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NUR 131 exam 2

males can become serile from mumps
inc 10-21 days, inf day or 2 before eruptions, direct droplet varicella Zoster, chicken pox
complications of varicella secondary bacterial inf, CNS comps, seizures, pneumonia, reyes
enterovirus, facal-oral, oral-oral, inc 1-3 wks, HA abd pain, malise, stiff trunk, neck poliomyelitis
inc 1-3 wks, dur 4 wks, rhinorrhea,barking cough, V, salivation, cough may last several months, droplet trans pertussis, whooping cough,
vacination for whooping cough Tdap at 2-4-6 months at 4mths they are immune.
inc 2-5 days, inf 2wks to mths, droplet, sore throat, foul smelling, gray membraine on tonsils , fever, hearth failure, diptheria
tx for diptheria diptheria antitoxin and antibiotics
tx for pertussis erythromycin, corticosteroids
live/attenuated vacines that have to b adm in 15 min MMR, nasal flu, varacella,
non infectious vaccines, inactive by heat/chem, cause body to produce antibodies, need several doses
bacteria; toxins that have been inactivated by heat/chem toxids
antibodies, temp passive immunity, nfor exposures humaqn immune globuline, "Hbig"
bacteria found in soil, anarobic bacteria, HA, stiffness in jaw/neck tetanus
bacterial menigitis, brain damage, deafness, immunize infant-15mths HIB-hemophilus Influenza type B
not required vacc, recommended for 2-4-6-15 mths for menigitis and sepsis in infants streptococcus pneumonia meningitis Prevnar7
vaccine prevents chronic inf that can cause liver desease/cancer hepatitis b
if mom has heptitis b and gives birth infant gets hep b vac and hep b immune globulin
hept b vac IM at birth, 1 mth, 6 mth
data compiled usinf lot numbers of vaccines VAERS vaccine adverse effect reporting
expected side effects os vaccines low grade temp x 24-48 hr, soreness at inj site, rash/fever 10 days after w MMR
majority of accute illness in children are caused by resp inf
upper resp tract oronasopharynx,laryns, upper part of trachea
most prevalent desesase of early childhood otitis media
theraputic management of otitis media amoxicillin 80-90mg/kg/day divided into two doses, tx fever/pain, myringotomy, tympanostomy, adenoidectomy
inc of eardrum myringotomy
tonsils are... lymphoid tissue that protect resp/ailmentary tracts from invasion of org
NS care after tonsilectomy comfort, low activities, soft/liquid diet, cool mist vapor, warm salt water gargles, losenges, analgesic,antipyretic meds
Homecare for tonsilectomy avoid, spicy foods, gargles/virgorus brushing, coughing/clearing throat, analgesics/ice collor for pain, mouth oder common
hoarseness, barking cough, inspiratory stridor, resp distress from swelling of throat croup
laryngotracheobronchitis occurs in very young children
epiglottitis occurs in older children
serious obstructive inflam process that occurs in children 2-8mths. requires immediate attentions, child has fever sits upright in tripod position accute epiglottitis
air raid airway closed, inc pulse, restlessness, retractions, anxiety inc, inspiratory stridor, drooling. emergency tracheomoty
most common croup syndrome affects children under 5 acute laryngotracheobronchitis, starts in upper goes lower.
lower resp tract lower trachea, mainstem bronchi, segmental bronchi, segmental bronchoiles, and alveoli
inflm of the trachea and bronchi, virus, dry hacking nonproductive cough, productive in 2-3 days bronchitis, tx analgesics, antipyretics, and humidity
acute inf, bigest cause of hosp of children, can develop asthma, narrowing bronchioles prevents air from leaving, emphysema RSV-tx cool humidified O2, meds, separate room, contact standard precausions, monitor O2
symptoms of RSV wheezing, retractions, crackles, dyspnea, tachypnea, diminished breath soundfs
pain of pneumonia can b confused w appendicitis
can cause wheezing, asymmetric breath sounds, dec airway entry, dyspnea foreign body aspiration
chronic inflam disorder of the airwyas, expiratory wheezing, chest tightness, breathlessness and cough asthma
viscosity of mucous gland secretions clogs lungs, obstructs ducts of pancreas preventing digestive enzymes going to intestines Cystic Fibrosis-tx dec fat, inc salt, antibiotics, fat sol vits, bronchodilators, mucolytics, pancreatic enzymes
prevention of sids no smoking, gaps in crib, toys, blanket below arms, on back, dont sleep with
separation anxiety protest=aggressive, dispair=crying stops, detachment=interested
severe emotional threat for adolescents peer group separtion
focus on childs developmental age not chronilogical
greatest stress of hosp of child separation anxiety
infants=trust, todlers=autonomy, tantrums, preschoolers=magical, school age=independence, adolescents=liberation
preschoolers think their thoughts can cause death, schoolage think its from their misdeeds, 9 and up understand
deoxygenated blood goes... from r side of the heart and pulmonary circulation
oxygenated blood goes.. to the left side of the heart and tissues
lungs transfer oxygen.... from the atmosphere to the alveoli
gases in and out of the lung ventilation
pump oxygenated blood to eh tissues and return deoxygenated blood to the lungs perfusion
trans of resp gases, O2 to blood, CO2 to be exhaled diffusion
most important factor controling resp depth CO2
active process stiulated by chemical receptors in aorta inspiration
passive process that depends on elastic recoil of lungs expiration
desease that loses teh elastic recoil of the lungs cuasing inc work for breathing COPD
chemical produced in lungs tgo prevent alveoli from collapsing surfactant
effort required to expand and contract the lungs work of breathing
left sided heart failure findings crackles, hypoxiaq, SOB on exertion, nocturnal dyspnea
right sided heart failure findings wt gain, distended neck veins, hepatomegaly,spienomegaly and dependent peripheral edema
maximun O2 for CO2 retainers 24-28%
leading cause of atherosclerosis peripheral artery disease-progressive narrowing of vessels in u/l extremities
peripheral artery disease effects 60-80 yrs, hispanics women, afro am, parethesia, red foot down, white foot up,intermitent claudation
PAD clinical ass ED, tight shiny skin, no hair on shins, pain at rest, gangrene
PAD risk facotrs smoking, lipid elevation, HTN, DM, history, obesity
PAD complications atrophy of skin/muscles, delayed healing, wound inf, amputation
diag studies for PAD doppler, duplex imaging(map blood flow), ankle-brachial index(compares BPs, angiography, MRA
dilated, tortuous, subcutaneous veins varicose, congenital weakness, bad valves, saphenous vein system
clinical mans of varicose veins discomfort, swelling, nocturnal leg cramps,
swelling of vein caused by a blood clot thrombophlebitis
clinical findings for DVTs edema, extremity pain, parethesias, warmth, redness, temp 100.4, pos holmans sign
diagnostic tests for DVTs venous compression ultrasound, duplex ultrasound, CT, MRI, phlebogram
prevention of DVTs mobile, positioning q 2hr, f/e of feet, knees, hips q 2-4hrs, teds, compression (not on effected side), anticoag
anti coag therapies vitamin K antagonists, indirect thrombin unhibitors,direct thrombin inhibtors, factor Xa inhibitors
vitamin K antagonists warfarin (Coumadin), INRs (2.0-3.0), antidote=vit K, no NSAIDS, ASAs, herbal sups, green leafies
indirect thrombin inhibitors unfractionated/low-molecular wt heparin, aPTT (N 25-35; T 46-70), LMWH=no tests, antidote=protamine sulfate
direct thrombin inhibitors lepirudin (Refludan)
factor Xa inhibitors Arixtra
immune reaction that causes severe sudden reduction in the platelet count w a paradoxic increase in venous/arterial thrombosis HIT heparin induced thrombocytopenia
two major groups of cardiovascular disorders congenital and acquired
congenital heart disease anatomic abnormalities present at birth that result in abnormal cardiac function. CHF, Hypoxemia
acquired heart disorders disease processes or abnormalities that occur after birth. inf, autoimmune responses, environmental factors, familiala tendencies
abnormal opening between atria atrial septum defect-blood flows from l to r atrium
clinical findings of ASD CHF, low growth, sys/dys murmur, dysthrythmias, pulmonary vascular obstructive desesase, emboli
surgical tx of ASD patch for lg defects, repai/cardiopulmonary bypass, valve replacement
abnormal opening between teh r/l ventricles ventricular septal defect-pinhole to absense of septum, may close
clinical findings for VSD CHF, murmur
surg tx for VSD pulmonary banding, complete repair, sutures, patch
most common cardiac defect in children AV septum defect-blood flows between all 4 chambers
clinical findings for AVSD CHF, loud sys murmur, cyanosis more w crying,
surg tx for AVSD banding, complete repair,
failure for fetal ductus arteriosus to close wi the 1st few week of life patent ductus arteriosus-murmur
cyanotic at birth, worses w age systolic murmur, anoxic p feeding/crying tetralogy of fallot
risks of tetralogy of fallot emboli, seizures, LOC, sudden death
high BP, bounding pulse in arms, weak/absent femoral pulses, coarchtation of the aorta
risks of coarchtation of the aorta HTN, ruptured aorta, aortic aneurysm, stroke
inability of teh heart to pump an adequate amount of blood to the meet systemic circulation needs CHF
causes of CHF in children strucutral abs, septal defect, myocardial failure, ventricle impared, demand on heart
med for CHF digoxin, Lanoxin
digitalis glycosides inc cardiac output, dec heart size, relief of edema
angiotensin-converting enzyme, ACE inhibitors vasodilation, dec BP, reduce afterload
beta blocker dec HR, BP, vasodilation
diuretics lasix, depletes vit K, Pot sups
cheifncause of death in downs resp tract inf combined w heart anomolies
occurs after streptococcal inf in school age children rheumatic fever
meds for rhematic fever penicillian, erythromycin, salicylates, bedrest
inadequate supply of dietary iron iron deficiency anemia-12-36mths at risk from milk, dec RBC production, reduction of O2 to tissues
clinical findings in iron deficiency anemia pallor, tachycardia, HA, SOB, pica
ascorbic acid (vit c) aides in absortion of iron
inherited autosomal recessive disorder, abnormal HGB shape sickle cell anemia-circulation obstruction due to sickled RBC
clinical findings of sickle cell anemia hypoxia, vasoocclusive, aplastic inf, acute splenic aquestration
tx of sickle cell hydration, splenectomy, antis for inf,
NS care for sickle cell dec fever, resp probs, hydrate, daily wt, pain, heat, no cold compresses, pulse ox
group of bleeding disorders w deficiency of one of the factors necessary for coagulation hemophilia- mostly boys, factor VII=hem A, factor IX-hem B
tx for hemophilia no asprin, use NSAIDS, monitor bleeding, non IMs, RIce
acquired hemorrhagic disorder idiopathic thrombocytopenic purpura-occurs 2-10 yrs of age, normal blood marrow inmature release of platelets/eosinophils
excessive destruction of platelets thrombocytopenia
discoloration caused by petechiae purpura
clinical findings of idiopathic thrombocytompenic purpura bruising, bleeding from mucus mems, hematomas on lower extrems,
tx of idiopathic thromvbocytopenic purpura quiet activities, no asprin/NSAIDS, acetaminophen prn, prednisone, IV immune globulin, anti D antibody
most common bacterial skin inf of childhood impetigo-can b secondary inf caused by staph aureus
clinical findings of impetigo yellow crusting lesions with yellow drainage
tx for impetigo wash TID soap water, remove crust, bacitracin/bactroban,
superficial inf caused by fungi called dermatophytes tinea inf=capitis=head, corporis=ringworm, cruris=jock itch, pedis=athletes feet
tx for capitis, corporis oral griseofulvin, selenium blue shampoo, topical antifungals (monostat/lamisil TID), keep dry and cool
tx of cruris, pedis compresses, epsom soaks, tolnaftate liquid/powder,
triggers of Herpes 1 and 2 sun, stress, menses, dec immune, smoking, drinking, dec sleep, steroids
tx for herpes oral antiviral=acyclovir, valtrex 500mg bidx5days, cool compresses
lice on humans pediculosis=direct contact
tx of lice remove nits/eggs daily, 1% permethrin (Nix/RID), laundry hot water/dryer, spray to furniture
contagious condition caused by itch mite scabies=close contact
clinical findings of scabies intense itching, rub hands/feet together, writs, finger webs, elbows, umbilicus, axillae, groin, butt,
tx of scabies 5% permithrin cream (Elimite), laundry in hot water/dryer,
results from direct skin to irritant contact contact dermititis=diaper rash, usde steroid cream
allergic skin condition atopic dermititis=eczema
tx of eczema vasoline, eurcerine, neivia, mild soap, hydrocortisone cream
disorder of sebaceous hair follicles, most common condition caused by testosterone acne vulgaris
clinical findings of acne vulgaris closed white/black heads, paules, pustules, nodules and cysts, upper body
ts for acne valgaris rest, exercise, well balanced diet, reduce stress, cleansing
isotretinoin-accutain tx of acne valgaris, causes depression, must b on 2 forms of BC, causes birth defects
most common intestinal parasite in US giardiasis-person to person
clinical findings of giardiasis diarrhea, V, cramps, greasy stool,
force of stress on the ligament results in displacement of the bone end from its socket dislocation
ligament is partially or completely torn or stretched by the force created as a jt is twisted or wrenched, sudden sprain
microscopic tear, occurs over time strain
5 Ps for NS care for fractures pulselesssness, pain, palor, paralysis, parathesia
purpose of traction fatigue the involved muscle so no spasms, realign, immobilize
intermittent traction for muscle spasms and to dec back pain
exerts force directly on the body surface on children <30#. skin traction
exerts greater force and is tolerated more than skin skeletal traction=metal device inserted in bone
pins/wires inserted in soft tissue and bone,metal structure external fixation
plantar flexed foot w inverted heel and adducted forefoot, more in boys and one foot club foot
slipped capital femerol epiphysis upper femoral growth plate, related to rapid growth, obesity, girls 12, boys13 1/2
clinical findings for slipped capital femerol epiphysis limp, gait disturbance,pain in groin, thigh or knee, gets worse w activity
tx for slipped capital femerol epiphysis stabilize, bedrest, traction and external fixation
legg calve perthes disease aseptic necrosis of femoral head, more in boys 4-8yrs, self limiting,
clinical findings of legg calve perthes limp, hip,thigh, knee jt soreness, limited ROM,
tx of legg clave perthes rest, NWB, traction to stretch abductor muscle, abduction cast pelvic or femoral osteotomy
scoliosis no tx if <10-20*, depends on age and >20-40 requires surgery
boston wilmington brace prevents further curvature, wear 20-22 hrs,
surgical intervention of scoliosis metal to stabalize spine, ly flat, log roll, unplug bed controls, PT asap, no trampolines/gymnastics
Osgood-schlatter disease bilater knee pain exacerbated by running jumpingclimbing stares. from over use, no kneeling
bacterial inf of the bone from staph aureus osteomyelitis
clinical findings tenderness, warmth, swelling, pain
progressively degenerative inherited diseases affecting muscle cells of specific muscle groups muscular dystrophy
most common dystrophy duchenne
clinical findings of MD meet miles stones until 3, 3-7 muscles hypertrophied, waddling gait, cant do stairs, scoliosis, in WC by Jr High, no cure
preparation NPO from midnight, bowel preparation such as magnesium citrate Barium enema,
Similar preparation as for the barium enema, clear liquids the day before, light sedation is required Colonoscopy
protrusion of viscus through an abdominal opening or a weakened area in the wall of the cavity where it is normally contained hernia
blood supply is cut off, surgery is immediate strangulated
hernia is trapped outside peritoneal cavity incarcerated
hernia moves back into peritoneal cavity reducible
hernia is when it escapes through the posterior inguinal wall direct inguinal
hernia is when the protrusion escapes through the inguinal ring . indirect hernia
a weakness in the abdominal wall where in men the spermatic cord and in women the round ligament emerge. inguinal hernia
mesh reinforced weakened area, distended ab from not voiding, strangulated may result in colostomy
decrease in frequency of bowel movements. constipation
maloderous stool,ab distention, vomiting, constipation no flatus bowel obstruction
detectable obstruction from surgery mechanical obstruction
neurochemical or vascular disorder, after ab surgery nonmechanical obstruction
tx for obstruction NG tube, strict I/Os, IV fluids, NPO
Care of Nasogastric tubes teeth cleaning and mouth washes, lube for lips, irritation of nose, tube patency
1/4 or 1/2 colon removed at decending or transvers colostomy
entire colon removed, sm intestine used for stoma ileostomy
Psychological preparation for colostomy Change of body image Loss of control over elimination Odors
dusky blue stoma indicates ischemia
brownish bluish stoma indicates necrosis
ns care for hemmoroids prevent constipation,no Avoidance, OTC drugs, sitz bath
leading cause of illness in children under the age of 5 years Acute diarrhea/ oral-fecal, close body contact
most common cause of diarrhea in children under 5 rotovirus-fecal/oral
dull pain in preimbilical area then to RLQ, low fever, N, anorexia, rebound pain appendicitis
sudden relief of appedicitis pain rupture
Dx of appendicitis inc WBC, abnormal sonogram, clinical signs
tx for inflamation of verniform appendix anitbiotics,rehydration, laproscopic removal
tx for ruptured verniform appendix IV fluids, anitibiotics, electrolytes, NG suction until bowel activitiy returns
Common cause of acute intestinal obstruction in children less than 5 years of age intussusception- telescoping of ascending colon, current jelly stools
Tx for intussusception Conservative-radiologist guided air enema or saline enema, cut bad spot out
Mechanical obstruction caused by inadequate motility of part of the intestine, occurs in 1 in 5000 live births. Hirshprungs disease-downs, 10% heredity
Hirshsprungs disease nerve cells are missing from last part of intestine
Clinical manifestations of hirshsprings disease abdominal distension, feeding intolerance, bilious vomiting, a delay in passing meconium,
Tx for hirshsprungs disease remove the aganglionic portion of the bowel to relieve obstruction and restore normal bowel function
NS care post op for hirshsprungs disease ab girth, low fiber, high cal/protein,stoma care,
zones of personal space` intimate, social, public, personal
zones of touch social, consent, intimate
phases of relationship Preinteraction, Orientation, Working, Termination
A sign that an inflamed appendix is worsening pain in the right lower quadrant?
sign of intussusception blood and mucus in stools?
non surgical treatment for intussusception radiologist guided air enema?
May be indicated by sudden pain relief in a child with acute appendicitis rupture of the appendix?
Priority postoperative intervention in a child with Hirschbrungs disease stoma care?
leading cause of illness in children under the age of 5 infectious diarrhea?
The priority intervention for children with infectious diarrhea rehydration?
Interventions that promote regular bowel movements in children increasing fluids and fiber in the diet, and establishing a regular bowel routine?
The way the Rotavirus is spread fecal and oral transmission?
A sign of Hirschbrungs disease constipation since birth and foul smelling stools?
Consistency of stool from an ascending or transverse colostomy semi formed stool?
The reason that ileostomy output is liquid the output has not entered the colon?
A priority nursing intervention when caring for a patient following placement of an ileostomy skin care around the ileostomy site? skin care around the ileostomy site?
A sign of ischemia in a stoma a dusky blue color?
A sign of acceptance following a colostomy placement willingness to take of the ostomy?
A cause of a nonmechanical bowel obstruction abdominal surgery?
A mechanical blockage that can cause an intestinal obstruction a surgical adhesion?
A complication following a hemorrhiodectomy constipation?
Hernia in which the blood supply is cut off a strangulated hernia?
Reason for administration of magnesium citrate before a barium enema achieve good visualization of the bowel?
The day that discharge for hospital starts the day of admission?
What is the termination phase? The final phase in the helping relationship
When intake or output should be charted as soon as the patient has finished the drink or voided?
The zone of personal space in which the nurse hugs a grieving relative the intimate zone of personal space?
A task that is not within the scope of practice of an LPN taking a verbal order from a physician?
Might happen if a rectal temperature is taken in a child with Hirschbrungs disease perforation of the bowel ?
Created by: vstein