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maternal child health RN > Neurology, Integumentary and cancer Final > Flashcards

Neurology, Integumentary and cancer Final Flashcards

1
Q

Problems in the neuro is system can start where ?

Can lead to what

A

Brain

Spine

Nerves

Muscles

-seizures, headaches, developmental delays

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2
Q

What scale to use that determines level of consciousness?

What it measures?

Higher numbers means?

Used For what ages

A

Glascow coma scale

alert , lethargy, obundation, stupor, coma (eye opening, motor response0-2 years, verbal response-2-5 years)

More conscious you are- 15 is the sum

0-5 years old

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3
Q

Level of alertness

Alert-

Lethargy-

obundation,

stupor,

coma

A

Alert- when patient answers questions appropriately

Lethargy-opens eyes, appears drowsy, answers questions appropriate but falls asleep and needs reminders to answer

obundation, - can open eyes but appears confused - overall alertness is decreased

stupor, - only responds to painful stimuli , verbal responses are absent or slow

coma - do not respond to internal or external stimuli and remain in unaroused state with eyes closed

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4
Q

The space in between the brain and skull create intercrainial pressure s/s such as?

Infants?

A 
Seizures 
Decreased eye contact 
Building fontanels 
HTN (pushing triad)?
Bradycardia 
Irregular resp

LOC, papilledema , pupil changes, impaired eye movement, decerebrate, decorticate, and flaccid posture, change in motor ability , speech, headache

Infants - bulging fontanels, cranial suture separation, increases head circumference, high pitched cry

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5
Q

intercrainial cranial pressure s/s in ER or nicu - what to do?

Overall goal?

A

Closely monitor pt

Address changing of vitals

Assess neuro status

  • ask what there normal state of being is from there parents

Provide care and prevent harm?

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6
Q

Important observation in infants to asses for intercranial pressure and dehydration

A

Anterior closes at 18 months of age

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7
Q

Things that can impacts intercrainal pressure /fluid In head

A

Growing tumor

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8
Q

Electrical disturbance activity in the brain resulting in motor dysfunction , alterations and sometimes sensation

A

Seizure

Classified?

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9
Q

Seizures can result from?

A

Traumatic brain injury

Toxic ingestion of chemicals

Endocrine dysfunction

Anoxic(low oxygen) episodes

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10
Q

Etiology of seizures (why it happens may be )

A

Unknown

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11
Q

Mom who has continuous late decelerations and progresses in labor may do what to the child

Decreased or absent variability

A

Anoxic (low oxygen) episodes and may cause seizures

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12
Q

What is a partial seizure

A

A seizure that affects only one part of the brain. Affects a single limb (hands , lips, wrist, arm, face)

LOC onset

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13
Q

What is a simple partial seizure ?

A

No LOC

Spread to other parts of body

Buzzing sounds

Flashing lights

Anxiety of unknown

Five minutes

Don’t remember

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14
Q

Complete partial

A

Complete LOC and awareness

Behavior changes, lip smacking, inappropriate mannerisms , confusion followed by a seizure

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15
Q

Generalized seizure aka ?

S/s

Phases

Other types

How it begins?

A

Tonic clonic (grand mal)- most common

Unconsciousness , onset with out warning

Other types- Mytonic , atonic, absent seizure

Begin with dyspnea on the limb= tonic phase

Breathing may decrease or stop, cyanotic on lips , mucus membranes,nail beds, and face in tonic phase

Followed by Jerking of limbs and face= clonic phase , breathing may return here but irregular, lasts less than a minute , some people may only experience this phase

Incontinent may occur , may have bit tongue (blood present) , raspy and labored breathing after

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16
Q

Care for one having a seizure

A

Be sure they are safe- do not hit anything surrounding them (head)

Get them on floor

Loosen tight constricting clothing around neck (bib, tie, scarf)

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17
Q

Care after seizure

A

Put them on their side

Get vomit out of mouth so they do not aspiriate

(Airway and repositioning)

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18
Q

When to call 911 during a seizure

A

Time the length of lasts longer than 5 minutes - call 911

The person does not have epilepsy

A second one occurs before patient is fully recovered

Regular breathing does not return after ending

Seizure occurs in water

Pt is pregnant

Pt has diabetes

Injury occurs during seizure

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19
Q

Do NOT do what?

A

Do not put anything in mouth or restrain patient

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20
Q

How to protect seizure pt from injury

A

Place something soft under head and remove dangerous objects out of the way

Roll onto side after seizure subsides

As seizure of ending pt may have bowel or bladder incontinence and excess saliva during

Stay with pt until full awareness returns

Pt may be tired , Talk softly after

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21
Q

Viral infection that occurs with an acute febrile illness characterized by cerebral edema and infection surrounding mengengies ?

A

Encephalitis

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22
Q

Most common cause of viral encephalitis is caused by?

A

Mosquito or herpes simplex virus type 1

May also be caused by rabies , mononucleosis, or Poliomyelitis

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23
Q

Swelling around the meninges causes what s/s of encephalitis?

A 
Confusion
Headache 
High fever
Photophobia 
Lethargy 
Nuchal ridgity (stiff neck) 
seizures 
Coma
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24
Q

When someone come into ER with cerebral edema or encephalitis s/s what to go?

A

Initiate seizure precautions

Head to toe assessment/ neuro exam

Vital signs

Draw labs - CBC and kem panel?

Position to avoid neck and vein compression

Monitor fluid and electrolytes and monitor or syndrome if innappopriate anti diuretic hormone

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25
Q

Inflammation of the structures of the central nervous system caused by infection

A

Meningitis

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26
Q

Meningitis Can be caused by

A

streptococcus pnemona

Meningitis

Influenza type b

Bacteria or viral

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27
Q

Meningitis that is deadly , spreads fast

Signs

A

Bacterial

Brudzinki (bend neck and hips and knees flex laying supine) and kernig sign (supine- knees can not extend due to pain when hip flexed 90 degrees) ** know?

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28
Q

Bacterial infection indications - opposite to viral

A

Cloudy spinal fluid -spinal tap

Elevated WBC count

Grams stain Positive

Decreased glucose levels

Protein content elevated

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29
Q

What to watch for after spinal tap

A

Headache that is more intense than previous headache

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30
Q

Liver and brain damage caused by aspirin to pt age 4-14

A

Reye’s syndrome

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31
Q

Meningitis s/s?

Interventions

A

Fever, headache, Steph Nik, lethargic, irritability, nausea, vomiting

Assess neurological status every 2 to 4 hours

Seizure precautions at all times

calm and quiet room

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32
Q

S/s of ryes syndrome

Tx and interventions

A

Restlessness, vomiting, drowsiness, seizures, loss of consciousness

ABCs , resp status

Head to toe vital signs

Seizure precautions for ICP

IV hydration - make sure they contain glucose and correct hypoglycemia and correct potassium , sodium electrolyte imbalances

Corticosteroids - decrease cerebral edema and inflammation

Insulin- increase glucose metabolism

Diuretics - increase fluid elimination - decrease edema/ICP

Vitamin K/ plasma

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33
Q

What does ryes syndrome primarily affect in children

A

Brain

But can affect all systems

2 part

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34
Q

Abusive head trauma aka

Why and how it happens

S/s -

A

Shaking baby syndrome (non accident)

emotional response - shake until quit crying

6 months or younger - not moving by self yet to injure self - ***

seizure activity , apnea , bulging of fontanels, coma , bradycardia, Hemorrhage, vomiting, poor feeding , lethargy, irritability ,failure to thrive

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35
Q

Nursing care for abusive head trauma

Progress for child depends on?

May result in?

A

—Recognize hallmark signs -
Maintain respiratory and cardiovascular support, assess for ICP and visible injury, prevent complications due to long-term impairment such as infections contractures decrease muscle tone and pressure ulcers, may need gastrostomy or tracheostomy tube

Inconsistency of what your assessing and what your being told by parents

Inconsistency in stories of each parent

  • severity of injury and timing of care after injury
  • Visual or neurological impairments , developmental delays
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36
Q

Why are children prone to head injuries?

A

Have larger head then body

Unstable gait

Soft cerebral tissue

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37
Q

Occurs when a joke or hit to the head disrupts the normal function of the brain

A

Trumatic brain injury

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38
Q

Traumatic brain injury nursing care?

A

Maintain airway
Give oxygen as needed
Assess pupils and reactivity
Asses reflexes
Assess skull fractures - palpate CSF fluid from ear or nose
Assess for blood in middle ear, mastoid bruising and periorbital bruising (raccoon eyes)

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39
Q

Warning signs of head injury?

A

Change in LOC, Drowsiness, confusion, difficult to arouse, seizures, bleeding or watery drainage from nose or ears, slurred speech, vomiting, blurred vision, loss of sensation to extremities, people slow to react or unequal

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40
Q

Common Reasons why children are seen in ER

What is anticipatory guidance (Education) to client and parent?

A

Motor vehicle accidents

Bicycle accidents

Sports trauma

Violence at home or school

Falls

  • wear knee pads , helmet, seatbelt , following safety rules
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41
Q

Spinal cord injures when most often seen

A

In summer

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42
Q

Spinal cord injuries have been associated with what

A

Traumatic births

Fighting with guns and knifes

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43
Q

S/s of spinal cord injuries

How they occur

A

Depends on severity of injury

Injury to cervical, thoracic, lumbar or sacral

Caused by direct or indirect force and damage which results in loss of sensation or paralysis below the level of injury

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44
Q

Cervical injury-

Thoracic -

Lumbar-

Sacrum-

A

Quadriplegia (all fours)

Paraplegic(legs and butt)

Paraplegia - (below waist)

Coccyx

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45
Q

Common through childhood and classified as primary or secondary

A

Headaches

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46
Q

Triggers for primary headaches

A

Lack of sleep

Stress

Exercise

Hunger

Loud noises

Persistent loud noises

Weather changes

Hormonal changes during mensuration

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47
Q

Triggers of secondary headaches

A

Trauma

Vascular disease

Infectious processes

Substance abuse

Psycho genic issues

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48
Q

Headache
●Associated with stress
●Dull to moderate pain located in the back head at the base of the skull

Radiate bilaterally or just above neck and shoulders

Sleep is affected , loss of vision, photophobia, nausea, auditory sensation

A

Tension headache

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49
Q

very common
Starts presenting during preschool and school age children

Family hx is usual

●Moderate to severe radiating pain located on one side of the head with throbbing or pulsating quality

Aura may be associated

Not easily remedied

A

Migraine headache

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50
Q

●Series of headaches that occurs over a period of weeks or months that vary in intensity
●Unilateral pain, behind one eye, causing ptosis and pupil constriction

Rhinorrhea and edema , URI

A

Cluster headache

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51
Q

Nursing care for headaches

A

●Nursing Care
●Maintain calm and quiet environment
●Promote relaxation techniques
●Use pharmacological techniques

Identify triggers and avoid triggers

Educate family about Rest and calm environment

52
Q

Eye sensory disorders

When are they commonly diagnosed?

A

Hyperopia (farsighted)
•myopia (nearsighted)
Color blindness - first three can be identified in elementary school screening

  • Astigmatism
  • strabismus (visual lines cross)
  • nystagmus (rapid, irregular eye movements)
  • cataracts (cloudy or hazy corneal lens)
  • glaucoma (thin, cloudy cornea)
  • retinoblastoma (malignant tumor of retina)

Eye screening in elementary school

53
Q

Tx for eye exams

A

Corrective lenses, patching of stronger eye to force weaker eye to work independently (strabismus), extraocular surgery (nystagmus), increase lighting (cataracts), fall assessment, preop/postop teaching

54
Q

Children eye test- what is it and how to do?

A

Snellen test

Stand 10 feet away

Cover one eye, then cover the other and read and then read with both , wear glasses or contacts if have corrected vision

55
Q

is one of the most common sensory disorders in the us

Early detection is important to improve and maximize outcomes

Caused by?

A

Hearing loss

Genetic / non genetic
Meningitis, maternal torch, infection during pregnancy, idiopathic (unknown cause)

56
Q

S/s of hearing loss

Classified how?

A

Classification – normal, slight, mild, moderate, moderate/severe, severe, profound loss

  • Signs and symptoms:
  • lack of startle reflex,
  • child does not turn toward sounds
  • child does not follow verbal directions or respond when called by name
  • child has delayed speech or is difficult to understand
  • child has difficulty with articulation
57
Q

When is the first hearing test done?

A

Newborn in hospital

58
Q

Child hearing loss signs?

A

May not turn to sound or follow direction , speech delay and pronunciation, articulation

59
Q

Speech in children

2 years old-

A

2 word sentences - understand 50% of time

3- 3 word sentence-understand 75%

4- 4 word sentence- understand 100% of time

60
Q

●Difficulty understanding what others are saying
●Problems following directions that are verbally given to them
●Difficulty organizing thoughts

A

Receptive speech disorder

61
Q

●Difficulty forming sentences
●Trouble finding the correct words when speaking
●Decreased vocabulary when compared with other children of the same age

A

Expressive speech disorder

62
Q

Nursing care for speech disorders

A

●Recognize and monitor for further speech and developmental delays
●Document milestone
●Recognize areas of difficulty

Listen to parents and what they tell you about any developmental issues during clinic visits

Understanding their growth and development and where it should be at each ***age milestones

“It must be difficult you.”

63
Q

is a genetic disorder caused when abnormal cell division results in extra genetic material from chromosome 21.

●Decreased or poor muscle tone.
●Short neck, with excess skin at the back of the neck.
●Flattened facial profile and nose.
●Small head, ears, and mouth.
●Upward slanting eyes, often with a skin fold that comes out from the upper eyelid and covers the inner corner of the eye.

A

Down syndrome

64
Q

What does the integumentary system do?

A

Barrier to protect against outside

Waterproof, prevent water loss , protects deeper tissues, regulates body temp, excretes waste , helps with vitamin D synthesis

65
Q

Bacterial Infection

●Reddish macule, vesicular
●Erupts, leaving skin moist, cursts
●Spreads peripherally and direct contact
●Treatment with topical antibiotic

●Others skin infections: folliculitits, furuncle, carbuncle, cellulitis, staphyloccal

A

Impetigo Contagiosa

66
Q

Viral skin infections

How to treat and what is can cause or caused from

Warts
Herpes type 1/2
Shingles

A

Warts - hand, planter (burnt with dry ice)

Shingles - from herpes zoster virus - caused by varicella virus (only can develop if you have had chicken pox)

Herpes simplex 1- fever blister

Herpes simplex type 2- antiviral - aceclovyir tx

67
Q

Fungal infections

Ring worm types? Who is it common in?

Jock itch types?

Athletes foot - tx ?

A

Tinea capitits (on scalp) ring-like

Tinea coporis- on body

Common in people who play close contact sports (wrestling) educate parents on head to toe skin assessments and good body hygiene

Tinea cruris- dark coloration near groin

Tinea pedis - dry scaley skin between toes - treat with antifungals -clotrimazole cream

68
Q

Education on burns in children to parents

A

Home safety

69
Q

What burns are the most common

A

Thermal burns

(type of burn resulting from making contact with heated objects, such as boiling water, steam, hot cooking oil, fire, and hot objects.

70
Q

Burns occur from the ignition of combustible materials and contact with fire, fireworks, candles, and campfires.

A

Flame burns

71
Q

burns are caused by explosions, especially with combustible fuels like gasoline, kerosene, charcoal lighter, and fireworks or hairspray.

Common in?

A

Flash burns

Young men population

72
Q

Burns occur when hot liquid is spilled on them

Common in?

A

Scald burns

Young children from pot handles not being turned in

73
Q

Burns that occur when exposure to hot object

Commonly from what?

A

Contact burn

Water heater should be set no higher than 120 degrees F , check before putting child in

74
Q

occur when the skin of the child comes in contact with radiofrequency or ionizing agents.
●Sunburn
●radiation burn (cancer treatment)
●radioactive material

Education ?

A

●Radiation burns

Wear sunscreen , glasses and hats

75
Q

●burns occur when the skin comes in contact with a chemical agent that is corrosive to the skin.
●Acids like sulfuric acid and muriatic acid are caustic to the skin.
●Alkaline agents like lye, lime, ammonia, and household cleaning agents are also caustic to the skin and cause injury.

Agents that are corrosive to the skin in the home

A

CHEMICAL burns

76
Q

occur when electricity passes through or around the body as it seeks the fastest path of least resistance to the ground.
●Household current of 110 volts can cause a full-thickness burn injury to the corner of the mouth.
●Electrical lines that carry electricity throughout towns and cities typically carry 14,800 volts.
●High-tension wires can carry as much as 150,000 volts.
●ightning can have between 10 and 100 million volts.

Education?

A

Electrical burns

Plug ins have caps over them in home , don’t chew on electrical cords

77
Q

Partial thickness injury burn involves the epidermis

minor Heat , sun, or friction exposure

A

First degree burn

78
Q

Superficial partial thickness injury

Thin walled fluid filled blisters that develop within minutes of exposure- blisters may weep , painful, bleed easily

Or Deep partial thickness, injury involve the entire dermis, appears waxy, white, and is surrounded by superficial partial thickness injury- dermis is pale , blisters do not weep,painful , 9 weeks to heal and scaring

Severe Sunburn , heat or friction burns

A

2nd degree burn

79
Q

Full thickness injury , destruction of the epidermis and subcutaneous tissue. Bone and muscle may also be destroyed

Escher is visible and may damage nerves , bones and muscles

Dry and leathery

Severe heat or friction exposure

A

3rd degree burn

80
Q

When burn pt comes in to hospital what to do first?

A

Primary- # 1 Fluid resuscitation -formula -most important - Make sure airway is patent completely (inhalation burn) , ventilation used for 2-4th degree burns

Second - head to to examine, history

Determine if it is due to abusive or neglectful - involve social services

Rule of nines (no need to know for his test)

81
Q

When to intubate burn pt

A

If inflation injury is present

82
Q

How to treat burn wounds

A

Debridement sand dressing changes

Hydrotherapy and dressing changes

83
Q

What percent is intentional and unintentional poisoning

A

80% unintentional

10-20 intentional

84
Q

1 most common medication poisoning

●Nausea, vomiting, sweating, pallor (initial symptoms)
●Pain in RUQ, confusion, stupor, jaundice, coagulation issues (36 hours to 7 days)

●Treatment: N-acetylcysteine orally

A

Poisoning:

Acetaminophen

85
Q

●Acute: nausea, vomiting, tachypnea, disorientation
●Chronic: Bleeding dehydration, seizures

●Treatment:
Intubation
●Activated Charcoal
●Gastric lavage
●Sodium Bicarbonate
●Vitamin K
●Hemodialysis  (severe)
A

Poisoning: Aspirin (acetylsalicylic acid)

86
Q

●Gagging, choking, nausea, vomiting, coughing, lethargy, weakness, tachypnea, cyanosis, grunting, retractions

●Treatment:
●Do not induce vomiting
●Intubation w/cuff prior gastric decontamination/lavage (pulled out of body)

A

Poisoning:

Hydrocarbons

87
Q

●Pain, burning in mouth, swollen mouth, vomiting, cyanosis, drooling, anxiety/ doom

●Treatment:
●Airway support
●NPO
●Do not neutralize substance

Address pain

A

Poisoning:

Corrosives

88
Q

Children poisoning occurs most often due to exploratory behaviors

A

Age 5 and below

89
Q

Ages that have increased finger to mouth activity and PICA = increased risk of accidental ingestion

A

1-4

90
Q

Guidance / education with chemicals and family with young children

Most common ingested agents ?

A

Lock cabinets
Put chemicals away
Crawl on hands and knees to see what children can see

Cleaning agents and laundry detergent

91
Q

Evaluation with poisoned child

A

Eval of ABCs - asses airway, breathing, circulation

Resuscitation and stabilization

If unstable, hx with be done along with resuscitation

92
Q

Most common approach in the poisoned child who had decreased level of consciousness or abnormal vitals is to do what?

A

Address causes of symptoms presented

93
Q

Many common malignancies arise from primitive a embryonic tissue in which there is a strong environmental link related to what?

Guideline

A

The development of cancer

94
Q

Why should childhood cancer survivors have their height measured regularly

Guideline

A

Complications from chemo and radiation

95
Q

What should pre pubertal girls with cancer be monitored for ?

Guideline

A

Signs of early onset puberty

96
Q

What to do for cancer patients who have impaired fertility

Guideline

A

Referred to specialist for ongoing assessment

97
Q

What is essential in cancer patients pertaining to growth and development

A

●Good nutrition is essential

●The nurse should promote good oral hygiene
to prevent complications of pharmacological therapies. Enteral and parenteral nutrition should be implemented when needed

●nurse should encourage activity and play
while allowing for adequate periods of rest

because the child with cancer may fatigue easily

●Quiet activities should be encouraged
when the child has low levels of energy

●nurse should encourage the child to attend school, or see peers when unable to attend school, to avoid social isolation

98
Q

●Rare kidney cancer, AKA nephroblastoma

●Symptoms:
●Parents notice a firm lump, average 1 pound at diagnosis
●Nausea, stomach pain, loss of appetite, fever, blood in urine

●Diagnosis/Treatment:
●Ultrasound,* CT, MRI
●Removal, chemotherapy*

Painless palpable abd mass often with increased abd girth - parents often find with diaper changes

Hematuria - microscopic may be present
Overall symptoms are decreased appetite and stomach pain

A

Wilms tumor

99
Q

Most common type of cancer in children

75-80% of all childhood leukemia’s

A

Acute lymphocytic leukemia

100
Q

Acute lymphocytic leukemia s/s

Diagnosis

A 
Fever 
Fatigue
Lethargy 
Anemia 
Pale 
Anorexia
Bone or joint pain 
Limp 
Refuse to walk due to pain

CBC, WBC , platelets , liver, kidney function , lumbar puncture

101
Q

Nursing care for ALL

Medical care

A

Without therapy and nursing care, it is fatal

Once remission is achieved most children relapse within a few months if treatment is stopped

  • Chemotherapy, bone marrow transplant, hormone therapy
102
Q

This cancer appears to be an arrest (stop)? in the differentiation pathway of myeloid progenitors or precursor rather than abnormal growth kinetics

A

Acute myelogenois leukemia

103
Q

Acute myelogenois leukemia s/s and diagnosis ?

A

Flulike symptoms, fever, infections, decreased RBCs, decreased O2 levels, pale, fatigue, headache, dizziness, “blueberry muffin” lesions (subcutaneous nodules) - nodules instead of joint pain

Bone marrow aspiration and analysis

104
Q

Acute myelogenois leukemia nursing care

Medical care

A

Treatment begins promptly especially to control any copresenting symptomatology (presenting problem)

Medical- cytarabine (Ara-C) and daunorubicin (mycin)

105
Q

Chronic myelogenous leukemia

A

Clonal disorder of the hematopoietic tissue (formation of blood cells ) that accounts for 2% to 3% cases of leukemia in children

106
Q

Chronic myelogenous leukemia s/s

A

Fever , fatigue , weight loss, anorexia

107
Q

Chronic myelogenous leukemia

Diagnosis

A

Increased numbers of myeloid cells With the differentiation to mature forms in the peripheral blood smear and bone marrow

108
Q

Chronic myelogenous leukemia

Nursing care

Medical care

A

Primary Care revolves around post bone marrow or transplant interventions such as..
(pain management, hand hygiene , good nutrition, infection control, alternative care therapies - talk to provider first to see if beneficial for disease)

Medical care: hydroxyurea (medication)

109
Q

Tumor of nerve tissue that develops an infant and children

It develops from the tissues that form the sympathetic nervous system

A

Neuroblastoma

110
Q

Neuroblastoma signs and symptoms

A

Hard, painless mass tumor palpated on midline and neck or abdomen

111
Q

Neuroblastoma diagnosis

A

MRI, CT, catecholamines in urine

112
Q

Nursing care for neuroblastoma

A

Complete nursing assessment is vital to ensure that the child does not have an infection
And his or her condition remains stable

Placed emphasis on the child’s discomfort and alleviating pain

113
Q

Medical care for neuroblastoma

A

Surgical resection, chemotherapy,Radiation, bone marrow transplant

114
Q

Most common pediatric soft tissue sarcoma
8% of childhood cancers

Most often found in the neck and head and genitourinary tract, extremities and trunk

2 types - embryonic and alveolar

Survival rate is about 65%

A

Rhabdomyosarcoma

115
Q

Rhabdomyosarcoma s/s

A

Orbital or eyelid tumors may cause proptosis(a downward displacement of the eyeball) and may impair vision, headache, vomiting, urinary obstruction, erythema, and tenderness

116
Q

Diagnosis of Rhabdomyosarcoma

A

Biopsy of lesions , physical examination, CT, MRI, X-ray

117
Q

Nursing care Rhabdomyosarcoma

A

monitoring of the surgical site is vital or if chemo is needed , initiate standard nursing care

118
Q

Medical care for Rhabdomyosarcoma

A

Chemo or surgery if possible

119
Q

Malignant tumor that arises from the retina at the back of the eye during fetal life or early childhood

It can grow rapidly or slow

A

Retinoblastoma

120
Q

Retinoblastoma s/s

A

Red painful eyes, blindness is the last sign because of retina, visual impairment, abnormal appearance of the eye,Unilaterally or bilaterally (one or both)

121
Q

Retinoblastoma diagnosis

A

Examination under anesthesia using ophthalmoscope , orbital ultrasound, CT , MRI

122
Q

Retinoblastoma nursing care

A

Show parents a photograph of another child who has had this type of surgery to show parents and child up there and parents will be nearly normal

123
Q

Retinoblastoma medical care

A

Primary enucleation (removal of the eye) Is usually performed if there is no potential for useful vision

124
Q

Retinoblastoma education

A

Child is usually discharged in 3 to 4 days after surgery.

The nurse Teacher’s parents about care of the eye socket by showing them gentle irrigation of the area with the prescribe solution and then applying a thin coating of the prescribed antibiotic ointment.

Eye gauze pads are applied until the wound has completely healed.

Enforce good hand washing for the entire family

125
Q

Nursing care for cancer

A

Neutropenia diet

Decrease infection- infection control, hand washing

Chemo/ radiation - educate negative effects

Pain management - morphine,

Psychosocial support,

asses safety interventions,

care for nausea and vomiting,

address hair loss, (alopecia)

assess for exervasion(chemo meds fall into tissue and can cause death)**

assess for mucositis-pain in mucus membrane - can use chlorahexidate oral swish or nystatin or sodium bicarbonate to keep oral mucosa pain free to be able to absorb nutrients *

Address any loose stools or constipation - electrolytes

Care for anemia

Understand thrombocytopenia (low platelet count ) Side effect

Neutropenia is side effect

126
Q

Chemotherapy nursing action

A

Stay with individuals

Monitor side effects - can happen within 20 minutes

Baseline vital sign and continued vital signs

maternal child health RN (15 decks)

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