PedsCardioGIGU

Question 1

Explain fetal heart development. Risk factors for complications?

Answer 1

Begins shortly after conception and is completed by 8wks gestation. Heartbeat starts at about 3wks.
Maternal substance abuse, maternal exposure to viruses, toxoplasmosis, German measles. Maternal diabetes. Family history of CHD. In most instances there is no known cause.

Question 2

Explain the heart in children.

Answer 2

Size of the fist. Compliance is less in infants and young children. Compensates for decreased contraction with increased heart rate. HR is higher in infants, 110-160. In teens the HR is 60-100.

Question 3

The heart in children under 7?

Answer 3

The heart lies more horizontally. Apex is higher and found at the 4th intercostal space. As lung grows, the heart is displaced downward.

Question 4

The heart in ages 6-10?

Adolescents?

Answer 4

Heart is 10x the birth size and grows more vertically. Apex is at the 5th intercostal space.
In teens, it grows in size with the there’s rapid growth spurt.

Question 5

Cardiac vs acquired heart disease?

Answer 5

Cardiac disease in children is congenital. The most common. Nearly half of all cases are diagnosed during the 1st week of life. 28% occur with as syndrome.
Acquired heart disease happens after birth and is a complication of CHD.

Question 6

Present illness/symptoms for cardiac disease in children?

Answer 6

Activity intolerance, tachypnea, color change, sweating around the head with feeds. Failure to thrive: smaller in size, g/d delay, may have difficulty with nutrition, must work extra hard to pump blood

Question 7

Past medical history and family history for cardiac issues?

Answer 7

Pregnancy hx: maternal infections, meds, illness, alcohol, diabetes.
Frequent respiratory infections. More than one episode of pneumonia is a red flag. CHD in the family, sudden deaths at early ages.
Risks include obesity and hyperlipidemia.

Question 8

Physical inspection for cardiac issues?

Answer 8

General appearance, LOC and activity level, color (cyanosis, pallor), sweating, dysmorphic, edema (in babies around the face and eyes). Late stage can mean clubbing in older children.

Question 9

Palpation for cardiac issues?

Answer 9

Pulses, their quality, amplitude, symmetry, hyperactive precordium/thrill. Femoral pulse is a critical assessment in infants. Start at the feet and move up.
Get arterial BP on all four extremities.
Hepatomegaly can mean the child is failing to pump enough blood and its backed up into the liver.

Question 10

Auscultation for cardiac issues?

Answer 10

Apical pulse for 1 min, rate, rhythm. Listen in all 5 locations for s1 and s2.
Murmurs (most common finding): Location, radiation, relationship to the cardiac cycle, intensity, quality, variation with position. >50% of newborns have an innocent systolic murmur with a usually normal EKG and Cxr.
Arterial BP in the upper and lower extremities

Question 11

Labs and diagnostics for cardiac issues?

Answer 11

ECG for valves and valve functions, how well the atrium and ventricles are functioning, definitively diagnostic. Echocardiography. ABG’s, CBC, BMP for h/h, check for polycythemia which is a compensation for hypoxia. Cxr for the size of the heart. ESR and CRP for inflammatory markers. Cardiac cath.

Question 12

Pre cardiac catheterization care in children?

Answer 12

Sedative procedure in children, usually overnight. History and PE age, s/s, physical, has the test been done before, allergies. Allergies to shellfish or iodine in a dye used. Mark pedal pulses to make sure we know where to look after surgery. Education, what to expect, dressing.

Question 13

Post cardiac catheterization care in children?

Answer 13

Monitor for complications. VS and pulse ox q15min for 1st hour, then q30mins for 2nd hour. Assess neuro and cardiac status. Femoral is the most common area of insertion, assess lower extremities for perfusion. May use a Doppler. Dressing. I+O, pain, education. Bedrest with extremity extended.

Question 14

Assessing the dressing post cardiac catheterization?

Answer 14

Almost for 30 minutes. If bleeding, put pressure 1 inch above the site for 5-15 minutes. No moisture on the dressing. Bed rest with extremity extended, keep the leg straight.

Question 15

Newborn cardiac screening?

Answer 15

Recommended at 24-48 hours of age. Detected with pulse ox. Screening should be no earlier than 24 hours after birth and prior to discharge.

Question 16

Hole in the septum between the two ventricles, right to left shunt, skips the lungs. De-saturated blood enters circulation. Not enough O2 in blood means blue!

Answer 16

Decreased pulmonary blood flow aka cyanotic heart lesion. Cyanosis not always easy to recognize especially if patient has polycythemia jaundice, racial pigmentation, or anemia. Infants are usually unable to achieve an O2 of >100 after breathing 100% inspired O2: “100% oxygen test.”
Tricuspid atresia, tetralogy of fallot (TOF)

Question 17

What four areas are affected with tetralogy of fallot?

Answer 17

Pulmonary stenosis, right ventricular hypertrophy, overriding aorta, ventricular septal defect (VSD)

Question 18

Nursing assessment of tetralogy of fallot?

Answer 18

Chronic hypoxia, leading to death. Loud murmur. Polycythemia, body detects poor oxygenation so to compensate creates more RBCs. Hyper cyanotic spells can happen with moments of distress and blood work

Question 19

Interventions for tetralogy of fallot?

Answer 19

Oxygen. Knee to chest position. Child may squat to push blood back up, increasing pressure and pushing blood back up into the core of the body. Keep calm. Morphine to calm the child and relax the pulmonary artery (vasodilator). Supply IV fluids.

Question 20

Blood flow from the right ventricle is obstructed and slowed.
Valve between right atrium and ventricle doesn’t develop. Deoxygenated blood passes through foramen vale into the left atrium, never getting O2.

Answer 20

Pulmonary stenosis

Tricuspid atresia

Question 21

Plentiful amount of blood in the lungs but can’t get out to the body, leading to increased pulmonary blood flow, which leads to HTN. Left to right shunt, oxygenated blood circulating throughout the lungs, although hypertrophy of RV can cause right to left shunting.

Answer 21

Increased pulmonary blood flow, acyanotic heart disease. Infants will present with a murmur of symptoms of congestive HF.
Atrial septal defect, ventricular septal defect, atrioventricular septal defect, patent ductus arteriosis

Question 22

Nursing assessment of a ventricular septal defect (VSD)?

Answer 22

Murmur, tachypnea (may not finish a feed due to fatigue), poor growth, peripheral edema (difficulty circulating), HF, HTN, respiratory infections.

Question 23

Hole in the wall between both ventricles. One of the more common ones with low risk and mortality. Patched up with a graft. Usually no further surgery is needed.

Answer 23

Ventricular septal defect.
Blood gets pushed into the right ventricle from the left ventricle because of pressure. Double blood going to the lungs. Increased RR, crackles, frequent respiratory infections like pneumonia. Symptoms depend on severity of defect.

Question 24

Increases the workload of the heart causing lung congestion. May close on its own or with meds (indomethacin). Assessment and treatment?

Answer 24

Patent ductus arteriosus.
Harsh, continuous, machine-like murmur. Respiratory infections, poor growth, bounding peripheral pulses (attempt to increase BP), widened pulse pressure.
Coiled thread to stop the blood from mixing. Surgery to cut it out.

Question 25

Defects that involve some type of narrowing, stenosis in the vessel.

Answer 25

Obstructive cardiac disorders Coarction of the aorta, aortic stenosis, pulmonary stenosis

Question 26

Narrowing of the aorta, commonly at the ductus arteriosus. Blood flow is impeded. Nursing assessment?

Answer 26

Coarction of the aorta.
Increased BP in the upper extremities, decreased in the lower. Bounding upper extremity pulses, softer in the lower. Epistaxis, leg pain, notching of the ribs because young ribs are made of cartilage
Risk for aortic rupture, aortic aneurysm, CVA

Question 27

Defects in which mixing of well oxygenated blood with poorly oxygenated blood. Overall decreased O2 content, decreased cardiac output, leads to HF.

Answer 27

Mixed cardiac defects.
Tranposition of the great arteries/vessels (TGV), total anomalous pulmonary venous connection (TAPVC), truncus arteriosus, hypoplastic left heart syndrome

Question 28

Poorly oxygenated blood circulating, vessels are backwards, the aorta and the pulmonary artery. Assessment and diagnosis?

Answer 28

Transposition of the great vessels. Cyanosis without murmur. Diagnosed early
Balloon septostomy, may create an ASD to encourage mixing and oxygenation.

Question 29

Underdeveloped, non-functional left side of the heart. Increasing cyanosis and circulatory collapse (shock).

Answer 29

Hypoplastic left heart syndrome.

Question 30

Nursing management of the child with CHD?

Answer 30

Monitory VS, BP. Assess cardiac status. Administer digoxin and other meds.
They have decreased cardiac output, ineffective tissue perfusion, imbalanced nutrition, interrupted family processes, risk for infection

Question 31

Med that slows down the heart rate and increases contractility?

Answer 31

Digoxin. In peds, small therapeutic range so accurate measurement. Avoid giving with food or fluid, 2 hours after a meal. Count apical pulse for 1 full minute. Do not give if <100 in children, <60 in adults.
Monitor levels and signs of toxicity: when vomiting check levels. If vomiting wait 4 hours, then give next dose. Call the HCP after two missing doses. Visual disturbances, low K+ increased risk for toxicity

Question 32

Nursing management for ineffective tissue perfusion related to cardiac issues?

Answer 32

Position to maximize chest expansion, fowler’s or semi-fowler’s. Infant seat. Assess VS and pulse ox. Oxygen PRN, only when it’s really needed. Respiratory status and lung sounds. HF HF, fluid in the lungs

Question 33

Nursing management for imbalanced nutrition related to cardiac issues?

Answer 33

Increased calorie meals (higher metabolic rate). Infants: high calorie formula or MBM fortifier. Child: high protein. Small, frequent feedings, limit to q20 mins every 3 hrs. Gavage remainder: tube feeding ensures proper nutrition. Special nipple to decrease work. Maybe pump then bottle feed, breastfeeding takes a lot of energy. Monitor growth: infants are 1 oz weight gain per day.

Question 34

Nursing management of interrupted family processes related to cardiac issues?

Answer 34

Provide support, encourage parents to participate, encourage to touch and hold the child, to play with familiar toys. Provide anticipatory guidance for NG feeds at home, weighing the child on a routine basis. Explain plan of care. Recognize vulnerable child syndrome, allow child to do normal activities

Question 35

Risk for infection related to peds cardiac issues?

Answer 35

Maintain strict hand hygiene. Assess VS, temp. Avoid contact with ill persons. Ensure up-to-date immunization status. Synergist to prevent RSV. Admin prophylactic antibiotic if indicated for any procedure including dental, RF bacterial endocarditis without it (6-8 weeks of meds)

Question 36

Acquired heart disease that occurs in children after birth. Common in children with an underlying CHD. Inability to pump O2 and nutrients effectively. Nursing assessment?

Answer 36

HF. Subtle signs: decreased feedings and time, irritability, lethargy, upright position preferred.
Pulmonary symptoms: crackles, coughing, dyspnea, tachypnea, increased WOB.
Tachycardia, diaphoresis, edema, weight gain, hepatomegaly.

Question 37

Nursing management of peds HF?

Answer 37

Promote oxygenation. Support cardiac function with digoxin and daily weights, will drop weight with a diuretic. Provide adequate nutrition. Promote rest with “all at once” care

Question 38

Reaction after a group A strep pharyngeal infection, commonly ages 5-15. Systemic reaction that causes valve damage and carditis.

Answer 38

Acute rheumatic fever. Diagnosis depends on the Jones criteria.

Question 39

Explain the Jones criteria to diagnose rheumatic fever?

Answer 39

Presence of 2 major and 2 minor.
Major: carditis, migratory polyarthritis, palpable subcut nodules, erythema marginatum (classic rash), chorea (involuntary jerking of the extremities).
Minor: Arthralgia, fever, high ESR or CRP (inflammation markers), prolonged PR interval, ASO titer to check for recent strep infection

Question 40

Nursing management of acute rheumatic fever?

Answer 40

Strict rest. Pain management that lasts for 6-12 weeks. Monitor for complications, cardiac. Education.
Antibiotic therapy with penicillin/ampicillin. Management will be based on labs. Penicillin could be for a lifetime.

Question 41

Assessment for HTN?

Answer 41

Health history, esp cardiac or renal issues. Screenings for children > or equal to 3 years. Physical exam, obesity: monitor nutrition, growth chart, diet. Labs and diagnostic testing.

Question 42

Nursing management of HTN?

Answer 42

Monitor BP and symptoms. Education: weight reduction, healthy diet, increased physical activity, antihypertensives PRN, keep follow up appointments

Question 43

Total cholesterol ranges? LDL?

Answer 43

Total cholesterol: <170 acceptable, 170-199 borderline, >equal to 200 elevated.
LDL: <110 acceptable, 100-129 borderline, >equal to 130 elevated

Question 44

Assessment and nursing management for hyperlipidemia?

Answer 44

AAP recommends screening >2 years. Health history, plot height and weight .
For greater than 2 years, lipid screening (fasting). Education: diet, exercise, meds prn, red nutrition labels

Question 45

Acute systemic vasculitis occurring mostly in young children. Peak age 1-2 years. Resulting in increased coagulation. Cause remains unknown.

Answer 45

Kawasaki disease. Leading cause of acquired heart disease, most frequently in <5yrs, males, and Asians. Diagnosis is based on clinical symptoms.
Myocarditis, pericarditis, conduction disturbances, mitral/aortic regurgitation

Question 46

Diagnostic criteria for Kawasaki disease?

Answer 46

Fever of at least 5 days and 4 of conditions:
Bilateral conjunctival injection (red eyes, no drainage). Changes of lips/oral mucosa (dry, red fissured lips, strawberry tongue, oropharyngeal edema)
Changes of peripheral extremities (erythema of plans/soles, edema of hands/feet, subsequent desquamation)
Polymorphous rash, cervical lymphadenopathy

Question 47

Nursing management of Kawasaki disease?

Answer 47

Monitor cardiac status, promote comfort, acetaminophen, quiet environment, IV fluids. Consultation with infectious disease specialist and cardiologist. Labs: increased ESR, leukocytosis, thrombocytosis. Education: avoid live vaccines, regular follow up. Echo at dx, 3wks and 8 after tx.

Question 48

Meds for Kawasaki disease?

Answer 48

Acetaminophen. IVIG (avoid live vaccines within 11 months). High dose aspirin therapy, up to 80 mg/kg/day for several weeks-months.
Aspirin toxicity: redness, ringing ears

Question 49

Complications of Kawasaki disease?

Answer 49

Aneurysmal dilation of the coronary arteries (most serious). May be present as early as 7-10 days after fever onset with peak prevalence 2-4wks after onset.

Question 50

The mouth and esophagus in children?

Answer 50

Mouth is immature until about age 2. Very common route for infection, very vascular. pH is different which allows organisms to live longer.
Lower esophageal sphincter is floppier under 6 months, RF acid reflux. Can see it in dental reports and erosion of molar areas.

Question 51

The stomach and intestines in children?

Answer 51

Stomach holds at birth 10-20 mL, gradually enlarges as the child grows. Gastric acid becomes mature at 6 months of age, emptying is delayed.
Most nutrients are absorbed the intestines, where motility is delayed, less mature until 2. More diarrhea and constipation. Half the length in a child than in an adult.

Question 52

Fluid balance and losses in children?

Answer 52

Higher water percentage than an adult. Greater water loss due to more body surface, which leads to fever/vomiting, RF dehydration. Needs more water to sustain.

Question 53

Urinary concentration in children?

Answer 53

Concentration is less than in an adult, lower specific gravity <1.010. Kidneys less protected, more up into the chest wall. Slower glomerular filtration rate, passage of blood through the kidney. Urine output is 1-2 mL/kg/hr. Bladder size is about 30 mL then 700mL as adult.

Question 54

Healthy history for GI/GU in children?

Answer 54

Growth patterns: may be smaller, shorter, and decreased weight if have Gi and Gu problems. Toiler training and enuresis (accidental urination), usually trained by around 3yr. Dietary concerns. Past medical history. Neonatal assessment/problems. Family history, many problems are genetics. Diabetic mother who delivers a child with issues with growth? Drug use?

Question 55

Explain esophageal pH probe and U/S for diagnostic testing for GI/GU?

Answer 55

Esophageal pH probe is used to find a source for GI absorption or weight problem. Like reflux. May be done endoscopically.
Ultrasound is used for ab and renal. Frequent and common test. Tolerated well in peds.

Question 56

KUB xray for diagnosing in GI/GU?

Barium study? Stool study?

Answer 56

Kidney, ureter, bladder xray instead of plain, plain are not common. Barium studies are less frequently used, involves large amounts of radiation so try not to use. Stool studies are done regularly, looks for WBC, blood, parasites.

Question 57

VCUG for diagnosing in GU?

Answer 57

Voiding cytourethrogram. Uncomfortable. Invasive and awake. Dye inserted into the urethra to see if it flows up into the kidneys. Checking for reflux of the dye, indicates urethral reflux. Complications include scarring dilation of ureters, further infection. Child will void after catheter is pulled out, psychosocial issues for potty-trained child.

Question 58

IVP, blood work for GI/GU?

Answer 58

Intravenous pyelogram.
H/h, WBC, BUN (indirect), Cr (direct). CBC, children can be anemia or polycythemia. Many illnesses are viruses so WBC may not elevate but will with bacterial infections.

Question 59

Urine studies for GU issues?

Answer 59

Must be sterile collection for urine cultures. Sometimes one of the most difficult samples to obtain but may be catheterized. Clean catch samples: midstream, should not have been sitting in the bladder for too long, and first void of the day should not be used.

Question 60

Inspection and observation for GI/GU issues?

Answer 60

How alert and active they are shows us signs of either improvement or deterioration. Mental status. Color. Hydration status: decreasing CO2 levels, skin turgor, mucous membranes, urine output, fontanels. Ab size and shape.

Question 61

Auscultation, palpation, percussion for GI/GU?

Answer 61

Auscultation: presence or absence of GI, check for whole five minutes.
Percussion: ab has a tympanic sound normally, but a dull sound when you percuss over an organ.
Palpation: Don’t if there’s an unknown mass. Always done last.

Question 62

Cleft lip and palate?

Answer 62

Cleft is normally formed during the first 5-9wks of pregnancy, cleft doesn’t close, some type of insult or trauma. The most common is to have the left side affected. Prenatal care, anticonvulsants, benzos, zofran, accutane, AMA, maternal smoking.

Question 63

Complications of cleft lip and palate?

Answer 63

Feeding, chewing, sucking, can’t form seal. Dry mouth and nasal congestion, aspiration. Dentician, teeth eruption and alignment difficulty. Speech problems, don’t have a plate to form words, high chance of ear infections. Colds.

Question 64

Medical management of cleft lip and palate?

Answer 64

Lip surgery is done usually after birth or at about 10lbs. Helps with feeding and cosmetic reasons. Palate surgery may be done when the child is developing speech (9-10 months). Scar tissue doesn’t grow so the child will need revisions.

Question 65

Physical exam for cleft lip and palate?

Answer 65

Put on gloves and check the mouth. Respiratory patterns. Growth measurements for adequate nutrition. Teeth as they erupt. Speech.

Question 66

Pre and post op surgery for cleft lip and palate?

Answer 66

Best if baby is breast fed before. Prevent injury to the repair. Position on their back. Restraints: give ROM, take off the restraint and assess for circulation one limb at a time. Protective device over the incision line. Help the parents with coping, before/after pictures, assure that well-developed mouth is possible

Question 67

Calming and mouth care post cleft surgery?

Answer 67

The more the child cries, the more pressure is put on the incision site. Meds may be prescribed. Baby sitter to rock and hold the baby. Use only water to clean, maybe vaseline or Neosporin.

Question 68

Feeding after cleft surgery?

Answer 68

NG tube, small cup with small lip, oral syringe. Haberman feeder, small soft nipple that doesn’t require sucking, just a jaw motion to work.

Question 69

Enlarged or overgrown pyloric muscle that closes leading to RF GERD/reflux. Leads to stenosis of the pyloric sphincter, obstruction, dehydration, shock, death.

Answer 69

Hypertrophic pyloric stenosis. Risks include male patients, often first born. Non-bilious emesis 30-60 minutes after feeding, not getting into the intestines so no bile. Hungry and crying despite having been fed. Progressive weight loss, poor weight gain. May be dehydrated. Olive shaped mass in the upper ab, U/s to visualize muscle-diagnostic.

Question 70

Management of hypertrophic pyloric stenosis?

Answer 70

Quick fluid management, can’t have surgery until they’re hydrated, usually within 24hrs. Educate the parent.
Pre and post op care: laparoscope, small incision by umbilicus and on the side. IV hydration. Small sips (15mL) of sterile water or sugar water, pedialyte. Gradually increase the volume, eventually moving to breast milk, usually within 24 hrs.

Question 71

As the bowel peristalsis slows down, it telescopes within itself into a distal segment and can possibly cause tissue necrosis. Can’t see anything proximal to the obstruction. Can be self-resolved or resected through surgery.

Answer 71

Intussusception. Walls rub together leading to edema and impaired blood circulation, damage to the tissue. Partial or total bowel obstruction. Gut motility decreased.

Question 72

Medical management of intussusception?

Answer 72

Air or barium enema, interventional tool. Barium enema is diagnostic. Surgical repair if enema is not successful.

Question 73

Health history, symptoms, and physical exam for intussusception?

Answer 73

Male pts, <2yrs. Have absorption problems, like cystic fibrosis. Sudden onset intermittent pain. Bilious emesis. “Currant jelly” stools with blood in them. Listlessness (doesn’t wanna get up) and lethargy (can’t get up). Sausage shaped mass when palpating the abdomen, mid or upper.

Question 74

Symptoms are not too severe, commonly undiagnosed. Gi and immunologic disorder. Malabsorption leading to malnutrition.

Answer 74

Celiac disease. Inability to digest gluten. Villi are destroyed and damaged. Found in wheat, barley, rye, some oats.

Question 75

Health history and symptoms for celiac, physical assessment?

Answer 75

Caucasian, European. Family, diarrhea, constipation, steatorrhea, failure to thrive, irritable, anemia, poor weight gain.
Ab distention due to a deficiency of protein, a reverse in osmotic fluid pressure, fluid retention. Thin extremities, almost looks wasting. Poor muscle tone.

Question 76

Diet for celiac?

Answer 76

Strictly gluten-free. Supplements. Referral to dietician. Read the ingredients. Close monitoring of growth.

Question 77

What happens in acute glomerulonephritis?

Answer 77

Antigen-antibofdy complex in glomeruli causing inflammation and decreased filtration rate. Post-strep infection, URI or skin infection. Frequently 5-12yrs.
Gross hematuria, oliguria, HTN, mild shifting edema, trace proteinuria, azotemia.

Question 78

S/s of AGN?

Answer 78

headache, increased BP, facial/periorbital edema, malaise, low-grade fever, weight gain, proteinuria, hematuria, oliguria.

Question 79

Nursing management of AGN?

Answer 79

Antibiotics, antiHTNs, monitor BP, bed rest, cluster care, I+O’s, daily weight, fluid restrictions as prescribed, monitor hematuria, low salt and protein diet

Question 80

Increased globular permeability. Congenital, idiopathic, secondary. Slow progression, leads to renal failure. Assessment?

Answer 80

Nephrotic syndrome. Marked proteinuria (albumin), hypoalbuminemia/proteinemia-fluid shifts, marked edema (periorbital/generalized), hyperlipidemia, weight gain, young age <3, RF increased coagulation. Altered immunity, malaise, n/v,

Question 81

Nursing management of nephrotic syndrome?

Answer 81

Corticosteroids, albumin and diuretics (furosemide), I+O’s, daily weights, proteinuria, avoid infection, protein rich foods

Question 82

Lower tract is cystitis, upper tract is ureter and kidneys, pyelonephritis (higher fevers and higher WBC). Cured with antibiotics. Risks?

Answer 82

UTI. Number 1 reason is urinary stasis, bacteria is able to multiply. Female and young, uncut males. Sexually active teens. Bubble baths, soap irritates the tissue. Alkaline urine, more susceptible. Vesicoureteral reflux.
Children will never be put on an antibiotic without a culture first being taken, requires sterile technique through cath

Question 83

Vesicoureteral reflux?

Answer 83

Valve dysfunction. Congenital, urine goes from bladder back into the kidneys. Surgically repaired. Girls with 2 or more UTI’s and males with 1 or more will have a work up done.

Question 84

Physical exam and symptoms of UTI in children?

Answer 84

Symptoms depend on the age of the child. Older children can report: fever, dysuria, enuresis, hematuria.
Infants: irritability, poor feeding, foul-smelling urine, listless, vomiting, may or not have a fever.
Reddened perineum, pallor, edema, elevated BP, flank pain. Urinalysis/urine culture, clean catch cath or suprapubic tap.

Question 85

Eradicating infection in UTI?

Answer 85

Antibiotic. Infant <3 months that present with fever and symptoms must be hospitalized. Hydration. Increase fluid intake, kidneys will filter and bladder will be flushed. Possible IV for first 24hrs. Comfort measures.

Question 86

Prevention of UTI’s?

Answer 86

Regular voiding, children at play may not know the need to pee. Proper hygiene, from front to back. Avoid bubble baths. Void after sexual intercourse. Cotton underwear, avoid tight pants. Cranberry juice, acidic and can be offered.