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Peds 2
Pediatric Nursing conditions
| Question | Answer |
|---|---|
| *What position should a patient be in post heart catheterization? | Have the affected limb kept flat and straight |
| Post-heart catheterization your patients affected limb has mottled skin and is cool to the touch, what is a possible complication? | arterial obstruction |
| Post-heart catheterization your patient has a dropping blood pressure and sanguineous drainage at the site of insertion, what complication do you suspect? | hemorrhage |
| What are the two types of heart defects and what is the difference between them? | congenital (defect the patient is born with) and acquired (defect the patient develops after birth) |
| What are the four classifications of congenital heart defects? | increased pulmonary blood flow (acyanotic), decreased pulmonary blood flow (cyanotic), obstruction of blood flow, and mixed blood flow |
| Classify and Describe Atrial Septal Defect | CHD-increased pulmonary blood flow; a hole between the two atrial chambers of the heart. s/s murmur, fatigue, HF symptoms |
| classify and describe ventricular septal defect (symptoms) | CHD-increased pulmonary blood flow; hole between the two ventricular chamber of the heart/ s/s murmur, cardiomegaly, HF symptoms |
| classify and describe atrioventricular canal defect | CHD-increased pulmonary blood flow; low ASD with a high VSD, plus fusion of the AV valves forms one central AV valve that allows blood flow through all 4 chambers of the heart. s/s mod-severe HF, loud murmur, cyanosis |
| classify and describe patent ductus arteriosus as a heart defect (and treatment options) | CHD-increased pulmonary blood flow; a bridge between the pulmonary and aorta present from birth (normally closes at 28 days); tx: meds or surgery |
| classify and describe coarction of the aorta | CHD-obstructive defect; narrowing of the aortic artery. tx: surgery |
| classify and describe aortic stenosis | CHD- obstructive defect; narrowing in the aortic valve |
| classify and describe pulmonary stenosis | CHD-obstructive defect; narrowing of the pulmonary valve |
| *What are the 4 components of tetralogy of fallot | 1. pulmonary stenosis (narrowed pulmonary valve) 2. right ventricular hypertrophy (boot shaped) 3. overriding aorta (centrally located aorta) 4. ventricular septal defect (hole between ventricles) |
| what is an overriding aorta | centrally located aorta |
| what is hypertrophy of the right ventricle | over developed right ventricle |
| classify and describe tetralogy of fallot | CHD-decreased pulmonary; overriding aorta, hypertrophy of the R. ventricle, ventricle septal defect, pulmonary stenosis |
| classify and describe tricuspid atresia | CHD-decreased pulmonary; valve between right atrium and ventricle is not developed |
| classify and describe hypoplastic left heart (tx and 02 considerations) | CHD-mixed defect; underdeveloped left ventricle. tx- transplant/ compassionate care DO NOT GIVE O2 |
| Describe endocarditis | acquired defect: infection of the inner lining of the heart; also usually affects the bowel |
| *describe rheumatic heart disease | bacterial infection triggers autoimmune response that damages the valves of the heart |
| Acute rheumatic fever manifestations and treatment | rheumatic rash, inflamed joints, speech issues, sporadic movements. Tx the inflammation and pain |
| describe Kawaski disease | systemic inflammatory disease; causes painful strawberry tongue and peeling on the hands and feet |
| 3 phases of kawaski's diease | acute: conjunctivitis; sub-acute: skin on hands and feet peel, "strawberry tongue"; increased risk of aneurysms. third phase: symptoms start to resolve |
| Upper respiratory infection affect which structures | Nose and pharynx |
| What is nasopharyngitis | Common cold |
| Lower respiratory infections affect which structures | bronchi and bronchioles |
| Croup syndromes affect which structures | epiglottis, larynx, trachea, and bronchi |
| Manifestations of pharyngitis | Inflamed and painful pharynx; may have white exudate in throat |
| What is a common secondary complication of tonsillitis | otitis media (ear infection) |
| Diet considerations for a patient post-tonsillectomy | Soft diet only; no red foods |
| *What is the biggest complication post-tonsillectomy; and what are the signs of this complication | Risk for bleeding (24 hours and 10 days out; excess swallowing, occult blood in stool; scabs in throat fall out (bleeding is a medical emergency) |
| What is a common complication of influenza | Bacterial lung infection 2nd to excess fluid in lungs from the influenza virus |
| Treatment for respiratory viruses like pharyngitis, nasopharyngitis, and influenza. | Therapeutic management, fluids, humidifier air, watch for secondary infections |
| Signs of otitis media in younger children | Pull at ear, ear pain, mild fever, inflamed tympanic membrane |
| Symptoms of croup syndrome | Barking cough, inspiratory strider, hoarseness, and fever |
| What are the 5 different croup syndromes | Acute epiglottis, acute laryngitis, acute laryngotracheobronchitis (LTB), acute spasmodic laryngitis, and bacterial tracheitis |
| *What is the major concern for a patient with acute epiglottitis | RESPIRATORY OBSTRUCTION: if the epiglottis is inflamed it can't open the airway *Medical Emergency |
| Which vaccine can prevent acute epiglottitis | Hib vaccine |
| Describe acute laryngitis | Dry/sore throat, hoarse voice. Usually self-limiting |
| What age does acute largynotracheobronchitis (LTB) affect most commonly | Children less than 5 |
| Describe the process of acute LTB | Inflamed larynx, trachea, and bronchi causes barking cough, inspiratory stridor, retractions, and mild hypoxia |
| Treatment for acute LTB | Hydration, humidifier O2, nebulized steroids and epinephrine to open airways |
| Describe acute spasmodic laryngitis | "Midnight Croup" intermittent attacks of laryngeal obstruction mainly at night. Most common in toddlers |
| Treatment for midnight croup | Humidifier air; avoid cold air. Epinephrine if severe |
| Symptomology of bacterial tracheitis | Infection of the mucosa of the upper trachea; affects trachea and epiglottis. Presents with purulent respiratory secretions |
| What is a possible cause of bacterial tracheitis | Secondary infection from acute LTB |
| Common symptoms of RSV | Wheezing/crackles, conjunctivitis (non-contagious), dehydration, nasal stuffiness, increased secretions |
| How is RSV diagnosed | Nasal secretion culture |
| *How is RSV treated | SUCTION (clear airways of secretions), cool O2, fluids, saline suction |
| What is a common cause of pneumonia in infants | aspiration pneumonia from improper feeding positions |
| What are common symptoms of Pertussis | Whooping cough, severe cough, cold-like symptoms, and fever |
| *Treatment of Pertussis and precautions | Antibiotics; isolation precautions |
| Diagnoses of TB | TB skin test, chest x ray, or blood test |
| Treatment of TB and precautions | 6 months regimen of multi-drug antibiotics; airborne precautions (neg-airflow room with N95 filter mask) |
| Toddler are at risk of this lower respiratory complication; and prevention | Foreign body aspiration; educate the parents |
| Common causes of aspiration infections | Baby powder, baby oil, nose drops, small toys, chunks of food, aspirated milk/formula from feedings |
| Describe asthma | Triggered by a specific allergen; inflammation of the trachea and bronchi with mucus production; immune regulated |
| Describe "wheezing" in asthma | "musical;" usually heard on expiration |
| *Interventions for asthma kids | Encourage exercise for endurance, RT to loosen mucous, hyposensitization (theory) |
| *What is status asthmaticus and how is it treated | Asthma attack that persists even after treatment; TX with epinephrine 0.01mg/kg |
| *What are the 3 characteristics of CF | Increased, thick mucous production. Increased sweat electrolytes. Nervous system abnormalities. |
| Diagnoses of CF | sweat-test: sodium will be 2-5 times greater than normal |
| *meconium ileus is an indicator of what | Cystic Fibrosis in newborns (thick meconium that causes a bowel obstruction in the newborn); or hirschsprung disease (lack of peristalsis causes constipation) |
| Intermediate respiratory involvement in CF patients | Risk for lung infections; increased mucous makes gas exchange difficult (= hypoxia), increased lung pressure can lead to CHF |
| Advanced respiratory involvement in CF patients | Pulmonary HTN, Core pulmonale (blood backs up into the heart), pneumothorax (collapsed lung), hemoptysis (coughing up blood) |
| GI involvement in CF patients (and stool description) | Mucous build up obstructs pancreas and blocks digestive enzymes, *stools are bulky, frothy, and foul-smelling (from impaired fat & protein absorption) |
| Endocrine involvement in CF patients | Increased risk for diabetes, sterility in males and decreased fertility in females, delayed onset of puberty |
| Presentation of CF patients | Undigested food in stools, frequent lung infections, dehydration, and electrolyte imbalances |
| Treatment for CF | manage lung infections, RT for inhaled meds and to loosen mucous, replace pancreatic enzymes, high protein and fat diets, and G-tube to supplement |
| Two types of respiratory failure | Hypoxic RF = not enough O2 can get in; hyperbaric RF = CO2 can't get out |
| What is tracheal malasia and what is the risk | The trachea in young children does not have hard cartilage and puts them at increased risk of collapsed airways |
| What is poisuelle's law | Children have decreased airway diameters = increased risk of obstruction; increased airway resistance, and increased respiratory distress with inflammation |
| *Define isotonic dehydration; Na+ blood levels and associated risks | Fluid and electrolytes are lost in equal amounts; Na+ levels stay normal; *Hypovolemic Shock |
| *Define hypotonic dehydration; Na+ blood levels, and risks | electrolyte loss is greater than fluid loss; Na+ is low (<130); risk for hyponatremia |
| *Define hypertonic dehydration; Na+ blood levels, and associated risk | Fluid loss is greater than electrolyte loss; Na+ is high (>150); *most dangerous kind of dehydration r/t neurological involvement |
| The "stomach flu" | gastroenteritis |
| Describe acute diarrhea and possible causes | Sudden onset diarrhea, last less than 2 weeks. Usually r/t antibiotics or GI infection |
| Describe chronic diarrhea and possible causes | Diarrhea lasting >14 days. Usually r/t food allergies, irritable bowel disease, or chronic bowel disease |
| Describe intractable diarrhea of infancy | Usually occurs in 0-2 months of life, has no known cause and treatments don't work (can be life-threatening) |
| *Nursing considerations for patients with C-diff | Have to WASH HANDS; no sanitizer use |
| *When should a newborn pass the first meconium by | 24-48 hours after birth |
| What diseases may be indicated in a newborn has not passed meconium in 48 hours after birth | Hirschsprung disease or CF |
| What is encopresis | Stooling "accidents" |
| Treatment of constipation | increase fiber, stool softeners, bowel schedules, increase fluids |
| Describe Hirschsprung disease | No neuroganglia on a portion of the intestines = no peristalsis through that area |
| Complications of hirschsprung disease | GI obstruction (fecal matter clogs bowels); Megacolon (colon loses elasticity and tone) |
| *Manifestations of hirschsprungs disease | Failure to pass meconium within 48 hours of birth, FTT, constipation, *thin ribbon-like stools that are foul smelling |
| Diagnoses of hirschsrung disease | Rectal biopsy |
| Treating hirschsprung disease | Fiber, fluids, enemas, stool softeners. Surgery to remove portion of bowel |
| Where is mcburney's point? | Lower right quadrant; acute appendicitis |
| Current jelly stools | Meckel Diverticulum and Intussusception |
| Meckel Diverticulum | A band connecting the intestine to the umbilicus |
| Crohn's disease | Involves all layers of the GI and can occur anywhere in the GI tract |
| Ulcerative colitis | Involves mucous layer of the GI in the Large intestine ONLY. Has blood/mucous stools. Pain before stools and relieved after |
| Labs for inflammatory bowel flare up | ESR, CRP |
| During IBD flare up what is the diet | NPO with TPN |
| TPN is hard on which organ | Liver |
| causes of Acute Hepatitis | contaminated food, needle sharing, sexual contact, exchange of body fluids, tattoos, piercings. "If it ends in a vowel it came from the bowel" A&E = contaminated food |
| Biliary atresia | Bile backs up and destroys the liver |
| Symptoms of biliary Artesia | Jaundice, itching, swelling of liver, bruising, off-white stools |
| Procedure for biliary Artesia | Kasai procedure: resect hepatic port to drain bile duct & possible liver transplant (cirrhosis) |
| Considerations for cleft palate | No pacifiers, special bottles; surgery at 12-18 months |
| Tracheoesophageal Fistual (TEF) 3 C's and considerations | Coughing, choking, cyanosis. NO FEEDING until after surgical correction |
| Complications of Hernias | Strangulation and encapsulation (loss of blood flow to the area) |
| Pyloric stenosis | Thickened pyloric sphincter; *projectile vomiting |
| Intussusception | A portion of the intestine runs into another portion of the intestine |
| Symptoms of intussusception | Sudden severe abdominal pain, vomiting, currant jelly stools |
| Malrotation and Volvulus | Bowel wraps around mesenteric artery cutting off blood flow. Needs immediate surgery |
| Celiac disease, need to avoid | Wheat, rye, barley, and oats |
| Anemia | Decreased RBC cells circulated in blood due to decreased production, increased destruction, or RBC loss. Decreases O2 carrying capacity of the blood |
| Treat anemia | Treat underlying cause of anemia (decreased RBC production; increased RBC destruction; RBC loss) |
| Sickle cell anemia | RBC CLUMP together and cause PAIN (especially joints) |
| Treating sickle cell | Fluids (NO anticoagulants), HEAT packs |
| Considerations for sickle cell | Risk of infection; risk of Hypovolemic shock if blood pools in spleen (*get a spleenectomy after 1yr old) |
| Sickle cell crisis | Triggered from stress; increase in severity where RBC clump and block circulation; PAIN |
| Idiopathic Thrombocytopenia (ITP) | decrease in platelets; Petechia, bruising, blood pooling in spleen (spleenectomy after 1 year)*NO Contact sports |
| Diagnosing leukemia | Bone marrow aspiration |
| Chemo diet | Eat whatever you like |
| what organ does chemo most affect and related monitoring interventions | chemo is renal toxic - monitor I&Os |
| First phase of Leukemia therapy | Induction therapy 4-6 weeks |
| Second phase of leukemia therapy | CNS prophylactic therapy (prevent leukemia from getting into the CNS) |
| Third phase of leukemia therapy | Intensification/Consolidation therapy (eradicate resistant cells- Heavy chemo) |
| Fourth phase of leukemia therapy | Maintenance therapy (preserve remission 2-3 years) |
| Leukemia labs to go home | Neutrophil has be above 500 to go home |
| Hodgkins lymphoma | nontender, firm, enlarged lymphs |
| Dx of Hodgkin lymphoma | Lymph biopsy |
| considerations for chemotherapy treatments | antineoplastic drugs; all bodily fluids are BIOHAZARD and go in yellow box; wear special chemo gloves |
| Non-Hodgkin lymphoma | Affects all nodes; may not have enlarged nodes; not a great outcome |
| Growth hormone deficiency | young bone age, short, overweight, youthful features |
| diagnosing HGH deficiency | bone age x ray; HGH blood test |
| Precocious puberty | early onset puberty (secondary sex traits); before age 8 in girls and 9 in boys |
| Hypothyroidism | decelerated growth, constipation, dry skin, edema, fatigue |
| Tx hypothyroidism | synthroid (levothyroxine) *give on empty stomach |
| Hyperthyroidism | goiter (enlarged thyroid), restlessness, weight loss, heat intolerance, difficulty sleeping |
| Tx hyperthyroidism | antithyroid meds, radioactive iodine, or thyroidectomy |
| Thyrotoxicosis (aka thyroid crisis) | sudden release of hormones from thyroid following stress. Tx with antithyroid meds and BP meds |
| Effects of steroid use | Females: hair growth, masculinization. Males: aggressiveness, testicular atrophy, breast development |
| Cushings syndrome | result of prolonged steroid use; increase in blood glucose, increased hair growth, moon face, slow wound healing, abdominal weight, ecchymosis (bruising) |
| Tx Cushings syndrome | *No abrupt withdrawal from steroids (causes adrenal insufficiency in kidneys; wean off steroids |
| Diabetes (type 1) | beta cells destroyed; no insulin production; insulin dependent |
| Causes of type 1 DM | genetics, environmental trigger, and autoimmune response |
| Functions of pancreas | endocrine function (insulin & glycogen production) and digestive function (enzyme production) |
| Symptoms of DM 1 | polyuria, polyphagia, polypepsia |
| Signs of ketoacidosis | fruity breath, Kussmauls respirations, dehydration, vomiting. (*may look like the gastroenteritis) |
| Kussmaul's respirations | long expiration to blow off CO2 (indicates DKA) |
| Tx hypoglycemia | fast acting carb (15g/15 minutes) follow with long-acting carbs |
| signs of increased cranial pressure | headache, vomiting, seizures, "neuro-cry" (high pitched scream), bulging fontanel, distended scalp veins, "setting sun" eyes |
| LOC- confusion | impaired decision making- 1 |
| LOC- disorientation | to time and place - 2 |
| LOC - lethargy | sluggish speech - 3 |
| LOC- Obtundation | arouses with stimuli - 4 |
| LOC- stupor | responds only to vigorous and repeated stimuli - 5 |
| LOC- coma | does not respond to stimuli - 6 |
| LOC- persistent vegetative state | permanently loss of cerebral cortex function - 7 |
| Pediatric Glasgow scale assessment | eyes, verbal, motor response (3-15 scale) |
| A peds patient has a Glasgow score of 8 - what is their LOC | coma |
| Flexion posturing | rigid and stiff - arms pulls in, chin tucked down, toes pointed hard |
| Extension posturing | rigid and stiff - arms straight, wrists bend out, knees together, calves apart, toes pointed |
| EEG | studies brain function |
| Considerations for increased cranial pressure | *DO NOT perform lumbar puncture (may cause hemorrhaging) |
| acceleration-deceleration injury aka? | Ku-Contra-Ku injury: brain hits front of skull then back of skull = head injury |
| Epidural hematoma | bleeding outside the cranial dural sac between the dura and the skull |
| subderal hematoma | bleeding inside the cranial dural sac |
| a patient who suffered a head injury now has a running nose, what test are you going to do | glucose test on the secretions; +glucose=cerebral fluid |
| why are CNS tumors hard to treat | chemo does not cross blood-brain barrier |
| considerations for CNS tumors | risk for infection, risk for seizures, watch for neuro-deficit, monitor neuro status q4h |
| Bacterial Meningitis | acute inflammation of CNS from a bacterial infection --**Medical emergency |
| what isolation is used for bacterial meningitis | droplet |
| DX for bacterial meningitis | lumbar puncture |
| considerations for bacterial meningitis | increase head of bed, seizure precaution, decreased stimuli |
| non-bacterial meningitis | caused by virus; tx the symptoms (less deadly than bacterial meningitis) |
| when is epilepsy diagnosed | two or more *unprovoked seizures |
| focal seizure | aka absent seizure: no loss of consciousness, blank stare, hearing noises |
| phases of a generalized seizure | tonic, clonic, postical |
| tonic phase | loss of consciousness, constant muscle contraction |
| clonic phase | altering muscle contraction and relaxation |
| postical phase | confusion, return to consciousness |
| seizure precautions | padded bed rails, bed low to floor, suction at bedside, O2 available |
| your patient is having a seizure what do you do | place on side, maintain patent airway, nothing in the mouth, do not restrain |
| hydrocephalus | increased cerebral fluid around the brain (associated with myelomenigocele spina bifida) |
| Tx for hydrocephalus | V-P shunt (drain cerebral fluid into abdomen) |
| V-P shunt complications | infection, kinking, clogging (hydrocephalus) |
| signs of infection in a V-P shunt | erythema along neck/abdomen on the shunt line, return of hydrocephalus symptoms, fever, pain |
| Consideration for ALL neuro patients | Report changes in LOC immediately |
| Cerebral palsy | non-progressive disorder affecting motor function, caused by a variety of different things |
| Tx for cerebral palsy | long-tern PT and adaptive equiptment |
| Trisomy 21 | "down syndrome" flat forehead, short limbs, protruding tongue, wide hand crease |
| Considerations for downs syndrome patients | increased risk of congenital heart defects and leukemia |
| developmental dysplasia of the hip (DDH) | shallow socket joint at the hip |
| signs of DDH | shortened femur, uneven gluteal folds, hip click, limiting abduction of hip |
| screening for DDH | ortolani-barlow test (adduction & abduction of hip) |
| Tx for DDH | Pavlik harness/spica cast (holds in abduction); surgery 6-18 months |
| Muscular dystrophy | muscle degeneration and wasting (genetic) |
| most common muscular dystrophy | Duchenne's (only males) |
| when does duchenne's MD start | 3-4 years |
| Signs of muscular dystrophy | delayed walking (>18 months), walking on toes with toes turned inwards, gowers maneuver |
| gowers maneuver | when in a bent position the patient needs to walk hands up the body in order to stand (sign of muscular dystrophy) |
| end stages of muscular dystrophy | gradual paralysis starting in legs and ascending; usually death occurs from respiratory paralysis |
| considerations for parents of child with muscular dystrophy | genetic counseling for future children |
| Leg-Calf Perthes disease | circulation to femoral head dies (aseptic necrosis of femoral head) |
| symptoms of leg-calf perthes | hip pain that worsens with activities and is relieved with rest |
| Tx for leg-calve perthes | abduct hip joint; if femoral head breaks = femoral head replacement (recovery is 3-4 months non-weight baring) |
| detecting scoliosis | unilateral rib hump, twisted rib cage, uneven shoulder, uneven hip, pants don't fit/shirts don't lay evenly |
| tx for scoliosis | mild=stretching; moderate=brace; severe=spinal fusion surgery (Painful) |
| spina bifida | failure of spine to fully close |
| spina bifida occulta | not visible externally |
| spina bifida cystica | visible, sac-like protrusion |
| preventative measure for spina bifida | prenatal folic acid |
| indicators of spina bifida occulta | sacral dimple, reddening/discoloration at sacrum, sacral hair growth |
| tethered spinal cord (symptoms) | spina bifida occulta - split spinal cord may attach to other points in body causing altered gait, feet deformities, elimination problems |
| spina bifida cystica meningocele | sac does not contain nerves |
| spina bifida cystica myelomeningocele | sac does contain nerves |
| considerations for myelomeningocele | keep that baby prone; beware of ruptured sac -- the higher up it is the less compatible with life & more severe. if below 2nd lumbar vertebra = lower paralysis; symtpoms dependent on location; may not affect both sides of body equally |
| Management for myelomeningocele | moist covering (sterile saline), prone, risk for infection, limit ROM |
| Treatment for spina bifida | surgery to re-tether spinal cord |
| Considerations for spina bifida kids | *Latex allergy (also banana, avocado, kiwi, and chestnut) - allergy response increases with each exposure |
| atopic dermatitis | eczema (3 types: infantile, childhood, preadolescent/adolescent) |
| skin lesions: macule | flat & circumscribed - freckles, moles, rubeola, rubella (baby-rashes) |
| skin lesions: papule | elevated - warts |
| skin lesions: vesicle/bulla | elevated filled with fluid - blister; varicella (chicken pox) |
| skin lesions: patch | flat and irregular - vitiligo; port-wine marks (occult spina bifida) |
| skin lesions: wheal | elevated, transient/changing - bug bites |
| skin lesions: nodule | elevated, firm, palpable - lipoma |
| skin lesions: pustule | vesicle filled with purulent fluid - acne |
| skin lesions: cyst | vesicle filled with fluid and semi-solids |
| skin lesions: scale | heaped up keratinized skin cells - exfoliative dermatitis |
| skin lesions: crust | dried secretions - scab |
| skin lesions: excoriation | abrasion; cut |
| skin lesions: fissure | cracked skin; athletes foot |
| skin lesions: erosion | after a vesicle bursts |
| 4 phases of wound healing | 1. inflammation 2. granulation 3. contraction 4. maturation |
| 1st phase of wound healing | inflammation: the area swells while WBC eat the dead tissues and defend against infection. involves swelling, pain, warm and redness at injury site |
| 2nd phase of wound healing | granulation-proliferation: body starts repairing damaged tissues, scab formation |
| 3rd phase of wound healing | contraction: body is building new skin to bring the wound edges closer together (may need debrievment) |
| 4th phase of wound healing | maturation: scar tissue formation, increased collagen at site; this tissue will change over time with continued healing |
| wound dressing considerations | wet-dry dressings for open wounds promote faster healing (sterile saline), wound dressings only require clean (not sterile) technique |
| wound diet considerations | increased protein- faster healing |
| s/s of wound infection | increased erythema margins, edema, purulent drainage, pain, warmth at site/fever |
| side effect of wound healing | pruritus (itching) tx with cold compress/bath, mittens, cut nails, benedryl |
| considerations for MRSA skin infection | abscessed off- abx hard to reach it; tx with draining abscess, PO/topical Bactrim/ IV Vancomycin |
| seborrhic dermatitis | cradle cap |
| contact dermatitis | allergy response ie. fabric softener |
| Tx for poison ivy, oak, or sumac | wash with cold water, clean with alcohol, wash with warm water, calamine bath and corticosteroids |
| Rashes from a drug reaction - what you do | stop the drug, talk to the provider about whether or not to continue based on severity of reaction (ie. Vancomycin & red man syndrome) May tx with benedryl, motrin, corticosteroids |
| Tx for bee stings | remove the stinger asap (scrape), cool compress, and benedryl |
| considerations for bee stings | reaction gets worse with each sting |
| scabies | bugs burrow into skin to lay eggs; tx with topical or PO meds |
| pediculosis capitis (lice) | bugs in hair, laying eggs/ tx family with lice kit |
| prevention of arthropod bites/infections | bug spray/lotion, check your clothes |
| concern with animal bites | rabies, infection, & wound care |
| age-related skin problems | diaper rash in infants; abrasions in childhood; acne with puberty |
| what puts women at greater risk of uti | shorter urethra and proximity to rectum |
| best way to get a urine sample from a young child | straight cath |
| signs of UTI | foul smelling urine, dysuria, increased frequency, fever, chills, flank pain |
| Tx for UTI | antibiotics and fluids |
| pyelonephritis | kidney infection |
| urosepsis | sepsis originating from a UTI |
| preventing UTIs in girls | wipe front to back |
| vesicouretal (VUR) | reflux of urine from ureters into the kidneys (risk for pyelonephritis) |
| risks for pyelonephritis | urinary tract obstruction, urinary tract stricture, VUR (reflux) |
| reoccurring pyelonephritis can cause what complications | kidney damage and scarring |
| presentation of pyelonephritis | N&V, flank pain, fever, chills, nocturia, frequency, urgency, anorexia, hematuria, dysuria |
| costovertebral tenderness | flank pain (pyelonephritis) |
| Tx for pyelonephritis | antibiotics, fluids; prophylaxis for reoccurring episodes |
| glomerulonephritis | inflammation of the kidneys -> decrease in filtering ability |
| primary cause of glomerulonephritis | infection (STREP/RHEUMATIC fever/heart) |
| group A beta-hemolytic streptococci complications | strep throat --> rheumatic fever --> rheumatic heart; glomerulonephritis |
| secondary cause of glomerulonephritis | autoimmune response (think chronic diseases like diabetes) |
| Signs of glomerulonephritis | edema (marshmellow men), HTN (extracellular fluid), hematuria, oliguria |
| What will the urine and UA of a patient with glomerulonephritis look like | coke-colored urine. UA will have RBC and protein (increased protein indicates severity of case) |
| Considerations for glomerulonephritis | Strict I&O monitoring; fluid and sodium restriction |
| Treatment of glomerulonephritis | antibiotics |
| nephrotic syndrome | inflammation of the kidneys leads to decreased filtering ability |
| primary cause of nephrotic syndrome | unknown |
| secondary cause of nephrotic syndrome | glomerular damage |
| tertiary cause of nephrotic syndrome | congenital defect |
| symptoms of nephrotic syndrome | edema (marshmellow men), HTN (extracellular fluid, oliguria |
| what will the urine and UA of a patient with nephrotic syndrome look like | beer-colored and frothy/foamy urine; UA will have massive amounts of protein |
| what will the CBC of a patient with nephrotic syndrome look like | hypoalbuminemia (low blood protein due to protein loss in urine); and high blood fat content |
| what is the risk of extracellular fluid retention | hypovolemia |
| Tx for nephrotic syndrome | steroids (possible chemo drugs) and diuretics (control HTN and fluid retention) |
| Wilms Tumor | nephroblastoma (kidney tumor) |
| wilms tumor presentation | firm, palpable abdominal tumor |
| Metastasis of wilms tumor | easily to spleen, liver, lungs, and brain |
| considerations with wilms tumor | put up a sign *DO NOT PALPATE ABDOMEN |
| what is the risk with wilm's tumor | ruptured tumor= cancer cells seeding all over the place |
| Treatment for wilms tumor | Surgery ASAP followed by chemo & radiation |
| hypospadias urethral malposition | urethral opening on the bottom shaft of the penis |
| epispadias urethral malposition | urethral opening on the top shaft of the penis |
| Tx for urethral malposition | surgical correction at 6-15 months |
Created by:
jperrault9941
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