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Test 4-2381.Snell
Nursing care of child with disorder-endocrine, integument, musculoskeletal
| Question | Answer |
|---|---|
| what tests are used to diagnose Lymes disease? | Elisa and western blot-same tests as for HIV |
| What kind of insulin is not recommended for children under 6? | peakless, but dr.'s still do |
| What is the most accurate site for BG testing: | finger tip-always use when symptoms |
| What is the best alternative site to check the BG? | the palm |
| CGMS=Continuous glocuse monitoring system: | it doesn't record blood glucose, the sensor goes into interstitial space |
| what insolin should be given with food? | humalog-take bolus when eating carbs |
| What insulin shoul be given in multiple injections daily? | Lantus |
| devices for insulin admin: | pens and pumps |
| most common combo for insulin admin: | Lantus/Humalog |
| what kind of insulin is in the pump? | rapid acting |
| General insulin/carb guidline for a preschooler: | 0.5 unit rapid insulin/15 grams |
| General insulin/carb guidline for a schoolager: | 1 unit/15 grams |
| General insulin/carb guidline for an adolescent: | 2 unit/15 grams |
| Fun way to learn how to carb count: | flashcards |
| what happens with blood sugar when a person excercises? | it goes down |
| what should a person with type 1 diabetes do before excercising? | eat a snack |
| high activity + low caloric intake = | hypoglycemia |
| every period of 30-60 min moderate intensity workout should be prepared for with ___carbs | 15 grams of carbs |
| what can be used in case of hypoglycemia? | orange juice, glucose tablets, frosting tubes, glucogon injection |
| decreased excersize + same food intake = | hyperglycemia |
| Can a person with diabetes 1 test for keytones in their urine at home? | yes |
| If a person has keytones in their urine what should they do: | call the doctor, go in |
| When sick, what should you do if you suffer from diabetes 1? | check for ketones, check BG frequently for hyperglycemia |
| How are records kept for diabetes? | BG needs to be recorded along with insulin given + food eaten. Pumps provide a printout. |
| How can we help someone adjust to type 1 DM? | provide written materials, demonstrate BG and insulin |
| School agers are able to participate in their DM1 management how? | able to do FSBG, give injections, keep records, understand Sx and what they mean, nutrition.... |
| What do school age kids who are managing their DM1 need from their parents? | parental involvement and supervision |
| What is the most difficult age for coping with chronic illnes? | adolescent |
| What complications does being an adolescent have in DM1? | eating disorders, just wants to be "normal", alcohol effects, rebellion |
| What is the pavlik harness used for? | DDH, developmental dysplasia of the hip |
| How often would a person need to go in to have their childs Pavlik straps adjusted? | q 2 wks |
| Family must follow MD order regarding removal or non removal of the ____harness for bathing. If parents can remove they must show how to ____harness | Pavlik, apply |
| How do we prevent skin breakdown under pavlik harness? | massage under straps, no lotion or powder, long socks, undershirt under chest strap, diaper goes under straps. |
| What do you need to encourage parents to do when their child is in a pavlik harness? | still hold the child |
| when toileting a child with DDH, be sure to keep their cast _____ | clean |
| handle a cast with your ____ until dry | palms |
| What should we assess and teach parents to assess in a child with a cast? | pain, pallor, pulselessness, paresthesia, paralysis |
| be sure to feed infants with a cast in the ____position | upright |
| Elavate the legs of a child with DDH and a cast for how long? | 1st day |
| What can happen in the development of a child in a cast? | slows |
| When a child with a cast is sitting, where should their feet be? | on a foot rest-no dangling |
| what factors affect onset of diabetes type 1? | hereditary and viral factors |
| JA= | juvinile arthritis |
| Possible nursing diagnosis for a child with juvinile arthritis: | pain, impaired mobility |
| Pharmacologic management of JA: | NSAIDS or other meds as ordered |
| non pharmacologic management of JA: | heat, pool therapy, rest periods throught the day, ROM |
| Nutrition of a child with juvinile arthritis: | well balanced diet based on energy expenditure, encourage activity as tolerated |
| When should pain meds be given to a child with JA? | when in pain or prior to activity |
| It is important to do ROM for a JA sufferer even when they are having a ____ __ | flare up |
| Symptoms of hypoglycemia: | ■Confusion, abnormal behavior or both, such as the inability to complete routine tasks ■Visual disturbances, such as double vision and blurred vision ■Seizures, though uncommon ■Loss of consciousness, though uncommon |
| S/S hyperglycemia | •Polyphagia (frequently hungry)•Polyuria (frequently urinating)•Polydipsia (frequently thirsty)•Blurred vision•Fatigue•Weight loss•Poor wound healing (cuts, scrapes, etc.)•Dry mouth•Dry or itchy skin•Impotence (male) |
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