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Nursing School > 👧🏾- Respiratory & Hematology Test > Flashcards

👧🏾- Respiratory & Hematology Test Flashcards

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0
Q

WBC (leukocytes)

A

Regulated by tissue damage

Normal range 4.5 - 13.5

Fights infection

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1
Q

RBC (erythrocytes)

A

Life span 120 days

Normal range 4.5 - 5.5

Function: transports hemoglobin , which transports O2 to tissues

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2
Q

WBC differential count

A
  • neutrophils (54-62%) (bacteria)
  • bands (immature neutrophils) (3-5%) leukemia
  • eosinophils (1-3%) (allergies, parasites, cancers)
  • basophils (0-0.1%) (healing tissues)
  • lymphocytes (25-33%) (chronic inflammation)
  • monocytes (3-7%) (early inflammation)
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3
Q

Shift to the left

A

More bands (immature or baby neutrophils, don’t fight infection) in circulation than there are segs (mature or grownup neutrophils)

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4
Q

Platelets

A

Function: clot formation

Normal range: 150-400

Life span 8-10 days

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5
Q

Who is most at risk for Fe deficiency anemia

A

Cause- inadequate Fe in diet

At risk-
Premature due to maternal Fe stores depleted to quickly

12-36 month olds due to whole milk intake with zero sources of Fe

Adolescents due to inadequate diet, growth spurts, menses

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6
Q

Infant feeding and Fe

A

Breast fed- Fe supplements by FOUR months

Premature - Fe supplements by TWO months of age

**give Fe on an acid stomach /between feedings or with vitamin C **

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7
Q

What should you educate the family on with Fe deficiency anemia and supplements

A
  • Fe will turn stools greenish black color
  • can stain teeth (use straw, brush after)
  • milk babies are overweight due to increased whole milk consumption that’s a poor source of Fe and causes increased fecal blood loss
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8
Q

What is the patho of Sickle cell anemia

A

AUTOSOMAL RECESSIVE DISORDER

  • normal HgA is replaced with HgS
  • sickling occurs with low O2
  • sickled RBC are fragile and rapidly destroy

anemia results when rate of destruction is greater than production

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9
Q

What does autosomal recessive mean

A

Meaning 2 copies of an abnormal gene must be present from mom and dad to develop disease

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10
Q

Causes of sickling RBCs

A

Low O2

Dehydration

Strenuous exercise, infections, fever, anemia, high altitudes, underwater swimming, non-pressurized flights, stress, anesthesia

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11
Q

Vaso-occlusive crisis /hand foot syndrome

A

Obstruction of blood vessels and causes distal ischemia

Most common in small vessels but can occur ANYWHERE in the body

Presents as hand foot syndrome and is most common in 6months -2yrs

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12
Q

Sickle crisis occurs in what parts of the body

A

Chest - acute chest syndrome

Heart - heart attack

Brain - stroke

Liver - jaundice

Kidney - failure

Eyes - blindness

Abdomen - obstruction

Penis - priapism

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13
Q

Symptoms of a sickle crisis

A

Pain in abd, legs , arms, hands , etc

Swelling of joints

Fever

Pallor

Weakness

Jaundice

Enlarged spleen

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14
Q

Diagnostic evaluation of sickle cell

A

Sickle - turbidity (sickledex): simple blood test that doesn’t differentiate between trait or disease

HgB electrophoresis: differentiates between trait and disease , “finger printing” of protein

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15
Q

Care of a sickle cell client

A

Prevent sickling

Promote adequate O2

Maintain hemodilution

Penicillin phrophaxis by 2 months old

Meningococcal vaccine (MCV4)

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16
Q

What is to be expected to be seen in clients with sickle cell

A

Growth delays, delayed sexual maturation and very susceptible to sepsis

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17
Q

Treatment of sickle cell crisis

A
  • bedrest
  • hydration (100-125ml/kg/DAY)
  • opioid analgesics (morphine)
  • NSAIDS (ibuprofen and ketorolac)
  • electrolyte replacement
  • HEAT APPLICATION ! NO ICE = SLOWS CIRCULATION
  • antibiotics
  • daily folic acid
  • hydroxyurea
  • blood transfusions
  • allogenic hematopoietic stem cell transplant
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18
Q

Cause of death with sickle cell

A

Infections causing severe sickling

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19
Q

Patho of beta thalassemia (Cooley anemia)

A

AUTOSOMAL RECESSIVE DISORDER

  • disease causes deficiency in synthesis of beta chains
  • leads to destruction of RBC’s

This destruction causes anemia

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20
Q

Diagnosis of beta thalassemia

A
  • hemoglobin electrophoresis

- increased RBC with decreased HgB & Hct

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21
Q

Signs and symptoms of beta thalassemia

A

Mediterranean decent , anemia , fever , poor feeding , enlarged spleen AND liver , headache , bone pain , exercise intolerance , delayed growth and sexual maturation

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22
Q

Treatment of beta thalassemia

A

Blood transfusions (goal to keep HgB above 9.5 g/dl)

Treat for Fe overload (chelating therapy)

Stem cell transplant

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23
Q

Hemosiderosis

A

Fe overload

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24
Q

Nursing care for beta thalassemia

A

Administer blood

Death is caused by heart failure related to severe anemia

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25
Q

Signs of acute chest syndrome

A

Severe chest, back or abd pain

Fever of 38.5’C (101.3’F) or higher

Cough

Dyspnea , tachypnea

Retractions

Declining oxygen saturation

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26
Q

Signs of cerebrovascular accident (CVA) or stroke

A

Severe, unrelieved headaches

Severe vomiting

Jerking or twitching of the face, legs or arms

Seizures

Strange, abnormal behavior

Inability to move an arm or leg

Stagger or an unsteady walk

Stutter or slurred speech

Weakness in the hand, foot, or leg

Changes in vision

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27
Q

Hemophilia

A

Disturbance in blood clotting factors VIII & IX

X-LINKED RECESSIVE DISORDER

Transmitted by mom to sons

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28
Q

What is x-linked recessive disorder

A

Don’t have to have a strand from mom and dad (2) to have the disease

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29
Q

Name 2 complications of hemophilia

A

Hemorrhage

Hemarthrosis (bleeding into joint spaces of knee , ankle , elbow leading to impaired mobility)

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30
Q

Hemophilia labs

A

PT should be normal
Measures platelet and fibrinogen , anticoagulation therapy

PTT is prolonged
Measures all clotting factors

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31
Q

Nursing care and treatment of hemophilia

A
  • replace missing factor
  • corticosteroids (reduces inflammation)
  • NSAIDS (no asprin)
  • DDAVP (synthetic vasopressin, increases plasma factor VIII)
  • PT (need regular exercise program to strength muscles around joints)
  • avoid injections
  • prenatal testing
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32
Q

What should the family be educated about hemophilia

A

Never USE ASPRIN

avoid contact sports

Oral care - soft tooth brush , water pick, toothetts

Electric razor

Medic alert tag

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33
Q

How do you treat bleeding at home in hemophilia

A

R rest (immobilize)

I ICE (NO HEAT)

C compression

E elevate (once bleeding stops active ROM)

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34
Q

Epitaxis

A

(Nose bleed)

Sit up and lean forward (no longer lean back)

Insert cotton in nostril

Apply pressure

APPLY ICE

cool mist humidifier

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35
Q

Frequent nose bleeds could mean what

A

Increased BP , leukemia or hemophilia

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36
Q

Signs and symptoms of HIV

A

Diffused lymphadenopathy (progressed)

Hepatosplenomegaly (90%)

Oral candidiasis & parotitis

Chronic diarrhea

FTT

developmental delays

Opportunistic infections

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37
Q

Signs and symptoms in newborns with maternal transmission

2-4 aids dysmorphic syndrome

A

Flattened nasal bridge

Short nose

Slanted eyes

Prominent triangular philtrum

Wide lips

Prominent forehead

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38
Q

Seroconvert and hiv

A

Seroconversion is the period of time during which HIV antibodies develop and become detectable.

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39
Q

Treatment of hiv

A

No cure

Supportive care

Prevent opportunistic infections (most common pneumocystis carinii pneumonia PCP)

Highly active antiretroviral therapy (HAART)

Gamma globulin

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40
Q

Blood transfusions

A

Monitor closely

Make sure to get base line VS (b4 starting blood) - VS q15 mins for 1 hr

Have NS ready / use blood filter set

Use blood within 30 min

Infuse 1 unit over 2-4 hrs

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41
Q

Signs of blood transfusions reactions

A
  • sudden severe headache
  • fever
  • chills
  • respiratory difficulty (wheezing, rales, dyspnea)
  • chest pain
  • nausea/vomiting
  • changes in VS
  • changes in behavior
  • rash/hives
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42
Q

Treatment of blood transfusions reaction

A

Stop infusion

Take VS

Start NS with new tubing

Notify MD

save everything from infusion

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43
Q

Acute lymphatic leukemia

A

Most common

Best prognosis

80% survival rate

90% will go into remission

Onset= persistent cold

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44
Q

Signs and symptoms of leukemia

A

Cold fails to completely disappear

Pale, listless, irritable, febrile, anorexic

Decreased blood count

Increased blast cells (bands)

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45
Q

Diagnosis of leukemia

A

Assessment

Bone marrow aspiration= definitive diagnosis

Normal blast cells 1-5% - all > 25% blast cells in leukemia

Lumbar puncture: determines CNS involvement, protected by blood brain barrier

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46
Q

Induction therapy of leukemia

What role do corticosteroids and allopurinal play

A

Lasts 4-5 weeks

Chemotherapy

Corticosteroids: stimulates production of neutrophils, platelets and RBC / decrease inflammation / increases appetite

Allopurinal: prevents kidney damage from uric acid crystals

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47
Q

CNS prophylactic therapy

A

Kids with leukemia are at risk for invasion of the CNS by leukemic cells.

Intrathecal administration of Chemo drugs

Intrathecal= into the spinal column

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48
Q

Intensification therapy

A

Continued treatment to eradicate residual leukemic cells and prevent resistance

Phase II

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49
Q

Maintenance therapy

A

Maintains remission of leukemia

Continued treatment for 2-3 yrs

If myelosuppression is severe stop therapy (WBC count less than 1000)

Phase III

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50
Q

What is classified as leukemia remission

A

No clinical signs of cancer

Blast cells less than 5%

Collect bone marrow for possible BMT later

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51
Q

Two types of BMT

A

Allogenic: (most common) sibling or family member, must be a hystocompatible donor

Autologous: own marrow , must be in remission

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52
Q

Ablation therapy

A

Is a lethal dose of chemo/radiation that destroys cancer cells and normal immune system

Risk for rejection

Therefore it’s a life threatening procedure if BMT fails

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53
Q

What are the 2 sites of BMT

A

Posterior iliac crest and sternum

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54
Q

Nursing care for BMT

A

Monitor labs

Monitor infusion

Reverse isolation

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55
Q

Hematopoietic stem cell transplant HSCT

A

Used to transfer healthy cells

Harvested from : bone marrow, peripheral blood, umbilical blood from placenta

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56
Q

Potential nursing diagnosis for HSCT

A

Alteration in comfort

Impaired mobility

Potential for infection , hemorrhage

Alteration in mucosal membranes

Alteration in nutrition

Disturbance in self concept

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57
Q

Respiratory infections are mainly caused by viruses or bacteria

A

Viruses so no antibiotic cure

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58
Q

Tonsillitis vs adenoiditis

A

Enlarged tonsils cause difficulty swallowing & breathing

Enlarged adenoids obstruct nasal breathing and causes mouth breathing

Most serious complication: airway obstruction

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59
Q

What is the major complication of a tonsillectomy & adenoidectomy and how does it present

A

Hemorrhage

Signs and symptoms:
Frequent swallowing and clearing throat

Increased HR , decreased BP

Irritability & pallor

Vomiting bright red blood

Can occur up to 14 days post op

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60
Q

Post-op nursing care for T&A

A

Bed rest

Clear soft diet (no red drinks & no milk )

Cool mist therapy

Warm salt H2O gargles

Tylenol w/ codeine

Avoid coughing or blowing nose

Ice collar

Local anesthetic

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61
Q

Acute otitis media (AOM)

A

Follows an upper respiratory infection (cold)

Short and rapid onset w/ symptoms

Fever & otalgia (ear pain)

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62
Q

Otitis media w/ effusion (OME)

A

Fluid in the middle ear spaces without symptoms of infection

Cause: allergies

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63
Q

OM occurs most often between what ages

A

6 months - 2 years

5-6 years

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64
Q

Contributing factors of OM

A

2nd hand smoke

Day care attendance

Bottle fed infants

65
Q

Clinical manifestations of OM

A

Irritability

Pulling at ear

Fever

Drainage from ear

Hearing loss

66
Q

Treatment for OM

A

Pain management: Tylenol or ibuprofen for pain , heat or ice for discomfort

Antibiotics (amoxicillin most common)

Myringotomy (surgical incision)

Tympanoplasty (PE tubes)

Prevention: pneumococcal vaccine (prevnar)

67
Q

Nursing care for OM

A

Pain management

Facilitating drainage when possible

Preventing complications or recurrence

68
Q

educating the family OM

A

Antibiotics until all gone

Hold infant (don’t prop bottle)

Stop smoking

Teach precautions following PE tubes

69
Q

Infectious mononucleosis

Cause/spread/diagnosis

A

Occurs most commonly between 15-24 years old

Cause: Epstein-Barr virus

Spread: direct contact (saliva) “kissing disease”

Diagnosis: blood test, mono spot, heterophil antibody test

70
Q

Symptoms of mono

A

May last 2-4 weeks

Headache 
Epitaxis 
Malaise & fatigue 
Fever & chills
Anorexia 
Sore throat 
Skin rash 
Abdominal pain 
Cervical adenopathy 
Hepatosplenomegaly
71
Q

Treatment of mono

A

Rest
Fluids
Warm salt water gargles
Analgesics or antipyretics

Severe cases- steroids

72
Q

Signs and symptoms of acute epiglottis

This is a medical emergency

A

Severe sore throat

Drooling

Pain on swallowing

Irritability

High fever

Respiratory distress

Tripod position

Increased HR

73
Q

What are the 3 clinical observations that are predictive of epiglottis

A

Absence of spontaneous cough

Presence of drooling

Agitation

74
Q

Treatment , prevention and cause of acute epiglottis

A

Cause: H influenzae

Treatment: IV antibiotics , corticosteroids , teach set up at bedside , no tongue blades , humidified oxygen

Prevention: HIB vaccine

75
Q

Nursing care for epiglottis

A

Monitor respiratory status

Pulse ox

Trach set up at bedside

IVF

Administer medications & humidified O2

76
Q

What should the nurse NOT do if epiglottis is suspected

A

Should not attempt to visualize the epiglottis directly with a tongue depressor or take a theist culture - refer the child for medical evaluation immediately

77
Q

Signs and symptoms of acute laryngotracheobronchitis

A

Inflammation of the mucosal lining the larynx and trachea causes a narrowing of the airway

Inspiratory stridor 
Retractions 
Croupy cough 
Restless & anxious 
Nasal flaring 
Hypoxia
78
Q

Early signs of impending airway obstruction include

A

Increased pulse and RR rate

Substernal, Suprasternal And intercoastal retractions

Flaring nares

Increased restlessness

79
Q

Objectives of medical management and nursing care of LTB

A

Objectives : Maintain open airway , Adequate air exchange

Nursing care: observe for signs of hypoxia , increased HR , increased RR , increased restlessness , retractions , nasal flaring

80
Q

Treatment of LTB

A

Increased humidity

Nebulized epinepherine

Corticosteroids

Hydration (PO or IV)

Cardiac & respiratory monitor

Pulse ox

81
Q

Signs and symptoms and treatment of acute spasmodic laryngitis

A

Recurrent paroxysmal attacks of laryngeal obstruction that occur chiefly at night

“Midnight croup”

Mild inflammation and uneventful recovery the next morning

Treatment: warm moist environment 10-15 mins shower steam or sudden exposure to cold air

82
Q

Signs and symptoms of RSV (a type of bronchiolitis)

Diagnosis

A 
Rhinorrhea (nasal congestion) 
Mild fever 
Pharyngitis, cough, wheeze 
Apnea 
Respiratory distress (tachypnea, cough, irritability, wheezing, crackles, nasal flaring, retractions, dyspnea, decreased breath sounds

Diagnosis : nasal washing

83
Q

Treatment for RSV

A

Symptomatic relief:

Increase humidity 
Good hydration (to thin secretions) 
NPO if RR > 60/min 
Suction as needed 
Rest with HOB elevated
84
Q

Prevention of RSV

A

Good hand washing

RSV vaccine recommended for high risk until 2 years old (passive artificial immunity)

Synagis (monthly IM injections) (nov - march):
Premature infants , chronic lung disease , congenital heart disease , immunodeficiency

85
Q

Are newborns predominantly nose breathers or mouth breathers

A

Nose

86
Q

Causes and S&S of pneumonia

A

Causes: viral, bacterial and aspiration

S&S: 
High fever 
Cough 
Tachypnea with diminished breath sounds 
Rhonchi, crackles or rales 
Retractions 
Nasal flaring 
Irritability & restless 
Anorexia 
Vomiting & diarrhea
87
Q

Treatment and prevention of pneumonia

A

Treatment: monitor VS & breath sounds , O2 , CPT , antipyretics , good hydration , antibiotics (bacterial) , antitussives @ night , cool mist therapy , nasal auctioning , LIE ON AFFECTED SIDE or “good lung up”

Prevention: prevnar

88
Q

Aspiration

Common foods, non foods

A

Children are vulnerable to aspiration due to growth and development and they explore with their mouths

Foods: hot dogs, round candy, nuts & grapes

Nonfood: latex balloons

Foreign bodies are removed by bronchoscopy

89
Q

Signs and symptoms of foreign body aspiration

A

Choking or gagging

Asymmetrical decreased breath sounds

Stridor or wheezing

Cough

Dyspnea

Retractions

Unable to speak

Cyanosis

90
Q

What are the 3 mechanisms responsible for asthma

A

Inflammation & edema

Mucus secretions

Bronchial spams & constriction

91
Q

Peak expiratory flow rate

A

Measures the maximum flow of air that can be forcefully exhaled in 1 second

Green (80-100% of personal best) all clear

Yellow (50-79%) signals caution

Red (<50%) signals a medical alert , severe airway narrowing may be occurring short-acting bronchodilator should be administered

92
Q

Asthma : drug therapy

A

Corticosteroids: 1. Anti inflammatory drugs to treat reversible obstruction, control symptoms and reduce bronchial hypertesponsiveness. 2. Oral - prednisolone (given for short period of time) 3. Inhaled - pulmicort & Flovent (less long term side effects)

Bronchodilators: (b-adernergic agonists) SHORT ACTING- albuterol (primary rescuer inhaler), xopenex, terbutaline. LONG ACTING- servent (usually given with steroid)

Theophylline (3rd line of defense)

Cromolyn sodium (maintenance therapy)

Leukotriene modifies

Accolate & singulair (long term control)

93
Q

Asthma care: acute

A
  • assessment for respiratory distress: LOC, quality of respirations (symmetry, expansion, effort, dyspnea) , color , capillary refill, presence of (tachypnea, nasal flaring, retractions) lung sounds
  • oxygen ONLY for dyspnea or cyanosis
  • positioning: high fowlers
  • cardiac & respiratory monitoring
  • pulse oximetry
94
Q

Asthma care: long-term

Education, hypersensitization

A

Education: use of home medications, preventing exacerbation, symptom recognition, promoting normal activities

use of prophylactic medication before exercise

Hypersensitization: role in asthma is controversial, considered for- poor adherence to therapy, incomplete response to allergen avoidance , significant medication side effects

95
Q

Status asthmaticus

A

Is a medical emergency

Child who continues to have respiratory distress despite treatment. Can occur gradually or rapidly

Therapy: improve ventilation, decrease airway resistance, relieve bronchospam, correct dehydration and acidosis

96
Q

Cystic fibrosis

A

Exocrine glands (abnormal mucus secretion)

Autosomal recessive gene

97
Q

What is the earliest sign of CF

A

Meconium ileus

98
Q

CF clinical manifestations

A
  • chronic pulmonary complications (thick mucus leads to obstruction)
  • obstruction of pancreatic ducts (blockage causes absence of pancreatic enzymes in GI tract, impaired absorption of fat, steatorrhea (fat in stool), diabetes)
  • sweat gland dysfunction (increased electrolyte concentration of sweat, parents report children taste “salty”)
99
Q

CF diagnosis

A
  • it is based on four findings: family history, absence of pancreatic enzymes, increased electrolyte concentration of sweat chloride, chronic pulmonary involvement
  • sweat chloride test: normal < 40, CF > 60,
  • chest x-ray
  • pulmonary function test
  • stool fat and/or enzyme analysis
100
Q

CF - respiratory care

A

Cpt

Bronchodilator

Exercise program

Antibiotic therapy

O2 used cautiously

101
Q

Name a medicine that decreases mucus viscosity

A

Pulmozyme (d-nase)

102
Q

Pancreatic enzymes for CF

A

Administered with meals & snacks

Dosage depends on severity of insufficiency and child’s response to enzyme

Amount is adjusted to achieve decrease in number of stools to 1-2 per day

103
Q

CF - endocrine management

A
  • well balanced diet: increased protein, calories
  • glucose monitoring
  • insulin therapy
  • A1C measurements
  • multivitamins (fat soluble vitamin KADE)
  • exercise management
104
Q

CF prognosis

A

Prognosis depends on pulmonary involvement

Median survival age: 40

Transplants

Research shows promise (CFTR Activator - kalydeco)

105
Q

Diaphragmatic hernia

A

Protrusion of abdominal organs through opening of diaphragm

106
Q

Signs and symptoms of diaphragmatic hernia

A

Tachypnea

Dyspnea

Cyanosis

Absent breath sounds in affected area

107
Q

Treatment and nursing care for diaphragmatic hernia

A

Treatment- surgical repair

Nursing care- NPO, NG (gastric decompression) oxygen, IVF, elevate hob

108
Q

CPR

A

C= compressions
At least 100/min
Depth 1/3 AP diameter

A= airway 
(Head tilt/chin lift) (trauma- jaw thrust) 
Alone 30:2 
2 rescuers 15:2 
Untrained rescuer - compressions only

B= breathing
1 breath every 6-8 seconds

109
Q

Idiopathic hypopituitarism

A

Deficient pituitary hormone

Most often growth hormone

Short stature

Looks younger than age

Delayed sexual development

Under developed jaw

110
Q

Treatment for Idiopathic hypopituitarism

A

Replacement of growth hormone

Daily subcutaneous injections

Until growth potential attained (determined by epiphyseal closure)

Given at bedtime (when body normally secretes GH)

111
Q

Hyperpituitarism

A

Excess growth hormone

Overgrowth of long bones (Tall)

Acromegaly- symptom that occurs if excess growth hormone occurs after epiphyseal closure - it’s an overgrowth of head, lips, nose, tongue and jaw

112
Q

Treatment of Hyperpituitarism

A

If lesion present = surgical removal

External radiation

Radioactive implants

113
Q

Signs and symptoms of juvenile hypothyroidism

A

Decelerated growth

Constipation

Sleepiness

Mental changes (if untreated)

Myxedematous skin changes- dry skin, periorbital puffiness, sparse hair

114
Q

Treatment of hypothyroidism

A

Lifelong thyroid replacement (levothyroxine)

Enlargement at birth can cause respiratory distress

115
Q

Hyperthyroidism

A

Known as Graves’ disease

Enlarged thyroid (goiter) & expothalmos

116
Q

Signs and symptoms of hyperthyroidism related to hyperactivity

A

Emotional liability

Irritability & restlessness

Short attention span & difficulties in school

Increased appetite w/ weight loss

Increased HR & tremors

Insomnia and heat intolerance

Thin fine hair and expothalmos

117
Q

Thyroid crisis

A

Life threatening

Thyrotoxicosis or thyroid storm

Caused by sudden release of thyroid hormone.

Maybe precipitated by acute infection , surgical emergencies or discontinuation of antithyroid therapy

118
Q

Signs and symptoms of thyroid storm

A

Acute onset of severe irritability & restlessness

Vomiting/ diarrhea

Hyperthermia

Hypertension

Severe tachycardia

Prostration (extreme weakness)

119
Q

Propylthiouracil and side effects

A

Treatment for hyperthyroidism

Side effects: lethargy & somnolence (excessive sleepiness)

Leukopenia report fever/sore throat ASAP

120
Q

Treatment for hyperthyroidism

A

Propylthiouracil

Radioiodine

Thyroidectomy

Post-op observe for signs and symptoms of laryngospasms
(Stridor, hoarseness, throat tightness)

121
Q

Facts and figures of eating disorders

A

70% girls want to be thinner

7% girls want to be larger

34% boys thinner

35% boys larger

5-10% anorexia

20% binging and purging

122
Q

Nursing interventions for children with obesity

A

Motivation of child

Focus on prevention

Weight loss programs

Self-esteem building

Family dynamics- encourage positive feedback for efforts regardless of success

Check on eating habits of whole family

123
Q

Nutrition for children

A

Increase fiber & complex carbs

Eat when hungry

Smaller portions

Read labels

Healthy snacks

Don’t focus on weight loss / just maintain weight

124
Q

Diagnostic criteria for anorexia

A

Occur in girs 12-30

1 refusal to maintain body weight at 85% of normal

2 morbid fear of being fat , even when underweight

3 disturbed perception of body weight and shape

4 amenorrhea

125
Q

Signs and symptoms of anorexia

A 
Emaciation 
Electrolyte problems 
Metabolic problems 
Dehydration 
Cold intolerance 
Lethargy 
Amenorrhea 
Constipation , abd pain 
Hypotension 
Bradycardia , loss of heart muscle, cArdiac arrhythmia 
Anemia 
Disturbance in wbc 
Loss of muscle mass 
Osteoporosis 
Pathological fractures 
Sleep disturbances
126
Q

Interpersonal issues and anorexia

A 
Control issues 
Obsessed with food 
Compulsive symptoms 
Inflexible thinking 
Restrained behaviors
Perfectionist & increased academic achievers 
Conforming & conscientious 
High energy level 
Possible sexual abuse
127
Q

Nursing interventions and anorexia

A
  • ask about self mutilation, suicidal ideation
  • behavior contracts
  • don’t reinforce manipulation
  • don’t over-react
  • lock bathrooms after meals
  • focus on weight gain and lab values, not food consumed
  • work on self esteem, social interaction, safe expression of feelings
  • weigh daily
  • assess for dehydration
  • provide opportunities to make decisions
128
Q

Medications to treat anorexia

A

Zyprexa - antipsychotic

Periactin - antihistamine (stimulates appetite)

129
Q

Diagnostic criteria for bulemia nervosa

A

Recurrent binge eating
(Experiences eating as out of control, occurs twice a week for 3 months)

Recurrent inappropriate compensation
(Induced vomiting, abuse of laxatives, enemas, excessive exercise, fasting)

130
Q

Signs and symptoms of bulemia

A

Weight nearly normal

Menses normal

Erosion of tooth enamel

Erosion or rupture of stomach, esophagus

Electrolyte imbalance

Abdominal pain

131
Q

Interpersonal issues and bulemia

A

Depression/anxiety

Potential for substance abuse

Shame about eating habits

Often diet excessively between binges

Hides eating binges

Chronic , long-term condition

132
Q

Nursing interventions for bulemia

A

Usually out-patient
Cognitive/behavioral therapy most effective
Meds of limited effectiveness
Positive acceptance
Self-affirmations
Help explore feelings in relation to binges
Help develop healthy ways to express feelings
Encourage group participation

133
Q

Intellectual development disorder

A

Onset prior to age 18 and is characterized by impairments in measured intellectual performance and adaptive skills across multiple domains

133
Q

Intellectual development disorder

A

Onset prior to age 18 and is characterized by impairments in measured intellectual performance and adaptive skills across multiple domains

133
Q

Intellectual development disorder

A

Onset prior to age 18 and is characterized by impairments in measured intellectual performance and adaptive skills across multiple domains

134
Q

Autism spectrum disorder

A

Characterized by a withdrawal of the child into the self and into a fantasy world of his or her own creation

134
Q

Autism spectrum disorder

A

Characterized by a withdrawal of the child into the self and into a fantasy world of his or her own creation

134
Q

Autism spectrum disorder

A

Characterized by a withdrawal of the child into the self and into a fantasy world of his or her own creation

135
Q

Predisposing factors to autism spectrum disorder

A

Neurological implications
Physiological implications
Genetics
Perinatal influences

135
Q

Predisposing factors to autism spectrum disorder

A

Neurological implications
Physiological implications
Genetics
Perinatal influences

135
Q

Predisposing factors to autism spectrum disorder

A

Neurological implications
Physiological implications
Genetics
Perinatal influences

136
Q

What 2 drugs are approved for treatment of autism

A

Risperidone and aripiprazole

Targeted for: aggression , deliberate self-injury , temper tantrums , quickly changing moods

136
Q

What 2 drugs are approved for treatment of autism

A

Risperidone and aripiprazole

Targeted for: aggression , deliberate self-injury , temper tantrums , quickly changing moods

136
Q

What 2 drugs are approved for treatment of autism

A

Risperidone and aripiprazole

Targeted for: aggression , deliberate self-injury , temper tantrums , quickly changing moods

137
Q

Common side effects of risperidone

A 
Drowsiness 
Increased appetite 
Nasal congestion 
Fatigue 
Constipation 
Drooling 
Dizziness 
Weight gain
137
Q

Common side effects of risperidone

A 
Drowsiness 
Increased appetite 
Nasal congestion 
Fatigue 
Constipation 
Drooling 
Dizziness 
Weight gain
137
Q

Common side effects of risperidone

A 
Drowsiness 
Increased appetite 
Nasal congestion 
Fatigue 
Constipation 
Drooling 
Dizziness 
Weight gain
138
Q

Common side effects of aripiprazole

A 
Sedation 
Fatigue 
Weight gain 
Vomiting 
Somnolence 
Tremor
138
Q

Common side effects of aripiprazole

A 
Sedation 
Fatigue 
Weight gain 
Vomiting 
Somnolence 
Tremor
138
Q

Common side effects of aripiprazole

A 
Sedation 
Fatigue 
Weight gain 
Vomiting 
Somnolence 
Tremor
139
Q

Drugs to treat adhd and their side effects

A

Central nervous system stimulants: dextroamphetamine, methamphetamine, lisdexamfetamine, methylphenidate, dexmethylphenidate, dextroamphetamine/amphetamine mixture

Side effects: insomnia , anorexia , weight loss , tachycardia , decrease in rate of growth and development

139
Q

Drugs to treat adhd and their side effects

A

Central nervous system stimulants: dextroamphetamine, methamphetamine, lisdexamfetamine, methylphenidate, dexmethylphenidate, dextroamphetamine/amphetamine mixture

Side effects: insomnia , anorexia , weight loss , tachycardia , decrease in rate of growth and development

139
Q

Drugs to treat adhd and their side effects

A

Central nervous system stimulants: dextroamphetamine, methamphetamine, lisdexamfetamine, methylphenidate, dexmethylphenidate, dextroamphetamine/amphetamine mixture

Side effects: insomnia , anorexia , weight loss , tachycardia , decrease in rate of growth and development

140
Q

Oppositional defiant disorder

A

Characterized by a persistent pattern of angry mood and defiant behavior that occurs more frequently than is usually observed in individuals of comparable age and developmental level and interfere with social, educational or vocational activities

140
Q

Oppositional defiant disorder

A

Characterized by a persistent pattern of angry mood and defiant behavior that occurs more frequently than is usually observed in individuals of comparable age and developmental level and interfere with social, educational or vocational activities

140
Q

Oppositional defiant disorder

A

Characterized by a persistent pattern of angry mood and defiant behavior that occurs more frequently than is usually observed in individuals of comparable age and developmental level and interfere with social, educational or vocational activities

141
Q

Conduct disorder

A

Persistent pattern of behavior in which the basic rights of others and major age-appropriate societal norms or rules are violated

Childhood-onset type
Adolescent-onset type

Precursor to the diagnosis of antisocial personality disorder

141
Q

Conduct disorder

A

Persistent pattern of behavior in which the basic rights of others and major age-appropriate societal norms or rules are violated

Childhood-onset type
Adolescent-onset type

Precursor to the diagnosis of antisocial personality disorder

141
Q

Conduct disorder

A

Persistent pattern of behavior in which the basic rights of others and major age-appropriate societal norms or rules are violated

Childhood-onset type
Adolescent-onset type

Precursor to the diagnosis of antisocial personality disorder

Nursing School (36 decks)

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