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chp 19 peds
immune disorders
| Question | Answer |
|---|---|
| acute, severe vasculitis of all blood vessels seen in children under 5, boys more than girls | kawasaki disease |
| leading cause of acquired heart disease in children | kawasaki disease |
| these are done for dx of kawasaki | lab test, 2d echocardiogram,clinical signs |
| s/s of kawasaki acute | prolonged high fever, strawberry tongue, irritability |
| s/s of kawasaki subcute | DESQUAMATION of hands and feet,arthritis,coronary aneurysms |
| s/s of kawasaki convalescent | all signs have disappeared |
| nursing care of child with kawasaki | EXTREME IRRITABILITY is the most challengeing nursing issue, symptom specific relief |
| treatment for kawasaki | reduce inflammation via IVIG an high dose asprin |
| a severe form of erythema multiforme involving lesions of the skin and mucous membranes | steven johnson syndrome |
| s/s of sjs | flu like symptoms, mucosal lesions in eyes,mouth and gi tract |
| treatment for sjs | med noted to allergy list,care of topical and oral lesions, ophthalmologist for corneal scarring |
| this syndrome affect joint,connective tissue,viscera,chronic with remissions and exacerbations | juvenile idiopathic arthritis |
| s/s of juvenile idiopathic arthritis | joint stiffness in morning or after rest, osteopenia-low bone mass |
| dx of juvenile idiopathic arthritis is done by | s/s, radiographs, lab test |
| JIA is categorized by what | method of onset |
| JIA systemic | acute febrile |
| JIA oligoarticular | involving 5 or fewer joints with risk for iridocyclitis |
| iridocyclitis is what | inflammation of the iris and ciliary body |
| JIA polyarticular | involving more than 5 joints |
| treatment for JIA | exercise, drug therapy-nsaids- to reduce pain and stiffness |
| intra articular long acting corticosteroid injections do what? | preserve joints |
| a subcutaneous injection twice a wk for JIA that needs monitored for allergic reactions | enbrel- etanercept |
| this med is used for JIA with rheumatoid arthritis, liver test and cbc test done regular | methotrexate-rheumatrex |
| home care for JIA | moist hot packs,firm mattresses prevent sagging joints,encourage swimming, avoid weight gain |
| school issues for a kid with JIA | clear path to nurses office, excess absences, REST PERIODS |
| a global disease caused by epstein barr virus | infectious mononucleosis |
| transmitted by saliva or contaminated eating utensils | infectious mononucleosis |
| s/s of mono | low grade fever,sore throat,headache,fatigue,skin rash,malaise |
| half of mono pt get this | splenomegaly |
| a small amount of mono pt have this | liver involvement with mild jaundice |
| treatment of mono | nsaids, acetaminophen,antipyretic,rest gargling with warm liquild, throat lozenges, adequate fluid intake |
| different chronic metabolic disorders involving disturbed glucose metabolism | diabetes mellitus |
| diabetes mellitus differ in cause,___________,_________ | pathophysiology, and genetic predisposition |
| _____ predispose you to type 1 or 2 | genetics |
| _____ can destroy beta cells of the islets of langerhans in the pancreas leading to_____ | toxins/viruses,type 1DM |
| _____ may lead to the development of insulin resistance and type 2DM | obesity,physical inactivity, high triglycerides and HTN |
| DM type 1 polyuria | excertion of large amounts of urine |
| DM TYPE 1 POLYDIPSIA | escessive thirst |
| DM type 1 polyphagia | constant hunger |
| s/s of DM type 1 | fatigue,anorexia,nausea,lethargy,weakness,dry skin,vaginal yeast infections,bed wetting |
| hyperglycemia,glycosuria,ketoacidosis s/s of what | DM type 1 |
| diabetic ketoacidosis happens when | conditions increase insulin demand, diabetic coma when awake or asleep |
| fruity breath, rapid breathing, increase in blood sugar | kussmaul breathing |
| dx for DM include 2 of the following | random blood test greater than 200,fasting blood test greater than 126, 2hr blood test greater than 200 with oral glucose |
| hba1c expected range over 2 months | target goal less 7%, expected range of 4-6%, diabetes 6.5-8% |
| 70 or below blood sugar means | hypoglycemic |
| you should give this at first sign of hypoglycemia | orange juice or carbs then protein like cheese or peanut butter |
| long term management can help | promote normal growth and development |
| diabetic ketoacidosis treatment | vital signs, increase fluids,low dose insulin |
| a doctor that treats DM | endocrinologist |
| human insulin is used why | less chance of allergic reaction |
| _____ is a standard unit in the us | 100 unit |
| insulin is given how | subcutaneously at 90 deg angle |
| when blood glucose is greater than 240 you should do what | restrict exercise until controlled |
| insulin lispro, onset less than 15min,duration 3-4hrs | rapid acting, humalog |
| regular insulin,onset 0.5-1hr,duration 5-7hrs | short acting, humulinR |
| NPH insulin,onset 1-2hr,duration 18-24hrs | intermediate acting, humulinN |
| insulin glargine, onset 1hr,duration 10.4 to 24hrs | long acting, lantus |
| severe hypoglycemia is treated with | glucagon |
| two types of diets for hypoglycemia | exchange list, constant carb diet |
| increasing this ____ will increases carb breakdown | fiber |
| nutritional management for hypogylcemia is elimination of these | concentrated carbs and refined sugars |
| when you exercise you use sugar so you should do this | keep a snack with you |
| you should test blood sugar when | before meals |
| pt needs to have great skin care by doing these things | inspect for cuts,rashs,adrasions,cysts,boils,keep skin dry |
| these occur greater in frequency in pt with diabetes | cystitis,subcutaneous nodules,monilial vulvitis |
| urine checks used to done for this | test for acetone |
| insulin doses may very through life but | you will always need to take insulin |
| these types of exams are important with DM | eye and dental |
| 1/3 to 1/2 of all new dx of diabetes pt are | younger than 18 |
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