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Peds 2

Pediatric Nursing conditions

*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