Test Review: Part 2 Flashcards
Wilms Tumor
-Renal symptoms
- Hematuria
- HTN
- Anemia
Wilms Tumor
- Wilms’ tumor is a rare kidney cancer than primarily affects children
- Usually manifests as an abdominal mass with abdominal pain and may include renal symptoms, such as hematuria, HTN, and anemia
Wilms Tumor
-Most affected age?
- Most often affects children ages 3 to 4 and becomes much less common after age 5
Wilms Tumor
-Disease Development & Alternative Name?
- Also known as nephroblastoma
2. Can affect both kidneys -usually only develops in one
Wilms Tumor
-Patho
- Tumor begins to grow as a fetus develops in the womb, with some cells that are destined to form into the kidneys malfunctioning and forming a tumor
Wilms Tumor
-Contraindication
- DO NOT PALPATE THE ABDOMEN
- Excessive manipulation of the tumor area can cause seeding of the tumor and spread of the malignant cells
Chemotherapy
-Side Effects
- Chemotherapy agents cause bone marrow suppression
- Institute precautions R/T reduced WBC’s, RBC’s, and Platelets - These precautions focus on preventing infection and bleeding
Meningitis
- Inflammation of the meninges of the brain
- Pathogens enter CNS and causes Toxic response
- Increased ICP
- Most common infectious process affecting the CNS
Meningitis
-Kernig Sign
- Pain with leg extension
Meningitis
-Brudzinski Sign
- Involuntary hip and knee flexion when head is bent
Meningitis
-Dx
- Lumbar puncture - CSF fluid
- cloudy with bacterial meningitis TEST
- high protein concentration in fluid
- blood culture
Meningitis
-Treatment
- Private Room
- Droplet precautions
- IV antibiotics uninterrupted
- Start broad spectrum before organism is identified (culture may take 3 days)
Cardiac Catheter
-Post Cardiac Cath Assessment?
- Bleeding
- Infection
- Thrombosis
Cardiac Catheter
-Nursing Interventions
- Lower head of bed
- Limit activity for 24 hours
- Encourage fluids
Cardiac Catheter
-NURSING PRIORITY IF DRESSING IS SATURATED W/ BLOOD TEST
- 1st action if the dressing is saturated with blood is to apply direct pressure 1 inch above site
Digoxin Administration
-When to Withhold Medication
- Withhold med if:
- Infant pulse <70/min
Digoxin Administration
-Signs of Toxicity
- Anorexia & lack of appetite
- Bradycardia
- Dysrhythmia
- N/V
Patent Ductus Arteriosus (PDA)
-Definition
- Persistent opening between two major blood vessels leading from the heart
Patent Ductus Arteriosus (PDA)
-Normal Purpose
- Necessary part of baby’s circulatory system before birth
- Usually closes shortly after the baby is born
- In some individuals it remains open (PATENT) and when this occurs it is called patent ductus arteriosus
Patent Ductus Arteriosus (PDA)
-Treatment
- Monitoring
- Medications
- Closure by cardiac catheterization
- Surgery
Ventricular Septal Defect (VSD)
-Definition
- VSD is a hole in the wall separating the two lower chambers of the heart
Ventricular Septal Defect (VSD)
-Normal Development
- In normal development, the wall between the chambers closes before the fetus is born
- This allows oxygen-rich blood to be kept from mixing with oxygen-poor blood
Ventricular Septal Defect (VSD)
-What happens when the Hole Doesn’t Close?
- When the hole doesn’t close, it may cause higher pressure in the heart or reduced oxygen to the body
- LOUD HARSH MURMUR
- Palpable thrill
Ventricular Septal Defect (VSD)
-S/S with Small Opening
- No symptoms because the heart and lungs don’t have to work harder
- The nurse may hear a LOUD HARSH MURMUR due to left to right shunt of blood that cause the heart muscle to hypertrophy
Ventricular Septal Defect (VSD)
-S/S of Large Opening
- Child may breathe faster and harder than normal
- Infants may have trouble feeding and growing at normal rate
- S/S may not occur until several weeks after birth
- High pressure may occur in blood vessels in the lungs because more blood than normal is being pumped there
- Over time this may cause PERMANENT damage to the lung blood vessels
Ventricular Septal Defect (VSD)
-Treatment & Management
- Some close spontaneously
- Diuretics
- Digoxin
- Occluder device
- Surgical Patch
Lyme Disease
-Prevention
- Primary prevention of Lyme disease includes:
- Anticipatory guidance and information about routine preventative measures to avoid insect bites - Tick must be attached for 24 hrs to transmit disease
- Use insect repellent (DEET)
- Inspect skin and hair after hikes
Allergic Rhinitis
-Treatment
- The treatment of choice is to ELIMINATE THE ALLERGEN from the child’s environment
- If this is not possible, medication can be used
- Antihistamines or intranasal corticosteroids
- Decongestants
Foreign Body Aspiration
-At Risk Age Group?
- Foreign body aspiration is seen most frequently in children ages 6 months to 5 years
Foreign Body Aspiration
-Stats
- Latex balloons account for a significant number of deaths from aspiration
- Occurs most frequently in children younger than 2 years of age
Foreign Body Aspiration
-Pathophysiology
- Most foreign bodies become lodged in the bronchi (Right side)
Foreign Body Aspiration
-Immediate S/S
- Sudden, violent coughing
- Gagging
- Wheezing
- Vomiting
- Brief episodes of apnea, and possible cyanosis
Mucositis
- Oral Inflammation caused by medications, esp those used to treat cancers or autoimmune disease
Mucositis Nursing Interventions
- Avoid excessive force w/ brushing
- Assist w/ saline mouth washes and rinses
- avoid alcohol mouthwashes - inspect child’s mouth regularly for ulcers
- At first sign of ulceration, an antifungal drug is initiated
- Oral hygiene 4 times a day
