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Language Development one word sentences by 1 two words sentences by 2 three or more words by 3
if not seeing normal language development, what to do? get a hearing screen
Toddler self esteem ego centric, unaware of difference in self and others
early preschool to school age self esteem -aware of difference between themselves and others -acceptance by adults and peers more important
early adol. and adol. self esteem -physical changes/peers -defining an identity and sense of self -vulnerable time -need positive feedback
social-affective play nuzzle, touch
sense-pleasure play objects in environment
skill play as acquire new skills
unoccupied behavior day dream, walk aimlessly
dramatic or pretend play dominate in preschool children
games solitary and interactive
do government agencies inspect toys? No, only recall after injury occurs
biggest concerning with toys? swallowing
therapeutic value of play releases stress and tension
three classifications of temperament easy, difficult, slow-to-warm-up
children need what in order to develop self-concept? recognition of achievements
when is it appropriate to ask children for history? 2, 3, 4 - where does it hurt?
thought process/communication of infants nonverbal
thought process/communication of early childhood ego-centric
thought process/communication of school years want explantations
thought process/communication of adolescence confidentiatlity
verbal communication techniques I messages, third-person, facilitative responding, storytelling, mutual storytelling, bibliotherapy, dreams, what if ?s, 3 wishes, rating, sent completion, pros & cons, word association
"I" messages -relate feeling about a behavior in term of "I" -describe effect behavior had on the person -avoid use of "you"-judgemental and provoke defensiveness -ex: I am concerned about how the treatments are going because I want to see you get better
3rd person technique -express feeling in terms of a 3rd person -gives child opportunity to agree or disagree -ex: sometimes when a person is sick a lot, he feels angry & sad bc he cant do what others can. -wait silently for a response or ask do you ever feel that way?
facilitative responding -careful listenin & reflectin back to patient feelings & content of statement -response empathic & nonjudgemental -legitimize person's feelings -u feel __ bc ___ ex: child: I hate hospitals & getting needles, u feel unhappy bc of all the things done t
Storytelling -use language of child to probe in2 areas of thinking, bypassing fears -ask child to relate story about event -ask child to describe pic of event (child in hospital) -have child add statements for scenes
mutual story telling -begin by asking child 2 tell story, follow by another story told by nurse thats similar but w/differences 2 help child Ex: child's story about going 2 hospital & never seeing parents again. Nurse's story about child in hospital seeing parent every day
bibliotherapy -use books -assess childs emotions & cognition in of readiness to understand books message -read book to child if unable to read -be familiar w/books content and the age for which it is written
dreams -ask child about dream -reveal unconscious thoughts & feelings -explore meaning of dream
"what if" questions -encourage child to explore potential situations and consider different problem-solving options Ex: what if u got sick & had to go to hosp.? child's response reveal what they know, what they're curious about and provide opportunity to help w/coping skill
rating game -use type if rating scale to rate an event -numbers, faces
word association game -state key word and have child say 1st word they think of -start with neutral words and the introduce more anxiety-producing words Ex: illness, needles, hospital, operation
pros and cons select topic and have child say 5 good and bad things about it
Nonverbal communication techniques writing, drawing, magic, play
writing -older children and adults -journal -write feelings or thoughts that are difficult to express -keep account of child's progress from both physical and emotional viewpoint
drawing -non-verbal (drawing) and verbal (have child describe picture) -spontaneous drawing (given paper and supplies) -direct drawing (draw a person)
guidelines for evaluating drawing -use spontaneous drawings & evaluate more than one when can -interpret as whole instead on specific details -large hands: aggression -tiny, unstable feet: insecurity -hidden hands: guilt -use of whole paper & continuous strokes: security
magic -no verbal response from child needed -help establish relationship w/child, encourage compliance, effective distraction during painful procedures
play -universal language -"work" of children -child projects inner self through activity -spontaneous or directed
health history indentifying info chief complaint present illness past hx (birth, diet, previous illness/surgery/injury, allergies, meds/immunizations, growth/development) review of systems family medical hx (structure/composition) pyschosocial hx sexual hx nutri
what VS do you do first 1) resp 2) HR 3) bp is applicable Last: temp -dont do head to toe until child is not fearful (preschool age)
pediatric physical exam same head-to-toe sequence for assessing adults
how should all babies be weighed? naked
laying down length, weight, and head circumference until what age? 36 months
standing height and weight after what age? 37 months
what is considered outside expected parameters for height, weight, and head circumference? <5th, 85th-95th (risk for overweight), >95th (overweight) percentile
infancy weight gain 1/2 - 1 oz/day double by 6 months triple by 1 year
infancy height gain 1 in/month first 6 months slows second 6 months double height at 2 yr to know adult height
where to measure temp? birth - 2 yrs 2-5 yrs >5 yrs -birth-2 yrs: axillary, *rectal -2-5 yrs: axillary, typanic, oral, *rectal ->5 yrs: oral, axillary, tympanic *: if definitive reading is needed
what to worry about if anterior fontanel closes first? how brain is going to grow
head and neck assessment -general shape and symmetry -flattening: if not rotate in crib/place on stomach when you can watch them -craniosynostosis: mal-shapened head/can be given helmet -fontanels -head control: head lag (>6 months: cerebral injury)/range of motion
Anterior fontanel closes
formula for average systolic bp -1-7 years: age in yrs + 90 -8-18 years: (2 x age in years) + 83
formula for average diastolic bp 1-5 years: 56 6-18 years: age in years + 52
low set ears: ? down sydrome
bowl legged in toddlers? normal, unless extreme (Ricketts)
knot kneed in adolescents? normal
if visual fixation and following is not present at what age is follow up evaluation needed? 3-4 months
when should whole milk be introduce to infants? after 1 yr
when is fluoride supplementation recommended? after 6 months
rear-facing position until? 20 lbs or 1 year If child is 20 lbs, but not 1 year still face rear
when is distraction not appropriate? when task and pain isn't brief
optimum dose for children -controls pain without causing severe side effects -calculated according to body weight (up to 50 kg)
administration of _____ has demonstrated pain relief in infants sucrose
used for mild-moderate pain? sever pain? Nonopiods (NSAIDS) Opiods
when should head lag go away? 4 months
grasp 2-3 months
crude pincer 8-9 months
neat pincer 11 months
transfer 7 months
tries to build tower of blocks 1 year
rolling over 5-6 months
sitting 7 months
pulling to stand 8-10 months
crawling 6-7 months
creeping 9 months
walk with assistance 11 months
walk alone 12 months
separation anxiety 4-8 months
knows when mom leaves 8-12 months
stranger anxiety 6-8 months
assumes flex position with pelvis high but knees not under abdomen when prone 1 month
can turn head side to side when prone; lifts head momentarily from bed 1 month
assumes less flexed position when prone- hips flat, legs extended, arms flexed, head to side 2 months
vocalizes distinct from crying 2 months
demonstrates social smile in response to various stimuli 2 months
actively holds rattle but will not reach for it 3 months
follows object to periphery 3 months
locates sound by turning head to side and looking in same direction 3 months
squeals aloud to show pleasure 3 months
moro, tonic, and rooting reflexes have disappeared 4 months
almost no head lag 4 months
balances head well in sitting position 4 months
rolls from back to side 4 months
inspects and plays with hands; pulls clothing or blanket over face in play 4 months
laughs aloud 4 months
able to grasp objects voluntarily 5 months
teething may begin with 2 lower central incisors 6 months
chewing and biting occur 6 months
begins to imitate sounds and babble 6 months
briefly searches for a dropped object 6 months
sitting, leaning forward on hands 7 months
transfer object from one hand to another 7 months
can fixate on very small objects 7 months
produces vowel sounds and chained syllabes-baba, dada, kaka 7 months
sits steadily unsupported 8 months
fear of strangers 8 months
pulls self to standing position; holds on to furniture 9 months
uses thumb and pointer in crude pincer grasp 9 months
develops object permanence 10 months
walks holding onto furniture or both hands held 11 months
birth weight tripled 12 months
birth length increased by 50% 12 months
walks with one hand held 12 months
mat attempt to stand alone or first step alone 12 months
says 3-5 words besides mama and dada 12 months
searches for object even if it has not been hidden; searches where last seen 12 months
when should wear shoes? when beginning to walk; soft soles
apnea in infancy unexplained resp pause >20 sec
toddler weight gain 4-6 lb/year weight should be quadrupled by 2 1/2 yr
toddler head v chest circumference chest exceeds head
favorite sense of a toddler taste
sphincter control 18-24 months
tiptoe, stand on one foot, jump, alternating stairs 2 1/2 years
throw ball overhand 18 months
physiologic anorexia -toddler -too busy to eat -dont battle about eating; kid will not starve self -dont leave food out for kid to eat
when to see dentist 2 1/2 years
preschooler weight gain 5 lbs/year
preschooler height gain 2.5-3 inches/year
tricycle/jump rope 3-5 years
stuttering normal 2-5 years
weight between 6-12 years weight will almost double
height 6-12 years 2 in/yr
puberty begins at ___ years in girls 10
puberty begins at ___ years in boys 12
where do we see childhood obesity school years
first permanent teeth erupt 6 years
time for formal sex ed middle childhood
when can sit in front seat 12-13 years old
most common cause of severe injury in school age MVA
what can you use to control height if initiated before menarche? estrogen
maybe first manifestation of serious disorder short stature
enuresis more common in males or females males
What best describes why children have fewer respiratory tract infections as they grow older? Repeated exposure to organisms causes increased immunity.
Cool-mist vaporizers rather than steam vaporizers are recommended in home treatment of respiratory tract infections because: they are safer
Decongestant nose drops are recommended for a 10-month-old infant with an upper respiratory tract infection. Instructions for nose drops should include: avoid use >3 days
When caring for an infant with an upper respiratory tract infection and elevated temperature, an appropriate nursing intervention is to: Give small amounts of favorite fluids frequently to prevent dehydration.
The parent of an infant with nasopharyngitis should be instructed to notify the health professional if the infant: Shows signs of an earache.
It is generally recommended that a child with acute streptococcal pharyngitis can return to school: after taking antibiotics for 24 hours
A child is diagnosed with influenza, probably type A disease. Management includes: Amantadine hydrochloride to reduce symptoms.
Chronic otitis media with effusion (OME) is differentiated from acute otitis media (AOM) because it is usually characterized by: a feeling of fullness of the ear
Which statement is characteristic of acute otitis media (AOM)? treated with broad range antibiotics
An infant's parents ask the nurse about preventing otitis media (OM). What should the nurse recommend? avoid tobacco smoke
Which type of croup is always considered a medical emergency? epiglotitis
The nurse encourages the mother of a toddler with acute laryngotracheobronchitis to stay at the bedside as much as possible. The nurse's rationale for this action is primarily that: The mother's presence will reduce anxiety and ease child's respiratory efforts.
A school-age child has had an upper respiratory tract infection for several days and then began having a persistent dry, hacking cough that was worse at night. The cough has become productive in the past 24 hours. This is most suggestive of: bronchitis
Skin testing for tuberculosis (the Mantoux test) is recommended: Periodically for children who reside in high-prevalence regions.
The mother of a toddler yells to the nurse, ""Help! He is choking to death on his food."" The nurse determines that lifesaving measures are necessary based on: inability to speak
The nurse is caring for a child with acute respiratory distress syndrome (ARDS) associated with sepsis. Nursing actions should include: monitor pulse ox
The nurse is caring for a child with carbon monoxide (CO) poisoning associated with smoke inhalation. What is essential in this child's care? monitor arterial blood gases
Asthma in infants is usually triggered by: a viral infection
A child has a chronic, nonproductive cough and diffuse wheezing during the expiratory phase of respiration. This suggests: asthma
It is now recommended that children with asthma who are taking long-term inhaled steroids should be assessed frequently because they may develop: slowed growth
β-Adrenergic agonists and methylxanthines are often prescribed for a child with an asthma attack. What is their action? bronchodilators
A parent whose two school-age children have asthma asks the nurse in what sports, if any, they can participate. The nurse should recommend: swimming
Which statement expresses accurately the genetic implications of cystic fibrosis (CF)? if it is present in child, both parents are carriers of the defective gene
The earliest recognizable clinical manifestation(s) of cystic fibrosis (CF) is: meconium ileus
Cystic fibrosis (CF) is suspected in a toddler. Which test is essential in establishing this diagnosis? sweat chloride test
A child with cystic fibrosis is receiving recombinant human deoxyribonuclease (rhDNase). This drug: may cause voice alterations
Pancreatic enzymes are administered to the child with cystic fibrosis. Nursing considerations should include: Pancreatic enzymes can be swallowed whole or sprinkled on a small amount of food taken at the beginning of a meal.
In providing nourishment for a child with cystic fibrosis (CF), which factor should the nurse keep in mind? diet should be high in carbs and protein
Cardiopulmonary resuscitation is begun on a toddler. Which pulse is usually palpated because it is the most central and accessible? carotid
Which drug is considered the most useful in treating cardiac arrest? epi hydrochloride
The Heimlich maneuver is recommended for airway obstruction in children older than: 1 year
An appropriate nursing intervention when caring for a child with pneumonia is to: encourage rest
An appropriate nursing intervention when caring for a child with pneumonia is to: Cluster care to conserve energy. AND Administration of antibiotics.
The nurse is caring for a 10-month-old infant with respiratory syncytial virus (RSV) bronchiolitis. Which interventions should be included in the child's care? Choose all that apply. Encourage infant to drink 8 ounces of formula every 4 hours. AND Cluster care to encourage adequate rest.AND Place on noninvasive oxygen monitoring.
The nurse is caring for a 5-year-old child who is scheduled for a tonsillectomy in 2 hours. Which actions should the nurse include in the child's postoperative care plan? (Choose all that apply.) Notify the surgeon if the child swallows frequently. AND Place the child on the abdomen until fully awake. AND Allow the child to have diluted juice after the procedure.
A chest x-ray film is ordered for a child with suspected cardiac problems. The child's parent asks the nurse, ""What will the radiograph show about the heart?"" The nurse's response should be based on knowledge that the x-ray film will: Provide a permanent record of heart size and configuration.
A complication that may occur after a cardiac catheterization is: cardiac arrythmia
Jose is a 4-year-old child scheduled for a cardiac catheterization. Preoperative teaching should be: adapted to level of development so he can understand
The nurse is caring for a school-age girl who has had a cardiac catheterization. The child tells the nurse that her bandage is ""too wet."" The nurse finds the bandage and bed soaked with blood. The most appropriate initial nursing action is to: apply direct pressure above cath site
Which defect results in increased pulmonary blood flow? atrial septal defect
Which structural defects constitute tetralogy of Fallot? Pulmonic stenosis, ventricular septal defect, overriding aorta, right ventricular hypertrophy
What is best described as the inability of the heart to pump an adequate amount of blood to the systemic circulation at normal filling pressures? CHF
A clinical manifestation of the systemic venous congestion that can occur with congestive heart failure is: peripheral edema
A beneficial effect of administering digoxin (Lanoxin) is that it: dec edema
Which drug is an angiotensin-converting enzyme (ACE) inhibitor? captopril (captoten)
A common sign of digoxin toxicity is: vomitting
The parents of a young child with congestive heart failure tell the nurse that they are ""nervous"" about giving digoxin. The nurse's response should be based on knowing that: Parents must learn specific, important guidelines for administration of digoxin.
As part of the tx for CHF, the child takes the diuretic furosemide. As part of teaching home care, the nurse encourages the family to give the child bananas, oranges, and leafy vegetables. These foods are recommended because they are high in: potassium
An 8-month-old infant has a hypercyanotic spell while blood is being drawn. The nurse's first action should be to: place child in knee to chest position
The nurse is caring for a child with persistent hypoxia secondary to a cardiac defect. The nurse recognizes that a risk of cerebrovascular accidents (strokes) exists. An important objective to decrease this risk is to: prevent dehydration
Parents of a 3-year-old child with congenital heart disease are afraid to let their child play with other children because of possible overexertion. The nurse's reply should be based on knowing that: child needs opportunities to play with peers
When preparing a school-age child and the family for heart surgery, the nurse should consider: Letting child hear the sounds of an electrocardiograph monitor.
Seventy-two hours after cardiac surgery, a young child has a temperature of 37.7 C (101 F). The nurse should: report findings to physician
An important nursing consideration when suctioning a young child who has had heart surgery is to: give supplemental oxygen before and after suctioning
The nurse is caring for a child after heart surgery. What should he or she do if evidence is found of cardiac tamponade? report this to physician
An important nursing consideration when chest tubes will be removed from a child is to: administer analgesics before procedure
The most common causative agent of bacterial endocarditis is: Streptococcus viridans.
What painful, tender, pea-sized nodules may appear on the pads of the fingers or toes in bacterial endocarditis? osler nodes
The primary nursing intervention to prevent bacterial endocarditis is to: Counsel parents of high-risk children about prophylactic antibiotics.
A common, serious complication of rheumatic fever is: cardiac valve damage
A major clinical manifestation of rheumatic fever is: polyarthritis
When discussing hyperlipidemia with a group of adolescents, the nurse should explain that high levels of what substance are thought to protect against cardiovascular disease? HDLs
The leading cause of death after heart transplantation is: rejection
When caring for the child with Kawasaki disease, the nurse should know that: Therapeutic management includes administration of gamma globulin and aspirin.
One of the most frequent causes of hypovolemic shock in children is: blood loss
What type of shock is characterized by a hypersensitivity reaction causing massive vasodilation and capillary leaks, which may occur with drug or latex allergy? anaphylactic shock
What occurs in septic shock? increased cardiac output
A child is brought to the emergency department experiencing an anaphylactic reaction to a bee sting. While an airway is being established, what medication should the nurse prepare for immediate administration? epi
Nursing interventions for the child after a cardiac catheterization include (choose all that apply) Assess the affected extremity for temperature and color. AND Maintain a patent peripheral intravenous catheter until discharge.
Which clinical manifestations would the nurse expect to see as shock progresses in a child and becomes decompensated shock? Choose all that apply. Cool extremities and decreased skin turgor AND Confusion and somnolence AND Tachypnea and poor capillary refill time
An accurate description of anemia is: decrease oxygen-carrying capacity of the blood
Several blood tests are ordered for a preschool child with severe anemia. She is crying and upset because she remembers the venipuncture done at the clinic 2 days ago. The nurse should explain that: Topical application of local anesthetic can eliminate venipuncture pain.
The most appropriate nursing diagnosis for a child with anemia is: Activity Intolerance related to generalized weakness.
What explains why iron deficiency anemia is common during toddlerhood? milk is a poor source of iron
When teaching the mother of a 9-month-old infant about administering liquid iron preparations, the nurse should include that: Adequate dosage will turn the stools a tarry green color.
Iron dextran is ordered for a young child with severe iron deficiency anemia. Nursing considerations include: inject deeply into large muscle
The nurse is recommending how to prevent iron deficiency anemia in a healthy, term, breastfed infant. What should he or she suggest? Iron-fortified infant cereal can be used at approximately 6 months of age.
A condition in which the normal adult hemoglobin is partly or completely replaced by abnormal hemoglobin is: sickle cell anemia
What describes the pathologic changes of sickle cell anemia? inc red blood cell destruction
Which clinical manifestation should the nurse expect when a child with sickle cell anemia experiences an acute vasoocclusive crisis? painful swelling of hands and feet, painful joints
A school-age child is admitted in vasoocclusive sickle cell crisis. The child's care should include: adequate hydration and pain management
The parents of a child hospitalized with sickle cell anemia tell the nurse that they are concerned about narcotic analgesics causing addiction. The nurse should explain that narcotic analgesics: rarely caused addiction bc they are medically indicated
Which statement best describes β-thalassemia major (Cooley's anemia)? Increased incidence occurs in families of Mediterranean extraction.
Chelation therapy is begun on a child with β-thalassemia major. The purpose of this therapy is to: eliminate excess iron
In which condition are all the formed elements of the blood simultaneously depressed? aplastic anemia
A possible cause of acquired aplastic anemia in children is: drugs
What is descriptive of most cases of hemophilia? X-linked recessive inherited disorder in which a blood-clotting factor is deficient
An acquired hemorrhagic disorder that is characterized by excessive destruction of platelets Idiopathic thrombocytopenic purpura.
What is most descriptive of the pathophysiology of leukemia? unrestricted proliferation of immature white blood cells
A boy with leukemia screams whenever he needs to be turned or moved. The most probable cause of this pain is: bone involvement
Myelosuppression associated with chemotherapeutic agents or some malignancies such as leukemia can cause bleeding tendencies because of a/an: dec in blood platelets
A child with leukemia is receiving triple intrathecal chemotherapy consisting of methotrexate, cytarabine, and hydrocortisone. The purpose of this is to prevent: CNS disease
A young boy will receive a bone marrow transplant (BMT). This is possible because one of his older siblings is a histocompatible donor. This type of BMT is termed: allogenic
What is often administered to prevent or control hemorrhage in a child with cancer? platelets
A school-age child with leukemia experienced severe nausea and vomiting when receiving chemotherapy for the first time. The most appropriate nursing action to prevent or minimize these reactions with subsequent treatments is to: administer antienemic before chemo
The nurse is preparing a child for possible alopecia from chemotherapy. What should be included? explain that when hair regrows it might have a slightly different color or texture
A common clinical manifestation of Hodgkin's disease is: enlarged, firm, nontender lymph nodes
What is caused by a virus that primarily infects a specific subset of T lymphocytes, the CD4+ T cells? AIDs
A young child with human immunodeficiency virus is receiving several antiretroviral drugs. The purpose of these drugs is to: delay disease progression
Which immunization should be given with caution to children infected with human immunodeficiency virus? varicella
The nurse is planning care for an adolescent with acquired immunodeficiency syndrome. The priority nursing goal is to: prevent infection
An inherited immunodeficiency disorder characterized by absence of both humoral and cell-mediated immunity is: SCIDS (severe combined immunodeficiency syndrome)
Several complications can occur when a child receives a blood transfusion. An immediate sign or symptom of an air embolus is: sudden difficulty in breathing
An 8-year-old girl is receiving a blood transfusion when the nurse notes that she has developed precordial pain, dyspnea, distended neck veins, slight cyanosis, and a dry cough. These manifestations are most suggestive of: circulatory overload
The parents of a child with cancer tell the nurse that a bone marrow transplant (BMT) may be necessary. What should the nurse recognize as important when discussing this with the family? Finding a suitable donor involves matching antigens from the human leukocyte antigen (HLA) system.
Which term is used to describe a child's level of consciousness when the child can be aroused with stimulation? obtundation
Which term is used when a patient remains in a deep sleep, responsive only to vigorous and repeated stimulation? stupor
The Glasgow Coma Scale consists of an assessment of: eye opening and verbal and motor responses
The nurse is closely monitoring a child who is unconscious after a fall and notices that the child suddenly has a fixed and dilated pupil. The nurse should interpret this as: neurosurgical emergency
Which test is never performed on a child who is awake? Oculovestibular response
The nurse is preparing a school-age child for a computed tomography (CT scan) to assess cerebral function. When preparing the child for the scan, which statement should the nurse include? the scan will not hurt
Which neurologic diagnostic test gives a visualized horizontal and vertical cross section of the brain at any axis? CT Scan
The priority nursing intervention when a child is unconscious after a fall is to: establish adequate airway
Which drug would be used to treat a child who has increased intracranial pressure (ICP) resulting from cerebral edema? mannitol
What is descriptive of a concussion? It is a transient, reversible neuronal dysfunction.
Which type of fracture describes traumatic separation of cranial sutures? diastatic
Which statement best describes a subdural hematoma? bleeding occurs between the dura and cerebrum
The nurse should recommend medical attention if a child with a slight head injury experiences: confusion or abnormal behavior
An adolescent boy is brought to the ED after a motorcycle accident. His respirations are deep, periodic, and gasping. There are extreme fluctuations in blood pressure. Pupils are dilated and fixed. What type of head injury should the nurse suspect? brainstem
A toddler fell out of a 2nd-story window. She had brief loss of consciousness & vomited 4 times. Since admission she has been a&o. Her mother asks why a CT scan is required when she ""seems fine."" The nurse should explain that the toddler: may have a brain injury
The nurse is assessing a child who was just admitted to the hospital for observation after a head injury. The most essential part of the nursing assessment to detect early signs of a worsening condition is: level of consciousness
A school-age child has sustained a head injury & multi fractures from bein thrown from a horse. The child's LOC varies. The parents tell the nurse their child is in pain bc of periodic cryin & restlessness. The most appropriate nursin action is Discuss with practitioner what analgesia can be safely administered.
A 5-year-old girl sustained a concussion when she fell out of a tree. In preparation for discharge, the nurse is discussing home care with her mother. Which statement made by the mother indicates a correct understanding of the teaching? I should suspect my child to have some behavioral changes after the accident
A 3-year-old child is hospitalized after a near-drowning accident. The child's mother complains to the nurse, ""This seems unnecessary when he is perfectly fine."" The nurse's best reply is: the reason for this is that complications can still occur
The most common clinical manifestation(s) of brain tumors in children is: headaches and vomitting
What best describes a neuroblastoma? Diagnosis is usually made after metastasis occurs.
The mother of a 1-month-old infant tells the nurse that she worries that her baby will get meningitis like her oldest son did when he was an infant. The nurse should base her response on knowing that: Vaccination to prevent Haemophilus influenzae type b meningitis has decreased the frequency of this disease in children.
The vector reservoir for agents causing viral encephalitis in the United States is: mosquitoes and ticks
What may be beneficial in reducing the risk of Reye's syndrome? Avoidance of aspirin and ibuprofen for children with varicella or those suspected of having influenza
When taking the history of a child hospitalized with Reye's syndrome, the nurse should not be surprised that a week ago the child had recovered from: varicella
When caring for the child with Reye's syndrome, the priority nursing intervention is to: monitor I&O
A young child's parents call the nurse after their child was bitten by a raccoon in the woods. The nurse's recommendation should be based on knowing that: Antirabies prophylaxis must be initiated.
A child is brought to the emergency department after experiencing a seizure at school. There is no previous history of seizures. The father tells the nurse that he cannot believe the child has epilepsy. The nurse's best response is: The seizure may or may not mean that your child has epilepsy
Which type of seizure involves both hemispheres of the brain? generalized
The initial clinical manifestation of generalized seizures is: losing consciousness
Which type of seizure may be difficult to detect? absense
An important nursing intervention when caring for a child who is experiencing a seizure is to: describe and record the seizure activity observed
What clinical manifestations would suggest hydrocephalus in a neonate? Bulging fontanel and dilated scalp veins
The treatment of brain tumors in children consists of which therapies? Choose all that apply. Surgery AND Chemotherapy AND Radiation
Clinical manifestations of increased intracranial pressure in infants are (choose all that apply): Diplopia and blurred vision AND Irritability AND Distended scalp veins
An infant with hydrocephalus is hospitalized for surgical placement of a ventriculoperitoneal shunt. Which interventions should be included in the child's postoperative care? Choose all that apply. -Observe closely for signs of infection -Maintain an accurate record of intake and output -Monitor for abdominal distention.
Which statement best describes hypopituitarism? Skeletal proportions are normal for age.
A child with growth hormone (GH) deficiency is receiving GH therapy. The best time for the GH to be administered is: at bedtime
A condition that can result if hypersecretion of growth hormone (GH) occurs after epiphyseal closure is: acromegaly
At what age is sexual development in boys and girls considered to be precocious? boys: 9 girls: 8
A child will start treatment for precocious puberty. This involves injections of synthetic: Luteinizing hormone–releasing hormone.
Diabetes insipidus is a disorder of the: posterior pituitary
The nurse is caring for a child with suspected diabetes insipidus. Which clinical manifestation would he or she expect to observe? polyuria and polydipsia
A common clinical manifestation of juvenile hypothyroidism is: dry skin
A goiter is an enlargement or hypertrophy of which gland? thyroid
Exophthalmos (protruding eyeballs) may occur in children with: hyperthyroidism
The nurse is teaching the parents of a child who is receiving propylthiouracil for the treatment of hyperthyroidism (Graves' disease). Which statement made by the parent indicates a correct understanding of the teaching? if my child develops a sore throat or fever, I should contact the physician immediately
A child with hypoparathyroidism is receiving vitamin D therapy. The parents should be advised to watch for which sign of vitamin D toxicity? weakness and lassitude
Glucocorticoids, mineralocorticoids, and sex steroids are secreted by the: adrenal cortex
Chronic adrenocortical insufficiency is also referred to as: addison's disease
A neonate born with ambiguous genitalia is diagnosed with congenital adrenogenital hyperplasia. Therapeutic management includes administration of: cortisone
What is characteristic of the immune-mediated type 1 diabetes mellitus? age of onset is usually younger than 18
What is considered a cardinal sign of diabetes mellitus? frequent urination
Hyperglycemia associated with diabetic ketoacidosis is defined as a blood glucose measurement equal to or greater than: > 330
Type 1 diabetes mellitus is suspected in an adolescent. Which clinical manifestation may be present? poor wound healing
A parent asks the nurse why self-monitoring of blood glucose is being recommended for her child with diabetes. The nurse should base the explanation on knowing that: children are better able to manage the diabetes
The parents of a child who has just been diagnosed with type 1 diabetes ask about exercise. The nurse should explain that: extra snacks are need before exercise
A child eats some sugar cubes after experiencing symptoms of hypoglycemia. This rapid-releasing sugar should be followed by: complex carbs and protein
Manifestations of hypoglycemia include: shakey feeling and dizziness
The nurse is caring for an 11-year-old boy who has recently been diagnosed with diabetes. What should be included in the teaching plan for daily injections? he is old enough to give most of his own injections
The nurse is discussing with a child and family the various sites used for insulin injections. Which site usually has the fastest rate of absorption? abdomen
Nursing care of a child diagnosed with syndrome of inappropriate antidiuretic hormone (SIADH) should include (choose all that apply): -weigh daily -restrict fluids
What effect does immobilization have on metabolism? dec metabolic rate
What effect does immobilization have on the cardiovascular system? It causes: venous stasis
What can result from the bone demineralization associated with immobility? osteoporosis
A young girl has just injured her ankle at school. In addition to calling the child's parents, the most appropriate, immediate action by the school nurse is to: apply ice
Which term is used to describe a type of fracture that does not produce a break in the skin? simple
An advantage to using a fiberglass cast instead of a plaster cast is that a fiberglass cast: dries rapidly
The nurse is teaching the parents of a 7-year-old child who has just had a cast applied for a fractured arm with the wrist and elbow immobilized. What instruction should be included in the teaching? Elevate casted arm when resting and when sitting up.
The nurse uses the palms of the hands when handling a wet cast to: Avoid indenting the cast.
What would cause a nurse to suspect that an infection has developed under a cast? hot spots felt on cast surface
A child is upset because, when the cast is removed from her leg, the skin surface is caked with desquamated skin and sebaceous secretions. What should the nurse suggest to remove this material? soak in a bath tub
Which problem is most often associated with myelomeningocele? hydrocephalus
if have latex allergy, what shouldnt you eat bananas or kiwis
antihistamines are contraindicated in child _____ yrs <2 yrs
single greatest cause of death in adolescents physical injuries
sun setting sign inc ICP in infants
LOC; no motor or verbal response to noxious stimuli coma
LOC; vegetative state: permanently lost function of cerebral cortex persistent
LOC; sluggish speech lethargy
full LOC consciousness
LOC; impaired decision making confusion
LOC; to time and place disorientation
Glasgow Coma scale scores 15: unaltered LOC, 3 extremely dec LOC (worst possible score)
neurosurgical emergency sudden appearance of fixed and dilated pupils
caloric test aka oculovestibular response shows impairment of pontine centers
sign of pain in comatose child agitation and rigidity
what should be expect in children w/inc drowsiness and fever who also have basilar skull fractures? posttraumatic meningitis
kids with subdural hematome and retinal hemorrhages should be evauated for what? abuse, esp SBS (shaken baby syndrome)
when should a child seek medical attention after a head injury if loses consciousness or vomits more than 3 times
neurosurgical emergency in a comatose child asymmetric pupills or one dilated, nonreactive pupil
what suggests leaking CSF from a skull fracture? watery discharge from the nose that is positive for glucose (tested with Dextrostix)
contraindicated suctioning in a fractured skull through the nares; cath can enter brain parenchyma through a fracture in the skull
what pupils may indicate inc ICP and potentia brainstem herniation sluggish, dilated, or unequal pupil; medicall emergency!
what findings are reported after brain tumor surgery presence of colorless drainage (CSF) and a foul odor from the dressing (infection)
what is contraindicated in both infratentorial and supratentorial surgeries? trendelburg position
SIADH low urine output, hyponatremia, common after head injury/meningitis/encephalitis
what would make things worse in SIADH? giving more fluids (low urine may be interpreted as dehydration and given more fluids)
SIADH tx fluid replacement, electrolyte balance, meds
meds for induced coma barbituates
concussions are transient (lasting for a shirt time) and reversible
why do you not let a person with a concussion sleep? to monitor LOC
what follows a concussion instantaneous loss of awareness & responsiveness lasting for minutes to hours, amnesia & confusion
coup bruising at point of impact
counter coup bruising at a site far from point of impact
what to suspect when see petechial eyes with no evident sign of trauma abuse
sign of shaken baby syndrome contusion; infants have pliable skull so lower incidence of contusions should occur
epidural hemorrhage blood accumulates between dura and skull
difference between MRI and CT MRI provides details of soft tissues better
problems with near drowning hypoxia, aspiration, hypothermia
tx for near drowning resuscitation, VS, mechanical ventilation, bld gases, chest therapy, help parents cope with guilt
most common solid tumors in children brain tumors
symptoms of brain tumors in children vomiting, seizures, visual distrubances, weakness, unstable gait, loss of physical abilities
dx for brain tumor presenting clinical signs, hx, MRI, CT, EEG, angiography
management of brain tumors surgery, radiation, chemo, VS, LOC, gait, balance
nursing care for brain tumors make comfortable, low lights, neuro checks, emotional support
if thinking brain injury, dont do _____ lumbar puncture
most common malignant extacranial solid tumor of childhood neuroblastoma
neuroblastoma sites adrenal gland (atop kidneys), head, neck, chest, pelvis
s/s neuroblastoma firm/non tender mass, weakness, anorexia, wt loss, abdominal pain
tx for neuroblastoma surgery, chemo
bacterial meningitis acute inflammation of meninges and CSF
causes of bact. meningitis group B strept, e coli, h influenza type b, meningococcus, s pneumoniae
difference between bact and viral meningitis bact more sudden, viral usually slower onset
s/s of bact meningitis fever, irritability, photophobia (most common), seizures, nucchal rigidity
tx of bact meningitis isolation precautions, antib, dark/quiet environment, monitor HC, control seizures and temp
cause of aseptic meningitis viruses (associated with measles, mumps, herpes, leukemia)
aseptic meningitis s/s headache, fever, malaise
tx of aseptic meningitis antipyretics, low lighting, pain meds, quiet environment
tx for rabies rabies immune globulin x 1, inactivated rabies vaccines (day 3, 7, 14, 28-only in er)
simple partial seizure local onset, involves sm location of brain (sensory or motor)
simple partial complex seizure psychomotor, period of altered behavior, aura
generalized seizure tonic-clonic, grand mal, both hemispheres w/o local onset, 30 sec, status
tx of sezures control and reduce freq and severity, discover and correct cause
med for status epilepticus rectal diazepam
adsence seizure brief loss of consciousness, can seem to tune out
atonic seizure sudden loss of muscle tone, 2-5 yr old, sudden fall to ground (often on face), less severe: head droops forward several times
myoclonic seizure sudden brief contractions of muscle group, no loss of consciousness, may be mistaken for exaggerated startle reflex
infantile spasms 6-8 mons, associated w/some cognitive impairment, caused by disturbance of central neurotransmitter regulator at specific phase of brain development
febrile seizures cause unknown, 6 mon-3 yrs, rare >5yr, occurs during rise in temp, if prolonged:ER
biggest problem with febrile seziures fever phobia
when post fontanel closes 8 weeks
when ant fontanel closes 18 months
hydrocephalus ventricles have too much fluid in them and press on brain, prob with production and absorption of CSF
tx of hydrocephalus treat complication, surgical: ventriculoperitoneal shunt
most serious complcation of ventriculoperitoneal shunt infection, greates risk 1-2 mons after placement
tx of shunt infection massive does of anti or removal
what has reduced the incidence of meningitis h. influenza B immunization
most effective care for cold supportive tx
cold/cough meds for children ineffective
pharyngitis tx PCN, amoxicillin, azithromycin, cephalosporins
nursing care for pharyngitis instruct on giving meds, hydrations, pain meds
tx of tonsillitis vaporizer (cool), lozenges, surgery (tonsillectomy, adenotoidectomy)
not allow after tonsillitis surgery straws, red color liquids
tonsillitis can cause snoring-->sleep apnea
tx of influenza symptomatic, avoid aspirin (Reyes Syn)
prevention of influenza vaccine, direct contact precautions
why is OM less frequent in breastfed infants positioning and secretory immune globulin A
AOM looks like TM bright red, bulging, stretch, purulent discharge, LOTS OF PAIN!
OME looks like TM slightly inflamed, dull
OM tx oral antib (Amoxicillin), ear drops (for perforation w/drainage), analgesics, antipyretics, tympanostomy tubes
why worried about acute or convalescent phase of mono contagious in acute and if acute worry about spleen
s/s of croup syndromes barking cough, hoarseness, inspiratory stridor, respiratory distress
epiglottitis s/s tripod, retractions, sore throat
tx for epiglottitis hydration, monitor O2, act quick!, corticosteriods, IV antib
epiglottitis vaccine HIB (h. influenza type B)
Laryngotracheobronchitis (LTB) s/s stridor, retractions, "seal-like" cough, resp pditress, hypoxia, dehydration (what lands them in hospital)
LTB can lead to resp acidosis, resp failure, death
tx for LTB maintain airway, IV fluinds, O2, listen to breath sounds (can change in a min), nebulizer, epi inj, oral steriods, NPO is resp rate high
bronchitis s/s non productive cough, worse at night
tx of bronchitis symptomatic
what causes bronchiolitis RSV
tx of bronchiolitis symptomatic
RSV s/s tight cough, wheeze, retractions, crackles, tachypnea, diminished breath sounds
dx RSV nasal wash, want nose cells, dont want mucous (bulb syringe and nasal drop before test)
tx RSV high humidity, O2, bronchdilators, cohort patient in hospital
what dont you give for RSV antib
prevent RSV synagis
what kind of pain seen with pneumonia abdominal pain
when is asthma more pronounced expiration
step I asthma mild intermittent, <2x/wk, nighttime symptoms <2x/month, PEF/FEV >=80% predicted value, PEF variability <20%
step II asthma mild persistent, symptoms >2x/wk <1x/day, nighttime symptoms >2x/month, PEF/FEV >=80% predicted value, PEF variability 20%-30%
step III asthma moderate persistent, daily symptoms, nighttime symptoms >1x/wk, PEF/FEV >60% <80% predicted value, PEF variability >30%
step IV asthma severe persistent, continual symptoms, freq nighttime symptoms, PEF/FEV <60% predicted value, PEF variability >30%
dx asthma clinical manifestations, pulm fxn tests, spirometry, peak flow
tx asthma maintain norm activity level and pulm fxn, allergen control, education, prevention, med management
long term meds for asthma corticosteriods, 1x/day, dec edema & airflow obstruction, swish & spit to prevent yeast
quick relief meds for asthma bronchodilators, 2 puffs, 4-6x/day as needed, rescue, relax bronchial sm musc & dilate airways
combination meds for asthma steriod with long acting bronchodilator
mediators of inflammation for asthma leukotriens
affected by cystic fibrosis resp tract, pancreas, growth, development
s/s of cystic fibrosis child taste salty, meconium ileus, excretion of undigested food, inc bulk/frothy/foul stool, hyponatremia
resp tx for cystic fibrosis bronchodilator, CPT, IV/aerosolized antib, aggressive tx of pulm inf
GI tx for cystic fibrosis replace pancreatic enzymes, hig cal diet, high protein, salt supplmentation
dx of cystic fibrosis is based on elevated immunoreactive trypsinogen, DNA analysis, sweat chloride analysis
r side card cath femoral vein to right atrium, most common
l side card cath artery into aorta then heart
preprocedural card cath care prep child and fam, height (correct cath selection), weight, alergies (some dyes are iodine based), s/s infection (diaper rash cancel femoral vein cath), pedal pulses (baseline), baseline O2 sat
postprocedural card cath care VS Q15 min, dressing, I&O, bld glucose, temp/color of extremity, positioning of extremity
drop in BP after card cath procedure could mean bleeding or cardiac perforation
cool/pale extremity could mean? (card cath) arterial obstruction
position of extremity after surgery (card cath) keep straight, 4-6 for vein, 6-8 for artery
most common anomly ventricular septal defect
inc the risk of having baby with CHD mom has diabetes/uncontrol PKU/drinks/has infection/exposed to toxin, 1* relative (parent/sibling)have hx
familial risk of CHD is higher with left sided obstructive lesions
Tx for ASD surgery (dacron patch), non surgical (card cath)
Tx for VSD surgery (dacron patch), non surgical (card cath)
Tx for PDA indomethacin (closes ductus), surgical ligation, non surgical (card cath)
tx for coarction of aorta resection of coarcted portion, balloon angioplasty
s/s aortic stenosis faint pulses, hypotension, exercise intolerance, chest pain, dizziness when standing for period of time
tx of AS aortic valvotomy, balloon angioplasty
s/s o f tetrology of fallot blue spells (tet crisis), cyanotic
Tetrology of Fallot causes pulm blood flow problem
what med keeps PDA open prostandglandin E
hypopplastic left heart syndrome surgeries for life, never will be normal
what heart defect puts you as a transplant recipient hypoplastic left heart syndrome
CHF w/impaired mycardial fxn tachycardia, sweating, dec urine output, pale, cardiomegaly
CHF w/pullmonary congestion tachypnea, dyspnea, retractions, flaring nares, cyanosis, wheeze, grunt, cough
CHF w/systemic venous congestion wt gain, hepatomegaly, peripheral edema, ascites, neck vein distention
tx for CHF 1) improve card fxn (digoxin, ace inhib) 2) remove fluid & sodium (diuretics, fluid & sodium restrictions)
s/s of hypoxemia cyanosis, polycythemia, clubbing, squatting
tx hypercyanotic spells knee-chest, 100% O2 face mask, morphine, IV fluid replacement, calm/comforting approach
how to avoid bacterial endocarditis proph. anti before dental work
how does rheumatic fever develop after group A B-hemolytic strept pharyngitis
rheumatic fever affects joints skin, brain, heart
most common complication of RF rheumatic heart disease, damage to valves
tx for RF high doses of antib (<4 wks - PCN)
tx for hyperlipidemia in children diet, if diet doesnt work: colestipol (Colestid) or cholestryamine (Questran)
vasal maneuvers bearing down, ice on face, adenosine
tachydyshythmias: ____ BPM >=200
long term tx of cardiomyopathy transplant
s/s Kawasaki Disease edema/erythema of palms/soles, conjuctivitus, strawberry tongue, polymorhpous rash, cervical lymphadenopathy
tx for Kawasaki gamma-globulin, aspirin
s/s compensated shock thirst! (tachycardia, pallor)
s/s decompensated shock oliguria! (confusion. tachypnea, cool extremities, poor cap refill)
s/s of reversible shock thready pulse, periodic breathing, stupor
tx of shock ventilation (O2), vasopressors, fluid (norm saline or LR), blood, antib, improve pumping of heart (ca chloride, na bicarbonate, dopamine, adrenaline)
hypopituitarism growth hormone deficiency
tx for GH deficiency subcut inj @ bedtime, once epiphyseal closes tx ends
pituitary hyperfunction excess GH, vertical growth + inc muscle (can b too heavy to carry)
acromegaly excess GH after epiphyseal closure
tx for pituitary hyperfunction remove tumor, radiation, hormone replacement after surgery
central precocious puberty GnRH
peripheral precocious puberty hormone stimulation other than GnRH
tx for precocious puberty luteinizing hormone-releasing hormone (stopped at age normal for puberty to resume)
diabetes Insipidus disorder of post pituitary, hyposecretion of ADH
s/s of DI polyuria, polydipsia, and uncontrolled diuresis
how can you tell DI? hold fluids and keep urinating and loses weight
tx for DI vasopressin, DDAVP, requires tx for life
SIADH oversecretion of pos pituitary
tx of SIADH I&O, watch for fluid overload, seizure precautions, ADH ANTAGONIZING MEDS
thyroid secretes what hormones TH and calcitonin
TSH secreted by ant pituitary
s/s hypothyroidism dry skin, sparse hair, puffy eyes
tx for hypothyroidism TH replacement, taken in morning before eat
Graves' disease hyperthyroidism
s/s of graves enlarged thyroid, exophthalmos (bulging eyes), weight loss
tx of graves antithyroid drugs (propylthiouracil & methimazole), total thyroidectomy, ablation with radio iodine
thyrotoxicosis sudden release of hormone
tx of thyrotoxicosis antithyroid drugs, propanolol
adrenal fxn secretes steriods (glucocorticoids, mineralocorticoids, sex steroids)
acute adrenocortical insufficiency dont make enough cortisone
tx of acute adrenocortical insufficiency replace cortisol, hydration, blood transfusion if cyanotic
Addison's Disease chronic adrenocortical insufficiency
dx addisons measure cortisol reserve
tx addisons oral cortisol
cushings syndrome excessive circulating cortisol
cause of cushings syndrome excess or prolonged oral steroid therapy or high dosed steroids
is cushings syndrome reversible yes, once steroids are discontinued
s/s cushings syndrome excessive hair growth, moon face, red cheeks, weight gain, red striae, pendulous abdomen, poor wound healing, ecchymosis
congenital adrenal hyperplasia overproduction of androgens, male type genitalia of female fetus
tx for congenital Adrenal Hyperplasia cortisone, reconstructive surgery
type 1 DM total or partial deficiency of insulin, destruction of beta cells, caucasians, 10-15 yrs old
most childhood DM is type ___ 1
s/s of DM type 1 polyphagia, polydipsia, polyuria
type 2 DM insulin resistance, after age 40, native amer, hispanic, afri amer
tx DM type 2 insulin inj
sign of insulin resistent child acanthosis nigricans (dark, thick, velvety skin in folds and creases)
ketoacidosis when glucose unavailable for cellular metabolism, body breaks down alternative sources of energy, ketons are released and excess ketones are eliminated through urine and lung, ketones in blood re strong acids
tx of ketoacidosis insulin drip
long term complications of DM poor control vascular changes w/in 2.5-3 yrs after diagnosis, neuropathy (protein build-up on nerve sheaths), retinopathy
consequence of anemia fatigue
dx anemia hgb < 10 or 11
tx anemia tx underlying cause, supportive care (IV fluids, O2, bed rest)
iron replacement problems constipation, black/tarry stool, upset stomach, teeth discoloration, doesnt get absorbed well
what helps iron to be absorbed well vit c
what causes iron to not be absorbed well calcium
how to prevent complications of anemia provide O2, prevent infections (hand washing), wear mask if have cold
iron deficiency anema inadequate supply of dietary iron
tx iron deficiency anemia inc amount of iron child receives, diet changes, ferrous iron for 3 months
teaching about ferrous iron give with food, may stain teeth, stool: tarry green, take with vit c
what can lead to iron deficient anemia lead posioning
what can bring on a sickle cell crisis anything that inc body's need for oxygen (trauma, infection, fever, stress, dehydration, hypoxia)
tx of sickle cell anemia vaccinations, aggressive tx of inf, proph antib 2 mons- 5yrs, short term O2 therapy
tx of sickle cell crisis rest, hydration, electrolyte replacement, exchange transfusion
leading cause of death in young children with sickle cell bacterial infection
B-thalassemia autosomal recessive inherited blood disorder of hgb synthesis and production
dx B-thalassemia chronic hyppoxia, hgb <6, hepatosplenomegaly, severe anemia, pallor, bone pain, exercise intolerance
four types of B-thalassemia minor, trait, intermediate, major
thalassemia minor asymptomatic silent carrier
thalassemia trait mild microcytic anemia
thalassemia intermediate moderate to severe anemia plus splenomegaly
thalassema major Cooley's anemia, sever anemia requiring transfusion to survive (homozygous)
tx B-thalassemia bld transfusion, spleenectomy
complication of bld transfusion for B-thalassemia hemosiderosis, Fe overload, treat with deferoxamine (desferal): iron-chelating drugs/binds excess iron for excretion by kidney
Aplastic Anemia all formed elements of blood are depressed; pancytopenia (profound anemia, leukopenia, thrombocytopenia)
thrombocytopenia decreased platelets
hypoplastic anemia depressed RBC but normal WBC and Platelets
dx of aplastic anemia bone marrow aspiration
tx for aplastic anemia immunosuppressive tx, bone marrow transplant, meds (antilymphocyte globulin & antithymocyte globulin)
von willebrand disease hemophilia (bleeding disorder) disease, affects both male and female
hemarthrosis bleeding into joint spaces of knee, ankle, elbow leading to impaired mobility
tx for hemophilia replace missing clotting factors, DDAVP, transfusion
interventions for hemophilia electric razor, applpy pressure & ice superficial bleeds, safe environment, dental procedure in controlled situation
thrombocytopenic purpura excessive destruction of platelets & discoloration caused by petechiae beneath skin, normal bone marrow
tx of thrombocytopenic purpura restrict activity, prednisone, IV immune globulin, spleenectomy
leukemia unrestricted proliferation of immature WBC in blood-forming tissues of body, destroys norm blood cells by competing for essential nutrients for metabolism
what organs are most affected by leukemia liver and spleen
s/s of leukemia anemia, infection, bleeding tendencies, enlarged/fibrosis spleen/liver/lymph
dx leukemia hx, peripheral bld smear, lumbar puncture, bone marrow aspiration/biopsy
tx for leukemia chemo, cranial irradiation
dx HIV/AIDS ELISA and Western blot
HIV/AIDS prenatal tx mothers prenatally, no breastfeeding
SCID Severe combined immunodeficiency disease, absence of both humoral and cell-mediated immunity
tx SCID prevent inf, support, bone marrow transplant
blood transfusion NS piggyback, use bld w/in 30 min of arrival, infuse over 4 hrs max, VS q15 min
most common cause of death in bld transfusion ABO incompatibiity r/t human error
nurses role in bld transfusion indentify donor and recipient bld type b4 transfusion, transfuse slow for 1st 15-20 min, observe patient, STOP IMMEDIATELY if reaction occurs
autologous patient's own marrow
allogenic histocompatible donor; siblings
where can get stem cells for transplantation 1) allogenic 2) umbilical cord blood 3) autologous 4) peripheral
HSCT hematopoietic Stem Cell Transplantation; replaces disease and malfxning bone marrow with viable stem cells
HSCT ablative tx high dose combination chemo to eradicate unhealthy cells and suppress immune system to prevent rejection of transplanted marrow
Created by: tarnowb