Pediatric Nursing conditions
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| *What position should a patient be in post heart catheterization? | Have the affected limb kept flat and straight
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| Post-heart catheterization your patients affected limb has mottled skin and is cool to the touch, what is a possible complication? | arterial obstruction
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| Post-heart catheterization your patient has a dropping blood pressure and sanguineous drainage at the site of insertion, what complication do you suspect? | hemorrhage
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| What are the two types of heart defects and what is the difference between them? | congenital (defect the patient is born with) and acquired (defect the patient develops after birth)
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| What are the four classifications of congenital heart defects? | increased pulmonary blood flow (acyanotic), decreased pulmonary blood flow (cyanotic), obstruction of blood flow, and mixed blood flow
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| Classify and Describe Atrial Septal Defect | CHD-increased pulmonary blood flow; a hole between the two atrial chambers of the heart. s/s murmur, fatigue, HF symptoms
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| classify and describe ventricular septal defect (symptoms) | CHD-increased pulmonary blood flow; hole between the two ventricular chamber of the heart/ s/s murmur, cardiomegaly, HF symptoms
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| classify and describe atrioventricular canal defect | CHD-increased pulmonary blood flow; low ASD with a high VSD, plus fusion of the AV valves forms one central AV valve that allows blood flow through all 4 chambers of the heart. s/s mod-severe HF, loud murmur, cyanosis
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| classify and describe patent ductus arteriosus as a heart defect (and treatment options) | CHD-increased pulmonary blood flow; a bridge between the pulmonary and aorta present from birth (normally closes at 28 days); tx: meds or surgery
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| classify and describe coarction of the aorta | CHD-obstructive defect; narrowing of the aortic artery. tx: surgery
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| classify and describe aortic stenosis | CHD- obstructive defect; narrowing in the aortic valve
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| classify and describe pulmonary stenosis | CHD-obstructive defect; narrowing of the pulmonary valve
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| *What are the 4 components of tetralogy of fallot | 1. pulmonary stenosis (narrowed pulmonary valve) 2. right ventricular hypertrophy (boot shaped) 3. overriding aorta (centrally located aorta) 4. ventricular septal defect (hole between ventricles)
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| what is an overriding aorta | centrally located aorta
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| what is hypertrophy of the right ventricle | over developed right ventricle
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| classify and describe tetralogy of fallot | CHD-decreased pulmonary; overriding aorta, hypertrophy of the R. ventricle, ventricle septal defect, pulmonary stenosis
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| classify and describe tricuspid atresia | CHD-decreased pulmonary; valve between right atrium and ventricle is not developed
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| classify and describe hypoplastic left heart (tx and 02 considerations) | CHD-mixed defect; underdeveloped left ventricle. tx- transplant/ compassionate care
DO NOT GIVE O2
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| Describe endocarditis | acquired defect: infection of the inner lining of the heart; also usually affects the bowel
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| *describe rheumatic heart disease | bacterial infection triggers autoimmune response that damages the valves of the heart
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| Acute rheumatic fever manifestations and treatment | rheumatic rash, inflamed joints, speech issues, sporadic movements. Tx the inflammation and pain
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| describe Kawaski disease | systemic inflammatory disease; causes painful strawberry tongue and peeling on the hands and feet
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| 3 phases of kawaski's diease | acute: conjunctivitis; sub-acute: skin on hands and feet peel, "strawberry tongue"; increased risk of aneurysms. third phase: symptoms start to resolve
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| Upper respiratory infection affect which structures | Nose and pharynx
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| What is nasopharyngitis | Common cold
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| Lower respiratory infections affect which structures | bronchi and bronchioles
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| Croup syndromes affect which structures | epiglottis, larynx, trachea, and bronchi
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| Manifestations of pharyngitis | Inflamed and painful pharynx; may have white exudate in throat
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| What is a common secondary complication of tonsillitis | otitis media (ear infection)
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| Diet considerations for a patient post-tonsillectomy | Soft diet only; no red foods
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| *What is the biggest complication post-tonsillectomy; and what are the signs of this complication | Risk for bleeding (24 hours and 10 days out; excess swallowing, occult blood in stool; scabs in throat fall out (bleeding is a medical emergency)
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| What is a common complication of influenza | Bacterial lung infection 2nd to excess fluid in lungs from the influenza virus
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| Treatment for respiratory viruses like pharyngitis, nasopharyngitis, and influenza. | Therapeutic management, fluids, humidifier air, watch for secondary infections
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| Signs of otitis media in younger children | Pull at ear, ear pain, mild fever, inflamed tympanic membrane
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| Symptoms of croup syndrome | Barking cough, inspiratory strider, hoarseness, and fever
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| What are the 5 different croup syndromes | Acute epiglottis, acute laryngitis, acute laryngotracheobronchitis (LTB), acute spasmodic laryngitis, and bacterial tracheitis
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| *What is the major concern for a patient with acute epiglottitis | RESPIRATORY OBSTRUCTION: if the epiglottis is inflamed it can't open the airway *Medical Emergency
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| Which vaccine can prevent acute epiglottitis | Hib vaccine
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| Describe acute laryngitis | Dry/sore throat, hoarse voice. Usually self-limiting
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| What age does acute largynotracheobronchitis (LTB) affect most commonly | Children less than 5
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| Describe the process of acute LTB | Inflamed larynx, trachea, and bronchi causes barking cough, inspiratory stridor, retractions, and mild hypoxia
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| Treatment for acute LTB | Hydration, humidifier O2, nebulized steroids and epinephrine to open airways
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| Describe acute spasmodic laryngitis | "Midnight Croup" intermittent attacks of laryngeal obstruction mainly at night. Most common in toddlers
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| Treatment for midnight croup | Humidifier air; avoid cold air. Epinephrine if severe
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| Symptomology of bacterial tracheitis | Infection of the mucosa of the upper trachea; affects trachea and epiglottis. Presents with purulent respiratory secretions
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| What is a possible cause of bacterial tracheitis | Secondary infection from acute LTB
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| Common symptoms of RSV | Wheezing/crackles, conjunctivitis (non-contagious), dehydration, nasal stuffiness, increased secretions
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| How is RSV diagnosed | Nasal secretion culture
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| *How is RSV treated | SUCTION (clear airways of secretions), cool O2, fluids, saline suction
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| What is a common cause of pneumonia in infants | aspiration pneumonia from improper feeding positions
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| What are common symptoms of Pertussis | Whooping cough, severe cough, cold-like symptoms, and fever
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| *Treatment of Pertussis and precautions | Antibiotics; isolation precautions
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| Diagnoses of TB | TB skin test, chest x ray, or blood test
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| Treatment of TB and precautions | 6 months regimen of multi-drug antibiotics; airborne precautions (neg-airflow room with N95 filter mask)
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| Toddler are at risk of this lower respiratory complication; and prevention | Foreign body aspiration; educate the parents
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| Common causes of aspiration infections | Baby powder, baby oil, nose drops, small toys, chunks of food, aspirated milk/formula from feedings
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| Describe asthma | Triggered by a specific allergen; inflammation of the trachea and bronchi with mucus production; immune regulated
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| Describe "wheezing" in asthma | "musical;" usually heard on expiration
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| *Interventions for asthma kids | Encourage exercise for endurance, RT to loosen mucous, hyposensitization (theory)
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| *What is status asthmaticus and how is it treated | Asthma attack that persists even after treatment; TX with epinephrine 0.01mg/kg
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| *What are the 3 characteristics of CF | Increased, thick mucous production. Increased sweat electrolytes. Nervous system abnormalities.
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| Diagnoses of CF | sweat-test: sodium will be 2-5 times greater than normal
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| *meconium ileus is an indicator of what | Cystic Fibrosis in newborns (thick meconium that causes a bowel obstruction in the newborn); or hirschsprung disease (lack of peristalsis causes constipation)
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| Intermediate respiratory involvement in CF patients | Risk for lung infections; increased mucous makes gas exchange difficult (= hypoxia), increased lung pressure can lead to CHF
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| Advanced respiratory involvement in CF patients | Pulmonary HTN, Core pulmonale (blood backs up into the heart), pneumothorax (collapsed lung), hemoptysis (coughing up blood)
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| GI involvement in CF patients (and stool description) | Mucous build up obstructs pancreas and blocks digestive enzymes, *stools are bulky, frothy, and foul-smelling (from impaired fat & protein absorption)
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| Endocrine involvement in CF patients | Increased risk for diabetes, sterility in males and decreased fertility in females, delayed onset of puberty
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| Presentation of CF patients | Undigested food in stools, frequent lung infections, dehydration, and electrolyte imbalances
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| Treatment for CF | manage lung infections, RT for inhaled meds and to loosen mucous, replace pancreatic enzymes, high protein and fat diets, and G-tube to supplement
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| Two types of respiratory failure | Hypoxic RF = not enough O2 can get in; hyperbaric RF = CO2 can't get out
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| What is tracheal malasia and what is the risk | The trachea in young children does not have hard cartilage and puts them at increased risk of collapsed airways
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| What is poisuelle's law | Children have decreased airway diameters = increased risk of obstruction; increased airway resistance, and increased respiratory distress with inflammation
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| *Define isotonic dehydration; Na+ blood levels and associated risks | Fluid and electrolytes are lost in equal amounts; Na+ levels stay normal; *Hypovolemic Shock
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| *Define hypotonic dehydration; Na+ blood levels, and risks | electrolyte loss is greater than fluid loss; Na+ is low (<130); risk for hyponatremia
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| *Define hypertonic dehydration; Na+ blood levels, and associated risk | Fluid loss is greater than electrolyte loss; Na+ is high (>150); *most dangerous kind of dehydration r/t neurological involvement
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| The "stomach flu" | gastroenteritis
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| Describe acute diarrhea and possible causes | Sudden onset diarrhea, last less than 2 weeks. Usually r/t antibiotics or GI infection
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| Describe chronic diarrhea and possible causes | Diarrhea lasting >14 days. Usually r/t food allergies, irritable bowel disease, or chronic bowel disease
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| Describe intractable diarrhea of infancy | Usually occurs in 0-2 months of life, has no known cause and treatments don't work (can be life-threatening)
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| *Nursing considerations for patients with C-diff | Have to WASH HANDS; no sanitizer use
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| *When should a newborn pass the first meconium by | 24-48 hours after birth
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| What diseases may be indicated in a newborn has not passed meconium in 48 hours after birth | Hirschsprung disease or CF
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| What is encopresis | Stooling "accidents"
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| Treatment of constipation | increase fiber, stool softeners, bowel schedules, increase fluids
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| Describe Hirschsprung disease | No neuroganglia on a portion of the intestines = no peristalsis through that area
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| Complications of hirschsprung disease | GI obstruction (fecal matter clogs bowels); Megacolon (colon loses elasticity and tone)
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| *Manifestations of hirschsprungs disease | Failure to pass meconium within 48 hours of birth, FTT, constipation, *thin ribbon-like stools that are foul smelling
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| Diagnoses of hirschsrung disease | Rectal biopsy
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| Treating hirschsprung disease | Fiber, fluids, enemas, stool softeners. Surgery to remove portion of bowel
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| Where is mcburney's point? | Lower right quadrant; acute appendicitis
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| Current jelly stools | Meckel Diverticulum and Intussusception
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| Meckel Diverticulum | A band connecting the intestine to the umbilicus
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| Crohn's disease | Involves all layers of the GI and can occur anywhere in the GI tract
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| Ulcerative colitis | Involves mucous layer of the GI in the Large intestine ONLY. Has blood/mucous stools. Pain before stools and relieved after
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| Labs for inflammatory bowel flare up | ESR, CRP
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| During IBD flare up what is the diet | NPO with TPN
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| TPN is hard on which organ | Liver
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| causes of Acute Hepatitis | contaminated food, needle sharing, sexual contact, exchange of body fluids, tattoos, piercings. "If it ends in a vowel it came from the bowel" A&E = contaminated food
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| Biliary atresia | Bile backs up and destroys the liver
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| Symptoms of biliary Artesia | Jaundice, itching, swelling of liver, bruising, off-white stools
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| Procedure for biliary Artesia | Kasai procedure: resect hepatic port to drain bile duct & possible liver transplant (cirrhosis)
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| Considerations for cleft palate | No pacifiers, special bottles; surgery at 12-18 months
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| Tracheoesophageal Fistual (TEF) 3 C's and considerations | Coughing, choking, cyanosis. NO FEEDING until after surgical correction
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| Complications of Hernias | Strangulation and encapsulation (loss of blood flow to the area)
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| Pyloric stenosis | Thickened pyloric sphincter; *projectile vomiting
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| Intussusception | A portion of the intestine runs into another portion of the intestine
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| Symptoms of intussusception | Sudden severe abdominal pain, vomiting, currant jelly stools
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| Malrotation and Volvulus | Bowel wraps around mesenteric artery cutting off blood flow. Needs immediate surgery
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| Celiac disease, need to avoid | Wheat, rye, barley, and oats
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| Anemia | Decreased RBC cells circulated in blood due to decreased production, increased destruction, or RBC loss. Decreases O2 carrying capacity of the blood
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| Treat anemia | Treat underlying cause of anemia (decreased RBC production; increased RBC destruction; RBC loss)
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| Sickle cell anemia | RBC CLUMP together and cause PAIN (especially joints)
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| Treating sickle cell | Fluids (NO anticoagulants), HEAT packs
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| Considerations for sickle cell | Risk of infection; risk of Hypovolemic shock if blood pools in spleen (*get a spleenectomy after 1yr old)
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| Sickle cell crisis | Triggered from stress; increase in severity where RBC clump and block circulation; PAIN
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| Idiopathic Thrombocytopenia (ITP) | decrease in platelets; Petechia, bruising, blood pooling in spleen (spleenectomy after 1 year)*NO Contact sports
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| Diagnosing leukemia | Bone marrow aspiration
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| Chemo diet | Eat whatever you like
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| what organ does chemo most affect and related monitoring interventions | chemo is renal toxic - monitor I&Os
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| First phase of Leukemia therapy | Induction therapy 4-6 weeks
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| Second phase of leukemia therapy | CNS prophylactic therapy (prevent leukemia from getting into the CNS)
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| Third phase of leukemia therapy | Intensification/Consolidation therapy (eradicate resistant cells- Heavy chemo)
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| Fourth phase of leukemia therapy | Maintenance therapy (preserve remission 2-3 years)
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| Leukemia labs to go home | Neutrophil has be above 500 to go home
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| Hodgkins lymphoma | nontender, firm, enlarged lymphs
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| Dx of Hodgkin lymphoma | Lymph biopsy
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| considerations for chemotherapy treatments | antineoplastic drugs; all bodily fluids are BIOHAZARD and go in yellow box; wear special chemo gloves
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| Non-Hodgkin lymphoma | Affects all nodes; may not have enlarged nodes; not a great outcome
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| Growth hormone deficiency | young bone age, short, overweight, youthful features
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| diagnosing HGH deficiency | bone age x ray; HGH blood test
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| Precocious puberty | early onset puberty (secondary sex traits); before age 8 in girls and 9 in boys
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| Hypothyroidism | decelerated growth, constipation, dry skin, edema, fatigue
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| Tx hypothyroidism | synthroid (levothyroxine) *give on empty stomach
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| Hyperthyroidism | goiter (enlarged thyroid), restlessness, weight loss, heat intolerance, difficulty sleeping
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| Tx hyperthyroidism | antithyroid meds, radioactive iodine, or thyroidectomy
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| Thyrotoxicosis (aka thyroid crisis) | sudden release of hormones from thyroid following stress. Tx with antithyroid meds and BP meds
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| Effects of steroid use | Females: hair growth, masculinization. Males: aggressiveness, testicular atrophy, breast development
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| Cushings syndrome | result of prolonged steroid use; increase in blood glucose, increased hair growth, moon face, slow wound healing, abdominal weight, ecchymosis (bruising)
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| Tx Cushings syndrome | *No abrupt withdrawal from steroids (causes adrenal insufficiency in kidneys; wean off steroids
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| Diabetes (type 1) | beta cells destroyed; no insulin production; insulin dependent
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| Causes of type 1 DM | genetics, environmental trigger, and autoimmune response
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| Functions of pancreas | endocrine function (insulin & glycogen production) and digestive function (enzyme production)
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| Symptoms of DM 1 | polyuria, polyphagia, polypepsia
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| Signs of ketoacidosis | fruity breath, Kussmauls respirations, dehydration, vomiting. (*may look like the gastroenteritis)
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| Kussmaul's respirations | long expiration to blow off CO2 (indicates DKA)
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| Tx hypoglycemia | fast acting carb (15g/15 minutes) follow with long-acting carbs
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| signs of increased cranial pressure | headache, vomiting, seizures, "neuro-cry" (high pitched scream), bulging fontanel, distended scalp veins, "setting sun" eyes
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| LOC- confusion | impaired decision making- 1
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| LOC- disorientation | to time and place - 2
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| LOC - lethargy | sluggish speech - 3
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| LOC- Obtundation | arouses with stimuli - 4
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| LOC- stupor | responds only to vigorous and repeated stimuli - 5
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| LOC- coma | does not respond to stimuli - 6
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| LOC- persistent vegetative state | permanently loss of cerebral cortex function - 7
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| Pediatric Glasgow scale assessment | eyes, verbal, motor response (3-15 scale)
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| A peds patient has a Glasgow score of 8 - what is their LOC | coma
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| Flexion posturing | rigid and stiff - arms pulls in, chin tucked down, toes pointed hard
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| Extension posturing | rigid and stiff - arms straight, wrists bend out, knees together, calves apart, toes pointed
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| EEG | studies brain function
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| Considerations for increased cranial pressure | *DO NOT perform lumbar puncture (may cause hemorrhaging)
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| acceleration-deceleration injury aka? | Ku-Contra-Ku injury: brain hits front of skull then back of skull = head injury
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| Epidural hematoma | bleeding outside the cranial dural sac between the dura and the skull
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| subderal hematoma | bleeding inside the cranial dural sac
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| a patient who suffered a head injury now has a running nose, what test are you going to do | glucose test on the secretions; +glucose=cerebral fluid
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| why are CNS tumors hard to treat | chemo does not cross blood-brain barrier
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| considerations for CNS tumors | risk for infection, risk for seizures, watch for neuro-deficit, monitor neuro status q4h
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| Bacterial Meningitis | acute inflammation of CNS from a bacterial infection --**Medical emergency
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| what isolation is used for bacterial meningitis | droplet
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| DX for bacterial meningitis | lumbar puncture
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| considerations for bacterial meningitis | increase head of bed, seizure precaution, decreased stimuli
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| non-bacterial meningitis | caused by virus; tx the symptoms (less deadly than bacterial meningitis)
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| when is epilepsy diagnosed | two or more *unprovoked seizures
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| focal seizure | aka absent seizure: no loss of consciousness, blank stare, hearing noises
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| phases of a generalized seizure | tonic, clonic, postical
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| tonic phase | loss of consciousness, constant muscle contraction
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| clonic phase | altering muscle contraction and relaxation
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| postical phase | confusion, return to consciousness
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| seizure precautions | padded bed rails, bed low to floor, suction at bedside, O2 available
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| your patient is having a seizure what do you do | place on side, maintain patent airway, nothing in the mouth, do not restrain
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| hydrocephalus | increased cerebral fluid around the brain (associated with myelomenigocele spina bifida)
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| Tx for hydrocephalus | V-P shunt (drain cerebral fluid into abdomen)
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| V-P shunt complications | infection, kinking, clogging (hydrocephalus)
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| signs of infection in a V-P shunt | erythema along neck/abdomen on the shunt line, return of hydrocephalus symptoms, fever, pain
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| Consideration for ALL neuro patients | Report changes in LOC immediately
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| Cerebral palsy | non-progressive disorder affecting motor function, caused by a variety of different things
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| Tx for cerebral palsy | long-tern PT and adaptive equiptment
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| Trisomy 21 | "down syndrome" flat forehead, short limbs, protruding tongue, wide hand crease
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| Considerations for downs syndrome patients | increased risk of congenital heart defects and leukemia
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| developmental dysplasia of the hip (DDH) | shallow socket joint at the hip
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| signs of DDH | shortened femur, uneven gluteal folds, hip click, limiting abduction of hip
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| screening for DDH | ortolani-barlow test (adduction & abduction of hip)
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| Tx for DDH | Pavlik harness/spica cast (holds in abduction); surgery 6-18 months
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| Muscular dystrophy | muscle degeneration and wasting (genetic)
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| most common muscular dystrophy | Duchenne's (only males)
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| when does duchenne's MD start | 3-4 years
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| Signs of muscular dystrophy | delayed walking (>18 months), walking on toes with toes turned inwards, gowers maneuver
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| gowers maneuver | when in a bent position the patient needs to walk hands up the body in order to stand (sign of muscular dystrophy)
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| end stages of muscular dystrophy | gradual paralysis starting in legs and ascending; usually death occurs from respiratory paralysis
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| considerations for parents of child with muscular dystrophy | genetic counseling for future children
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| Leg-Calf Perthes disease | circulation to femoral head dies (aseptic necrosis of femoral head)
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| symptoms of leg-calf perthes | hip pain that worsens with activities and is relieved with rest
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| Tx for leg-calve perthes | abduct hip joint; if femoral head breaks = femoral head replacement (recovery is 3-4 months non-weight baring)
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| detecting scoliosis | unilateral rib hump, twisted rib cage, uneven shoulder, uneven hip, pants don't fit/shirts don't lay evenly
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| tx for scoliosis | mild=stretching; moderate=brace; severe=spinal fusion surgery (Painful)
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| spina bifida | failure of spine to fully close
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| spina bifida occulta | not visible externally
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| spina bifida cystica | visible, sac-like protrusion
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| preventative measure for spina bifida | prenatal folic acid
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| indicators of spina bifida occulta | sacral dimple, reddening/discoloration at sacrum, sacral hair growth
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| tethered spinal cord (symptoms) | spina bifida occulta - split spinal cord may attach to other points in body causing altered gait, feet deformities, elimination problems
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| spina bifida cystica meningocele | sac does not contain nerves
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| spina bifida cystica myelomeningocele | sac does contain nerves
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| considerations for myelomeningocele | keep that baby prone; beware of ruptured sac -- the higher up it is the less compatible with life & more severe. if below 2nd lumbar vertebra = lower paralysis; symtpoms dependent on location; may not affect both sides of body equally
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| Management for myelomeningocele | moist covering (sterile saline), prone, risk for infection, limit ROM
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| Treatment for spina bifida | surgery to re-tether spinal cord
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| Considerations for spina bifida kids | *Latex allergy (also banana, avocado, kiwi, and chestnut) - allergy response increases with each exposure
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| atopic dermatitis | eczema (3 types: infantile, childhood, preadolescent/adolescent)
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| skin lesions: macule | flat & circumscribed - freckles, moles, rubeola, rubella (baby-rashes)
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| skin lesions: papule | elevated - warts
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| skin lesions: vesicle/bulla | elevated filled with fluid - blister; varicella (chicken pox)
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| skin lesions: patch | flat and irregular - vitiligo; port-wine marks (occult spina bifida)
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| skin lesions: wheal | elevated, transient/changing - bug bites
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| skin lesions: nodule | elevated, firm, palpable - lipoma
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| skin lesions: pustule | vesicle filled with purulent fluid - acne
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| skin lesions: cyst | vesicle filled with fluid and semi-solids
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| skin lesions: scale | heaped up keratinized skin cells - exfoliative dermatitis
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| skin lesions: crust | dried secretions - scab
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| skin lesions: excoriation | abrasion; cut
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| skin lesions: fissure | cracked skin; athletes foot
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| skin lesions: erosion | after a vesicle bursts
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| 4 phases of wound healing | 1. inflammation 2. granulation 3. contraction 4. maturation
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| 1st phase of wound healing | inflammation: the area swells while WBC eat the dead tissues and defend against infection. involves swelling, pain, warm and redness at injury site
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| 2nd phase of wound healing | granulation-proliferation: body starts repairing damaged tissues, scab formation
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| 3rd phase of wound healing | contraction: body is building new skin to bring the wound edges closer together (may need debrievment)
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| 4th phase of wound healing | maturation: scar tissue formation, increased collagen at site; this tissue will change over time with continued healing
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| wound dressing considerations | wet-dry dressings for open wounds promote faster healing (sterile saline), wound dressings only require clean (not sterile) technique
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| wound diet considerations | increased protein- faster healing
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| s/s of wound infection | increased erythema margins, edema, purulent drainage, pain, warmth at site/fever
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| side effect of wound healing | pruritus (itching) tx with cold compress/bath, mittens, cut nails, benedryl
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| considerations for MRSA skin infection | abscessed off- abx hard to reach it; tx with draining abscess, PO/topical Bactrim/ IV Vancomycin
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|
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| seborrhic dermatitis | cradle cap
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|
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| contact dermatitis | allergy response ie. fabric softener
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|
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| Tx for poison ivy, oak, or sumac | wash with cold water, clean with alcohol, wash with warm water, calamine bath and corticosteroids
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|
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| Rashes from a drug reaction - what you do | stop the drug, talk to the provider about whether or not to continue based on severity of reaction (ie. Vancomycin & red man syndrome) May tx with benedryl, motrin, corticosteroids
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| Tx for bee stings | remove the stinger asap (scrape), cool compress, and benedryl
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|
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| considerations for bee stings | reaction gets worse with each sting
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|
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| scabies | bugs burrow into skin to lay eggs; tx with topical or PO meds
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|
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| pediculosis capitis (lice) | bugs in hair, laying eggs/ tx family with lice kit
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|
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| prevention of arthropod bites/infections | bug spray/lotion, check your clothes
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|
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| concern with animal bites | rabies, infection, & wound care
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|
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| age-related skin problems | diaper rash in infants; abrasions in childhood; acne with puberty
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|
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| what puts women at greater risk of uti | shorter urethra and proximity to rectum
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|
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| best way to get a urine sample from a young child | straight cath
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|
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| signs of UTI | foul smelling urine, dysuria, increased frequency, fever, chills, flank pain
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| Tx for UTI | antibiotics and fluids
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|
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| pyelonephritis | kidney infection
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|
||||
| urosepsis | sepsis originating from a UTI
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|
||||
| preventing UTIs in girls | wipe front to back
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|
||||
| vesicouretal (VUR) | reflux of urine from ureters into the kidneys (risk for pyelonephritis)
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|
||||
| risks for pyelonephritis | urinary tract obstruction, urinary tract stricture, VUR (reflux)
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|
||||
| reoccurring pyelonephritis can cause what complications | kidney damage and scarring
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|
||||
| presentation of pyelonephritis | N&V, flank pain, fever, chills, nocturia, frequency, urgency, anorexia, hematuria, dysuria
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|
||||
| costovertebral tenderness | flank pain (pyelonephritis)
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|
||||
| Tx for pyelonephritis | antibiotics, fluids; prophylaxis for reoccurring episodes
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|
||||
| glomerulonephritis | inflammation of the kidneys -> decrease in filtering ability
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|
||||
| primary cause of glomerulonephritis | infection (STREP/RHEUMATIC fever/heart)
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|
||||
| group A beta-hemolytic streptococci complications | strep throat --> rheumatic fever --> rheumatic heart; glomerulonephritis
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|
||||
| secondary cause of glomerulonephritis | autoimmune response (think chronic diseases like diabetes)
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|
||||
| Signs of glomerulonephritis | edema (marshmellow men), HTN (extracellular fluid), hematuria, oliguria
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|
||||
| What will the urine and UA of a patient with glomerulonephritis look like | coke-colored urine. UA will have RBC and protein (increased protein indicates severity of case)
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|
||||
| Considerations for glomerulonephritis | Strict I&O monitoring; fluid and sodium restriction
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|
||||
| Treatment of glomerulonephritis | antibiotics
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|
||||
| nephrotic syndrome | inflammation of the kidneys leads to decreased filtering ability
🗑
|
||||
| primary cause of nephrotic syndrome | unknown
🗑
|
||||
| secondary cause of nephrotic syndrome | glomerular damage
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|
||||
| tertiary cause of nephrotic syndrome | congenital defect
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|
||||
| symptoms of nephrotic syndrome | edema (marshmellow men), HTN (extracellular fluid, oliguria
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|
||||
| what will the urine and UA of a patient with nephrotic syndrome look like | beer-colored and frothy/foamy urine; UA will have massive amounts of protein
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|
||||
| what will the CBC of a patient with nephrotic syndrome look like | hypoalbuminemia (low blood protein due to protein loss in urine); and high blood fat content
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|
||||
| what is the risk of extracellular fluid retention | hypovolemia
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|
||||
| Tx for nephrotic syndrome | steroids (possible chemo drugs) and diuretics (control HTN and fluid retention)
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|
||||
| Wilms Tumor | nephroblastoma (kidney tumor)
🗑
|
||||
| wilms tumor presentation | firm, palpable abdominal tumor
🗑
|
||||
| Metastasis of wilms tumor | easily to spleen, liver, lungs, and brain
🗑
|
||||
| considerations with wilms tumor | put up a sign *DO NOT PALPATE ABDOMEN
🗑
|
||||
| what is the risk with wilm's tumor | ruptured tumor= cancer cells seeding all over the place
🗑
|
||||
| Treatment for wilms tumor | Surgery ASAP followed by chemo & radiation
🗑
|
||||
| hypospadias urethral malposition | urethral opening on the bottom shaft of the penis
🗑
|
||||
| epispadias urethral malposition | urethral opening on the top shaft of the penis
🗑
|
||||
| Tx for urethral malposition | surgical correction at 6-15 months
🗑
|
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