Children non-osmosis finals Flashcards
Assessent of HEAD INJURY
CLC: GCS+ pupil+limb+vitals
Monitor for:
- raised ICP ( bradycardia, irregular respi, HTN)
- CSF/blood drainage from nose or ears
S&S INTUSSUSCEPTION
Classic Triad
* Severe paroxysmal colicky abdominal pain, causing the child to scream and draw his knees to the abdomen
* Bilious vomiting
* “currant jelly” stools (contains blood and mucus) - late manifestation
*caused by hyperperistalsis-invagination of intestine
S&S APPENDICITIS (3)
- Mild fever and pain around umbilical region
- Worsen and moves to the lower right quadrant of abdomen
- Vomiting, nausea and loss of appetite
S&S HERNIA
Assessment finding: soft swelling protrusion around the umbilicus, usually reducible with finger. protrusion of the bowel through an abnormal opening in the abdominal wall
- usually close spontaneously by the time child is 3-4 years old
- but if the bowel incarcerated, NOT reducible by finger –> repair surgically
S&S IMPERFORATE ANUS + treatment
no patent opening
so must after surgery:
Anal Dilation
- Twice daily for 1 week (or more frequent)
- Gradually upsize dilator
- KY Jelly
FLACC is used in patients that are intubated, sedated for severely disabled, what does it stand for?
Face, Limbs, activity, Cry, Consolability
0 to 2 each. total 10 marks
Neonates pain scales? (3)
NIPS, CRIES, facial coding.
NIPS=neonate infant pain score
CRIES=Cry, Require O2, Increased vital signs, Expression, Sleelpiness
List the types of head injury
Concussion
Fractures: linear, depressed, diastatic (along suture lines), basilar (break in bone at base of skull)
Hematoma (bruise): epidural, subdural, intracerebral (bleeding in brain tissue)
Contusion: small bleed in brain tissue, may cause seizure
S&S PNEUMONIA and treatment
Symptoms like fever, cough and tachypnoea
Investigations: CXR, FBC, CRP, Blood Culture
- Treatment
- Oxygenation aim SaO2 > 95%
- Hydration & Nutrition (KIV NGT)
- Oral antibiotics is sufficient for majority
- IV antibiotic eg, Ampicillin and Gentamycin for neonates and toxic presentation
S+S GASTROENTERITIS (general, mild, moderate, severe)
Diarrhoea, vomiting, fever, abdominal cramps, dehydration, electrolyte imbalance, URTI
* Mild: Few loose stools without other symptoms
* Moderate: Several loose or watery stools, elevated temperature, vomiting and irritability,
weight loss
* Severe: Numerous stools, signs of moderate or severe dehydration, drawn appearance,
weak cry, irritability, purposeless movements
Nursing management gastroenteritis (5)
Reinstate adequate hydration
* Oral rehydration therapy (ORT) for moderate and severe diarrhea and dehydration
* Administered IV fluids as prescribed
* Monitor fluid intake and output and daily weight.
Ensure adequate nourishment
* Tolerance of feeds
* Reintroduce nutrients according to daily requirement needs
Prevent Infection
* Hand hygiene
* Food and bottle hygiene
Skin Care
* Change diaper frequently
* Apply barrier cream as prescribed
ORT with Oral Rehydration Salt (ORS) OR pedialyte Glucose-electrolyte solution
nursing problems gaastroenteritis (4)
- Deficient fluid volume - diarrhea, inadequate intake
- Imbalanced nutrition - inadequate intake
- Risk of infection – microorganisms invading GIT
- Impaired perinium skin integrity – irritation cause by frequent loose stools (acidic)
S+S Glomerulonephritis (8) + treatment (short)
- Child typically has history of URTI (within 1-2 week) – streptococci infection
- Sudden onset of gross hematuria – tea colored, reddish-brown or smoky
- Proteinuria (Total 24 hour urine) > 1gm
- Oliguria
- Urine sediment – WBCs epithelial cells hyaline granular and RBC casts
- May have low grade fever, abdominal pain, edema, vomiting, anorexia or headache
- Hypertension from hypervolemia
- Hypoalbuminemia – losing protein in urine
Treatment: Symptomatic – strict assessment of intake and output
What bacteria causes:
a. glomerulonephritis
b. UTI
a. nepritogenic streptococci
b. Ecoli
S&S UTI + treatment
Sign and symptoms
* Lower tract: Dysuria, frequent voiding, suprabubic pain
* Upper tract: generally <2years old, fever, loin pain
Treament: Antibiotic
* 1st line – Amipicillin and/or Gentamycin
* 2nd line – Ceftriaxone or cefotaxime
