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NUR 131 EXAM 3
| Question | Answer |
|---|---|
| what is most common complication of DM | cardiovascular disease. will die from complications not DM |
| what do our cells need | O2, H2O and glucose. Insulin is the key to let the glucose in the cell. |
| Too much glucose in blood makes blood | thicker and cant get to smallest vessels in body |
| risk factors for DM | immediate family member, physically inactive, ethnicity, gestational diabetic, HTN, hyperlipidemic, previous A1C > 5.7% |
| Dx of DM | A1C, fasting, 2h, random BG |
| how do you prepare pts for BG testing. | Make sure they follow directions...NPO for 12h... |
| BG lab values for toddlers/preschoolers | before meals=100-180, bedtime=110-200, A1C=<8.75, >7.5 |
| BG lab values for school age | before meals=90-180, bedtime=100-180, A1C=<8% |
| BG lab values for adolescents | before meals=90-130, bedtime=90-150, A1C=<7.5% |
| how is insulin administered | SubQ |
| what insulin can be given IV | regular |
| which insulin do you draw up first | clear |
| how does the age of the child effect you approach | younger more compliant and ready to learn. Adolescents are more noncompliant |
| ss hyperglycemia | |
| what should you do for hyperglycemia | |
| ss hypoglycemia | |
| what should you do for hypoglycemia | |
| known as diabetic acidosis or diabetic coma | diabetic ketoacidosis |
| which type of diabetes is more likely to have diabetic ketoacidosis | type I |
| clinical manifestations of diabetic ketoacidosis | |
| tx for diabetic ketoacidosis | |
| what criteria do you use to measure whether your pt is moving towards wellness or illness | BG should be with in normal range |
| When excesses and losses are only water so the concentration of the fluid changes | What is an osmolar fluid disturbance? |
| A serious result of large amounts of gastric drainage | What is metabolic alkalosis? |
| Cardiac dysrhythmias showing an electrolyte imbalance | What is a sign of an increased potassium level? |
| Water and electrolytes are lost in equal proportions concentration remains the same | What is an isotonic fluid imbalance? |
| What are signs of hypocalcemia? | Tetany and twitching showing an electrolyte imbalance |
| An important intervention incase a naso-gastric tube becomes dislodged | What is check placement |
| The correct patient position when receiving tube feedings | What is elevated head to at least 30 degrees? |
| A sign of a hiatel hernia | What is heartburn 30-60 minutes after eating? |
| The first priority when caring for a client who has had a throidectomy | What is a patent airway |
| A sign of hypothyroidism | What is a mask like face? |
| Caused by the insertion of gas into the abdomen during laparoscopy | What is shoulder pain that will diminish with early ambulation following surgery? |
| The main cause of peptic ulcer disease | What is Helicobacter pylori bacteria? |
| A diet that will decrease the risk of dumping syndrome | What is small dry feedings, low in carbohydrate, with restricted refined sugars, containing moderate amounts of protein and fat? |
| A serious complication of the roux-en-Y procedure | What is an anastomosis leak? |
| Blood tests that are sign of hypothyroidism | What is an increased TSH and decreased T4? |
| A disease that is caused by an inability to digest gluten | What is Celiac disease |
| Disease in which the most common sign is projectile vomiting | What is Pyloric stenosis? |
| A congenital abnormality that causes aspiration, respiratory distress, and dehydration | What is esophageal atresia? |
| What is measurement of urine output in a baby by weighing the diaper? | 1 g of wet diaper equals 1 ml urine |
| The most important cause of serious diarrhea in children | What is the rotavirus |
| A sign of impaired fat absorption which is a sign of celiac disease | What is steatorrhia |
| Children have a greater extracellular requirement | What is the reason that fluid and electrolyte maintenance is so critical children? |
| A sign of severe dehydration in an infant | What is a weak thready pulse? |
| The main goal for a child with GERD | What is gain weight |
| Main assessment of an infant with pyloric stenosis | What is weigh the infant? |
| An important assessment following endoscopy | What is assess for a gag reflex? |
| consists of all the fluids inside cells about 42% of body weight. | Intracellular fluid |
| Extracellular fluids | divided into 3 smaller compartments, interstitial (lymph), intravascular (blood plasma), and transcellular (fluids separated from other fluids by a cellular barrier e.g. gastrointestinal). Consists of about 17% of body weight. |
| element or compound that when dissolved in water or another solvent separates ions into that are electrically charged | electrolyte |
| Positively charged ions is called | cations |
| negatively charged ions is called | anions |
| Positively charged ions | sodium, potassium, calcium |
| negatively charged ions | chloride, bicarbonate, sulfate |
| movement of water across a semipermeable membrane from an area of less concentration to an area of higher concentration. | Osmosis |
| movement of a solute across a semipermeable membrane from area of higher concentration to an area of lower concentration. | Diffusion |
| is the process by which water and diffusible substances move together across a cell membrane in response to fluid pressure. | Filtration |
| requires metabolic activity and expenditure of energy to move substances across cell membranes | Active transport |
| rarely occur alone and disrupt normal body processes or homeostasis. | fluid imbalance |
| drug overdose, pulmonary edema, airway ob, nuromuscular disease | hypoventilation/respiratory acidosis |
| asa od, sepsis, shock, diarrhea, renal failure, diabetic ketoacidosis | metabolic acidosis |
| acidosis | pH < 7.4 |
| anxiety, pregnancy, high altitude, fever, hypoxia, pulmonary emboli | hyperventilation/respiratory alkalosis |
| loss of gastic juices, overuse of antacids, pot waste duiretics | metabolic alkalosis |
| alklosis | pH > 7.4 |
| When water and electrolytes are lost in equal proportions, but the osmolality (concentration) remains the same. | Isotonic |
| can get isotonic from... | Deficit-diarrhea, vomiting, drainage Excess-heart failure, renal failure |
| When excesses and losses are only water so the concentration (osmolality) of the fluid changes. | Osmolar |
| can get osmolar from... | Deficit-dehydration , administration of hypertonic parental fluids or tube feeding formulas Excess-Excess water intake |
| provide more water than electrolytes diluting the ECF, osmosis then produces movement from the ECF to the ICF. Isotonic solutions expand the ECF there is no loss | Hypotonic solutions |
| expand the ECF there is no loss or gain to ICF. | Isotonic solutions |
| raise the osmolality of ECF and expands it. The higher osmotic pressure draws fluid out of the cells into the ECF. | Hypertonic solutions |
| s/s Hyponatremia | confusion, behavior changes, convulsions and death. |
| s/s Hypernatremia | Polyuria, oliguria, weakness, restlessness, vomiting, nausea. convulsions and death. |
| s/s Hypokalemia | alkalosis, shallow resp, irritablity, confusion, weakness, arythmias, lethargy, thready pulse, dec intestinal mobility |
| s/s Hyperkalemia | Extreme muscle weakness and paralysis,tachycardia then bradycardia, diarrhea, cramps, dec BP,drowsiness |
| s/s Hypocalcemia | Tetany, twitching |
| s/s Hypercalcemia | Asymptomatic with mild hypercalcemia, Later, nausea, vomiting, constipation, decreased peristalsis, weakness and fatigue. |
| s/s Hypomagnesemia | Neuromuscular and CNS hyperirritability. |
| Hypermagnesemia | Depression of neuromuscular and CNS functions. |
| Complications of Nasogastric Suctioning | Metabolic alkalosis,Electrolyte imbalance |
| gastrointestinal dysfunction asess what for children | edema on the extremities, buttocks, and around the eyes, Anterior fontanel |
| Clinical assessment of gastrointstinal dysfunc | Intake and output IV fluids; tubes; urine color 24 hour diet recall Calorie consumption Daily weight |
| minimum out put of urine for an adult | 30 cc.hr |
| minimum urine output for child | 1 wet diaper = 1 ml of urine |
| Upper GI – Barium swallow | NPO status prior, Drink contrast medium, x –rays,Flush body with fluids, laxatives, stools will be white |
| Upper GI endoscopy | Signed consent, NPO for several hours prior, medication for gag reflex, tube with camera goes down esophagus, check return of reflex |
| Endoscopic retrograde cholangiopancreatography; ERCP | NPO, signed consent, administer sedation, antibiotics may be given, Endoscope to common bile duct and pancreatic ducts, check for return reflex |
| Gallbladder series | Ultrasound, Percutaneous transhepatic cholangiogram, ERCP |
| Insufficient circulating thyroid hormone: The most common cause is atrophy of the thyroid. | Hypothyroidism |
| s/s Hypothyroidism | Cold intolerance, dry skin, mask like appearance, weight gain |
| Hyperactivity of the thyroid gland | Hyperthyroidism |
| s/s Hyperthyroidism | Goiter, exothalamus, nervousness, restlessness, weight loss |
| Nursing care of clients receiving tube feedings | Check placement Check residual Follow orders for rate, type of tube feeding Check insertion site for signs of infection Monitor intake and output |
| Composition of parenteral nutrition | Calories Protein Electrolytes Trace elements Vitamins |
| GERD-child | Short abdominal lower esophageal sphincter, in intrabdominal pressure from crying, coughing, and slumping. |
| GERD adult | Incompetent esophageal sphincter.cause in adults is a hiatal hernia |
| Antisecretory agents –decrease the secretion of HCL histamine 2 blockers | Zantac, Pepcid |
| Proton pump inhibitors, expensive | Prilosec, Protonix |
| Sulcrafate, Reglan | |
| GERD surgery-Fundoplication | Fundus of stomach is wrapped around distal esophagus and sutured |
| GERD – Nursing care - child | Positioning on Rt side with HOB up. Minimize handling infant after feeding.cardiac/apnea monitoring, diet, medications, and infant CPR. |
| main goal for child with gerd | wt gain |
| gastric ulcer s/s | wt loss, burning on right, food aggravates, no pain at night |
| duodenal ulcer s/s | right pain at night, burning cramping med epi, pain 2-4 hours after meal, eating dec pain, wt gain |
| Main cause of Peptic Ulcer Disease | Helicobacter pylori bacteria |
| Perforation | Sudden sharp and severe pain in the mid epigastrum. Pain spreads to the entire abdomen. The abdomen becomes rigid, hard, and tender. |
| tx for perferation | partial removal of stomach |
| ingested food enters the jejenum too soon and without proper mixing and normal digestive processing | Dumping syndrome sweating, N, diarrhea, inc HR |
| no use of morphine w gallstones makes spasms worse | |
| open cholecystectomy | issues with dec. peristalsis, pain, infection, lung infection, DVT, divert bile using a T- tube, Do not clamp t-tube, Vit. K shots |
| Obesity | BMI ≥40kg/m² or ≥35kg/m² with one or more serious complications. |
| Gastric bypass | The stomach size is decreased with a gastric pouch anastomosis emptying directly into the jejunum. |
| Surgical repair occurs at about 4 weeks for cleft lip and about 12 months for cleft palate. | |
| Esophageal Atresia with a Tracheoesophageal Fistula | Esophagus terminates before it reaches the stomach and a fistula occurs that represents an unnatural connection with the trachea., aspiration, respiratory distress and dehydration |
| Pyloric Stenosis | Circular area of muscle around pylorus hypertrophies and obstructs gastric emptying. projectile vomiting. Dehydration |
| Celiac disease | inability to digest gluten. no wheat, rye, barley, and oats |
| Dehydration – children | higher the proportion of extracellular fluid to intracellular body fluid. EC depletes faster than IC. cant say when thirsty |
| s/s dehydration child | no tears, no elasticity, sunken fontenals, dec urine |
| sexual health for men | breast, contraception, sexual hx |
| sexual health for women | breast, contraceptives, obstetric, gynecologic, genitourinary, reproductive, menstrual hx |
| when assessing sexual hx | match gender to pt, strong relationship before talking, eye contact, |
| womens breast exams | at 20, same day each month not on menses |
| males testicular exam | at 15 |
| pap smears | 3 yrs after 1st sexual encounter, no later than age 21 every year, at 30 3 norm paps in a row get screened q 2-3 yrs. |
| abnormal pap | repeated paps q 4-6 months x2yrs. |
| cause erectile dysfunction | antihypertensives (thyazides= ) mood stabilizers |
| meds that affect the risk of cancer and cardiovascular disease | HRT and contraceptives |
| mamograms | at 40 x yearly |
| PSA | at age 50 or 45 if father has prostate cancer |
| changes in aging women | URINARY FREQUENCY, CONSTIPATION, UTERINE PROLAPSE, DEC LUB IN VAG |
| changes in aging men | ED, hesitancy w urination |
| empty bladder for pelvic | |
| cyst usually soft during reproductive years | ovarian cysts |
| polycystic ovarian syndrome | benign cysts form on ovary, dec egg release, in obese, irr menses. tx: oral contr, both ovaries/tubes removed after child bearing yrs. |
| ab pain prior to menses, nodular uterosacral ligaments, limited movement of uterus, benign, in child gearing yrs, painful intercourse, pain meds | endometriosis |
| slow growing solid tumors, irr menses, surg intervention, women might fear cancer and dont do surg | uterine leiomyoma |
| bladder in vag area | cystocele-urinate freqently, urgency, protrusion of the anterior vag wall |
| rectum into vag area | rectocele-constipation and protrusion of the posterior wall of vag |
| feeling of heaviness or pressure in the low abd or groin | uterine prolapse |
| supports uterus. cant be left in too long. external device | pessary |
| painful,round delineated moveable lumps, benign, in non contraceptive using women, s/s occur during mense | fibrocystic breast changes |
| benign lumbs in breast ages 15-25, painless, round, mobile | fibroadenoma |
| surgical change in the size or shape of the breast | mammoplasty-semi fowlers, gradual mvt of arm, jp drain, no IVs, BP use leg. |
| lymphedema | fluid shift, never goes away |
| imbalance of hormones | vaginitis |
| STD, bleeding, red inflamed | cervicitis |
| effects all repro organs, silent disease, septic shock, can spred to liver, hxectomy | pelvic inflammatory disease |
| dilation of vessels that drain testes of spermatic cord, vessels feel nobby not smooth, usually on L, pain | varicocele |
| painless sperm filled cyst, surgery, | spermatocele |
| twisting of veins, pain swelling, N/V, may resolve itself | testicular torsion |
| poor hygene, edema/inflam of foreskin | phimosis |
| lump in scotum, swelling, feeling of heaviness. mass nonotender | testicular cancer-common in R, light shows it, alteration in urine func, back pain, highly matasticizing |
| removal of testis, spermatic cord and regional lymph nodes | orchiectomy |
| acute or chronic condition affecting the prostate gland | prostatitis-fever, chills, backache, perineal pain |
| inflammatory process of the epididymis | epididymitis-ice elevation, H2O, maintain fever |
| infection of the bladder that minics UTI | (prostatistis)acute cystitis-tx antibiotics |
| cause by pathogen, trauma, secondary to clymedia, gonerrhea, swelling for months | epididymitis-tx antibiotics, lots of fluids |
| acute inflam of testes | orchitis-painful, tender, swollen, secondary to bacterial/viral inf, antibiotics, pain meds elevation, ice |
| leading causes of injury for 6-12 mtns | falls, ingestions, burns |
| leading causes of accidental deaths 6-12 mtns | suffocaiton, MVA, drowning |
| school age cause of injury | MVA as a passenger or a pedestrian |
| most common fatal drugs are | methyl salicylate, camphor, topical imidazolines (sympathomimetics contained in visine, clear eyes), benzocaine, diphenoxylate-atropine (lomotil) |
| call poision control before anything | |
| antidote for acetaminophen | N-acetylcysteine-do not force V |
| too high lead blood level | 10 mcg/dl |
| removing lead from the circulating blood, organs and tissues | chelation |
| substances used to remove lead from blood | calcium disodium edetate, and succimer |
| most sugnificant NS asess for ICP is | crainial measurement |
| S/S of ICP | high pitch cry, size of pupils, eyes follow together, irreg breathing, up/down temp, tremors, symetric facial feathures, excessive yawning, dialated fixed pupils (emergency) |
| painful, for meningitis, unexplained fever, change in LOC, odd affect | Lumbar puncture-ly flat p procedure, check for leakages, more fluids |
| insertion of needle into subarachnoid space fo lower spinal cord (lumbar puncture) | for inf, inc pressure, insert meds |
| Normal findings of CSF | clear, no blood, minimal protein, 60-70% blood glucose |
| NS care of lumbar puncture | fetal postion, monitor cardiorespiratory status, label speciman (1,2,3), carry immediately to lab, pt flat x 8-12hr to avoid severe HA, monitor VS, LOC site for drainage, hosp policy |
| glasgow coma scale | asess eyes, motor and verbal. High score=intact functions, low=coma |
| inc pressure causes siezures | tx identify cause, correct problem, control seizure activity |
| most common seizure meds | tegretol, neurontin, phenobarbital, dilantin, depakene |
| dilantin precauctions | soft toothbrush, floss p q meal, affects platelets |
| inf of meninges | meningitis |
| most common inf of meninges, considered medical emergency | bacterial caused by hemophilus influenzae type B (HIB vac, neisseria meningitides, strep pneumoniae, group bstrep and E. Coli (most common in newborns) |
| self limiting meningitis disease lasting 7-10 days | viral-infants greatest risk |
| S?S of Meningitis children less than 2 yo | nuchal ridgidity, poor feeding, V, irritability, lethargy, bulging gontanels, high pitched cry, fever or low temp, hyper extentin of neck and spine (opisthotonus) |
| s/s of meningitis children older | resp/GI probs, nuchal redgidity, petechial type rash, V |
| NS care for meningitis | assist w lumbar punc, VS/neuro check q 15 min, i/o, fluid limited to decrease cerebral edema, NPO if dec LOC, measure head circ, fontanels q 8hr, isolation |
| meds for meningitis | monitor closely, antibiotics, corticosteroids and mannitol/diuretic |
| bacterial tozins are relased as the antibiotic destroys the bacteria predisposing child to septicemia, purpura and seizures | |
| inflamatory process of the CNS caused by a variety of organisms, most associated w viruses=herpes | encephalitis |
| clinical manifestations of encephalitis | malaise, fever, HA, neck stiffness, N/V, tremors |
| Dx of encephalitis | CT scan maybe normal, serologic testing |
| no isolation necessary for encephalitis | |
| follows mild viral inf (influenza/varicella), linked to ASA use in children, fatty degeneration of the liver, kidneys, heart, skeletal muscle and pancreas, coma/death in 24-48hrs | reyes syndrome |
| definitive dx for reyes | liver biopsy |
| congenital neural tube defect in which there is incomplete closure of vertbrae and neural tube during fetal develpment | spina bifida |
| IPC | changes in brain, CSF dynamics, cerebral flow |
| if there is a change in one of those the others will change to maintain normal cerebral pressure and volume | |
| NS care of IICP (increased inter cranial pressure) | freq ass, HOB 30*, no prone, neck/hip flex, emergency equip at bedside, I/O, block care no over stimulating, nutrition, skin care, family involvement |
| spina bifida any malformation | myelodysplasia |
| no visible problem | spina bifida occulta-occurs between L5-S1, no deficits, tuft of hair, dimple, hemangioma/limpoma in sacral region |
| visible defect | spina bifida cystic |
| saclike defect includes meninges and spinal fluid but no neural elements | meningocele |
| most severe saclike defect contains meninges, spinal fluid, nerve roots, spinal cord andneurologic deficit (nuelomeningocele) | mengomyelocele |
| risk factor for spina bifida | dec folic acid |
| dx of spina bifida | serum alpha fetaprotein level at 16-18wk gest, then ultra sound, amnio, CT scan, myleogram |
| Ns care of myelomeningocele | measure sac, head circ, palpate fontanel, avoid stress, on stomach, foot/leg alignment to reduce tension |
| preop care of myelomeningocele | cover sac, prone, avoid facal contam,warm, proper nutrition, hydration |
| post op care of myelomeningocele | measure head circ, resp function, correct postioning |
| accum of excess CSF on the brain | hydrocephalus-over production of CSF, obstruction of fliud passage, dec absption of |
| s/s of hydrocephalus | shiny head, bulging fontanels, prominent scalp veins, cownward cast of eyes, permanent braindamage if not treated |
| NS care of hydrocephalus | measure head circ, neuro ass, changes positions freq, |
| Dx of hydrocephalus | MRI, CT, LP, serial measurments of head circ |
| chronic progressive disorder of posture, and movement | cerebral palsy-static encephalopathy from brain defect at birth or shortly after |
| risk factors for CP | maternal DM, Rh/ABO incompatibiltiy, rubella in first trimester, genetic, asphyxia, precipitous delivery, prolonged labor |
| surgery for CP | relase of spastic muscles/tendons for positioning and posture, placement of long term tube feeding |
| deficits in general intellectural functioning, IQ of 70 or less | mental retardation |
| inattentive, difficulty with task completion and organization, day dream | ADD |
| inattentive, difficulty with task completion and organization, daydream with hyperactivity | ADHD=interrrupts, talk out of tern, impulsive, high energy, talk excessively |
| NS care for ADHD | inforce desirable behaviors, decrease stimuli, refocus, structure time and schoolwork, remark on good behavior, dec wt and encourage sports. |
| drugs for ADD | ritalin, concerta, welbutrin, adderal |
| complex neurodevelopmental disorder that effects cognitive, communication and social func. | autism |
| s/s autism | avoids eye contact, strange body sensations, disturbance in rate and appearance physical, social avoid contact |
| Why does the profession of nursing have a set of Standards of Practice? | nurse acted “as any reasonably prudent nurse would under the same or similar circumstances? |
| what are negligent acts | Medication and/or IV errors,Burns from equipment,Falls,Failure to use aseptic technique as required,Failure to give report/give an incomplete report Failure to adequately monitor the patient,Failing to notifyphysician of significant change in patient’s c |
| Physical abuse | Unexplained bruises/welts in various stages of healing Often in clustered pattern Unexplained or multiple fractures Wariness Apprehension Aggressiveness or withdrawal |
| Physical Neglect | Failure to thrive Constant hunger Poor hygiene Bald patches on scalp Permission to engage in unsafe activities Inconsistent school attendance Fatigue/listless at school Assume adult responsibilities |
| Sexual abuse | Difficulty walking or sitting Torn, stained, or bloody underwear Pain, swelling, itching of genitalia Pain on urination Poor sphincter tone Unwillingness to change clothes or go to gym Promiscuity Poor peer relations Running away |
| Emotional abuse | Speech disorders Lag in development Hyperactive, disruptive behavior Habit disorders (biting, sucking, rocking) Learning disorders Neurotic traits (unusual fearfulness) Suicide attempt |
| Shaken Baby Syndrome | FTT, seizures, resp irregularities, coma, vomiting, drowsiness or lethargy, death |
| Munchausen Syndrome by Proxy | Caretaker falsifies illness in child through simulation or production of illness and then takes child for medical care |
| A treatment for cancer that suppresses bone marrow production | chemotherapy |
| A side effect of chemo that is the reason mouth care is extremely important | inflammation of the mucus membranes that leads to mouth ulcers? |
| A side effect of chemo that can cause spontaneous bleeding | low platelet count? |
| An important goal when chemo decreases the child white cell count | prevention of infection? |
| Diet that helps children host their defense against infection | small frequent meals high in calories and protein? |
| A treatment for cancer that causes damage to the cells and stops them replicating | radiation therapy? |
| A common side effect of radiation therapy caused by the fact that radiation is site specific | skin damage |
| Skin should not be exposed to this while a child is receiving radiation therapy | sunlight |
| Often covered with a transparent dressing and should not be removed from the skin when a child is receiving radiotherapy | marks on the skin to identify the site for radiation therapy? |
| A risk in giving radiotherapy to children because normal cell development is not complete especially brain tissue | altered cognitive potential |
| The most common primary bone lesion in children | oesteosarcoma |
| This is an assessment that can cause rupturing of the protective capsule if a child has a Wilms tumor | palpate the abdomen? |
| The two most common signs of brain tumors | headache on awakening and vomiting not related to feeding? |
| A cancer that originates in the lymphoid system | Hodgkin's disease? |
| A result of taking a rectal temperature if a child has a low platelet count | rectal bleeding |
| The most common childhood cancer | leukemia |
| The cancer that is confirmed by bone marrow biopsy | leukemia |
| Results from the low numbers of WBC’s that occur in acute lymphoid leukemia | frequent infections? |
| A childhood cancer that causes symptoms often first reported by parents | retinoblastoma |
| The three stages in development of cancer | initiation, promotion, and progression? |
| An important adaptive mechanism of the body to acute stress | fight and flight response? |
| Two characteristics that possibly buffer the effects of stress | attitude and resilience? |
| Seyle’s three stages of the physical response to stress | alarm reaction, stages of resistence, and stage of exhaustion? |
| A response to increased sympathetic nervous system activity stimulated by the fight or flight mechanism | increased blood glucose, oxygen consumption, and cardiac output? |
| A body system that studies have shown is affected by chronic stress. | immune system? |
| A tumor which would stop children from playing contact sports | Wilms tumor |
| cancer is when cells start to proliferate when other cells arent dying | |
| maturation in cells genetic structure so that it can develop a clone | initiation |
| reversible proliferation of the altered cells | promotion |
| increased growth rate of the tumor, increased invasiveness, increased metastasis | progression |
| development of cancer in a child | alterations in normal DNA, chromosomal abnormalities, failure of the immune system (cant distinguish between normal/abnormal cells), inactivation of tumor suppressor genes |
| cancers early warning signs | C change in bowel/bladder, A a lesion that doesnt heal, U unusual bleeding/DC, T thickening/lump in breast or elsewhere, I indigestion/difficulty swallowing, O obvious changes in wart or mole, N nagging cough/persistent hoarseness |
| side effects of radiation | fatigue, skin damage, hair loss, nausea, vomiting, low blood counts |
| tumors can develop immunity to chemotherapy agents. | |
| chemo affect... | bone marrow production, the GI tract, integumentary system |
| side effects of chemo | bone marrow suppression, alopecia, maliase and fatigue, nausea, vomiting, anorexia, stomatitis |
| precautions for immunocompromised child | private room, restrict visitors w active inf, strict hand washing, germ free environment |
| abnormal proliferation of immature white blood cells which compete w normal cells for space and nutrients | Leukemia |
| lukeimia produces | low numbers of WBC (Leukopenia), RBC (anemia), platelets (thrombocytopenia) |
| most common type of leukemia found in children | acute lymphoid leukemia=all blood cells affected, most common in boys 2-6yo |
| symptoms of leukemia | A anemia, N neutropenia, T thrombocytopenia |
| systemic signs of leukemia | wt loss, fever, frequent inf |
| s/s leukemia | SOB, weakness, pain/tenderness bones/jts, swollen lymph nodes |
| psychological s/s of leukemia | loss of appetite |
| skin s/s of leukemia | night sweats, easy bleeding/bruising, purplish patches/spots |
| phase 1 of chemo for leukemia | induction-induces remission |
| phase 2 of chemo for leukemia | CNS prophylactic-prevents cells from invading the CNS |
| phase 3 of chemo for leukemia | consolidation-maintains remission |
| phase 4 of chemo for leukemia | maintenance-maintains remission phase |
| NS care of child w leukemia | inf control, hemorrhage=avoid hard play, hydration=antiemetic before chemo, anorexia, encourage to eat, NG feeding, TPN |
| most common malignant renal tumor of childhood | wilms tumor=L kidney |
| tx of wilms | chemo to reduce tumor then surgery, no radiation, no palpation of ab |
| the most common primary bone lesion in children | osteosarcoma |
| originates from the bone producing cells htat invade the medullary canal of the bone. Happens in rapid growing bones | osteosarcoma |
| second most common bone tumor in kids | ewings sarcoma |
| invades the bone and is most often found in the midshaft of long bones | ewings sarcoma |
| originates in the lymphoid system in nodes. prevalent in adolescence/young adult. | hodgkins |
| staging of hodkins | based on the number of sites of lymph node involvement |
| s/s hodgkins | enlarged cervical/supraclavicular lymph nodes, fever, wt loss, night sweats, caugh, abd distension, anorexia, pruritus, N |
| arises from the retina, is the most common congenital malignant intraocular tumor in kids | retinoblastoma |
| caused by an existing stress-causing factor or stressor | stress |
| stress that continues when stressor is gone | anxiety |
| stages of seyles | alarm, resistance, exhaustion |
| separation anxiety initially act aggressively then become passive | infants |
| dependency is stressful, react by regression in all stages of development | toddler |
| suffer loss of control and feel shame, guilt and fear | preschooler |
| striving for independence and are particularly vulnerable to events that lessen their feeling of control. respond with hostility, depression and frustration | school age children |
| react to dependency with rejection, cooperativeness and withdrawal | adolescents |
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vstein
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