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Nursing 250-255 > Test 2 PEDS > Flashcards

Test 2 PEDS Flashcards

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1
Q

Explain Trisonomy 21

A

The extra chromosome at site 21. No known reason why this happens

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2
Q

Name some of the signs of down’s syndrome?

A

Thickened tongue. Low set ears. Extra eye flap. Bridge of nose spacing.

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3
Q

Down’s syndrome patients may have what defects?

A

Cardiac defects, GI defects (Hirschsprung)

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4
Q

An IQ <75 suggests what?

A

Subaverage intellectual development

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5
Q

Children with downs should be encouraged to have high fluids and high fiber foods due to?

A

Hirschprungs Syndrome, Decreased peristalsis in GO tract.

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6
Q

What percentage of Downs syndrome babies die in the first year due to defects?

A

45%

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7
Q

What is the purpose of corticosteroids for the management of nephrotic syndrome?

A

Stabilize glomerulus Decrease loss of protein in urine.

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8
Q

What are the signs of a Wilm’s tumor?

A

Tight Diapers, Clothes not fitting correctly, Abnormal renal functioning.

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9
Q

What are the consequences of Leukemia

A

Infection, bleeding anemia, fractures, bone pain.

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10
Q

congenital heart disease s/s, what meds to give?

A

failure to thrive, poor intake
meds:dig hold if hr less than 100 infants or 80 in toddlers
watch for dig toxicity!!! I.e-n&v and anorexia

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11
Q

<3 disease is dx by? and contraindicated when?

A

cardiac cath, contraindicated with a diaper rash or febrile illness

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12
Q

Tetralogy of fallot

A

R to L shunt, pressure builds up on R ride of the heart
Transposition of the vessels – deoxygenated blood
Pulmonary stenosis
Ventricular septae defect
Overiding aorta
Hypertrophy left ventricle

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13
Q

TET Spells/Blue spells

A

Squatting position, knee chest position (for infants mom places them like this)This is a sign of decompensation and these positions decrease the preload and
Venous return. If unsuccessful then hospitalized placed on 100% O2

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14
Q

Child with congenital heart disease should play / be disciplined how?

A

like any other child. This promotes normalcy & growth & development.

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15
Q

Risk factors for Rheumatic fever

A

Strep infection / Scarlet fever
Glomelularnephritis = complication & mitral valve disorder
Test CRP if high indicated inflammation. If decreased indicates that treatment is working

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16
Q

Major clinical manifestations of rheumatic fever

A

RF may lead to glomerulonephritis, Polyarthritis
Cardidis
Erythema Marginatum
Chorea (St. Vitus Dance, Sydenham Chorea)

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17
Q

Discharge Tx for rheumatic fever

A 
Cultures done for all sore throats
	Take ABX (PCN to protect the heart) for 5 yrs or lifetime for invasive procedures
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18
Q

Classic Hemophilia

A

Apply pressure for 15 minutes.

X linked recessive inherited disorder of factor VIII (8)

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19
Q

S/S of hemophilia

A

Bruising
Bleeding w/circumcision
Hematoma with Vit K or Hep B vaccine

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20
Q

Dx test done for hemophilia & treatment

A

DX: PTT (clotting time study)

TX: R.I.C.E. – Rest, Ice, Compression & Elevation
DO NOT GIVE Aspirin (ASA), Over the counter drugs (OTC) or Motrin
When hemophiliac rides bike make sure to wear protective equipment.
Give factor Vlll When there is bleeding into the joint structure. The IV is reconstituted and it is given IV Push thru port.
Proper activities would include; swimming, golfing (no contact sports, no hard play areas) Physical therapy consult for ROM exercises to strengthen muscles

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21
Q

PKU (Phenyketonuria) DX

A

Guthrie Test – detects phenylalanine (a metabolic amino acid), hypothyroidism, galactosemia, hemoglobin defects like sickle cell. Must have 24-48 hrs of ingested protein before test.

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22
Q

Complications of PKU

A 
Stains neurons (kernicturus) causing seizures
 Encephalopathy/ mental retardation
 accumulation of phenylalanine that cant be converted into tyrosine.
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23
Q

People who have PKU usually look like?

A

blonde hair, blue eyes, light skin (lack of melanin)

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24
Q

PKU diet

A

Lifelong
Special Formula (lofenalac or Phenex 1 (infants) Phenex-2 (children & adults)
No artificial sweeteners/aspertane
Limit proteins
Fruits & Veggie @ lib
Monitor levels s/b up to 6 in infants, 10 in children & 15 in adults

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25
Q

Dx test for jaundice

A

Amniocentesis
Coombs test – measures antibodies attached to RBC’s
(indirect on mom) (Direct on baby once born)
If (+) mom built antibodies & is sensitized, hemolysis in baby

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26
Q

Dx of diabetes

A

Hemoglobin A1C 4-6 is normal anything above, investigate

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27
Q

Hemolytic in uteral

A

(mixing of fetal & maternal blood) – Give mom rhogam shot & give baby same Rh factors as mom. This happens because 1st child was Rh+

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28
Q

Teaching plan priority of newly diagnosed diabetic

A

Insulin administration and s/s & tx of hypoglycemia (tremors, sweating, confusion)
Give fast acting carb (juice w/sugar, candy) followed by protein to stabilize

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29
Q

Insulin difficult to adjust in toddlers why?

A

because they get it before hand & you don’t know what or how much they are going to eat.
Increased activity reduces insulin needs.

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30
Q

How to decrease food allergies

A

Introduce one food at a time every 4-7 days.

Start with rice cereal, light color fruits & veggies, then proteins

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31
Q

Priority Assessment for glomerolonephritis AGN

A

Can cause renal failure

Assess behavior, vital signs, irritability, and neuro status

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32
Q

Clinical manifestations of glomerolonephritis AGN

A 
Periorbital edema (swollen eyes)
Increased BP – accompanied by a headacheTea colored urine, Acute renal failure
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33
Q

– renal diet – low potassium, low sodium, low protein

A

Diet for glomerolonephritis AGN

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34
Q

Dx of glomerulonephritis

A 
ASO titers
ESR
CRP inflammation (C-reactive protein)
ANA titers
**all elevated!!
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35
Q

During the ACUTE phase of glomeruloneph.

A

Usually make complete recovery home rest, home school, check BUN & creatnine, chest xray

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36
Q

Clinical manifestations of Nephrotic syndrome

A

3rd spacing edema – elevate arms/hands and give scrotal support
Decreased protein in serum (hypoproteinemia), high in urine (hyperproteinuria)
Weight gain, ascities, lethargy
Increased cholesterol, increased fats

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37
Q

CorticoSteroids given - to stabilize the glomerulus
Decrease protein loss in urine
Teach mother NOT to suclude the child from the outide world

A

treatment for Nephrotic syndrome

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38
Q

Diet for Nephrotic Syndrome

A

Increased protein decreased fat

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39
Q

Myelomeningocele

A

out pouching of menengies & spinal nerves L4-L5.
Can be prevented by taking folic acid
Dx through AFP or quad screening

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40
Q

Nsg Care for Myelomeningocele

A

Pre- op – baby lays on stomach with moist gauze over spine
Post-op – Keep supine (on back)
Check head circumference (for ICP from spinal fluid)
S/S of ICP – poor feeding, bulging fontanel, shrilling cry

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41
Q

Complications of myeolomeningocele

A

Paraplegics

bowel & bladder problems (straight cath)

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42
Q

Communicating Hydrocephalus- CSF absorbs normally

A

Caused by surgery repair of myelomeningocele, adhesions between meninges & base of brain

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43
Q

Non Communicating Hydrocephalus – Blocked flow of CFS

A

Caused by congenital, infection, tumor, aneurysm, blood clot

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44
Q

Nsg care for Hydrocephalus shunt

A 
No pumping of shunt
Position on opposite side of the shunt
Check for abdominal distention
Head circumference measured
Teach mother s/s of pump failure (ICP- bulging fontanel)
Strict I & O
Neurological Assessment
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45
Q

Bacterial Meningitis

A

caused by HIB vaccine, H influenza

S/S –Increased temp
	WBC’s are up
	Headache
	Preceeded by upper resp  infection- protect from resp contamination
	Photophobia, 
	Nuchal rigidity
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46
Q

Dx/Tx for Bacterial Meningitis

A

–Dx: CSF examination by spinal tap/lumbar puncture

Tx:Broad spectrum ABX (24 hours isolation until affective) Dark quiet room Seizure precautions, Resp Isolation

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47
Q

When providing care for a child with ALL (Acute Lymphoid Leukemia) Unrestricted proliferation of immature WBC’s

A

Protect from child with Upper Resp infection
Neutropenic precautions – peal fruits & veggies. NO fresh flowers
Warm toothbrush to soften bristles to decrease bleeding

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48
Q

Nsg care (A.L.L)

A

Hand washing
Protect from infection
Increased Nutrition

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49
Q

Cleft lip Care

A

Pre op feeding using elongated nipple and sitting upright place on side or back after surgery to decrease manipulation of sutures (Logans bar)
Cuddle to decrease crying

Post – op feeding using formula and soft foods only NO UTENSILS
Long Nipples, infant seat used for feeding, breast feedings ok, allow breaks in feedings due to difficulty breathing

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50
Q

Cleft Palate Care

A

place on stomach to promote drainage
Faulty speech pattern, otitis media, orthodontic problems, plastic surgery needed and hearing impairment, same pre/post op as CL

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51
Q

Emergency surgery needed for what?

A

Tracheosophageal Fistula (TEF)

s/s: Chocking, coughing, cyanosis
Drooling of saliva
Abdominal distention
Apnea (period of no breathing)

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52
Q

PRE-op TEF surgery

A 
NPO
	IV
	Warm baby
	Increase HOB
	Catheter to suction secretions
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53
Q

POSTop TEF surgery

A 
Gtube – gravity drainage
	Gtube feedings (up to 10 days)
	Reintroduce bottle
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54
Q

Regerg of formula causes metabolic alkalosis
Progressive projectile vomiting then immensely hungry
Failure to thrive – weight loss
Dehydration
Hypertrophied pylorus
Olive like mass

A

PYLORIC STENOSIS

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55
Q

Pyloromyotomy Post op mngment

A 
Restore fluids – electrolyte balance
May vomit 24-48 hrs after
IV fluids
Begin feeding 4-6hrs after surgery
Increase HOB
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56
Q

Kawasaki TX

A

– ASA, Anticoagulants, IVIG (Intravenous Immunoglobulin)Defer immunizations

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57
Q

Long term complications –Kawasaki

A

Coronary Artery Anurysms

S/S – red hands & feet, rash, strawberry tongue, painful joints, heart failure & irritability for 2-3 weeks.

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58
Q

Ryes Syndrome – Liver & CNS involvement

A

Causes – ASA, viruses (varicella, influenza)
S/S – Same as ICP
Care – Supportive

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59
Q

SIDS

A

(age 2-4months) Allow parents to express themselves

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60
Q

carditis s/s

A

tachycardia at rest, cardiomegaly, CP, Give Dig!

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61
Q

clinical manifestations of TEF

A

excessive salivation and drooling, **coughing choking, cyanosis **
3 C’s!!!!!!

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62
Q

Nsg care for TEF

A

NPO, IV fluids, suction, elevate HOB Ambu bag, possible surgery

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63
Q

When an NG tube into the stomach meets resistance and cannot be advanced this is a dx of what?

A

TEF

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64
Q

TEF is usually identified when?

A

after their first feeding if they cough choke & become cyanotic this is why nurses feed the baby their 1st meal!

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65
Q

Hypertrophic Pyloric Stenosis

A

constriction of the pyloric sphincter with obstruction to gastric outlet, more in boys usually dx 2-5 wks old that are bottle fed

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66
Q

Abdominal Ultrasound

A

confirms dx of pyloric sphincter, determines diameter and length of pyloric muscle

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67
Q

Pyloric sphincter (HPS) clinical manifes.

A

presents w/ PROJECTILE VOMITTING sour smelling bc no bile, dehydrated (lack of tears dry mucus membranes sunken fontanels decreased output poor skin turgor, wt loss) FTT, lethargic, dec na, k, cl, increased BUN,pH ,bicarbonate (hco3)
METABOLIC ALKALOSIS

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68
Q

when is feeding begun after a pylorotomy for HPS?

A

a few hours after, clear liquid diet, increase amount q 1/2 hour! start w/ 5 mL and increase slowly
STRICT FEEDING SCHEDULE

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69
Q

if there are massive amounts of protein in urine, dec serum protein albumin, increased cholesterol levels, dec BP, and edema in diaper area or abdomen this indicates?

A

Nephrotic syndrome

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70
Q

when is nephrotic syndrome usually dx?

A

bet 2-7 years old usually males often after an upper respiratory infec. (2-3 days)

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71
Q

For nephrotic syndrome what is the treatment?

A

steroids *first line (prednisone), diuretics for the edema, 25% albumin for severe edema, antibx if infection, monitor i&o, daily wts, check for edema, monitor vs (low bp) monitor for protein in urine and spec gravity, keep away from infections (steroids may cause), keep warm and dry

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72
Q

Acute Glomerulonephrotis (AGN)

A

immune complex r/t group A beta hemolytic strep (GABHS) POST STREP!! seen 10-21 days after pharyngitis

BASEMENT MEMBRANE

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73
Q

Clinical Manifestations of AGN…

A

hypertension, oliguria, edema, hematuria, circulatory congestion(fluid in lungs!) and a little protein in urine, elevated ASO titer, pale, HA dysuria

74
Q

Managing AGN

A

moderate Na and fluid restriction, potassium might be restricted due to oliguria, VS, i&o, daily weights, d5.45

75
Q

the two differences between nephrotic syndrome and acute glomerular nephritis?

A

BP will be high in AGN and hematuria

BP will be low in Nephrotic syndrome and NO hematuria

76
Q

AGN patients due to their increased BP and edema are at risk for what?

A

STROKE!!

provide a no added salt diet , diuretics, anti hypertensives

77
Q

how is diabetes usually detected?

A

bed wetting in a post potty trained child, also 3 P’s!

78
Q

when talking to a patient or family about diabetes?

A

USE A MATTER OF FACT APPROACH

79
Q

I’m DM l, what are they at risk for??

A

DKA! (same as adults) demonstrated with kussmauls, ketonuria, so Metabolic Ass (acidosis)

80
Q

normal HgA1c

A

4-6%
question Anything above

***one of the study guide I read said 1.8-4.0 so not sure

81
Q

highest risk age for DKA and why?

A

adolescents bec they lie, they wanna be like peers and fit in

82
Q

things to pick on a test for food to give in a hypoglycemic episode

A

CHEESE, CRACKERS, MILK

protein

83
Q

Insulin should or shouldn’t be omitted ?

A

NEVER omitted, may need to be adjusted based on findings

ex. if they are gonna have a big meal or work out GIVE LESS

84
Q

Magical thinking occurs among which age group

A

PRESCHOOLERS

85
Q

Atopy

A

allergy with a hereditary tendency

86
Q

food sensitivities include?

A

milk eggs wheat nuts soy shellfish chocolate

NEVER GIVE AN INFANT HONEY BEC AT RISK FOR BOTULISM R/t honey

87
Q

it is best to breast feed or give formula as opposed to cows milk until what age

A

12 months

88
Q

PKU is an autosomal recessive metabolic disease that lacks what enzyme that’s needed to metabolize amino acids

A

Phenylalanine (hyperphenylalaninemia)

too much protein they can’t break it down

89
Q

PKU may lead to?

A

Mental retardation

90
Q

Guthrie blood test is used to dx what?

A

PKU and is most reliable if blood sample is taken after infant has recently ingested protein

91
Q

children with PKU should have what diet modifications?

A

special formula for infants (lofenalac or phenex 1)

Phenex 2 for children and adults

LIMIT ALL NATURAL FOODS WITH PHENYLALANINE
avoid artificial sweeteners with ASPARTAME

Diet is LIFELONG

92
Q

Hemophilia A is a deficiency in what?

A

Factor Vlll

93
Q

Treatment of the bleed in a hemophilia begins when?

A

at home!, apply pressure for 15 min, RICE, ROM and PT after the bleeding stops

94
Q

to prevent isoimmunization administer RHIG RHOGAM) to all Rh negative moms with an Rh positive fetus when?

A

28 weeks into pregnancy

95
Q

photo therapy may control what

A

bilirubin levels in mild cases

96
Q

heart murmur is indicative of?

A

often 1st sign of a heart defect, get an EKG and BP of all 4 extremities

97
Q

most common congenital heart defect?

A

VSD Ventricular septal defect which is a major cause of death in infants under 1 year

98
Q

with coarctation of the aorta what to assess for

A

BP and pulse q4 extremities it’s usually higher in upper extremities and lower in lower

99
Q

what is a TET spell?

A

an anoxic spell when o2 requirements > blood supply!
when you’re starting an IV they turn blue, put em in a knee chest position(squat down) to reduce systemic blood flow return to the heart! in infants have their moms hold them in this way

100
Q

Med Management with a mixed blood flow defect

A

IV administration of Prostaglandin E to help keep ductus arteriosis open

101
Q

Kawasaki Disease

A

an acute self limiting systemic vasculitis of unknown cause

102
Q

Kawasaki is treated with

A

high dose IV IgG 2g/kg over 10-12 hrs, ASA 80-100 mg/day–fever then 3-5mg/kg/day —anti platelet !

be careful when giving ASA can cause Reye

103
Q

rheumatic fever treatment

A

cultures done for all sore throats

take ABX (PCN) to protect the heart for 5 years or for life if having an invasive procedure

104
Q

Chorea

A

abnormal neuromuscular (kids get clumsy) sudden involuntary movement of limbs due to inflammation of the basal ganglia

105
Q

if jaundice is not treated (too much bilirubin that can’t be converted from indirect bilirubin to direct and liver can not excrete it ) what can occur?

A

encephalopathy or mental retardation

106
Q

in pathological jaundice hemolysis in utero may occur this is dx by amniocentesis Coombs test,when the blood transfusion is performed who is the compatible blood matched to mom or baby?

A

MOMMY!

107
Q

cephalocaudal assessment is done how?

A

starts at head and goes down, heels from feet up

108
Q

hemolysis in utero occurs when

A

mom is rH - and her first born is Rh + the first baby is ok but the second baby will experience the hemolysis is Rh+

109
Q

s/s of hypoglycemia

A

tremors sweating confusion (loc)

110
Q

a fast acting carb and then a protein is given for hypoglycemia what are some examples

A

fast acting carb: juice w/ sugar or candy then protein: cheese eggs milk etc.

111
Q

increased activity requires more/less insulin

A

LESS

112
Q

Glomerulonephrotis (AGN) can cause renal failure what are the main assessments

A

behavior, VS, neuro status and irritability, electrolytes, BUN and Creatine

113
Q

acute phase of Glomerulonephrotis (AGN) if treated may result in?

A

complete recovery! rest, home school, BUN and Creatine checked routinely, chest x-rays done

114
Q

Goal for a Down’s syndrome child

A

function at highest level possible, not their chronological age, their highest developmental ability!

115
Q

Myelomenigocele (outpouching of meninges and spinal nerves (4-5)) can be prevented by what?

A

FOLIC ACID

116
Q

Myelomenigocele is dx by what?

A

AFP or Quad screening

117
Q

s/s of ICP

A

poor feeding, bulging fontanel, shrilling cry

118
Q

communicating hydrocephalus (adhesions between meninges and base of brain) may occur after what?

A

after surgical repair of Myelomenigocele

119
Q

non-communicating hydrocephalus (blocked flow of CSF) what are causes

A

congenital, infection, tumor, aneurysm, blood clot

120
Q

ICP is indicated as the child has bulging fontanel what may have happened?

A

shunt pump failure

121
Q

CSF is examined by what procedure

A

spinal tap/lumbar puncture

122
Q

a child with leukemia is on what type precaution

A

reverse isolation

123
Q

pre-op surgery (nephrectomy) for a kid with a Wilms tumor what do you post over the bed

A

a sign saying DO NOT PALPATE ABDOMEN because it can metastasize

124
Q

for a baby with a cleft LIP repair you place then how after surgery

A

side lying or back to protect the suture line (Logan’s bar)

125
Q

how do you place a baby after cleft palate repair?

A

on tummy to promote drainage! no utensils in the mouth or anything that may mess up the sutures

126
Q

if a cath is done for VSD OR PULMONARY STENOSIS what will the labs show?

A

polycythemia high h & h and low o2 sat

127
Q

with a coarctation of the arteries how will their BP read

A

at least 20 mmHg higher in the arms than in the legs

128
Q

A child with coarctation of the aorta on assessment reveals absence of a murmur does this rule out the coarctation

A

No!

129
Q

surgery (balloon cath/angiography) Is preformed when? for coarctation of the aorta

A

at age 2 usually, must be preformed before a GIRL reaches their childbearing age bec the extra blood volume during pregnancy can cause heart failure

130
Q

hemophilia is a sex linked recessive disorder that occurs in which gender? and is Carried by which gender?

A

occurs in males, carried by females

131
Q

factor VIII associated with hemophilia is intrinsic or extrinsic?

A

intrinsic ! diagnosed by PTT

132
Q

hemophilia is usually recognized when?

A

what a boy infant bleeds excessively following circumcision or if a boy gets bruised very easily after any bumping into something (lower extremities)

133
Q

Major causes of death in a hemophiliac?

A

intracranial hemorrhage or laryngeal bleeding

134
Q

when a hemophiliac has a mouth trauma or surgery what med must be given to prevent clot destruction

A

Amicar, also corticosteroids for hematuria

NEVER GIVE NSAIDS TO A HEMOPHILIAC THEY INHIBIT PLATELET FORMATION

135
Q

most important nursing intervention for a hemophiliac

A

PREV OF INJURY

136
Q

which blood incompatibility is most severe? Rh or ABO?

A

Rh!!!

137
Q

cleft lip deficit

A

inability to suck, best method for feeding is upright position using a commercial cleft lip nipple

138
Q

complications of cleft palate

A

poor teeth alignment, risk for ear infections (post repairment) (tubes may be needed in ears to drain the fluid) speech problems before and after surgery

139
Q

definitive dx of a pyloric stenosis is made by watching the infant drink and

A

PALPATE for a RUQ mass, it will feel it will be round and firm the size of an olive and observe for gastric peristaltic waves passing from L to R across the abdomen as the infant drinks

SONOGRAM WILL DIAGNOSE HPS

140
Q

prior to laparoscopic correction in HPS what must be done

A

lytes must be balanced and dehydration and starvation must be reversed if tetany is present give Ca+

BEFORE GIVING K+ ALWAYS CHECK KIDNEY FX!!!

141
Q

high risk for what after surgery for HPS

A

infection because abdominal incision is near diaper area

142
Q

after HPS surgery which position do you place child in

A

side lying so that if they vomit there is no aspiration

143
Q

in an emergency which type of insulin is used

A

regular insulin or lispro IV in normal saline it is the quickest

144
Q

corticosteroids are given to a nephrotic syndrome patient and the parents are worried because a s/e is stunted growth what do you say?

A

this will not occur if prednisone (corticosteroid) is given every other day strictly teach them to mix it with applesauce and never stop it abruptly because it can cause renal insuff.

145
Q

igG antibodies against streptocci are found in a patient with Glomerulonephrotis (AGN) what is this indicative of?

A

the illness is a result of previous strep throat infection

146
Q

encephalopathy may occur in AGN if the BP reaches 100/60 what are s/s

A

HA, irritable, seizures, coma, lethargy, vomitting

147
Q

main interventions in AGN

A

i&o daily weights VS, emotional support, prophylactic PCN

148
Q

downs babies have how many chromosomes?

A

47—–normal is 46

149
Q

initially, downs is DX at birth by the physical appearance but it is confirmed with

A

karyotype (chromosome study) or an amniocentesis at 12-20 weeks gestation chronic villus sampling 8-13 wks, per cutaneous blood sampling @ 20 weeks

150
Q

mild cognitive challenge (mental retardation) is most common what are the IQ ranges

A

50-70 (74)

151
Q

mild mental retardation can be educated to what grade

A

6th

152
Q

moderate mental retardation can be educated to what grade

A

2nd grade with an IQ of 35-49

153
Q

severe mental retardation can be educated to what grade

A

basic hygiene and dressing skills IQ 20-34 CONSTANT SUPERVISION

154
Q

profound mental retardation can be educated to what grade

A

IQ BELOW 20 Provide a highly structured environment very limited self care constant help and supervision

155
Q

what are Brudzinskis signs and when do they occur

A

occurs with meningitis, occurs when child lays flat on back and flexes neck forward, with an unconscious flexion of hip knee ankle

156
Q

Kernigs signs

A

occurs in meningitis, as the nurse flexes the child’s hip and knee as leg is extended pain resistance and spasm are noted (kid can’t straighten leg)

157
Q

symptoms of meningitis in newborn

A

poor sucking high pitched cry lethargy

158
Q

meningitis is dx by

A

lumbar puncture

159
Q

what kind on isolation is a kid with meningitis placed on

A

respiratory till 24 hours after start of antibiotics

160
Q

with meningitis hearing acuity is reduced why?

A

pressure on cranial nerve 8

161
Q

first s/s of leukemia

A

pallor, low grade fever, lethargy, symptoms of anemia

162
Q

a child with leukemia is receiving chemo which can release a high Uric acid level and can hinder kidney fx, what drug can be also given to prevent this kidney failure and release Uric acid

A

allopurinol (prevents)

***think of GOUT and how it had high levels of Uric acid

163
Q

biggest risk in a leukemia pt receiving chemo?

A

infection teach parents to look for low grade fever and change in behavior. Also may be prescribed prophylactic anti bx

164
Q

during the maintenance phase of therapy for leukemia children are allowed what

A

normal activity and go to school

165
Q

SIDS occurs more freq in ..

A

adolescent moms preterm labor twins narcotic dependent moms

166
Q

most infants that die of SIDS don’t make a sound as they die this indicates

A

they die of laryngospasms

167
Q

a family had a baby that died of SIDS they now have another baby what is done

A

new baby is screened using a sleep study for the first 2 weeks of like then placed on continuous apnea monitoring

168
Q

TRUE OR FALSE

kids go to home school if they have Acute Glomerular Nephritis and are secluded from outside world

kids go to public school if they have nephrotic syndrome and are encouraged to be exposed to outside world

A

True

169
Q

TRUE OR FALSE

AGN kids are on a renal diet and are encouraged to eat low levels of protein

Nephrotic syndrome kids are encouraged to eat high levels of protein

A

TRUE AGAIN!

170
Q

it is possible for a girl to be a hemophiliac when?

A

when both her father has it and her mother has it or she is a carrier !

171
Q

when a hemophiliac rides a bike?

A

MAKE SURE THEY WEAR PROTECTIVE EQUIPMENT

172
Q

when and how is factor Vlll given

A

when there is bleeding into a joint structure IV is reconstituted and given IV thru port PUSH

173
Q

a 15 year old is diabetic and gives up on his daily insulin admin. what to do?

A

put him in a support group

174
Q

TET spells (cyanotic) occur when

A

decreased blood and o2 (hypoxia) flow to the brain, usually follows prolonged crying or exertion

175
Q

a child is placed in squatting position

A

to trap blood in the lower extremities

176
Q

when there is coarctation that is slight what may be the only sign

A

absence of palpable femoral pulses

177
Q

in coarctation of the aorta , the EKG, MRI, etc. will show

A

left sided heart enlargement due to back- pressure and also notching of the ribs from the enlarged collateral vessels

178
Q

after surgery to correct coarctation the kid may have abdomen pain or discomfort due to abdominal muscles getting more blood than prior to surg. tell them what?

A

this is normal and temporary

179
Q

how much factor Vlll is given when needed

A

1 bag per 5 kg body weight. may be repeated after 12 hrs

180
Q

Which baby is anemic? the ABO incompatible baby or the Rh sensitized child?

A

the Rh sensitized child so this is more serious, can cause baby heart failure

181
Q

when is phototherapy done for excess bilirubin

A

when bilirubin levels are 15mg/dl or more at 25-28 hours of age

Nursing 250-255 (6 decks)

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