reye syndrome

Question 1

primary affects

Answer 1

liver brain

causing dysfunction and cerebral edema

Question 2

cause of reye

Answer 2

not understood

Question 3

peak incidence of reye

Answer 3

when flu is most common

jan- march

Question 4

can be mistaken for

Answer 4

Encephalitis
Meningitis
Poisoning
Sudden infant death syndrome (SIDS)
Diabetes mellitus
Psychiatric illness
Prognosis is best with early recognition and treatment.

mostly from asprin

Question 5

risk factors

Answer 5

• There is a potential association between using aspirin (salicylate) products fortreating fevers caused by viral infections.

Reye syndrome typically follows a viral illness

• Influenza
• Gastroenteritis
• Varicella

Question 6

expected findings

Answer 6

• Recent viral illness or use of aspirin or aspirin-containing products.
• Reye syndrome presents in clinical stages based on the severity of liver and neurologic findings.
• Lethargy
• Irritability, Combativeness
• Confusion, Delirium
• Profuse vomiting
• Seizures
  Loss of consciousness

Question 7

labs

Answer 7

• **Liver enzymes [ALT] [AST]: elevated
• Serum ammonia level: elevated.
• Serum electrolytes: altered due to cerebral edema and liver changes.
• Coagulation times can be extended.

Question 8

diagnosis liver biopsy

Answer 8

• Ensure that clotting studies are normal
• Maintain NPO status prior to the procedure.
• Monitor for hemorrhage postprocedure.
• Assess vital signs frequently postprocedure.
• Encourage parents to limit the client’s post-procedure activities to decrease the risk of hemorrhage.

Question 9

csf analysis

Answer 9

A lumbar puncture should be performed to collect CSF and rule out meningitis.

Question 10

nursing care

Answer 10

• Maintain hydration while preventing cerebral edema.
• Administer IV fluids as prescribed.
• Maintain accurate I&O.
• Insert indwelling urinary catheter as ordered.
• Position the client.
• Avoid extreme flexion, extension, or rotation.
• Maintain the head in a midline neutral position.
• Keep the head of the bed elevated 30°.

Question 11

nursing care

Answer 11

• Monitor coagulation and prevent hemorrhage.
• Note unexplained or prolonged bleeding.
• Monitor pain status and response to painful stimuli.
• Administer pain medications when appropriate
• Assist with intubation if required.
• Implement seizure precautions.
• Provide private time for the family to be with the client if death is imminent.
• Initiate referrals to support resources for family.

Question 12

osmotic diuretic: mannitol

Answer 12

To decrease cerebral swelling.

Monitor for increased ICP.

Question 13

vitamin K

Answer 13

• Improves synthesis of blood clotting factors in the liver
• Subcutaneous is the preferred route.
  ● Identify client sensitivity to benzyl alcohol and castor oil.
• Teach the client about dietary intake of vitamin K.

Question 14

education

Answer 14

Teach parents to avoid giving salicylates for pain or fever in children.

Teach parents to read labels of over-the-counter medications to check for the presence of salicylates.

Clients regain full liver function, but can have some neurological deficits.

Question 15

complications

Answer 15

• Neurologic complications include speech or hearing impairment, and developmental delays based on the length and severity of illness.
  - Explain the client’s condition and needs to the family.
  - Help the family identify support services for home care.
• Death
  • Support the family in grief.
  • Make referrals to spiritual support as appropriate.