. Accumulation of amino acid that is toxic to cell and villi.
  2. Cheese, banana, rice cakes whole milk
  3. stool sample and prep for jejunal biopsy
50
Q
  1. Symptoms that suggest NEC?
  2. Treatment for NEC
  3. Population for NEC
A
  1. bloody diarrhea
  2. IV antibiotics to prevent or treat sepsis
  3. more common in preemies but also in term or low birth weight infants
51
Q
  1. How does SBS affect child? (short bowel syndrome)
  2. IF sbs child is on TPN what is important
  3. Children that need extra fluids to avoid dehydration
A
  1. shorter intestine will not be able to absorb all nutrient and vitamins in food and will need to get in alternative ways (hyperalimentation)
  2. begin feeding ASAP so that it received stimulatio and doesn’t atrophy
  3. infant receiveing phottherapy, pyloric stenosis, pneumonia, burns to chest or abdomen
52
Q
  1. Causes for constipation?
A
  1. hypothyroidism, muscular dystrophy, spina bifida (myelomengiocele), drinks a lot of milk (SATA)
53
Q
  1. How do parents have to adapt to special need child?
A
  1. dev needs of other family memebers, cope with stress, assist in managing feeling, educate others about child’s condition
54
Q
  1. How can nurses help with families that have child with disability
A
  • families strengths and weaknesses
  • give infor about the disability/chronic illness
  • include child in decision making
  • apply rules to everyone in the family
  • prep child for changes
  • build self esteem
55
Q
  1. 2 coping strategies for child with special needs
  2. Kathy Snow- people first language
  3. Contraindications for immunizations
A
  1. Assign meaning, ability to share burdens with others
  2. Brain injury instead of “brain damage”
  3. seizure, fever, prego, altered immunodeficiency, anaphylactic
56
Q
  1. What age group does SID fall under?
  2. Explanation of SIDS
  3. What seasons does SIDS occur?
A
  1. Under 1 year of age (usually 2-3 months)
  2. None, deaths are unobserved
  3. Fall/Winter
57
Q
  1. S/Sx of SIDS
  2. SIDS and Apnea
A
  1. frothy, blood tinged secretion from mouth/nares, struggle change in positions, cardiac arrest
  2. Unrelated
58
Q
  1. SIDS prevention, how shall baby sleep?
  2. What environmental factors can constribute?
  3. What has decreased incidence of SIDS
A
  1. not on abdomen
  2. second hand smoke, overheating,
  3. pacifiers
59
Q
  1. What gender is more prone to SIDS
  2. What characteristics of child and mother for SIDS
  3. What is SIDS NOT
A
  1. male
  2. young mother, low birthweight, premature
  3. suffocation, vomiting, choking, vaccination, child abuse
60
Q
  1. Nursing Care for SIDS
  2. What is obesity the result of
  3. What percentil is considered overweight
A
  1. grief/religious counseling, cessation of breast feeding, support
  2. energy imbalance, caloric intake exceeds requirement of expenditures
  3. 85 and 95th percentile
61
Q
  1. Formula for BMI calc
  2. How old until screening for BMI
  3. Autism and speech
A
  1. weight/height (meter2)
  2. 2 years
  3. Delayed speech, atypical language
62
Q
  1. Nursing interventions for autism
  2. How to communicate with autism
A
  1. parent support, decrease stimulation, minimum holding/eye contact, introduce new situations slowly
  2. be direct, with developmental level, brief and concrete
63
Q
  1. What is bottle mouth syndrome?
  2. What limitation should be addressed?
  3. What is suicide
A
  1. sweetened liquids are given and are left clinging to an infant’s teeth for long periods
  2. No bottles in the bed accept water (+6 mnths)
  3. permanent solution to a temporary problem
64
Q
  1. Associative factors with suicide
  2. Nursing Care for suicide
  3. What is tthe bladder capacity of a 3 year old
A
  1. lack of sleep, loss, racism, exhaustion, bullying
  2. take threats seriously, identify support, crisis ctr, screening, lock up pills and guns
  3. 5 oz.
65
Q
  1. How do you calculate bladder capacity
  2. Expected range of urine output
  3. What tests are used routinely for uti’s?
A
    • 2 to Age
  2. 0.5-1mL/kg/hr
  3. urinalysis, urine culture
66
Q
  1. When is a VCUG used?
  2. Classic signs of uti
  3. Other signs of UTI
A
  1. extent of urinary tract involvement when second occurence w/in a year
  2. frequency and urgency
  3. irritability, lack of appetitie, infection, fever, inc HR,
67
Q
  1. Best way to obtain urine sample on child not toilet trained?
  2. What infection is associated with glomerulonephritis
  3. What skin infection is associated with Strep?
A
  1. straight cath, obtain sample, remove cath w/o waitng for results
  2. Strep
  3. Impetigo
68
Q
  1. Common findings in glomerulonephritis?
  2. What is urgent with glomerulonephritis?
  3. Signs of encephalopathy
A
  1. Mild proteinura, hemautria (tea colored), dec u output, lethargy
  2. Encephalopathy
  3. severe headache photophobia due to HTN
69
Q
  1. How do you know when globerulonephritis is improving?
  2. What precedes with MCNS (minimal change nephrotic syndrome)
  3. Causes of manifestation of MCNS?
A
  1. urine output increase, less tea colored
  2. Bad cold (URI)
  3. increased permeability of glomeruli (lg substances such as proten can pass)
70
Q
  1. Why does MCNS cause elevated lipids?
  2. Tx for Severe Edema w/ MCNS
  3. What has been linked to relapse with MCNS
A
  1. loss of protein stimulates liver making more lipids (hypoalbuminemia)
  2. IV albumin
  3. exposure to infectious illness
71
Q
  1. Hypospadias and circumcision
  2. Why is chordee repaired along with hypospadias?
  3. Discharge teaching with epispadias?
A
  1. is an option, delayed- foreskin needed for repair of defect
  2. to optimize sexual function
  3. gently irrigate if mucous plug forms
72
Q
  1. HUS, child hx
  2. What bacteria causes HUS
  3. What’s the patho for HUS
A
  1. child & parents had vomiting and diarrhea due to something they ate
  2. E.coli
  3. swollen lining of small blood vessels damags RBCs, then removed by spleen leading to anemia
73
Q
  1. Lab results for HUS
  2. HUS plan of care
  3. What needs to be present to dx HUS
A
  1. Hematuria, mild protenuria, increase BUN/Creat, low H/H
  2. admin blood producs (anemia), dialysis (tx of choice)
  3. low RBC, high reticulocyte coutn, low platelets, renal failure
74
Q
  1. How long are children with HUS contagious
  2. Top priority of care w/ bladder extrophy
  3. Medication post op bladder extrophy
A
  1. up to 17 days prior diarrhea. Contact isolation
  2. prevent infection from stool, skin breakdown. Change diaper frequently
  3. oxybutynin (controls spasms)
75
Q
  1. Children w. urological malformation (bladder extrophy) prone to…
  2. Due to latex allergy what should children be cautious around
  3. Causes of hydronephrosis
A
  1. Latex allergy
  2. playgrounds, may have latex
  3. structural abnormality, urine backs up causes pressure and cell death
76
Q
  1. Clinical findings of hydronephrosis?
  2. Plan of care for hydronephrosis
  3. Primary enuresis
A
  1. inc BP, metabolic acidosis, polydipsia, polyuria, bacterial growth in urine
  2. strict I/O, Vitals (BP- measures kidney)
  3. incontinence child who has NEVER had bladder control
77
Q
  1. Secondary enuresis
  2. Diurnal enuresis
  3. Nocturnal enuresis
A
  1. child who previously had bladder control
  2. daytime urinary incontinence
  3. nighttime urinary incontinence
78
Q
  1. How to limit nocturnal enuresis
  2. Testicular torsion signs
  3. What causes Sx in testicular torsion
A
  1. limit fluids in the evening, reward system after dry nights (inc sense of ctrl)
  2. intense pain/ swelling to sscrotal area. Vomiting, ab pain. Surg URGENT!!
  3. Twisting of spermatic cod, interrupts blood supply
79
Q
  1. Teaching post op repair of testi torsion
A
  1. testicular self exam monthly
  2. avoid strenuous activity 2-4 weeks
  3. gradually increase activity
  4. do not become infertile (only 1 testi)
80
Q
  1. Female inguinal hernia, most likely caused by
  2. Hydrocele vs Inguinal Hernia
  3. What happens to bulge inguinal hernia when baby is asleep
A
  1. Fallopian tube
  2. fluid vs tissue
  3. bulge is smaller
81
Q
  1. Typical hx with incarerated hernia
  2. Growth of wilms tumor
  3. Assessment finding wilms tumor
A
  1. acute pain, ab distention mass unable to reduce, bloody stool, edema of scrotum, poor feeding
  2. fast growing may not be evident a few days prior
  3. inc BP, norm temp, firm mass on one side of the midline abdomen
82
Q
  1. Why would MRI of lungs with wilms tumor
  2. Wilms Tumor Stage 3 means
A
  1. to see if disease has spread
  2. confined to badomen, spread to lymph nodes or perioneal area, prognosis still good
83
Q
  1. Surgery for Wilms Tumor
  2. Cause for pain after removal of kidney
  3. CRF vs ARF
A
  1. removal of affected kidney only
  2. shift of fluids and organs in abdominal cavity
  3. ARF is reversible, CRF perm deterioration of kidney function
84
Q
  1. Prerenal failure causes
  2. Drug of choice for ARF if cardiac irritabilty/hyperkalemia
  3. fluid requirement oliguric phase of ARF
A
  1. dehydration and hemorrhage
  2. Calcim gluconate
  3. 1/3 of daily requirement (350ml answer)
85
Q
  1. S/Sx of ARF
  2. Intervention when medication don’t work
  3. Rationale for peritoneal dialysis vs hemodialysis
A
  1. eye can’t open, enlarged liver, dec urine output, inc HR, RR, BP
  2. Tenckhoff cath for peritoneal dialsis
  3. removes fluid slower, less complications
86
Q
  1. Signs of peritonitis with peritoneal dialysis
  2. How is it treated?
  3. Inadequate volume return with periotneal dialysis, intervention
A
  1. cloudy return with ab pain
  2. antibiotics in dialysis fluid before next dwell time
  3. increase glucose concentration of dialysate (pulls water)
87
Q
  1. S/Sx disequilibrium syndrome
  2. How can it be prevented?
  3. Chronic HTN in child with CRF is due to
A
  1. headache, nausea, generalized muscle twitching, during hemodialysis
  2. slow rate of solute removal of dialysis
  3. retention of sodium and water
88
Q
  1. Why is CRF at risk for spontaneous fracures
  2. Diet for CRF
  3. Medication after kdney transplant
A
  1. depletion of phosphorus and calcium stores from the bones
  2. high in calorie, high protien, high Ca, low potassium/phosphorus
  3. Corticosteroids- antirejection
89
Q
  1. Assessment questions for child with more accidents
A
  • stressful event, like birth of a sibling
  • anyone else in family with accidents
  • child drinking more than usual
  • child more irritiable, pain when urinating?
90
Q
  1. What type of tumor is wilms
  2. At what age can it occur
  3. How does it occur
A
  1. Nephroblastoma
  2. any age, most at 2-5 years
  3. on its own, congential anomalies
91
Q
  1. Wilms tumor prognosis
  2. What assessment do you not do if child has wilm’s tumor
A
  1. very good
  2. do not palpate, could spread
92
Q
  1. What happens with C-reactive protein in RF
  2. What happens to heart with RF
  3. What happens to ESR with RF?
A
  1. elevated
  2. carditis
  3. elevated (erythrocyte sedimentation rate)
93
Q

REVIEW ALL SLIDES! NOW!

A
94
Q
  1. What 3 things increase risk for digtalis toxicity
  2. First priority intervention with Congestive Heart Failure
  3. Leads to cyanosis and tachycardia mixing of deox and oxy in the left side of the heart
A
  1. Hypokalemia, Hypomagnesemia, hypothyroidism
  2. Administer oxygen
  3. Tricuspid atresia
95
Q
  1. Excessive sweating, fatigue and loud holosystolic murmur on left sternal border, what disease condition?
  2. Aortic stenosis involves what 2 things
  3. Upon assessment with a child who has pulmonary valve stenosis, what 2 things?
A
  1. Ventricular Septal Defect
  2. inc pressure in left ventricle, obstruction of blood flow from left ventricle
  3. thrill, systolic murmur over left sternal borner
96
Q
  1. What 2 things would you find upon assessment of child with Atrial Septal Defect?
  2. Priority intervention with acute glomerulonpehritis?
  3. Tacrolimus is used for after organ transplant what is a side effecT?
A
  1. murmur over pulmonic area and 2nd S2 split, fatigue and dsypnea upon exertion
  2. fluid and salt restriction (due to edema and fluid retention)
  3. Tremors
97
Q
  1. Signs of complications with glomeruonpehritis?
  2. What is the common surgical technique to repair hypospadias?
  3. What is cryptochidism?
A
  1. adventitious lung sounds- fluid overload
  2. tubularized urethroplasty
  3. undescended testes
98
Q
  1. What is the srugical procedure to repair cryptorchidism?
  2. How to promote dryness with enuresis child?
  3. Nephrotic Syndrome Mnemonic?
A
  1. Orchiopexy
  2. Retention control training (drinks fluids and delays urination as long as possible)
  3. People Have Endless Appetities (Proteinuria, Hyperlipidemia, Edema, Albuminaria)
99
Q
  1. What are the 2 first clinical symproms of Acute Glomerulonephritis?
  2. Risk associated with Oral contreceptive?
  3. What are signs of serious complication of oral contraceptive?
A
  1. Hematuria, proteinura
  2. Venous thromboembolism
  3. heat and swelling of the right lower extremity

Nursing School Pt 4 (8 decks)

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