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Lap 7
Care of the child with a physical disorder/W. Calley
| Question | Answer |
|---|---|
| Congenital heart disease (CHD) | an abnormality or anomaly of the heart, present at birth |
| Acquired heart disorders | consists of abnormalities occurring after birth that compromise the hearts function |
| Hypoproliferative | defective erythrocyte production |
| Hemolytic | premature destruction of erythrocytes |
| Sickled Cell | Erythrocyte whose characteristic round shape has altered to an elongated crescent shape. As it clumps, circulation slows resulting in obstructions. |
| Priapism | persistent penile erection that can occur in response to occluded penile veins. |
| Pneumothorax | a collection of air or gas inthe pleural space causing the lung to collapse |
| Nissen Fundoplication | involves wrapping the fundus of the stomache around the distal esophagus to prevent reflux of the stomach contents into the esophagus, is the most commonly performed medical procedure. |
| "Currant jelly" stools | feces that is mixed with blood and mucus from the intestinal mucosa. a hallmark sigh of intussuception (intestinal obstruction) |
| Intussusception | the most common cause of intestinal obstruction in children between 3 mo-6 years. twice as common in males. cause unknown |
| Megacolon | congenital aganglionic megacolon; a functional intestinal obstruction caused by the absence of parasympathetic ganglion cells in a portion of the colon |
| Hernia | the protrusion of organs or protions of an organ through a structural defect or weakened muscle wall |
| Flomerulonephritis | is an inflammation of the glomeruli of the kidney. associated with pneumococcal, streptococcal and viral infections. |
| Acute poststreptococcal glomerulonephritis | the most common of hte postinfection forms. primarily affects early school aged children with a peak age of onset of 6-7 years, more dominant in males (2:1) |
| Type 1 diabetes | characterized by destruction of the pancreatic beta cells which produce insulin; this usually leads to absolute insulin deficency. results from an autoimmune destruction of the beta cells. starts in young children. |
| Type 2 diabetes | usually arises because of insulin resistance, in which the body fails to use insulin properly, combined with relative insulin deficiency, occurs in older people, obese, and family history |
| What is the cardinal sign of diabetes? | polyuria |
| Polyuria | excessive urination |
| Polydipsia | excessive thirst |
| Glucogenesis | protein being broken down and converted to glucose by the liver. this glucose contributes to hyperglycemia |
| Polyphagia | excessive hunger |
| ketonuria | ketones in the urine |
| ketonemia | ketones in the blood |
| ketoacidosis | acidosis accompanied by an accumulation of ketone in the blood resulting from faulty carbohydrate metabolism |
| Kussmaul's respirations | hyperventilation characteristic of metaolic acidosis |
| Diabetic Ketoacidosis (DKA) | a pediatric emergency, |
| Subluxation | is the degree of Developmental dysplasia of hte hip most commonly seen in infants. dislocation occurs when the femoral head has no contact with the acetabulum |
| Legg-Calve-Perthes disease | is a disorder caused by decreased blood supply to the femoral head, which results in epiphyseal necrosis and degeneration of the femoral head followed by regeneration or calcification. 4 times mor likely in boys and affects children from 3-12y |
| Gowers sign | classic sign of Duchennes muscular systrophy; the child positions on all fours and uses the hands to walk up the thighs |
| Kernig's sign | resistance to knee extension in hte supine position with the hhips and knees flexed agains the torso |
| Brudzinski's sign | flexion of hte knees and hips when hte neck is flexed rapidly onto the chest |
| Alpha-Fetaprotein | antigen present in the human fetus that can be used to evaluate fetal development |
| Neural tube | tube formed from the fusion of hte neural folds from which the brain and spina cord arise |
| Chelation therapy | in toxicology, to use a compound to grasp a toxic substance and make it nonactive and thus nontoxic |
| Prodromal | early sign of a developing conditon or disease |
| Amblyopia | laz eye' reduction ofr dimness of vision, espically in which there is no apparent pahologic conditionof the eye |
| What congenital heart defects typically produce cyanosis? | Congenital heart disease, Tetralogy of Fallot, Transportion of the Great Vessels, |
| What are the four congenital defects involved with Tetralolgy of fallot? | Pulmonary stenosis, Ventricular Septal Defect, right ventricular hypertorphy and overriding aorta. |
| What is the medical management for Coarctation of the Aorta? | Surgical correction involves removal of hte narrowed portion of the aorta with an end-to-end anastomosis or gract replacement if hte narrowing is extensive. |
| Coarctation of the Aorta | narrowing of the lumen of the aorta resulting in increased pressure proximal to the defect (head and upper extremities) and decreased pressure distal to the defect(body and lower extremities). |
| Iron Deficiency Anemia | is a decrease in the RBC volume, a decrease in hemoglobin, or both. Anemias reduce the oxygen carrying capacity of the blood and can result in tissue hypoxia.can be classified as hypoproliferative or hemolytic. becomes apparent at 6m |
| What are the Clinical Manifestations of IDA? | clinical signs and symptoms can be vaguse and nonspecific and include irritability, weakness, decreased play activity, and fatigue. When hemoglobin falls below 5 the child will have anorexia, skin pallor, pal mucous membranes, cant concentrate, tachycardi |
| What are the Diagnostic tests for IDA? | history of childs diet, appetite, activity, weight and rate of growth, recent blood loss. CBC, reticulocyte count, serum ferritin (iron storage protein) |
| What is the Medical management for IDA? | iron replacement therapy, nutritional counseling and treatment of any underlying conditions. oral iron supplements are prescribed until hemoglobin levels return to normal. citrus fruits or juices given with iron supplements, ascorbic acid ^ iron absorptio |
| What are the Nursing interventions for IDA? | Dietary counseling, assist family in choosing iron rich foods, oral preparations should be given 3 times dsily between meals with citurs fruits. for infants place syringe at back of mouth, older kids give through a straw |
| Sickle Cell Anemia | hemoglobinopathies; normal hemoglobin is partly or completly replaced by abnormal sickle hemoglobin. when oxygen is relased into the tissues the abnormal hemoglobin becomes more viscous and crystalizes causing the erythrocyte to change shape. |
| What does Sickle Cell Anemia do to the bodies circulation? | as the cells clump, circulation slows resulting in obstructions with severe tissue hypoxia and necrosis. |
| What are the clinical manifestation of SCA? | pallor, irritability, fatigue, and jaundice, growth impairment, cardiomegaly and heart failure develop in response to hypoxia nad decreased cardiac output, joints may swell and hurt, strokes, sensory deficits, paralysis, death, penile erection. |
| What are the diagnostic tests for SCA? | newborn screenigns are mandatory. sickle cell identity test (sickledex)can be performed by fingerstick, if that is positice ahemoglobin electrophoresis id done to determine sickle cell trait or disease. |
| What are the nursing interventions for SCA? | maintining adequate hydrationto prevent further sickling, administer analegesics PRN, provide adequate o2, comfort measures such as warm baths and local heat, teach families to avoid situations that lead to hypoxia, sickling, infection, dehydraion, e |
| What are some abnormal diagnostic tests results for Hemophillia? | abnormal PT, PTT and INR. |
| What is the Medical management for leukemia? | Supportive therapy until bone marrow recovers, induction therapy is started and lasts 4-6wks, corticosteroids, vincristine, L-asparaginase,(w/ or w/o doxorubicinor daunorubicin)and cytosine arabinoside. Prophylatic TX, CNS prophylaxis, Methotrexate,pg1105 |
| What are the Nursing interventions for a child with Juvenile Rheumatioid arthritis? | no strenuous activities, daily program of rest, excercise, medications and pain management, encourage to perform ADL with littl or no help, support groups for child and family |
| What is the Pathophysiology of Respiratiory distress syndrome? | severe lung disorder that is the major cause of morbidity and mortality in the neonatal period. caused by a deficiency of surfactant. the infant is unable to keep the lungs inflated and the alveoli collapse at the end of expiration resultingin hypoxia |
| What are the clinical manifestations of RDS? | respiratory signs show immediatly after birth, s/s-nasal flaring, expiratory grunting, intercoastal , subcostal or substernal retractions, dusky color, tachypnea, dyspnea, low body tempapnea, absent movement, mottling. may improve by 4th day if doesnt die |
| What can you do to prevent SIDS? | prevent maternal smoking, no bed sharing, avoid overheating, position them off of their stomach, place them on their back, no pillows or soft bedding, no stuffed animals. |
| What is the etiology of Tonsillitis? | the tonsils are masses of lymphoid tessue located in the pharyngeal cavity to protect the respiratory and alimentary tracts from invasion of microorganisms. play a role in antibody formation. usually occurs from pharyngitis anc be viral or bacterial |
| What are the Clinical Manifestations of Tonsillitis? | sore throat, headache, edematous and tender cervical lymph glands, fever, hoarsness, and cough. (vomiting, muscle aches, dysphagia may be from streptococcal tonsillitis.) |
| What is the Medical Management for Tonsillitis? | comfort measures, 10 day course fo PCN or erythromycin, surgical removal of tonsils that are hypertrophied, |
| What some Nursing interventios for tonsillitis? | assess for signs of infection, loose teeth and check lab data(PT, PTT, H&H, Plt ct), monitor for excessive bleeding, give analgesics, provide fluids, soft diet, no straws, assess for hemorrhage; increased pulsem pallor, clearing of throat frequently |
| What is the pathophysiology of Laryngotracheobronchitis (LTB)? | is the most common form of croup affecting children 3mo-3years and is usually viral in origin, LTB usually follows an upper respiratory infection that descends to the lower respiratory tract and has a gradual progressive onset. |
| What is the Clinical Manifestations of LTB? | hoarseness, inspiratory stridor, tachypnea, nasal flaring, suprasternal, substernal and intercoastal retractions, barking cough, check fo rdrooling, dyspnea, dysphonia and dysphagia. |
| What is the medical Management for LTB? | focused on maintaing the airway, high cool mist humidity w/ low concentration o2 via mist tent, epi by aersol to decrease edema. NPO during acute phase, never used sedatives |
| What is the pathophysiology of Acute Epiglottitis? | is a severe, potentially life threatening bacterial infection of the epiglottis in older chidren. the inflamed epiglottis becomes cherry red and edematous which can lead to total airway obstruction. |
| What is the Medical management for Acute Epiglottitis? | artificial airway, humidification via mist tent, gentle oral suctioning, constant observation, aerosol epi, IV antibiotics. child can be extubated when swelling goes down (about 3 days) |
| What are the treatments for a child with cystic fibrosis? | breathing excercises, bronchodilators, expectorants, mucolytic agents adn antibiotics. high calorie high fat diet with water soulable vitamin supplements. |
| What is the Pathophysiology of cystic fibrosis? | is an inherited autosomal recessive trait; the affected child inherits the defective gene from both parents. its a disorder of the exocrine glands characterized by thick mucus that obstructs the lungs and GI system. most common fatal genetic disorder |
| What is the clinical manifestations of cystic fibrosis? | steatorrhea(foul smelling fatty stools), growth failure, protruding abdomen, thin wasted extremities, rectral prolapse, vitamin K deficiency, transparent skin, chronic cough, wheexing , sputum production, dyspnea, hypoxia, clubbing, cyanosis. barrel chest |
| When are pancreatic enzyme supplements given to a child? | mixed with a carbohydrate and administered before meals and snacks? |
| What are the clinical manifestations of bronchial asthma? | thightness in the chest, audible expiratiory wheezes. SOB, tachypnea, dyspnea, coarse breath sounds, prolonged expiration, restlessness, anxiety , deep dark red color to lips, cyanosis, paroxysmal cough progressign fromdry and hacking to productive, |
| What medications are used to treat bronchial asthma? | corticosterioids, cromolyn sodium, nedocromil sodium, B-adrenergic agonists, methylaxanthines, leukothriene modifiers |
| What are the clinical manifestations for a cleft lip/palate? | feeding difficulties may result depending on severity of cleft palate, ineffective suck, saliva and feedings may leak into the nasal cavity causing gaging and choking, speech may be delayed, predisposed ot recurrent otitis media. |
| what is the medical management for cleft lip/palate? | surgicla closure of cleft lip and palate usually performed at 1-2 mo of age |
| Dehydration | is when the body loses more fluid than it absorb. |
| What is the most acurate way of assessing a childs degree of dehydration? | noting changes in body weight. Mild, moderate, and severe dehydration corresponds to fluid deficits of 5%, 10%, and 15% |
| What are the nursing interventions for a child with dehydration? | assess, I&O, assess frontanell in infants, infants and young children are at greatest risk. |
| What is the treatment for GERD? | small frequent feedings that are thickened w/infant cereal, H2 antagonists are given to reduce acid, reglan may be given before meals to assist gastric emptying. nissen fondoplication( wrapping the fundus around the esophagus) is more commonly done now. |
| What are the clinical manifestations for Pyloric Stenosis? | vomiting 30-60 min afer feeding, lethargy, weight loss, poor skin turgor, sunken fontanells, loss of sub Q tissue may be apparent if dehydration continues. |
| Pyloric Stenosis | an obstructive disorder in which the gastric outlet is mechanically obstructed by a congenitally hypertorphied pyloric muscle. |
| What is the Pathophysiology of Hirschsprung's disease? | an absence of innervation to a segment of hte bowel. lower portion of the sigmoid colon is affected no peristaltic waes in the affected portion to proped fecal contents causing an obstruction and distenito of the bowel |
| What is the pathophysiology of Nephrotic syndrome? | autoimmune process and hypersensitivity to antigen antibody reaction are implicated as possibel causes. proteinuria resulting from glomerular damage that renders the glomerulus permeable to protein.leads to low blood protein. |
| COntinued | edema results form hydrostatic pressure in the capilaries, the shift of fluid causes hypovolemia, kidneys retain Na+ and water, leading to increased edema. |
| What are the nursing interventions for a child with glomerulonephritis? | focused on promoting rest and adequate nutrition, preventing and detecting complications and supporting the child and family. placed on bed rest during acute phase. vitals, I&O, weight should be monitored. |
Created by:
wcalley
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