Study Guide Quizlet Flashcards
Quizlet
Near Drowning
Requires immediate resuscitative care. Give the child oxygen, or entubation/endotracheal tube if the kid is severely affected
Near Drowning Monitor
Monitor vitals closely as well as blood gases
Requires 6-8 hours of monitoring after the incident. Aspiration pneumonia may occur 48-72 hours afterwards. Aspiration is the greatest risk
Try to care for the family as well, let them know everything is being done for the child
Hirschsprung Disease
Rare congenital anomaly where the absence of ganglions in the colon causes the internal anal sphincter to be unable to relax, and subsequent stool accumulation
Hirschsprung Disease S/S
S/S: Newborn- no meconium stool, constipation, reluctant to eat, abdominal distention. Infant- failure to thrive, constipation, abdominal distention, vomiting, diarrhea. Foul smelling ribbon like stools”. Toddlers/Children- foul smelling stool, abdominal distention, visible peristalsis, palpable fecal mass, malnourishment, signs of anemia/hypoproteinemia
Hirschsprung Disease Diagnosis
Diagnosis: x-ray, barium enema study, anorectal exam, rectal biopsy. These are performed when the S/S point to this
Hirschsprung Disease Management
Management: surgical removal of aganglionic portion of bowel to restore motility. 1st stage is a temporary ostomy, 2nd stage is a “pull-through” procedure
Hirschsprung Disease Care
Care: peroperative- stablaize malnourished child; postoperative- slow reintroduction to food, take it easy
Diarrhea Types
Acute, Chronic, Acute infectious/infectious gastroenteritis, Intractable diarrhea of infancy, Chronic nonspecific diarrhea (CNSD)
Acute Diarrhea
sudden increase in stool frequency and change in consistency, last less than 14 days, no meds given.
Acute infectious/infectious gastroenteritis
caused by infectious agent in GI tract.
Chronic nonspecific diarrhea (CNSD)
irritable colon of childhood and toddler’s diarrhea, loose stools, often with undigested food particles, lasting no more than 2 weeks
Chronic Diarrhea
duration of more than 14 days, often caused by chronic conditions (malabsorption syndromes, inflammatory bowel disease, etc.)
Intractable diarrhea of infancy
occurs in first few months of life, persists no more than 2 weeks
Diarrhea causes
Caused by a number of different infectious agents, as well as antibiotic side effects (prevent with probiotics)
Diarrhea management
assess fluid and electrolyte status, avoid rectal temp when taking vitals. Rehydration is the goal, give fluid capsules such as pedialyte (enhances fluid reabsorption), move onto IV rehydration if it fails. Reintroduce an adequate diet, give antidiarreals and antibiotics as ordered. For the infant, take special care of the skin in the diaper area (irritation risk)
Diarrhea
Frequent loose, watery stools
Diarrhea Goals
Goals: urine gravity 1.005-1.020, 1-2 mL/kg of urine. No vomiting, diarrhea (less than 4 per day), regular diet, and maintained skin integrity
Dehydration
When fluid output exceeds intake, kids are more sensible
Dehydration causes
Causes: insensible fluid loss (fever, sweating), excessive renal excretion, GI dysfunction (n/v), ketoacidosis (vomiting), and burns
Dehydration management
Management: give small but frequent opportunities for oral intake for mild cases, move onto IV rehydration if it fails or for moderate-severe cases
Measurement: 1 gram of wet diaper = 1 mL of urine. Monitor amount, color, consistency, and time of vomiting, and sweating.
Daily weights are the best indicator: same time and scale each day. In infants their fontanels become sunken
Cleft Lip post-surgery care
protect the suture line- don’t let the baby lie prone. Manage the pain with meds or other methods, use distraction. Position the baby on their back and for feedings use a syringe/dropper inside the mouth
CHD Postop Care (Congestive Heart Disease)
Most patients need IV analgesics immediately after surgery, the strength of the drug can be decreased as IV and tubes are removed.
Educate the the family on medications, activity restrictions, diet (more protein), wound care, follow ups, community resources, and postop problem S/S
Make the child and parents feel more at ease by including them in the care process and explanations
Hypercyanotic Spell (Tet/Blue Spell)
Acute episodes of cyanosis and hypoxia when they cry, defecate, or feed (stressful situation).
Hypercyanotic Spell (Tet/Blue Spell) occurrence
Can occur with any type of pulmonary blood obstruction, manifests most frequently in the 1st year of life
Hypercyanotic Spell (Tet/Blue Spell) intervention
Put them in a squatting position and calm them down. They often hold their breath
Keep them in a quiet area, cluster care. Put them into a knee to chest position to increase vascular systemic resistance
Hypercyanotic Spell (Tet/Blue Spell) risk
Risk for great neuro damage, requires prompt intervention
Hypercyanotic Spell (Tet/Blue Spell) Meds
Digoxin is used to strengthen squeeze of heart and to control its rate and rhythm. Prostaglandins and morphine are also used, eventually there may be surgery. 100% oxygen, morphine, IV fluid. Calm them first
Rheumatic Fever
Inflammatory disease that occurs after group A β-hemolytic streptococcal pharyngitis
WBCs attack joints, skin, brain, serous surfaces, and heart. Mitral valve is most often affected
Rheumatic Fever S/S
fever, rash, swollen and painful joints
Rheumatic Fever Goal
eradicate infection, prevent permanent damage, prevent recurrences. Salicylates (prednisone) control inflammation, then bedrest, aspirin, and penicillin are prescribed
What can Rheumatic Fever progress to?
Rheumatic heart disease, causing permanent valve disease
Tonsillectomy
Used to relieve tonsillitis
Tonsillectomy Postop care
Maintain an upright position to allow drainage
Tonsillectomy Assess for
Signs of bleeding, airway patency, and vital signs
Tonsillectomy Diet
Clear liquids, then advance to soft foods, then bland foods. No red roods (color can be confused with bleeding)
Offer Ice collar, ice chips, and pain meds for comfort
Tonsillectomy Instructions
Protect surgical site
Viral Respiratory infections
Include influenza, bronchitis, and RSV
Viral Respiratory infections manage/monitor
Manage w/ hydration, monitor I/Os & weights daily, monitor pulse ox, decrease anxiety, monitor airways
Bacterial Respiratory Infections
Includes strep throat, TB, and tracheitis.
Can create thick purulent secretions that can cause respiratory distress
Bacterial Respiratory Infections- Manage
With humidified oxygen, antipyretics, antibiotics. May need intubation until swelling decreases or mechanical ventilation
The more serious type of infection
Cardiac Catherization
Invasive procedure looks at oxygen/pressure levels in each chamber and their structure. Can also blow a balloon to expand a heart chamber.
Cardiac Catherization Risk
Risk for bleeding, pulse lost in cathed extremity
Cardiac Catherization Postop Care
Strict bed rest for 6 hours with a quiet environment, check vitals, capillary refill, swelling. Give pressure dressings, give more dressings if bleeding present, don’t take off.
Patient will lose a lot of fluid so monitor I/O’s, blood glucose. Make sure affected limb is extended and flat.
Pyloric Stenosis Patho
The circumferential muscle of the pyloric sphincter becomes thickened. Obstructs outlet and causes dilation, hypertrophy, and hyperperistalsis of the stomach.
Usually develops in first 2-5 weeks of life
Pyloric Stenosis S/S
Projectile vomiting, with hunger afterwards.
Weight loss, dehydration, lethargy, palpable mass in RUQ
Pyloric Stenosis Treatment
Pyloromyotomy-incision non the pylorus, high success rate. NPO and educate preoperatively. Post-op: slowly resume food per orders, IV fluids, comfort and rest, and incision care.
Intussusception Patho
Portion of intestine slides into another or invagination (inside out) of one portion of intestine into another.
Most common cause of intestinal obstruction of children 3 months- 3 years.
