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PHCC Mat/Child # 4
Exam 4 (Pedi - disorders: renal, sensory, MS, psych, oncology
| Question | Answer |
|---|---|
| PEDI UTI'S | Peak between 2& 6 years of age, females at higher risk. Escherichia coli ( E Coli) organism responsible 80% of the time. |
| Glomerulonephritis | Inflamation of kidneys in response to group A B-hemolyitic streptococcus (strep throat). Most common non-infectious disease of child hood. S/S Dysuria, H/A, vomiting, hematuria and proteinuria. Monitor BP. |
| Acute renal failure | When kidney are suddenly unable to regulate volume of urine in response to intake. S/S oliguria or anuria, lethargy, pallor. Most common cause of acute renal failure is DEHYDRATION. |
| Chronic Renal Failure (ERSD) | Kidneys are unable to maintain normal fluid levels, 50% of renal capacity is destroyed by disease or injury. Most frequent cause is congenital renal and urinary tract malformations. Early S/S loss of normal energy, increased fatigue on exertion, HTN |
| Uremia | Clinical syndrome in which presence of excessive amounts of urea in the blood. (a sign of chronic kidney disease or failure.) |
| Minimal Change Nephrotic Syndrome | Massive urinary protein loss and edema. Mostly between ages of 2 & 7, twice as likely to be males. Unkown cause. Prednisone is drug of choice. |
| Vesicoureteral reflux | Back flow of urine from bladder into ureters. Haven for bacterial growth.Can cause renal scarring and HTN. TX= low dose antibiotics and surgical reimplantation of ureters. |
| Hypospadias | Opening behind glans penis or anywhere along the penile shaft. Surgery to correct so child can void standing up. Nursing considerations: assess for infection, keep wound free of urine and stool. |
| Cryptorchidism | Failure of one or both testes to descend into the scrotum. Can cause malignant tumor formation and infertility. Can give HCG to older children or surgery between 1st and 2nd year. (retractile= can be pushed back into the scrotum) |
| The nurse suspecting a fever checks tympanic and oral temperatures on a 4 year old with a diagnosis of leukemia because | Rectal temperatures are avoided to reduce the risk of rectal trauma |
| A 4 year old child is admitted with the diagnosis of acute lymphoctic leukemic. Platelets are ordered and an iv is started. The nurse should | Administer the platelets rapidly |
| An 8 year old child admitted to the hospital for intrathecal methotrexate chemotherapy is prescribed allopurinol and ask the nurse why this medication has to be taken. The nurses best response would be | Because the pills hellp the other medications get rid of the things that make you sick |
| When caring for a 15 y/o client receiving chemo for leukemia the nurse should keeping mind that an adoslescent of this age will | Fell different because of an altered body image |
| When a 5 year old is reciving dactinomycin and doxorubicin therapy following a nephrectomy for a wilms tumor nursing care should include | Unsing an anesthetic mouthwash |
| When assessing the status of a child with leukemia who is receiving oncovin the nurse should be increased when the child’s | Uric acid level is elevated |
| The alkylating agent cyclophosphamide is ordered for a child with cancer. When the child is reciving this drug the nurse should assess for | Extent of hydration |
| The initial medications the nurse anticipates that the physician would order for a child admitted to the hospital with acute glomerulonephritis with hypertension would include | Reserpine and hydralazine |
| When assessing a child with leukemia for the possible side effects of oncovin the nurse should be aware that a sign of toxicity | Peripheral neuropathy |
| The nurse teaches a teenager about the needs for special mouth care because of the potential for lesions from the chemotherapy being administered. The nurse evaluates that the instructions where understood when the teenager states I should | Brush my teeth with a foam tipped applicator |
| A child survives a near drowning in a cold pound but still has many problems to over come. The nurse is aware that the prognosis will depend on the extent of damage resulting from the | Hypoxia |
| a child with leukemia is to be sent home on a protocol that includes several antineoplastics after an intrathecal administration of methotrexate. Before the discharge the nurse instructs the child parent to | Schedule routine laboratory screening to evaluate response to the medication |
| When giving nursing care to a child with leukemia, the nurse noted blood on the pillow case and several bloody tissues. The nurse should check the childs laboratory report for the | Platelet count |
| When obtaining a health Hx from the parents of a toddler who is admitted to the hospital with acute lymphocytic leukemia, the nurse would be surprised if the parents report that the first sign they observed was | A sore ness in the mouth |
| The nursing care plan for a newborn with hypospadias should include | Explaining to the parents why a circumcision will not be done |
| The nurse encourages a child with glomerulonephritis to choose combination of foods that included | Corn on the cob, baked chicken, rice, applesauce, milk , low sodium |
| When a child with a history of hypospadias with chordee becomes an adult, he will be at increased risk for | Sexual inadequacy |
| When assessing a child with glomerulonephritis the nurse should expect to find | The presence of periorbital edema |
| After a child has a surgical correction for hypospadias it is important for the nurse to | Keep the child properly immobilized with restraint |
| The nurse is aware that to confirm a Dx of acute glomerulonephritis in a 6y\o. the test that the Dr will order will include | A routine urinalysis a cbc, nasopharyngeal culture and ASO titer |
| The nurse is aware the uncorrected bilateral cryptorchidism can cause | Sterility |
| 6 weeks after birth an infant is DX as having congenital hip dysphasia the infant is admitted to the hospital for immediate corrective measures because | the infant joint is still cartilaginous and molding of the acetabulum is possible |
| the priority of care in the immediate postoperative period for a youngster with a newly applied spica cast would be | checking the childs peripheral circulation |
| after giving a bath to a 12 y\o in balance suspession with a Thomas splin and a pearson attachment for a complex Fx of the femur the nurse should\ | ensure that the traction weights are hanging unimpeded |
| when assisng a child suspected of having congenital hip dysplasis the nurse would expect that an assessment of the child orthopedic status would reveal what | an apparent shortening of the leg |
| during a newborn assessment a positive ortolani sign would be indicated by | an audible click on hip manipulation |
| nursing care specific for a child in bucks extension traction should included | assessing that the elastic bandages are not to tight or loose |
| when planning home care for a 6month old in a hip spica cast the nurse should emohasize to the parents that | the edges of the cast should be covered |
| after giving a teenager d/c care regarding cast care the nurse evaluates that the instructions are understood when the teemager say when if I am itichy around the cast I will | pat the area with an alcohol swab |
| when elevating the head of an infant in a spica cast the nurse should be aware | that it is important to raise the entire mattress or bed at the head of the bed |
| a 9 y/o has a Fx and a full leg cast has been applied the nures should call the dr if what | pt has inability to move the toes |
| a 12 y/ old is dx as having idiopathic scoliosis. Because exercise and avoidance of fatigue are essential components of care, the nurse is aware that the most therapeutic sports for this child would be | Swimming |
| to assist curvature correction in scoliosis the preadolescent is fitted with a brace. The nurs explains to the child and parents that the length of time the brace must be worn varies but is usually worn until | cessation of bone growth occurs at the time of physical maturity |
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