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Peds/OB - Nrsg 206 > Quiz GI & Cardio > Flashcards

Quiz GI & Cardio Flashcards

1
Q

What is Kwashiokor?

A

Malnutrition due to lack of protein

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2
Q

What is Marasmus?

A

A condition of chronic undernourishment occurring especially in children and usually caused by a diet deficient in calories and proteins.

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3
Q

Dehydration that causes an imbalance of electrolytes is called _____ if there is a lack of electrolytes, and _____ if there is an excess of electrolytes.

A

Hypotonic. Hypertonic

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4
Q

How do we check for dehydration?

A

Check turgor on chest or forehead and look at the tongue. (scrotal/geographic tongue)

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5
Q

How much fluid does a child require per 24 hrs?

A

100 mL/kg for the 1st kg. 50 mL/kg for the second 10 and 20 mL/kg for any above 20 kg

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6
Q

What are gastroenteritis, enteritis, colitis, and entercolitis?

A

Gastroenteritis = inflammation/irritation of the stomach (gastro) and small intestines (entero). Enteritis = small intestines only. Colitis = colon only. Entercolitis = colon and small intestines involved

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7
Q

How is most diarrhea spread?

A

The fecal/oral route

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8
Q

Why is listeria so bad?

A

It can survive in cold temperatures

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9
Q

How is listeria cured? Prevented?

A

Antibiotics. Clean, clean, clean, keep fridge at 40 deg and below

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10
Q

What are many cases of listeria related to? What else shouldn’t you eat while pregnant?

A

Eating soft or raw cheese, like caso fresco from Mexico. Brie or veined cheese, pates, or other soft meats

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11
Q

What fish should be avoided while pregnant? Why?

A

Shark, Swordfish, Tilefish, King Mackerel. Methyl mercury accumulates in larger, predatory fish

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12
Q

How is toxoplasmosis spread, and why avoid it when pregnant?

A

It is a parasite often found in cat feces, so don’t change the litter box when pregnant! It can cause fetal problems

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13
Q

How else can toxoplasmosis be avoided?

A

Change litter daily, wear gloves when changing litter, stay out of the pig pen!

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14
Q

What diet is recommended for diarrhea?

A

BRAT = Bananas, rice, apples, toast/tea

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15
Q

How is diarrhea avoided in a breast feeding baby?

A

Wash hands (not breasts)

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16
Q

What causes idiopathic constipation? Chronic?

A

It’s idiopathic b/c the cause is not known. Chronic may be caused by environmental factors (food) or psychological factors

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17
Q

What is Hirschsprung disease? What can be done for it?

A

Congenital aganglionic megacolon. No nerves in the sigmoid colon and rectum, so they fill with stool. Biopsy to dx, diet may control milder cases, but removal in 2 stages (temporary colostomy) is the option for worse cases

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18
Q

What is the leading cause of death in kids with Hirschprungs? Is it genetic?

A

Entercolitis. Yes. More common in males and kids with Down’s Syndrome

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19
Q

When should a newborn pass meconium?

A

Within the first 24-48 hrs

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20
Q

What is a common physical side effect of Hirschprungs?

A

Alternating bouts of constipation/diarrhea and anemia

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21
Q

What is the difference between GER and GERD?

A

GERD is a disease because it causes issues

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22
Q

What is GER/GERD?

A

Stomach contents are transferred into the esophagus

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23
Q

What makes GER abnormal (GERD)?

A

Frequency and persistency

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24
Q

What surgical procedure can help/cure GERD?

A

Nissen fundoplication. Fundus of the stomach is wrapped around the esophagus to lift it off the diagram

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25
Q

What can GERD result in?

A

Barrett’s esophagus, which is scarring from the constant exposure to stomach acid and may lead to cancer

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26
Q

What parasites are mentioned in the PowerPoint?

A

Giardiasis and pinworm

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27
Q

What are some later signs of appendicitis?

A

Pain at McBurney’s point, rigid/board like abdomen

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28
Q

What is an earlier sign of appendicitis?

A

Stooped posture

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29
Q

What does it mean if the pain disappears?

A

The appendix has ruptured and is an emergency

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30
Q

What are some other signs of appendicitis?

A

WBC’s 10,000-18,000. Anorexia, rigid abdomen, absent bowel sounds, N/V, fever, leukocytosis, no eosinophils

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31
Q

What did Carley teach us about appendicitis?

A

If you can’t isolate pain at McBurney’s point, have the child jump up and down, if no pain it’s not appendicitis

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32
Q

How can appendicitis & pinworm incidences be reduced?

A

Increase fiber in the diet

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33
Q

What is the most common congenital malformation of the GI tract?

A

Meckel’s diverticulum, which is a bulge in the wall of the colon

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34
Q

Who is usually affected by Meckel’s diverticulum?

A

Children < 2 years old

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35
Q

What is a common complication of Meckel’s?

A

Intesussecption

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36
Q

What is a common sign of Meckel’s diverticulum?

A

Bloody, jellylike diarrhea

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37
Q

What is done in most cases of Meckel’s?

A

Usually nothing, as it is asymptomatic, or it mimics peptic ulcer/Crohn’s/appendicitis s/s. Surgical repair if severe

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38
Q

What 2 problems compromise IBD (inflammatory bowel disease)?

A

Crohn’s disease and ulcerative colitis

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39
Q

What can cause IBD?

A

Diet, infection, environmental factors

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40
Q

What is the difference between Crohn’s and ulcerative colitis?

A

Crohn’s can affect the entire GI tract, from mouth to anus, while ulcerative colitis only affects the colon

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41
Q

Is there a cure for IBD?

A

Pancolectomy (removal of the colon) will cure colitis, although meds are tried 1st. Crohn’s is managed with meds only

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42
Q

What are the s/s of ulcerative colitis?

A

Bloody diarrhea, abdominal pain, anemia, N/V, lesions remain

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43
Q

Which form of IBD is slow/fast?

A

Crohn’s is slow and has skip lesions. UV is fast, with bad lesions that stay (bloody diarrhea)

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44
Q

Where does Crohn’s usually start?

A

Terminal ileum (where small bowel & colon meet)

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45
Q

How does Crohn’s affect the body?

A

Arthritis, liver disease, renal calculi, long term debilitating, FTT in children

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46
Q

Which form of IBD increases cancer risk within 15 years?

A

UC

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47
Q

What meds are used to treat IBD?

A

Steroids, 6MP immune modulators, sulfasalazine (Azulfidine), TPN

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48
Q

What foods are not allowed on the IBD diet?

A

Everything, so you might as well quit eating

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49
Q

What can cause hepatitis to become acute?

A

Chemical reaction, drug reaction, other disease processes

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50
Q

What forms of hepatitis are passed via the fecal/oral route?

A

A and E. (The A&E channel is pretty crappy)

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51
Q

What forms of Hepatitis are caused by blood and sex?

A

Basically all that aren’t fecal/oral: B, C, D & G

52
Q

Which forms of hepatitis have vaccines available?

A

A & B

53
Q

What are the 2 phases of hepatitis?

A

Anicteric (absence of jaundice) and icteric (jaundice)

54
Q

What are some s/s of phase 1 hepatitis?

A

Malaise, fatigue, RUQ pain, N/V

55
Q

What are some s/s of phase 2 hepatitis?

A

Dark urine, clay colored stools, jaundice of skin and sclera

56
Q

How long does each phase of hepatitis last?

A

Anicteric = 5-7 days; Icteric = 4 wks

57
Q

What does Hirshprung’s disease cause?

A

A mechanical blockage of the colon

58
Q

In what demographic groups is Hirshprung’s more prevelent?

A

Males and those with Down’s syndrome

59
Q

Which is closed first, the cleft lip or palate?

A

The cleft lip is always repaired first (at 3 mo), then the palate is repaired at 12-18 months

60
Q

Is cleft lip/palate more common in males or females?

A

Cleft lip & palate are more common in males while just cleft palate is more common in females. Cleft lip/palate is more common in Asian & white populations and less prevalent in black populations

61
Q

How is breast feeding different for a baby with a cleft palate/lip?

A

Baby must be stimulated first (rub nipple on lip) and milk flow must be started first (warm washcloth)

62
Q

How do you reduce the chance of choking while feeding a baby with cleft lip/palate?

A

Keep slow steady pressure on the bottle or breast

63
Q

What acronym applies to feeding a baby with cleft lip/palate?

A

ESSR. Enlarge (nipple - unless, of course, you are breast feeding), Stimulate, Swallow, Rest

64
Q

Should you burp a baby more or less often if it has a cleft lip/palate?

A

Burp often

65
Q

What is a tracheoesophageal fistula and why do we need to know what it is?

A

It is an abnormal connection between the esophagus and trachea and is an emergency. 50% have more complex defects like cupped ears

66
Q

What is the most important nursing intervention for an tracheoesophageal fistula?

A

NPO! Prognosis is poor

67
Q

What is another name for gluten-induced enteropathy and what are its 4 main characteristics?

A

Celiac’s disease. Steatorrhea, malnutrition, abdominal distention, secondary vitamin deficiencies

68
Q

How is a hiatal hernia repaired?

A

Nissen fundoplication

69
Q

What are the s/s of pyloric stenosis?

A

Projectile vomiting, non-bilious vomiting

70
Q

What is hypertrophic pyloric stenosis?

A

An enlarged muscle of the pyloric sphincter occludes the passageway to the small intestine

71
Q

What is an intussusception and what is done for it?

A

The bowel folds in on itself. A barium or air enema

72
Q

What is a “tet spell” and what are the s/s?

A

Bluish fingers/toes/mouth during feeding/crying. Other symptoms include cyanosis, clubbing, SOB, fainting, poor weight gain, irritability, prolonged crying, murmur

73
Q

If you attempt to put a rectal thermometer in an infant and it won’t go in, that baby has an _____ _____.

A

Imperforate anus

74
Q

What are some s/s of Celiac’s disease/gluten intolerance?

A

Steatorrhea, chronic diarrhea, weight loss/malnutrition, pale/foul smelling stool/floaters, low RBC/anemia, bone pain, gas, behavioral changes/irritable, numbness in legs, discolored teeth

75
Q

At what point are cardiac problems visible?

A

With normal hemoglobin, when O2 sat is at 85%

76
Q

What is done for a tet spell?

A

Hold in the knee/chest position

77
Q

What is the best way to examine heart abnormalities?

A

Electrocardiogram, echocardiogram, heart cath, O2 challenge test

78
Q

What are the early s/s of CHF in infants?

A

Tachycardia at rest, fatigue during feeding, sweating scalp and forehead, dyspnea, sudden weight gain

79
Q

What meds are used to treat HF?

A

Digoxin (improves cardiac fxn), Ace inhibitors (lisinopril made me cough!)(decrease vascular resistance, BP, afterload), diuretics

80
Q

What heart defects increase pulmonary blood flow?

A

Abnormal connection between two sides of the heart. Either the septum or the great vessels

81
Q

What heart defects decrease pulmonary blood flow?

A

Tetrology of FAllot and tricuspid artresia

82
Q

Most cardiac defects are _____ (from birth) and affect the structure of the heart.

A

Congenital

83
Q

What are some nursing considerations for Digoxin?

A

Assess HR, RR, BP q2-4hrs. Accurate I&O (1-2 mL/kg/hr)

84
Q

What is Heart failure?

A

Not enough cardiac output to maintain METABOLIC NEEDS

85
Q

How is HF compensated for?

A

Impaired myocardial fxn (vasoconstriction [cold/blue hands and feet], < BP/urine), Pulmonary congestion (tachypnea, dyspnea, cyanosis), Systemic congestion (peripheral and periorbital edema, wt gain, ascites, hepatomegaly, neck vein distention)

86
Q

What are some s/s of dig toxicity?

A

N/V, anorexia, bradycardia, dysrhythmias

87
Q

What are some nursing measures for HF?

A

HOB at 45 degrees, maintain nutrition status to fight infection

88
Q

What is a s/s of hypoxemia?

A

Clubbing

89
Q

What is bacterial endocarditis?

A

An infection in the valves and inner lining of the heart

90
Q

How is bacterial endocarditis treated?

A

Long term antibiotics lasting for 7-8 wks

91
Q

What does endocarditis lead to?

A

HF. Will take antibiotic before any dental work

92
Q

What causes Rheumatic fever?

A

Beta-hemolytic strep

93
Q

What tissues does RF involve?

A

Collagen of the joints, heart, CNS (brain), skin, subQ system

94
Q

When is RF more likely to occur?

A

In the winter and spring of kids age 5-15

95
Q

What is RHD?

A

An autoimmune disease that is the result of untreated strep

96
Q

How is RF diagnosed?

A

Must have 1 major and 2 minor symptoms, and a hx of strep infection

97
Q

How is it treated?

A

Antibiotics for 5 years. If cardiac involvement even longer. Education/follow-up is essential. Prophylactic antibiotic before dental work/procedures

98
Q

What are the major criteria of RF?

A

Carditis, polyarthritis, erythema marginatum (rash), chorea (not to be confused with Korea), subcutaneous nodes

99
Q

What are the minor criteria for RF?

A

Fever, arthralgia

100
Q

What is Kawasaki disease?

A

Acute systemic vasculitis of unknown cause. Leads to HF

101
Q

What can Kawasaki’s lead to?

A

Aneurysm due to weakening of vessel walls

102
Q

How can Kawasaki’s be treated?

A

Oil change! Dig, angiotensin enzyme inhibitors, K+ supplements

103
Q

How is Kawasaki’s diagnosed?

A

Clinical s/s, no lab studies. S/S = fever >102 deg F >5 days + 4/5 clinical criteria which are edema/erythema of extremities (desquamination), conjunctival infection without exudate, changes in oral mucosa (red), polymorphous rash, cervical lymphadenopathy (1 >1.5 cm)

104
Q

What are some s/s of hypertension in kids?

A

Teens - HA, dizziness, visual changes; Kids - irritability, head banging/rubbing, wake up screaming at night

105
Q

What meds are given for Kawasaki’s?

A

High dose aspirin (antiplatelet) and IV immunoglobulin

106
Q

At what Hgb level is blood shunted to the core?

A

<8 g/dL

107
Q

What is the treatment for anemia?

A

IV fluids, O2, bedrest

108
Q

What is sickle cell anemia and what is its cause?

A

A genetic defect causes “s” shaped Hgb cells

109
Q

What are some consequences of sickle cell anemia?

A

Growth retardation, chronic anemia, delayed sexual maturity, sepsis, vaso-occlusive crisis, sequestration crisis

110
Q

What are the s/s of a vaso-occlusive crisis?

A

Pain, ischemia

111
Q

What are the s/s of a sequestration crisis?

A

Pooling of blood, hepatomegaly, splenomegaly, circulatory collapse

112
Q

How is sickle cell anemia diagnosed?

A

Neonatal metabolic screening, cycledex test (result in 3 min) if +, then Hgb electrophoresis

113
Q

What is the treatment for sickle cell anemia?

A

IV fluids/electrolytes, O2, analgesics, blood replacement, antibiotic therapy (bacterial infection is the leading cause of death in these kids)

114
Q

What is hemophilia “A”?

A

Lack of clotting factor VIII. 80% of cases. X-linked recessive. Only males affected/females are carriers

115
Q

What can precipitate a sickle cell crisis?

A

Stress, dehydration, accident

116
Q

How is hemophilia treated?

A

Transfusion, DDAVP increases factor VIII activity

117
Q

What is hypoplastic left heart syndrome?

A

Critical underdevelopment of the left side of the heart

118
Q

What are some s/s of hypoplastic left heart syndrome?

A

Tachypnea, cyanosis, poor feeding, cold hand/feet, drowsy/inactive

119
Q

What is a grave complication of hypoplastic left heart syndrome?

A

If the hole btwn the foramen ovale and the ductus arteriosis is allowed to close, the child may die

120
Q

What kids are at greater risk for ALL?

A

Kids with trisomy 21 have 20x greater risk for ALL

121
Q

What are “neutropenic” precautions?

A

Child wears a mask, no flowers or fresh fruit

122
Q

What organs does ALL affect?

A

Liver and spleen

123
Q

What is the difference between Hodgkin’s and non-Hodgkin’s lymphoma?

A

Both are lymphomas (neoplastic disease), Hodgkins is more prevalent in the 15-19 year old range, while non-Hodgkin’s is more prevalent in kids <14

124
Q

What genetic defect increases risk for ALL?

A

Down’s syndrome

125
Q

What are the 2 classifications of Hodgkin’s? Describe them.

A

A=asymptomatic. B=temp >38 deg C for 3 days, night sweats, unexplained weight loss of 10% or more over previous 6 months

126
Q

What is done for hypotrophic left heart syndrome?

A

Mechanical vent, inotropic support, prostaglandin E, surgery

Peds/OB - Nrsg 206 (7 decks)

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