Test 11 Flashcards
- Rheumatic fever: causes
Group A strep
- Rheumatic fever: Diagnostics
Elevated ESR
Elevated WBC
+ Group A Strep culture
- Rheumatic fever: manifestations
Carditis
- Polyarthritis
Chorea (disorder characterized by emotional instability, purposeless movement, and muscular weakness)
- Rheumatic fever: nursing care
Conserving energy
Reducing pain
Providing diversional activities and sensory stimulation
Preventing injury
- Iron supplements for toddler’s client education(slide 10)
Inform patient/parent that iron salts change stool to dark green or black.
Advise patient/parent to take liquid forms of iron via a straw, rinse mouth with water, and dilute with juice, avoid staining.
Take between meals and not with milk.
Provide iron rich foods.(Eat with vitamin C for better absorption (OJ and strawberries)
Lock solution up! Iron toxicity
- Iron deficiency anemia client education(slide 10)
Administer IM or IV iron when oral iron is poorly absorbed.
Z-track for parenteral injections (do not massage)
- Thalassemia manifestations(slide 8)
Anemia
Fatigue
Pallor
Irritability
Failure to thrive.
Bone pain and fractures
Lethargy
Enlargement of spleen
Skin bronze color or jaundice
- Thalassemia client education
Diet: avoid foods high in iron (red meats, lentils/beans, egg yolks, spinach, dried fruit, dark leafy greens, peanut butter, poultry) (7-10mg of iron is needed daily)
Child and family support important
Assist with RBC transfusion and iron-chelating therapy: deferoxamine.
- Hemophilia manifestation
Bruising
Bleeding
Pain
- Hemophilia priority
Nursing care is focused on stopping the bleeding, decreasing pain, increasing mobility and preventing injury.
- Hemophilia nursing actions
Subcutaneous injections, when possible, with smallest needle, apply pressure and monitor for excessive bleeding.
Monitor urine, stool for blood.
No ASA or NSAIDS
Elevate and apply ice to affected joints during bleed.
Immobilize and apply elastic wrap to reduce bleeding.
Avoid activities that include high contact/ensure safety.
- CHF manifestations in infants
Infants: hard to detect in
Tires easily, tachycardiac
Rapid respirations with expiratory grunt
Flaring of nares
Sternal retractions
May refuse bottle after 1 to 2oz.
Periorbital edema; rapid weight gain
- CHF manifestations older child
Tachycardia
Failure to gain weight.
Abdominal pain, nausea
Vomiting, weakness, fatigue
Restlessness, Irritability, pale, tachypnea, dyspnea
Coughing, edema, enlargement of liver and heart
- CHF in actions and concerns(slide 3 &4)
Administer medications digoxin, furosemide, ACE.
Decreasing workload of heart
Elevate HOB
Small frequent feedings
Allow for maximum chest expansion with loose clothing.
- Digoxin Kill hurt know(Old study guide)
Use: HF, A-fib, and flutters
Adverse Reactions
Toxicity: nausea and vomiting, anorexia, irregular pulse(dysrhythmias), or decrease pulse rate (bradycardia)
Nursing Actions
Check apical pulse for 1 minute, hold if less than (90-110 for infant and 70-85 for older children).
Check digoxin levels 0.8-2.0
Immune Fab is the antidote.
Contraindicates with clients on loops and thiazides.
St. John Wart (herb med) increases toxicity.
- Furosemide therapeutic response(Old study guide)
Use: HF, HTN, and Ascites (fluid in abdomen)*Most powerful
Adverse Reaction/Hurt
Hyperglycemia
Hypotension
Hyponatremia
Dehydration
Adverse Reaction/Kill
Hypokalemia (sx. Bradycardia, fatigue, and muscle twitching)
Toxicity (sx. Tinnitus, dizzy or any hearing changes)
Nursing Actions/client education
Photosensitivity (Avoid sun and wear sunscreen)
Increase potassium (bananas, potatoes, dried fruit, nuts, spinach and citrus fruit)
Monitor potassium labs, toxicity, glucose, weight and output.
Administer in the morning.
- Kawasaki disease manifestations
Red eyes without drainage
Red chapped lips
Strawberry tongue
Enlarged lymph nodes.
- Kawasaki disease nursing intervention
Advise parents to keep cardiac evaluation.
No live vaccines for 6 months
- Kawasaki disease client education(slide 6)
Kawasaki disease is an acute, febrile disease. Serious complication for MI if aneurysm is formed.
o Teach monitor for o2 deprivation; inconsolable crying; abdominal pain, restlessness, and pale skin
o Aspirin is used to control inflammation and fever-often for months.
- no live vaccine
- Sickle cell anemia manifestations(slide 12)
Pain
Fever
Elevated WBC
- Sickle cell anemia complications
The impaired circulation results in tissue damage and infarction-priority complication (sx.MI sudden onset of a headache and paralysis)
- Sickle cell anemia nursing actions
Relieving pain
Increasing fluid intake
Conserving energy-to maintain o2 levels.
Avoid strenuous activity following crisis.
Improving physical mobility-mild activity is encouraged.
Avoid infections and maintaining skin integrity.
- Leukemia client education related to vaccines(slide 16)
NO LIVE VACCINES (MMR, varicella, Rotavirus, live influenza)
- Leukemia manifestations
Fatigue and pallor
Low-grade fever
Bone and joint pain
Petechiae, purpura, and bleeding
Lymph nodes may be enlarged, and bruising is a constant problem.
Low platelets, elevated WBC
- Leukemia client education
Work with the child to help promote normal growth and development and improve body image.
Encourage caregivers to verbalize feelings and help them to increase their coping abilities.
- No vaccine
- Leukemia neutropenic precautions and nursing care priority
Preventing infection-strict handwashing
Preventing injury
Relieving pain and reducing fatigue
No fresh flowers, fruits, bottle waters only and no salad bar
What is Digitalization
The use of large doses of digoxin, at the beginning of therapy, to build up the blood levels of the drug to a therapeutic level
