Final: What I think is most important part 2 Flashcards Preview

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Flashcards in Final: What I think is most important part 2 Deck (64):
1

What are some causes of CP?

-Brain injury
-Maternal chorioamnionitis
-Extremely LBW
-LBW (low birth weight)
-Mutltiple births
-Placenta didn't provide developing fetus with enough oxygen and nutrient
-Kernicterus (high levels of bilirubin in neonatal period)
-Shaken baby syndrome surivors

2

What are some long term problems associated with CP?

-Visual and hearing impairment
-Communication and speech difficulities
-Seizures
-Intelectual impairment
-ADHD
-Dental caries
-Drooling
-Nystagmus

3

The most common chromosomal abnormality of a generalized syndrome?

Down syndrome

4

97% of all down syndrome are attributable to what?

An extra chromosome 21 group

5

What pregs are more at risk for down syndrome baby?

Those over 35

6

DS: What kind of separation in suture? How is head look?

Separated sagittal suture
Enlarged anterior fontanel
Small, rounded head
Flat face profile

7

DS: What are eyes like?

Upward, outward slant

8

DS: What is nose like?

Small nose, depressed nasal bridge (saddle nose)

9

DS: How are ears?

Small with short pinna

10

DS: How is mouth?

High, arched, narrow palate
Protruding tongue

11

DS: What is chest like?

Shortened rib cage

12

DS: How does abdomen look?

Protruded

13

DS: What are hands like?

Broad, short hands and stubby fingers

14

DS: What are feet like?

Wide space between big and second toes
Plantar crease between big and second does

15

DS: Musculoskeletal signs noted?

Hyperflexibility and hyptonia

16

DS: Increased risk for what cancer?

Leukemia

17

A viral infection in which the virus affects the t-lymphs, causing immune dysfunction, which leads to organ dysfunction and a variety of opportunistic illnesses in a weakened host

HIV

18

What kind of HIV/AIDs infection will we see children with Kaposi sarcoma?

Severely symptomatic infection

19

What is the main therapy for HIV?

HAART

20

What antibiotic do we administer to all infants who are born to infected mothers with HIV?

Give TMZ-SMZ until HIV infection is excluded

21

Why would IV gamma globulin be given to HIV pts?

To prevent recurrent or serious bacterial infections

22

What are priority nursing problems for child with HIV?

1. Infection (hand-washing, deep breathing/coughing, and needing to get PCV and flu vaccine)

2. Education: They cannot miss a dose of their med!! and it needs to be taken on regular schedule!! Adolescents need to under stand high risk sexual behaviors can infect others!!!

23

What bacteria can cause UTI?

E. coli (just an example, there are others)

24

What does urinalysis look like for UTI?

pH: weak acid or neutral alkaline

Protein, glucose, ketones, leukocytes, and nitrates: ALL POSITIVE in urine

Note: Normal urine should be NEGATIVE for protein!!

25

UTI infants: Feeding like? How do they take it?

Poor feeding
Vomiting
Failure to gain weight

26

UTI infants: Increase or decrease in thirst?

Increase

27

UTI infants: Infrequent or frequent urination?

Frequent--staining with urination and foul smelling

28

UTI infants:
Fever?
Diaper rash?
Blood in urine?
Swelling of face, edema?
Seizure, pallor?
Dehydration?

Infants:

Fever: yes
Diaper rash: yes
Blood in urine: No (this is in children though!)
Swelling of face, edema: No (this is in children though)
Seizure, pallor: yes
Dehydration: Yes

29

UTI children: How is appetite?

Poor--vomiting

30

UTI children: How is growth?

Slowed

31

UTI children: Increase or decrease in thirst?

Increase--eneuresis; frequent urination

32

UTI children: Is there swelling anywhere?

Yes, face--also edema

33

UTI children: Tired? Hypotension or hypertension?

Yes fatigued, hypertension; also have tetany

34

UTI children: What kind of urine

Foul smelling or blood in urine?

Blood in urine

35

What are some antibiotics given for UTI?

Penicillins
Sulfonamide
Cephs
Nitrourantoin

36

What kind of underwear for UTI: cotton or nylon?

Suggest use of cotton

37

What should we instruct sexually active adolescents to do to prevent UTI?

Instruct them to void immediately after intercourse

38

Nephrotic Syndrome (NS): What is urinalysis like? (4)

-Elevated protein in urine (2+ on dipstick)
-Hyaline casts
-FEW RBC
-Oval fat bodies

39

NS: What is chemistry like? (8)

-Hypoalbuminism: less than 2 g/dl
-Elevated Hgb, Hct
-Elevated platelets: 500,000-1,000,000
-Possible hyponatremia
-Decreased serum protein level (6.1-7.9)
-Hyperlipidemia
-Serum cholesterol: (450-1500 mg/dl)
-Normal potassium

40

The most common presentation of glomerular injury in children

Nephrotic syndrome

41

In nephrotic syndrome, alterations in the glomerular membrane allow proteins, especially _____, to pass into the urine; resulting in decreased serum osmotic pressure

Albumin

42

What is most common form of NS?

MCNS

43

If a patient with NS has edema, what should we do?

RESTRICT SALT

44

A non-specific upper resp. tract infection that manifestations by 4-8 days but is considered to be a precipitation factor rather than a cause of NS

Minimal change nephrotic syndreom (MCNS)

45

What are some clinical manifestations of MCNS?

-Gain weight over a period of days or weeks
-Puffiness of face (especially around eyes) [this is apparent on arising in am but subsides during day-->then swelling of abdomen and lower exremtieis is more prominent]
-Diarrhea
-Loss of appetite
-Lethargic
Decreased urine volume--dark, opalescent and frothy
-BP NORMAL OR SLIGHTLY DECREASED

46

MCNS: An acute infection may precipitate severe generalized edema..Where?

Periorbital edema
Abdominal swelling from ascites
Labial or scrotal swelling

47

What is DOC for MCNS/NS? Client education?

Prednisone

-Administer with meals

48

Why would we give diuretics for MCNS/NS? Client education?

Eliminates excess fluid from body

-Encourage child to eat foods high in K

49

Why would we give 25% albumin to MCNS/NS pts?

To increase plasma volume and decrease edema

50

What drug is given for MCNS/NS for children with frequent relapsing of MCNS or steroid resistant NS?

Cyclophosphamide or chlorambucil

51

How does urine look for glomerulonephritis?

Smoky or tea colored urine

52

Glomerulonephritis: What test can show presence of streptococcal antibodies?

Elevated ASO titer

53

The glomeruli are inflamed, which impaired the kidney to filter urine properly

Acute glomerulonephritis (AGN)

54

What VS change is anticipated with glomerulonephritis?

Increased BP--HTN

Can give loop diuretics and anti-HTN drugs to help with this

*if not treated, seizures can occur

55

Glomerulonephritis: What are signs of renal failure?

1. Decreased urine output-first sign
2. HTN encephalopathy
3. Cardiac decompensation

56

Glomerulonephritis:
How is urine?
Increased or decreased blood protein level?
Low, normal, or elevated lipid level?
Increased or decreased K level?

Urine: smoky, tea color (also hematuria and proteinuria)

INCREASED blood protein level

NORMAL lipid level

INCREASED K level

57

Since glomerulonephritis can have an increased K level, what foods should be avoided?

Bran cereal
Potatoes
Tomatoes
Bananas
Melons
Orange
OJ
Yogurt
Leafy greens
Beans
Avacodos

58

Inappropriate urination that must occur at least 2weeks for at least 3 months--the child must be at least 5 years of age before there is consideration about diagnosis

Eneuresis

59

What does DDAVP do?

An antidiuretic hormone that reduces volume of urine--given for enuresis

*Can be given PO or nasal, if nasal--store in fridge

60

Why would we give a child with enuresis a TCA?

We could give imipramine hydrochloride to INHIBIT urination. We need to make sure to monitor child for increase suicidality though

This is for 6-8 weeks, with a gradual withdrawal

Administer with food and 1 hr before bedtime

Avoid sun exposure and OTC meds while on drug

61

What anticholinergic could we give to child with enuresis?

Oxybutin chloride to reduce bladder contractions

62

Meatus opening located on the dorsal surface of the penis

Epispadias

Male: widened pubic symphysis, broad/spade like penis
Female: Wide urethra, bifid clitoris

Both: possible exstrophy of bladder

63

Urethral opening located behind glans of penis or on the ventral surface of penile shaft

Hypospadias

64

Narrowing of the preputial opening of the foreskin

Phimosis

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