FINAL EXAM Flashcards
(57 cards)
What is the most common cause of acute renal failure in children?
Hemolytic uremic syndrome (HUS)
What are the symptoms of UTI in an infant?
Fever over 100.4ºF without a known focus for infants and young children 2-24 months of age suggests a UTI (this is the most common cause of fever in infants).Irritability, dysuria as evidence by crying when voiding, change in urine odor or color, poor weight gain, feeding difficulties, suprapubic tenderness.
What will be found in a urinalysis in a child with acute glomerulonephritis?
Glomerulonephritis is a problem with tiny filtering units in the kidneys called glomeruli become inflamed and the kidneys stop working properly. Microscopic (small) or macroscopic (large) amounts of hematuria with RBC casts. High serum potassium, low serum bicarbonate levels.
Why does the child with acute glomerulonephritis develop edema?
Sodium and water are retained – causing edema
What is the most common cause of acute renal failure in children?
Hemolytic uremic syndrome (HUS)
What are the primary clinical manifestations of acute renal failure?
Electrolyte abnormalities – potassium elevated, sodium decreased
Fluid volume shifts – edema
Increased BUN and serum CRE levels
Acid-imbalances – unable to excrete hydrogen ions and ammonia through the kidney, metabolic acidosis develops
HUS is characterized by abdominal pain, fever, vomiting, bloody diarrhea
What diagnostic finding is present when a child has primary nephrotic syndrome?
Urinalysis demonstrates protein (+3 to +4), urine appears dark and frothy, microscopic hematuria
Serum cholesterol, triglycerides, hematocrit, and hemoglobin values are elevated
Serum albumin is markedly decreased
At what age is hypospadias corrected?
6-12 months old
What dietary modification is appropriate for a child with chronic renal failure?
Diet supplements, administration of Growth Hormone, small frequent meals – but with food the child likes
Reduction in sodium and fluid intake, phosphorus is restricted to manage bone disease
Possible decrease in serum potassium levels if the kidneys can
How is acid-base balance regulated in children?
Chemical and cellular buffers
Respiratory control of carbon dioxide
Renal regulation of bicarbonate and secretion of hydrogen ions
The amount of fluid ingested during the day should equal the amount of fluid that is lost through sensible (urination) and insensible (respiratory tract and skin).
What are normal potassium, sodium and calcium levels?
Potassium: 3.5-5.0
Sodium: 135-150
Calcium: 8.5-11.0
Why are infants at greater risk for dehydration than older children?
Severe gastroenteritis is the most common cause of hospitalization in infants – intestinal infection (N/V/D, cramps, fever) results in dehydration
They are at greater risk because they have a higher ECF than older children, which makes them more susceptible to rapid fluid depletion.
difference between hyper-hypo-isotremic dehydration.
Hypernatremic – sodium concentration is above that of normal body fluids
Hyponatremic – sodium concentration is below that of normal body fluids
Isonatremic – sodium concentration is practically identical to that of body fluids and is the most common form
Know the criteria used for diagnostic evaluation of dehydration.
History of acute or chronic fluid loss
Clinical manifestations
Child’s weight
Serum electrolyte values (determine moderate to severe dehydration)
Know symptoms of dehydration
Hypernatremic = fever, diarrhea, high sodium intake, DI (diabetes Insipidus)
Hyponatremic = fever, vomiting, diarrhea, increased water intake without electrolytes, burns, CF
Fewer wet diapers than usual
No tears when crying, inside of mouth is dry and sticky
Irritability; high-pitched cry
Difficulty in awakening
Increased respiratory rate or difficulty breathing
Sunken soft spot, sunken eyes
Abnormal skin color, temperature, or dryness
Why would antidiarrheal medications NOT be used in an infant who is diagnosed with diarrhea caused by a pathogen?
Potential for toxicity
Binding nature of the products
Have not been found to shorten the course of diarrhea
Might increase fluid and electrolyte loss interfering with the body’s attempt to rid itself of the organism.
Therapeutic management of a child with acute diarrhea and dehydration usually begins with what type of therapy?
Wash hands, increase fluid intake, continue feedings, eat frequently, close monitoring and observation, antibiotics given if diarrhea is caused by bacteria, parasites, or fungi
What STD should the nurse suspect when the adolescent girl complains of vaginal discharge that is white and has a fishy smell?
Bacterial Vaginosis
May be asymptomatic and is not usually associated with abdominal pain, skin rashes, itching, or painful urination.
What is part of innate immunity?
Skin and intact mucous membranes
Acid secreted in sweat and by sebaceous glands
Smooth muscle contraction and ciliary actions (coughing, sneezing)
Physical and chemical membranes
What are the symptoms of Erythema Infectiosum (Fifth disease)?
Mild systemic disease
Headache, runny nose, mild fever, malaise
Intense, fiery red, edematous rash on cheeks
“Slapped cheek” appearance
Approx. 1-4 days after the facial rash appears, an erythematous, maculopapular rash appears on trunk and extremities
The disease is most contagious the week before the rash appears.
What should be included in the care of a neonate diagnosed with pertussis?
Erythromycin (-mycin) antibiotic given
Hospitalization, supportive care
Monitor airway, respiratory status
Droplet precautions
What education should be given to parents to prevent Lyme disease?
Anticipatory guidance and information about routine preventive measures to avoid insect bites
Proper use of diethltoluamide (DEET) insect repellent should be stressed
What action is taken when a child has been scratched or bitten by a rabid animal?
The bite should be cleaned with A LOT of soap and water
Human Rabies Immune Globulin (HRIG) is infiltrated locally around the wound and IM
Rabies vaccination should be given as early as possible after exposure (within 24 hrs)
Only vaccine that can be given after exposure and still work
What are the symptoms of mumps?
Fever, myalgia (muscle pain), headache, malaise
Parotid glandular swelling (in the mouth) – classic sign
