👧🏾- Respiratory & Hematology Test Flashcards
1
Q
WBC (leukocytes)
A
Regulated by tissue damage
Normal range 4.5 - 13.5
Fights infection
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)
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)
4
Q
Platelets
A
Function: clot formation
Normal range: 150-400
Life span 8-10 days
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
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 **
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
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
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
10
Q
Causes of sickling RBCs
A
Low O2
Dehydration
Strenuous exercise, infections, fever, anemia, high altitudes, underwater swimming, non-pressurized flights, stress, anesthesia
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
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
13
Q
Symptoms of a sickle crisis
A
Pain in abd, legs , arms, hands , etc
Swelling of joints
Fever
Pallor
Weakness
Jaundice
Enlarged spleen
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
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)
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
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
18
Q
Cause of death with sickle cell
A
Infections causing severe sickling
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
20
Q
Diagnosis of beta thalassemia
A
- hemoglobin electrophoresis
- increased RBC with decreased HgB & Hct
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
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
23
Q
Hemosiderosis
A
Fe overload
24
Q
Nursing care for beta thalassemia
A
Administer blood
Death is caused by heart failure related to severe anemia
25
Signs of acute chest syndrome
Severe chest, back or abd pain
Fever of 38.5'C (101.3'F) or higher
Cough
Dyspnea , tachypnea
Retractions
Declining oxygen saturation
26
Signs of cerebrovascular accident (CVA) or stroke
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
27
Hemophilia
Disturbance in blood clotting factors VIII & IX
X-LINKED RECESSIVE DISORDER
Transmitted by mom to sons
28
What is x-linked recessive disorder
Don't have to have a strand from mom and dad (2) to have the disease
29
Name 2 complications of hemophilia
Hemorrhage
Hemarthrosis (bleeding into joint spaces of knee , ankle , elbow leading to impaired mobility)
30
Hemophilia labs
PT should be normal
Measures platelet and fibrinogen , anticoagulation therapy
PTT is prolonged
Measures all clotting factors
31
Nursing care and treatment of hemophilia
- 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
32
What should the family be educated about hemophilia
Never USE ASPRIN
avoid contact sports
Oral care - soft tooth brush , water pick, toothetts
Electric razor
Medic alert tag
33
How do you treat bleeding at home in hemophilia
R rest (immobilize)
I ICE (NO HEAT)
C compression
E elevate (once bleeding stops active ROM)
34
Epitaxis
(Nose bleed)
Sit up and lean forward (no longer lean back)
Insert cotton in nostril
Apply pressure
APPLY ICE
cool mist humidifier
35
Frequent nose bleeds could mean what
Increased BP , leukemia or hemophilia
36
Signs and symptoms of HIV
Diffused lymphadenopathy (progressed)
Hepatosplenomegaly (90%)
Oral candidiasis & parotitis
Chronic diarrhea
FTT
developmental delays
Opportunistic infections
37
Signs and symptoms in newborns with maternal transmission
2-4 aids dysmorphic syndrome
Flattened nasal bridge
Short nose
Slanted eyes
Prominent triangular philtrum
Wide lips
Prominent forehead
38
Seroconvert and hiv
Seroconversion is the period of time during which HIV antibodies develop and become detectable.
39
Treatment of hiv
No cure
Supportive care
Prevent opportunistic infections (most common pneumocystis carinii pneumonia PCP)
Highly active antiretroviral therapy (HAART)
Gamma globulin
40
Blood transfusions
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
41
Signs of blood transfusions reactions
- sudden severe headache
- fever
- chills
- respiratory difficulty (wheezing, rales, dyspnea)
- chest pain
- nausea/vomiting
- changes in VS
- changes in behavior
- rash/hives
42
Treatment of blood transfusions reaction
Stop infusion
Take VS
Start NS with new tubing
Notify MD
*save everything from infusion*
43
Acute lymphatic leukemia
Most common
Best prognosis
80% survival rate
90% will go into remission
Onset= persistent cold
44
Signs and symptoms of leukemia
Cold fails to completely disappear
Pale, listless, irritable, febrile, anorexic
Decreased blood count
Increased blast cells (bands)
45
Diagnosis of leukemia
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
46
Induction therapy of leukemia
What role do corticosteroids and allopurinal play
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
47
CNS prophylactic therapy
Kids with leukemia are at risk for invasion of the CNS by leukemic cells.
Intrathecal administration of Chemo drugs
Intrathecal= into the spinal column
48
Intensification therapy
Continued treatment to eradicate residual leukemic cells and prevent resistance
Phase II
49
Maintenance therapy
Maintains remission of leukemia
Continued treatment for 2-3 yrs
If myelosuppression is severe stop therapy (WBC count less than 1000)
Phase III
50
What is classified as leukemia remission
No clinical signs of cancer
Blast cells less than 5%
Collect bone marrow for possible BMT later
51
Two types of BMT
Allogenic: (most common) sibling or family member, must be a hystocompatible donor
Autologous: own marrow , must be in remission
52
Ablation therapy
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
53
What are the 2 sites of BMT
Posterior iliac crest and sternum
54
Nursing care for BMT
Monitor labs
Monitor infusion
Reverse isolation
55
Hematopoietic stem cell transplant HSCT
Used to transfer healthy cells
Harvested from : bone marrow, peripheral blood, umbilical blood from placenta
56
Potential nursing diagnosis for HSCT
Alteration in comfort
Impaired mobility
Potential for infection , hemorrhage
Alteration in mucosal membranes
Alteration in nutrition
Disturbance in self concept
57
Respiratory infections are mainly caused by viruses or bacteria
Viruses so no antibiotic cure
58
Tonsillitis vs adenoiditis
Enlarged tonsils cause difficulty swallowing & breathing
Enlarged adenoids obstruct nasal breathing and causes mouth breathing
Most serious complication: airway obstruction
59
What is the major complication of a tonsillectomy & adenoidectomy and how does it present
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
60
Post-op nursing care for T&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
61
Acute otitis media (AOM)
Follows an upper respiratory infection (cold)
Short and rapid onset w/ symptoms
Fever & otalgia (ear pain)
62
Otitis media w/ effusion (OME)
Fluid in the middle ear spaces without symptoms of infection
Cause: allergies
63
OM occurs most often between what ages
6 months - 2 years
5-6 years
64
Contributing factors of OM
2nd hand smoke
Day care attendance
Bottle fed infants
65
Clinical manifestations of OM
Irritability
Pulling at ear
Fever
Drainage from ear
Hearing loss
66
Treatment for OM
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
Nursing care for OM
Pain management
Facilitating drainage when possible
Preventing complications or recurrence
68
educating the family OM
Antibiotics until all gone
Hold infant (don't prop bottle)
Stop smoking
Teach precautions following PE tubes
69
Infectious mononucleosis
Cause/spread/diagnosis
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
Symptoms of mono
May last 2-4 weeks
```
Headache
Epitaxis
Malaise & fatigue
Fever & chills
Anorexia
Sore throat
Skin rash
Abdominal pain
Cervical adenopathy
Hepatosplenomegaly
```
71
Treatment of mono
Rest
Fluids
Warm salt water gargles
Analgesics or antipyretics
Severe cases- steroids
72
Signs and symptoms of acute epiglottis
| This is a medical emergency
Severe sore throat
Drooling
Pain on swallowing
Irritability
High fever
Respiratory distress
Tripod position
Increased HR
73
What are the 3 clinical observations that are predictive of epiglottis
Absence of spontaneous cough
Presence of drooling
Agitation
74
Treatment , prevention and cause of acute epiglottis
Cause: H influenzae
Treatment: IV antibiotics , corticosteroids , teach set up at bedside , no tongue blades , humidified oxygen
Prevention: HIB vaccine
75
Nursing care for epiglottis
Monitor respiratory status
Pulse ox
Trach set up at bedside
IVF
Administer medications & humidified O2
76
What should the nurse NOT do if epiglottis is suspected
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
Signs and symptoms of acute laryngotracheobronchitis
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
Early signs of impending airway obstruction include
Increased pulse and RR rate
Substernal, Suprasternal And intercoastal retractions
Flaring nares
Increased restlessness
79
Objectives of medical management and nursing care of LTB
Objectives : Maintain open airway , Adequate air exchange
Nursing care: observe for signs of hypoxia , increased HR , increased RR , increased restlessness , retractions , nasal flaring
80
Treatment of LTB
Increased humidity
Nebulized epinepherine
Corticosteroids
Hydration (PO or IV)
Cardiac & respiratory monitor
Pulse ox
81
Signs and symptoms and treatment of acute spasmodic laryngitis
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
Signs and symptoms of RSV (a type of bronchiolitis)
Diagnosis
```
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
Treatment for RSV
Symptomatic relief:
```
Increase humidity
Good hydration (to thin secretions)
NPO if RR > 60/min
Suction as needed
Rest with HOB elevated
```
84
Prevention of RSV
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
Are newborns predominantly nose breathers or mouth breathers
Nose
86
Causes and S&S of pneumonia
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
Treatment and prevention of pneumonia
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
Aspiration
Common foods, non foods
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
Signs and symptoms of foreign body aspiration
Choking or gagging
Asymmetrical decreased breath sounds
Stridor or wheezing
Cough
Dyspnea
Retractions
Unable to speak
Cyanosis
90
What are the 3 mechanisms responsible for asthma
Inflammation & edema
Mucus secretions
Bronchial spams & constriction
91
Peak expiratory flow rate
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
Asthma : drug therapy
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
Asthma care: acute
- 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
Asthma care: long-term
Education, hypersensitization
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
Status asthmaticus
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
Cystic fibrosis
Exocrine glands (abnormal mucus secretion)
Autosomal recessive gene
97
What is the earliest sign of CF
Meconium ileus
98
CF clinical manifestations
- 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
CF diagnosis
- 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
CF - respiratory care
Cpt
Bronchodilator
Exercise program
Antibiotic therapy
O2 used cautiously
101
Name a medicine that decreases mucus viscosity
Pulmozyme (d-nase)
102
Pancreatic enzymes for CF
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
CF - endocrine management
- well balanced diet: increased protein, calories
- glucose monitoring
- insulin therapy
- A1C measurements
- multivitamins (fat soluble vitamin KADE)
- exercise management
104
CF prognosis
Prognosis depends on pulmonary involvement
Median survival age: 40
Transplants
Research shows promise (CFTR Activator - kalydeco)
105
Diaphragmatic hernia
Protrusion of abdominal organs through opening of diaphragm
106
Signs and symptoms of diaphragmatic hernia
Tachypnea
Dyspnea
Cyanosis
Absent breath sounds in affected area
107
Treatment and nursing care for diaphragmatic hernia
Treatment- surgical repair
Nursing care- NPO, NG (gastric decompression) oxygen, IVF, elevate hob
108
CPR
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
Idiopathic hypopituitarism
Deficient pituitary hormone
Most often growth hormone
Short stature
Looks younger than age
Delayed sexual development
Under developed jaw
110
Treatment for Idiopathic hypopituitarism
Replacement of growth hormone
Daily subcutaneous injections
Until growth potential attained (determined by epiphyseal closure)
Given at bedtime (when body normally secretes GH)
111
Hyperpituitarism
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
Treatment of Hyperpituitarism
If lesion present = surgical removal
External radiation
Radioactive implants
113
Signs and symptoms of juvenile hypothyroidism
Decelerated growth
Constipation
Sleepiness
Mental changes (if untreated)
Myxedematous skin changes- dry skin, periorbital puffiness, sparse hair
114
Treatment of hypothyroidism
Lifelong thyroid replacement (levothyroxine)
Enlargement at birth can cause respiratory distress
115
Hyperthyroidism
Known as Graves' disease
Enlarged thyroid (goiter) & expothalmos
116
Signs and symptoms of hyperthyroidism related to hyperactivity
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
Thyroid crisis
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
Signs and symptoms of thyroid storm
Acute onset of severe irritability & restlessness
Vomiting/ diarrhea
Hyperthermia
Hypertension
Severe tachycardia
Prostration (extreme weakness)
119
Propylthiouracil and side effects
Treatment for hyperthyroidism
Side effects: lethargy & somnolence (excessive sleepiness)
Leukopenia **report fever/sore throat ASAP**
120
Treatment for hyperthyroidism
Propylthiouracil
Radioiodine
Thyroidectomy
Post-op observe for signs and symptoms of laryngospasms
(Stridor, hoarseness, throat tightness)
121
Facts and figures of eating disorders
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
Nursing interventions for children with obesity
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
Nutrition for children
Increase fiber & complex carbs
Eat when hungry
Smaller portions
Read labels
Healthy snacks
Don't focus on weight loss / just maintain weight
124
Diagnostic criteria for anorexia
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
Signs and symptoms of anorexia
```
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
Interpersonal issues and anorexia
```
Control issues
Obsessed with food
Compulsive symptoms
Inflexible thinking
Restrained behaviors
Perfectionist & increased academic achievers
Conforming & conscientious
High energy level
Possible sexual abuse
```
127
Nursing interventions and anorexia
- 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
Medications to treat anorexia
Zyprexa - antipsychotic
Periactin - antihistamine (stimulates appetite)
129
Diagnostic criteria for bulemia nervosa
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
Signs and symptoms of bulemia
Weight nearly normal
Menses normal
Erosion of tooth enamel
Erosion or rupture of stomach, esophagus
Electrolyte imbalance
Abdominal pain
131
Interpersonal issues and bulemia
Depression/anxiety
Potential for substance abuse
Shame about eating habits
Often diet excessively between binges
Hides eating binges
Chronic , long-term condition
132
Nursing interventions for bulemia
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
Intellectual development disorder
Onset prior to age 18 and is characterized by impairments in measured intellectual performance and adaptive skills across multiple domains
134
Autism spectrum disorder
Characterized by a withdrawal of the child into the self and into a fantasy world of his or her own creation
135
Predisposing factors to autism spectrum disorder
Neurological implications
Physiological implications
Genetics
Perinatal influences
136
What 2 drugs are approved for treatment of autism
Risperidone and aripiprazole
Targeted for: aggression , deliberate self-injury , temper tantrums , quickly changing moods
137
Common side effects of risperidone
```
Drowsiness
Increased appetite
Nasal congestion
Fatigue
Constipation
Drooling
Dizziness
Weight gain
```
138
Common side effects of aripiprazole
```
Sedation
Fatigue
Weight gain
Vomiting
Somnolence
Tremor
```
139
Drugs to treat adhd and their side effects
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
Oppositional defiant disorder
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
Conduct disorder
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
142
Conduct disorder
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
143
Conduct disorder
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
144
Oppositional defiant disorder
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
145
Oppositional defiant disorder
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
146
Drugs to treat adhd and their side effects
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
147
Drugs to treat adhd and their side effects
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
148
Common side effects of aripiprazole
```
Sedation
Fatigue
Weight gain
Vomiting
Somnolence
Tremor
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149
Common side effects of aripiprazole
```
Sedation
Fatigue
Weight gain
Vomiting
Somnolence
Tremor
```
150
Common side effects of risperidone
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Drowsiness
Increased appetite
Nasal congestion
Fatigue
Constipation
Drooling
Dizziness
Weight gain
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151
Common side effects of risperidone
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Drowsiness
Increased appetite
Nasal congestion
Fatigue
Constipation
Drooling
Dizziness
Weight gain
```
152
What 2 drugs are approved for treatment of autism
Risperidone and aripiprazole
Targeted for: aggression , deliberate self-injury , temper tantrums , quickly changing moods
153
What 2 drugs are approved for treatment of autism
Risperidone and aripiprazole
Targeted for: aggression , deliberate self-injury , temper tantrums , quickly changing moods
154
Predisposing factors to autism spectrum disorder
Neurological implications
Physiological implications
Genetics
Perinatal influences
155
Predisposing factors to autism spectrum disorder
Neurological implications
Physiological implications
Genetics
Perinatal influences
156
Autism spectrum disorder
Characterized by a withdrawal of the child into the self and into a fantasy world of his or her own creation
157
Autism spectrum disorder
Characterized by a withdrawal of the child into the self and into a fantasy world of his or her own creation
158
Intellectual development disorder
Onset prior to age 18 and is characterized by impairments in measured intellectual performance and adaptive skills across multiple domains
159
Intellectual development disorder
Onset prior to age 18 and is characterized by impairments in measured intellectual performance and adaptive skills across multiple domains
160
RBC (erythrocytes)
Life span 120 days
Normal range 4.5 - 5.5
Function: transports hemoglobin , which transports O2 to tissues
