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NUR 131 EXAM 3

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 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
Created by: vstein