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pedi exam 3

ch 26, 27,. 28, 29 & 30

What regulates the rate of RBC production? Erythropoietin
What is an enlargement of lymph nodes that is indicative of infection or disease? Lymphadenopathy
What is the triad management of diabetes? Well-balanced diet, precise insulin administration, and regular exercise.
What are the main goals of therapy for the sickle cell patient? To prevent sickling, dehydration, hypoxia and infection which can bring on a sickle cell crises.
What are Thalassemias? The thalassemias are a group of hereditary blood disorders in which the patient's body cannot produce sufficient adult hemoglobin.
What does the urinary system consist of? Two kidneys, two ureters, the urinary bladder, and the urethra.
What is exanthem? Skin rash
Which acquired platelet disorder is thought to be an autoimmune system reaction to a virus and is the most common of the purpuras, a group of disorders affecting the numbers of platelets or their function? ITP - Idiopathic (immunological) thrombocytopenic purpura
What is a protrusion of part of the intestine through the umbilical ring? Umbilical hernia
What ae common skin problems in infants? Diaper dermatitis, seborrheic dermatitis, and atopic dermatitis (eczema).
When is growth hormone administered? Growth hormone is administered at bedtime to simulate the natural timing of hormone release.
What is a major goal of education of the child with diabetes? Self-management to maintain glucose control and to prevent complications
With hemophilia, appropriate sports activities should be selected to avoid undue injury and the risk of bleeding episodes. When bleeding does occur, what treatment approach should be taken? The traditional approach to care includes rest, ice, compression, and elevation (RICE).
Which stage of Hodgkins is restricted to single site or localized in a group of lymph nodes; asymptomatic? Stage I
Why is exercise important for the patient with diabetes? Because it causes the body to use sugar and promotes good circulation. It lowers the blood glucose level, and in this respect it acts like more insulin.
What is plumbism? Lead poisoning
Which medication is not recommended for children with sickle cell disease because of the risk of normeperidine-induced seizures? Meperidine (Demerol)
What is an excessive amount of fluid in the sac that surrounds the testicle and causes the scrotum to swell? Hydrocele (hydro, “water,” and cele, “tumor”)
In Celiac disease, what happens with repeated exposure to gluten? It damages the villi in the mucous membranes of the intestine, resulting in malabsorption of food
Parents can obtain normal saline solution from the pharmacy without prescription, or they can make it at home. How is this done? By using one half of a teaspoon of noniodized salt to 1 cup of lukewarm tap water.
The newborn should be closely observed for signs of tracheoesophageal fistula, which includes WHAT during feedings? Coughing, choking, cyanosis, and apnea
What is the recommended nutritional intake of carbohydrates, fats or proteins for the diabetic patient? 55% carbohydrates (mostly complex carbohydrates), 30% fat, and 15% protein
What is uncontrolled voiding after bladder control has been established? Enuresis
Red lips and fruity odor to the breath may indicate what in a diabetic child? A need for insulin
What is a disease of infancy and childhood caused by deficient amounts of vitamin D? Rickets
What are the initial signs of Diabetes Insipidus? Polydipsia and polyuria are the initial signs.
How is ITP diagnosis confirmed? Diagnosis is confirmed by bone marrow aspiration to rule out leukemia.
What factors account for UTIs in girls? Shorter urethra, the location of the urethra closer to the anus, the wearing of close-fitting nylon underwear, the use of bubble baths, the retention of urine, and vaginitis.
Which type of FTT can be caused by physical pathology, such as congenital heart disease or malabsorption syndromes? Organic failure to thrive (OFTT)
What is useful for investigating congenital abnormalities or acquired lesions in the bladder and lower urinary tract? Cytoscopy
Dialing WHAT NUMBER anywhere in the United States will route the call to the nearest poison control center? 1-800-222-1222
The two major systems that control and monitor the functions of the body are which? Nervous system and the endocrine system.
What is characterized by thick, yellow, oily, adherent, crustlike scales on the scalp and the forehead. The skin beneath the patches may be red (erythematous)? Seborrheic dermatitis (cradle cap)
Hypospadias may be accompanied by what which is a downward curvature of the penis caused by a fibrotic band of tissue? Chordee
The continuous loss of WHAT from the stomach can cause alkalosis? Hydrochloric acid and sodium chloride
Which type of dehydration is it when the child has lost more electrolytes than fluid? Hypotonic Dehydration
Hemophilia B also known as the Christmas disease, involves a deficiency of which factor? Factor IX
Insulin potency can be decreased if the bottle has been opened for longer than what period of time? More than 1 month
With Intussusception, bowel movements diminish, and little flatus is passed. Movements of blood and mucus that contain no feces are common about 12 hours after the onset of the obstruction and are called what? These are termed currant jelly stools.
Electrical burns carry what risk? Thrombosis and tissue damage in other parts of the body.
The bladder capacity of a child can be approximated by what formula? Age in years + 2 = Ounces of bladder volume or capacity
What are anthelmintics? Anti worm medications such as Mebendazole (Vermox), Pyrantel pamoate (Antiminth) or Pyrvinium pamoate (Povan) suspension
What are the goals in the treatment of poisoning? Remove the poison, prevent further absorption, call the poison control center and provide supportive care—seek medical help.
Which disease is an inherited defect in the formation of hemoglobin? Sickle Cell
What is the priority concern for the infant with gastroeneritis? Preventing fluid and electrolyte imbalance
What are the stages of dying according to Kübler-Ross? Denial, anger, bargaining, depression, acceptance, and reaching out to help others.
What are the 6 C's of burn care? Clothing, cooling, cleaning, chemoprophylaxis, covering, and comforting or pain relief
ITP occurs in all age-groups, with the main incidence seen between which ages? 2 to 4 years of age
The highest incidence of iron-deficiency anemia occurs from the ninth to the twenty-fourth month. Why? During this period, the infant outgrows the limited iron reserve that was in the body; iron-fortified formula and infant cereals may have been eliminated from the diet. Poorly planned meals or feeding problems also contribute to this deficiency.
In children under 2 years of age, why is surface area particularly important in fluid and electrolyte balance? Because more water is lost through the skin than through the kidneys. The surface area of the infant is from 2 to 3 times greater than that of the adult in proportion to body volume or body weight.
Failure to Thrive (FTT) children fall below which percentile in weight and height on standard growth charts? Children fall below the third percentile (some authorities suggest the fifth) in weight and height on standard growth charts.
What are the types of burns? Thermal, electrical, chemical, and radiation.
What is a serious congenital defect in which the bladder lies exposed on the lower portion of the abdominal wall. Surgical correction of this defect is lifesaving. Bladder exstrophy
What is the greatest threat to life in isotonic dehydration? Shock (hypovolemia)
What must the nurse confirm before IV potassium is administered? The nurse must document that at least one void has occurred.
What is an operation to correct pyloric stenosis called? Pyloromyotomy
What results when the lower esophageal sphincter is relaxed or not competent, which allows stomach contents to be easily regurgitated into the esophagus? GER
What is a malignant disease of the blood-forming organs of the body that results in an uncontrolled growth of immature WBCs? Leukemia
What is a narrowing of the preputial opening of the foreskin, which prevents the foreskin from being retracted over the penis? Phimosis
What is a slipping of one part of the intestine into another part just below it? Intussusception (intus, “within,” and suscipere, “to receive”)
Which disorder is one of the oldest hereditary diseases known to humanity. In this disorder the blood does not clot normally, and even the slightest injury can cause severe bleeding. Hemophilia
What is the term for the deposit of iron into organs and tissues in the body? Hemosiderosis
Where is gluten found? Wheat, barley, oats and rye
Which type of thalassemi occurs when two thalassemia genes are inherited, the child is born with a more serious form of the disease. A progressive, severe anemia becomes evident within the second 6 months of life. Thalassemia major also known as Cooley's anemia
After a feeding, the infant with GER should be placed in which position? In an upright position or on the right side. The body is inclined 30 to 40 degrees, and the infant is held in place by a Fowler's sling. The upright prone position has been recommended for the infant with GER.
Drooling in the newborn may be a sign of what? An obstructed esophagus (TEF).
What is the term for large petechiae? Purpura
What are signs of transfusion reactions? Chills, itching rash, fever, and headache.
What is the most common endocrine disorder of children? Diabetes mellitus type 1
What is a congenital defect in which the urinary meatus is on the UPPER surface of the penis? Epispadias
Which disease involves a deficiency of hexosaminidase, an enzyme necessary for the metabolism of fats. Lipid deposits accumulate on nerve cells, causing both physical and mental deterioration and is found primarily in the Ashkenazic Jewish population. Tay-Sachs
What are the most common symptoms during the initial phase of leukemia? Low-grade fever, pallor, bruising tendency, leg and joint pain, listlessness, abdominal pain, and enlargement of lymph nodes.
In what timeframe does normal blood clot? 3 to 6 minutes
Thalassemia major (Cooley's anemia) is treated primarily with what? Multiple blood transfusions
Sickling (clumping) caused by decreased blood oxygen levels may be triggered by WHAT? Dehydration, infection, physical or emotional stress, or exposure to cold.
The presence of giant multinucleated cells called what is diagnostic of the Hodgkins disease? Reed-Sternberg cells
What are the two portions of circulating blood? Plasma and formed elements.
What are the two types of Sickle Cell? Sickle Trait and Sickle Cell Anemia
In thalassemia, what causes changes in the contour of the child's skull and face? Massive expansion of the bone marrow
What is the outstanding symptom of Pyloric Stenosis? Vomiting is the outstanding symptom of this disorder. The force progresses until most of the food is ejected a considerable distance from the mouth. This is termed projectile vomiting, and it occurs immediately after feeding.
What is a severe generalized edema? Anasarca
What is the most common form of childhood cancer? Leukemia
In general, a child can be taught to perform self-injection after what age? 7 years of age
Thalassemia occurs mainly in persons of WHAT origin? Mediterranean
Which stage of Hodgkins is diffuse disease; least favorable prognosis? Stage IV
Hemophilia A, the most common form, results from a deficiency in which coagulation factor? Factor VIII
What is caused by hypertrophy of the pyloric muscles and is manifested by projectile vomiting? Pyloric Stenosis
What is the treatment for Tay-Sachs disease? There is no treatment for this devastating disease. The nursing care is mainly palliative. Most care is given in the home, with periodic hospitalization for complications such as pneumonia.
A hemoglobin level below WHAT NUMBER results in an increased cardiac output and a shunting of blood from the periphery of the body to the vital organs? Below 8 g/dl
Which iron-chelating agent, is given to counteract hemosiderosis? Deferoxamine mesylate (Desferal)
Children do not develop a realistic concept of death as a permanent biological process until what age? 9 to 10 years of age
The mainstay of treatment for thalassemia major is frequent blood transfusions to maintain the hemoglobin level above 10 g/dl. As a result of repeated blood transfusions, excessive deposits of iron may be stored in the tissues.What is the term for this? This is termed hemosiderosis and is seen especially in the spleen, liver, heart, pancreas, and lymph glands.
During a sickle cell crises, what type of nursing care should the nurse anticipate? Anticipate the child's need for tissue oxygenation, hydration, rest, protection from infection, pain control, blood transfusion, and emotional support for this life-threatening illness.
Which stage of Hodgkins involves two or more lymph nodes in area or on same side of diaphragm? Stage II
What is 'Wilms' tumor? Nephroblastoma (nephro, “kidney,” blasto, “bud,” and oma, “tumor”). An embryonal adenosarcoma (adeno, “glandular,” and sarcoma, “cancer of connective tissue”) known to be associated with congenital anomalies, particularly of the genitourinary tract.
Which form of Sickle Cell is asymptomatic and occurs in about 10% of the African-American population in the US. The blood of the patient contains a mixture of normal (hemoglobin A) and sickle (hemoglobin S) hemoglobins. Sickle Trait
Which sugar substitutes should not be given to children and why? Sorbitol and xylitol because they may contribute to diabetic complications
Of the several varieties of worms that affect humans, the most common is which? Pinworm
What is hypotonia? “ragdoll limpness”
What is an inflammation of the colon and the small intestine? Enterocolitis
What are the classic symptoms of rickets? Bowlegs; knock-knees; beading of the ribs, called the rachitic rosary; and improper formation of the teeth.
GER is associated with neuromuscular delay and is often seen in which patients? In preterm infants and children with neuromuscular disorders, such as cerebral palsy and Down syndrome.
What is the volume of swallow? The volume of a swallow has been estimated to be 0.21 ml/kg
What are good sources of iron for the infant? Boiled egg yolk, liver, leafy green vegetables, Cream of Wheat, dried fruits (apricots, peaches, prunes, raisins), dry beans, crushed nuts, and whole-grain bread are good sources of iron.
How is pinworm diagnosed? Pinworm is diagnosed by a “Scotch tape test.” Preventing the child from scratching the anal area is an essential part of breaking the cycle of worm reinfestation.
Which type of FTT may be caused by a lack of parent-infant interaction that can result from environmental factors, neglect, or lack of information concerning the nutritional needs of infants? This is nonorganic failure to thrive (NFTT).
What is the treatment of choice for Intussusception? A barium enema is the treatment of choice, with surgery scheduled if reduction is not achieved.
What is a congenital defect in which the urinary meatus is located not at the end of the penis but on the LOWER SHAFT? Hypospadias
Which drug has now replaced aspirin as the most commonly ingested drug that causes toxicity? Acetaminophen (Tylenol)
Which type of dehydration is it when the patient has lost equal amounts of fluids and electrolytes? Isotonic Dehydration
Priority teaching for a parent of a child who ingested a foreign body includes what? Slicing each stool passed to observe for the foreign body
Which form of Sickle Cell disease results when the abnormality is inherited from both parents? Sickle Cell Anemia
A priority nursing responsibility in the care of a child with Wilms' tumor is to what? Omit abdominal palpation during daily assessments because it can cause the tumor to spread.
Which stage of Hodgkins involves lymph node regions on both sides of diaphragm; involves adjacent organ or spleen? Stage III
When one or both testes fail to lower into the scrotum, the condition is termed what? cryptorchidism (kryptos, “hidden,” and orchi, “testis”)
What is an infection of the mucous membranes of the mouth caused by the fungus Candida? Thrush
When is the best time to appoly a topical hydrating medication? After a warm bath because this is when absorption will be best.
Pica, the eating of nonfood items, is characteristic of children with what? Lead poisoning
What is the characteristic symptom of nephrosis? Edema
What type of respirations are seen in diabetic children with Ketoacidosis? Kussmaul's
What is a classic symptom of hemophilia? Hemarthrosis - bleeding into the joints
What is a disease caused by insufficient fruits and vegetables that contain vitamin C in the diet? Scurvy
In which form of Sickle Cell are the hemoglobin and RBC counts normal? Sickle Trait
A child who has diabetes mellitus asks why he cannot take insulin orally instead of by subcutaneous injection. The best response of the nurse would be: Insulin is destroyed by digestive enzymes
In the newborn, failure to pass meconium stools within 24 to 48 hours may be a symptom of which disease? Hirschsprung's
What is miliaria? Prickly heat - refers to a rash caused by excess body heat and moisture
With accidental ingestion of a nonfood object, unless the object is sharp or large, passage through the GI tract may be possible and can take up to how many days? 4 to 6 days
Which type of sickle cell crises is the most common type; there is an obstruction of blood flow by cells, infarctions, some degree of vasospasm? Vaso-occlusive (painful crises)
Tap water enemas in infants and small children can lead to what? Water intoxication and death
Why are the sides of the fingertips recommended testing sites for blood glucose testing? Because there are fewer nerve endings and more capillary beds in these areas.
What is Gastroenteritis? It involves an inflammation of the stomach and the intestines
Drugs that contain what are contraindicated for children with hemophilia? Salicylates
What is an abnormal collection of fluid in the peritoneal cavity. It is seen in advanced cases of nephrosis and in other conditions? Ascites
What is Kwashiorkor? Protein deficiency
With the anthelmintic Pyrvinium pamoate (Povan), what should the nurse advise parents? That Povan stains and turns the stools red.
What is the medical term for chafing? Intertrigo (in, “into,” and terere, “to rub”)
The stools of infants who are taking oral iron supplements are what color? Tarry green
The insulin pump should not be removed for longer than what period of time? The pump should not be removed for more than 1 to 2 hours at a time
Which type of dehydration is it when more fluids are lost than electrolytes? Hypertonic Dehydration
What are the symptoms of scurvy? Joint pains, bleeding gums, loose teeth, and lack of energy
In the diabetic patient, WHAT has been shown to reduce blood glucose levels, lower serum cholesterol values, and sometimes reduce insulin requirements. It also appears to slow the rate of absorption of sugar by the digestive tract. Soluble fiber
Which disease is a malignancy of the lymph system that primarily involves the lymph nodes? Hodgkins
Which type of thalassemia occurs when the child inherits a thalassemia gene from only one parent and is associated with mild anemia? Thalassemia minor
The presenting symptom of which disease is generally a painless lump along the neck? Hodgkin's
Which type of sickle cell crises is it when bone marrow stops producing red blood cells (RBCs); a number of infections may precipitate this (usually viral)? Aplastic crises
What are good sources of soluble fiber? Raw fruits and vegetables, bran cereals, wheat germ, beans, peas, and lentils are good sources of soluble fiber.
Which type of sickle cell crises is it when large amounts of blood pool in liver and spleen? Splenic sequestration
What is the term for spleen enlargement? splenomegaly
Created by: bsmymicareo