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Complex Care > Week 9 TUES > Flashcards

Week 9 TUES Flashcards

Peds elimination

1
Q

How to diagnose a UTI

A

Get a urine culture

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2
Q

A child is taking an antibiotic for UTI and has a white coating covering her mouth. Is this concerning

A

Can be, it is not unusual for fungal infections to occur while taking antibiotics
- but they can spread and become a secondary infection

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3
Q

What is the plan of care for a child with the rotavirus

A
  • maintain IV Fluids
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4
Q

What is a way to help prevent preschoolers from getting a uti?

A

teach them to wipe front to back and never hold urine in

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5
Q

The nurse is providing care to a child with an intussusception. The child has a bowel movement and the nurse inspects the stool. The nurse is most likely to describe the stool as having what quality?
A. Greasy
B. Clay-colored
C. Currant jelly-like
D. Firm

A

C!
Currant jelly-like is a common s/s of intussusception

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6
Q

A child required significant bowel resection following a bowel perforation. After recovering from the post-op period, what will the nurse expect to be included in this patient’s long-term plan of care? Select all that apply.
A. Antibiotics
B. Immunosuppressants
C. Vitamin supplements
D. Total parenteral nutrition
E. Laxatives

A

A, C, D
pg. 1610

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7
Q

Obstructive Uropathy is a _____1_____disorder and the therapeutic management includes_____2_____.
Options for #1: Acute, Chronic, Structural, Acquired
Options for #2: Antibiotics, Surgical Repair, Dialysis, Intravenous Fluids

A
  1. Structural
  2. Surgical Repair
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8
Q

Which of the following features are considered part of the “triad” of Hemolytic Uremic Syndrome? Select all that Apply.
A. Hemolytic Anemia
B. Edema
C. Diarrhea
D. Thrombocytopenia
E. Urinary Tract Infection
F. Acute Renal Failure

A

A, D, F
- triad of HUC

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9
Q

the removal of waste products from the body through the skin, lung, kidneys, and intestines via the process of perspiration, expiration, urination, defication

A

elimination

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10
Q

what parts of the GI system are different from children to adults

A
  • mouth
  • esophagus
  • stomach
  • intestines
  • biliary system
  • fluid balance and losses
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11
Q

primary functions of the GI system

A
  • digestion, elimination, secretions
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12
Q

Nursing GI assessment

A
  • health hx
  • physical exam; inspect, auscultate, percussion, palpation
  • lab and diagnostic testing; occult blood, rbs, WBC, ect
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13
Q

Acute GI disorder in peds

A

intussusception

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14
Q

Chronic GI disorder in peds

A

short bowel syndrome

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15
Q

T or F the GI tract is from mouth to anus?

A

TRUE
- from ingestion to elimination

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16
Q

What GI disorder is; intussusceptiona proximal segment of the bowel “telescopes” into more distal segment resulting in obstruction

A

intussusception

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17
Q

T or F intussusception is the least common cause of intestinal obstruction is infants and young kids

A

FALSE; it is the MOST common cause!

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18
Q

most common cause of intussusception

A

often unknown in children

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19
Q

Possible complications of intussusception

A
  • edema, vascular compromise, and potentially partial or total bowel obstruction
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20
Q

Risk factors for intussusception

A
  • siblings w intussusception
  • intestinal malformations already diagnosed
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21
Q

Nursing assessment intussusception

A

Health hx;
- description of present illness
physical exam;
- palpate abdomen for the presence of a sausage-shaped mass in the upper midabdomen
lab/ diagnostic tests;
- air or barium enema

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22
Q

Common s/s of intussusception

A
  • sudden onset of intermittent, crampy, severe abdominal pain esp after eating
    - guarding, crying, putting legs up
  • vomiting, diarrhea
  • currant jelly stools; gross blood, hemoccult pos stools
  • lethargy
  • s/s will typically flare and regress
23
Q

Nursing management of intussusception

A
  • IV fluids and antibiotics
  • lab tests; WBC, electrolytes
  • post op care of child
  • emotional support and education for the family
24
Q

Therapeutic management for intussusception

A
  • barium enema is successful at reducing a large percentage of intussusception cases
  • if unsuccessful> reduced surgically
  • if bowel necrosis occurs> bowel resection
25
Q

Syndrome of nutrient malabsorption and excessive intestinal fluid and electrolyte losses

A

Short Bowel syndrome

26
Q

Risk factors for Short Bowel syndrome

A
  • massive small intestinal loss or surgical resection
27
Q

Possible complications of Short Bowel syndrome include

A
  • bacterial overgrowth
  • vitamin deficiency
  • poor intestinal motility
28
Q

Therapeutic management of Short Bowel syndrome

A
  • antibiotics; treat bacterial overgrowth
  • antidiarrheals
  • vit and mineral supplements
  • TPN/Lipids
  • slow to oral foods
29
Q

Nursing assessment of Short Bowel syndrome

A

health hx;
- note past history of bowel disease or resection
physical exam;
- diarrhea is primary symptom, hydration status, inspect stool, wt loss
lab/diagnostic tests;
- electrolyte to evaluate hydration status, liver function tests

30
Q

Nursing management of Short Bowel syndrome

A
  • encouraging adequate nutrition; strict I&O, assess stool, consult / dietitian, monitor s/s of infection
  • promoting effective family coping
31
Q

Common s/s of Short Bowel syndrome

A
  • diarrhea> #1
  • wt loss
  • dehydration
  • nutritional deficiency
32
Q

GU differences in children vs adults

A
  • structural differences; kidneys are large and less protected from injury and urethra is shorter in children
  • urinary concentration is higher in children
  • urine output is more frequent in children> less bladder capacity
  • reproductive organs are not mature in children
33
Q

Alterations in urinary elimination occur as a result of

A
  • infectious processes
  • trauma
  • neurologic deficit
  • genetic influence
34
Q

GU assessment

A
  • health hx> hydration status, # of wet/poopy diapers
  • physical exam; inspection, auscultation, percussion, palpate> kidneys impact cardiac system and can cause murmurs
  • labs and diagnostic test> BUN, creat, flank pain
35
Q

Most common bacterial infection

A

Urinary tract infection

36
Q

How to prevent UTI’s in children

A
  • girls wipe front to back
  • cotton underwear
  • ease constipation
  • avoid bubble baths> high risk kids
  • encourage hydration
37
Q

Structural GU disorder in peds

A

Obstructive uropathy

38
Q

Acquired GU disorder in peds

A

hemolytic-uremic syndrome

39
Q

Obstruction at any level along the upper or lower urinary tract

A

obstructive uropathy

40
Q

possible complications of obstructive uropathy

A

recurrent UTI’s, renal insufficiency, progressive damage to the kidney

41
Q

Nursing assessment for obstructive uropathy

A

Health hx;
- description of present illness and chief complaint
physical exam;
- palpate the abdomen for the presence of an abdominal mass(hydronephrotic kidney) and assess BP
lab/ diagnostics;
- prenatal ultrasound

42
Q

Risk factors for obstructive uropathy

A
  • chromosomal abnormalities
  • anorectal malformations
  • ear defect
43
Q

Common s/s of obstructive uropathy

A
  • frequent UTI’s
  • change in urinary pattern
  • fever
  • flank or abdominal pain
  • hematuria
  • urinary frequency and urgency
  • dysuria
44
Q

Therapeutic management of obstructive uropathy

A

Surgical correction;
- specific to the type of obstruction
consists of removing the obstruction and reimplantation of the ureters
- occasionally results in a urinary diversion

45
Q

Nursing management of obstructive uropathy

A

post op care;
- monitor I &O, assess urine for color, clarity, clots, pain management, encourage fluids once child can tolerate them
Family education;
- child may be d/c’d w/ vesicostomy or drainage tubes> pus/ blood know what is normal/abnormal

46
Q

What GU disorder is characterized by hemolytic anemia, thrombocytopenia, and acute renal failure and is typically the result of a diarrheal illness

A

hemolytic uremic syndrome

47
Q

T or F features of HUS are primarily caused by microthrombi and ischemic changes w/in the organs

A

TRUE!!
- small obstruction> acclusion> kideny can’t function properly> renal failure

48
Q

Possible complications of HUS

A
  • chronic renal failure
  • seizures and coma
  • rectal prolapse
  • cardiomyopathy
    -CHF
  • acute resp distress syndrome
49
Q

Nursing assessment for HUS

A

Health hx;
- decreption of present illness and cheif complaint
physical exam;
- pallor, toxic appearance, edema, oliguria
- elevated BP
- tenderness in the abdomen
- neuro involvement> irritability, seizures, alter LOC
Lab and diagnostics;
- urinalysis> blood, protein, pus
- serum labs> elevated BUN, Cr, anemia and thrombocytopenia, hyponatremia, hyperkalemia, hyperphosphatemia, leukocytosis, increased bili

50
Q

Risk factors of HUS

A
  • ingestion of ground beef
  • visits to water parks or petting zoos
  • not washing hand properly
51
Q

Common s/s of HUS

A
  • watery diarrhea
  • cramping
  • vomiting
52
Q

Therapeutic management of HUS

A
  • no known treatment can stop the progress of the syndrome once it has started
  • ease s/s and prevent complications
  • maintain fluid balance
  • correct hypertension, acidosis, and electrolyte abnormalities
  • replenish circulating rbcs> transfusion
  • provide dialysis if needed
53
Q

Nursing Management of HUS

A
  • close observation and monitoring the child’s status> often ICU
  • institute and maintain contact precautions to prevent spread of e. coli
    fluid volume status;
  • strict I&O, IV infusions and diuretics as ordered, assess BP> hypertensive as prescribed, monitor for bleeding> possible blood transfusions
    preventing (future) hemolytic- uremic syndrome
  • proper handwashing!! thoroughly cook all meets, wash fruits/ veggies, drink properly treated water

Complex Care (26 decks)

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