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Peds/OB - Nrsg 206 > Quiz GI & Cardio > Flashcards

Quiz GI & Cardio Flashcards

(126 cards)

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1
Q

What is Kwashiokor?

A

Malnutrition due to lack of protein

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2
Q

What is Marasmus?

A

A condition of chronic undernourishment occurring especially in children and usually caused by a diet deficient in calories and proteins.

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3
Q

Dehydration that causes an imbalance of electrolytes is called _____ if there is a lack of electrolytes, and _____ if there is an excess of electrolytes.

A

Hypotonic. Hypertonic

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4
Q

How do we check for dehydration?

A

Check turgor on chest or forehead and look at the tongue. (scrotal/geographic tongue)

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5
Q

How much fluid does a child require per 24 hrs?

A

100 mL/kg for the 1st kg. 50 mL/kg for the second 10 and 20 mL/kg for any above 20 kg

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6
Q

What are gastroenteritis, enteritis, colitis, and entercolitis?

A

Gastroenteritis = inflammation/irritation of the stomach (gastro) and small intestines (entero). Enteritis = small intestines only. Colitis = colon only. Entercolitis = colon and small intestines involved

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7
Q

How is most diarrhea spread?

A

The fecal/oral route

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8
Q

Why is listeria so bad?

A

It can survive in cold temperatures

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9
Q

How is listeria cured? Prevented?

A

Antibiotics. Clean, clean, clean, keep fridge at 40 deg and below

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10
Q

What are many cases of listeria related to? What else shouldn’t you eat while pregnant?

A

Eating soft or raw cheese, like caso fresco from Mexico. Brie or veined cheese, pates, or other soft meats

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11
Q

What fish should be avoided while pregnant? Why?

A

Shark, Swordfish, Tilefish, King Mackerel. Methyl mercury accumulates in larger, predatory fish

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12
Q

How is toxoplasmosis spread, and why avoid it when pregnant?

A

It is a parasite often found in cat feces, so don’t change the litter box when pregnant! It can cause fetal problems

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13
Q

How else can toxoplasmosis be avoided?

A

Change litter daily, wear gloves when changing litter, stay out of the pig pen!

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14
Q

What diet is recommended for diarrhea?

A

BRAT = Bananas, rice, apples, toast/tea

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15
Q

How is diarrhea avoided in a breast feeding baby?

A

Wash hands (not breasts)

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16
Q

What causes idiopathic constipation? Chronic?

A

It’s idiopathic b/c the cause is not known. Chronic may be caused by environmental factors (food) or psychological factors

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17
Q

What is Hirschsprung disease? What can be done for it?

A

Congenital aganglionic megacolon. No nerves in the sigmoid colon and rectum, so they fill with stool. Biopsy to dx, diet may control milder cases, but removal in 2 stages (temporary colostomy) is the option for worse cases

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18
Q

What is the leading cause of death in kids with Hirschprungs? Is it genetic?

A

Entercolitis. Yes. More common in males and kids with Down’s Syndrome

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19
Q

When should a newborn pass meconium?

A

Within the first 24-48 hrs

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20
Q

What is a common physical side effect of Hirschprungs?

A

Alternating bouts of constipation/diarrhea and anemia

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21
Q

What is the difference between GER and GERD?

A

GERD is a disease because it causes issues

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22
Q

What is GER/GERD?

A

Stomach contents are transferred into the esophagus

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23
Q

What makes GER abnormal (GERD)?

A

Frequency and persistency

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24
Q

What surgical procedure can help/cure GERD?

A

Nissen fundoplication. Fundus of the stomach is wrapped around the esophagus to lift it off the diagram

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25
What can GERD result in?
Barrett's esophagus, which is scarring from the constant exposure to stomach acid and may lead to cancer
26
What parasites are mentioned in the PowerPoint?
Giardiasis and pinworm
27
What are some later signs of appendicitis?
Pain at McBurney's point, rigid/board like abdomen
28
What is an earlier sign of appendicitis?
Stooped posture
29
What does it mean if the pain disappears?
The appendix has ruptured and is an emergency
30
What are some other signs of appendicitis?
WBC's 10,000-18,000. Anorexia, rigid abdomen, absent bowel sounds, N/V, fever, leukocytosis, no eosinophils
31
What did Carley teach us about appendicitis?
If you can't isolate pain at McBurney's point, have the child jump up and down, if no pain it's not appendicitis
32
How can appendicitis & pinworm incidences be reduced?
Increase fiber in the diet
33
What is the most common congenital malformation of the GI tract?
Meckel's diverticulum, which is a bulge in the wall of the colon
34
Who is usually affected by Meckel's diverticulum?
Children < 2 years old
35
What is a common complication of Meckel's?
Intesussecption
36
What is a common sign of Meckel's diverticulum?
Bloody, jellylike diarrhea
37
What is done in most cases of Meckel's?
Usually nothing, as it is asymptomatic, or it mimics peptic ulcer/Crohn's/appendicitis s/s. Surgical repair if severe
38
What 2 problems compromise IBD (inflammatory bowel disease)?
Crohn's disease and ulcerative colitis
39
What can cause IBD?
Diet, infection, environmental factors
40
What is the difference between Crohn's and ulcerative colitis?
Crohn's can affect the entire GI tract, from mouth to anus, while ulcerative colitis only affects the colon
41
Is there a cure for IBD?
Pancolectomy (removal of the colon) will cure colitis, although meds are tried 1st. Crohn's is managed with meds only
42
What are the s/s of ulcerative colitis?
Bloody diarrhea, abdominal pain, anemia, N/V, lesions remain
43
Which form of IBD is slow/fast?
Crohn's is slow and has skip lesions. UV is fast, with bad lesions that stay (bloody diarrhea)
44
Where does Crohn's usually start?
Terminal ileum (where small bowel & colon meet)
45
How does Crohn's affect the body?
Arthritis, liver disease, renal calculi, long term debilitating, FTT in children
46
Which form of IBD increases cancer risk within 15 years?
UC
47
What meds are used to treat IBD?
Steroids, 6MP immune modulators, sulfasalazine (Azulfidine), TPN
48
What foods are not allowed on the IBD diet?
Everything, so you might as well quit eating
49
What can cause hepatitis to become acute?
Chemical reaction, drug reaction, other disease processes
50
What forms of hepatitis are passed via the fecal/oral route?
A and E. (The A&E channel is pretty crappy)
51
What forms of Hepatitis are caused by blood and sex?
Basically all that aren't fecal/oral: B, C, D & G
52
Which forms of hepatitis have vaccines available?
A & B
53
What are the 2 phases of hepatitis?
Anicteric (absence of jaundice) and icteric (jaundice)
54
What are some s/s of phase 1 hepatitis?
Malaise, fatigue, RUQ pain, N/V
55
What are some s/s of phase 2 hepatitis?
Dark urine, clay colored stools, jaundice of skin and sclera
56
How long does each phase of hepatitis last?
Anicteric = 5-7 days; Icteric = 4 wks
57
What does Hirshprung's disease cause?
A mechanical blockage of the colon
58
In what demographic groups is Hirshprung's more prevelent?
Males and those with Down's syndrome
59
Which is closed first, the cleft lip or palate?
The cleft lip is always repaired first (at 3 mo), then the palate is repaired at 12-18 months
60
Is cleft lip/palate more common in males or females?
Cleft lip & palate are more common in males while just cleft palate is more common in females. Cleft lip/palate is more common in Asian & white populations and less prevalent in black populations
61
How is breast feeding different for a baby with a cleft palate/lip?
Baby must be stimulated first (rub nipple on lip) and milk flow must be started first (warm washcloth)
62
How do you reduce the chance of choking while feeding a baby with cleft lip/palate?
Keep slow steady pressure on the bottle or breast
63
What acronym applies to feeding a baby with cleft lip/palate?
ESSR. Enlarge (nipple - unless, of course, you are breast feeding), Stimulate, Swallow, Rest
64
Should you burp a baby more or less often if it has a cleft lip/palate?
Burp often
65
What is a tracheoesophageal fistula and why do we need to know what it is?
It is an abnormal connection between the esophagus and trachea and is an emergency. 50% have more complex defects like cupped ears
66
What is the most important nursing intervention for an tracheoesophageal fistula?
NPO! Prognosis is poor
67
What is another name for gluten-induced enteropathy and what are its 4 main characteristics?
Celiac's disease. Steatorrhea, malnutrition, abdominal distention, secondary vitamin deficiencies
68
How is a hiatal hernia repaired?
Nissen fundoplication
69
What are the s/s of pyloric stenosis?
Projectile vomiting, non-bilious vomiting
70
What is hypertrophic pyloric stenosis?
An enlarged muscle of the pyloric sphincter occludes the passageway to the small intestine
71
What is an intussusception and what is done for it?
The bowel folds in on itself. A barium or air enema
72
What is a "tet spell" and what are the s/s?
Bluish fingers/toes/mouth during feeding/crying. Other symptoms include cyanosis, clubbing, SOB, fainting, poor weight gain, irritability, prolonged crying, murmur
73
If you attempt to put a rectal thermometer in an infant and it won't go in, that baby has an _____ _____.
Imperforate anus
74
What are some s/s of Celiac's disease/gluten intolerance?
Steatorrhea, chronic diarrhea, weight loss/malnutrition, pale/foul smelling stool/floaters, low RBC/anemia, bone pain, gas, behavioral changes/irritable, numbness in legs, discolored teeth
75
At what point are cardiac problems visible?
With normal hemoglobin, when O2 sat is at 85%
76
What is done for a tet spell?
Hold in the knee/chest position
77
What is the best way to examine heart abnormalities?
Electrocardiogram, echocardiogram, heart cath, O2 challenge test
78
What are the early s/s of CHF in infants?
Tachycardia at rest, fatigue during feeding, sweating scalp and forehead, dyspnea, sudden weight gain
79
What meds are used to treat HF?
Digoxin (improves cardiac fxn), Ace inhibitors (lisinopril made me cough!)(decrease vascular resistance, BP, afterload), diuretics
80
What heart defects increase pulmonary blood flow?
Abnormal connection between two sides of the heart. Either the septum or the great vessels
81
What heart defects decrease pulmonary blood flow?
Tetrology of FAllot and tricuspid artresia
82
Most cardiac defects are _____ (from birth) and affect the structure of the heart.
Congenital
83
What are some nursing considerations for Digoxin?
Assess HR, RR, BP q2-4hrs. Accurate I&O (1-2 mL/kg/hr)
84
What is Heart failure?
Not enough cardiac output to maintain METABOLIC NEEDS
85
How is HF compensated for?
Impaired myocardial fxn (vasoconstriction [cold/blue hands and feet], < BP/urine), Pulmonary congestion (tachypnea, dyspnea, cyanosis), Systemic congestion (peripheral and periorbital edema, wt gain, ascites, hepatomegaly, neck vein distention)
86
What are some s/s of dig toxicity?
N/V, anorexia, bradycardia, dysrhythmias
87
What are some nursing measures for HF?
HOB at 45 degrees, maintain nutrition status to fight infection
88
What is a s/s of hypoxemia?
Clubbing
89
What is bacterial endocarditis?
An infection in the valves and inner lining of the heart
90
How is bacterial endocarditis treated?
Long term antibiotics lasting for 7-8 wks
91
What does endocarditis lead to?
HF. Will take antibiotic before any dental work
92
What causes Rheumatic fever?
Beta-hemolytic strep
93
What tissues does RF involve?
Collagen of the joints, heart, CNS (brain), skin, subQ system
94
When is RF more likely to occur?
In the winter and spring of kids age 5-15
95
What is RHD?
An autoimmune disease that is the result of untreated strep
96
How is RF diagnosed?
Must have 1 major and 2 minor symptoms, and a hx of strep infection
97
How is it treated?
Antibiotics for 5 years. If cardiac involvement even longer. Education/follow-up is essential. Prophylactic antibiotic before dental work/procedures
98
What are the major criteria of RF?
Carditis, polyarthritis, erythema marginatum (rash), chorea (not to be confused with Korea), subcutaneous nodes
99
What are the minor criteria for RF?
Fever, arthralgia
100
What is Kawasaki disease?
Acute systemic vasculitis of unknown cause. Leads to HF
101
What can Kawasaki's lead to?
Aneurysm due to weakening of vessel walls
102
How can Kawasaki's be treated?
Oil change! Dig, angiotensin enzyme inhibitors, K+ supplements
103
How is Kawasaki's diagnosed?
Clinical s/s, no lab studies. S/S = fever >102 deg F >5 days + 4/5 clinical criteria which are edema/erythema of extremities (desquamination), conjunctival infection without exudate, changes in oral mucosa (red), polymorphous rash, cervical lymphadenopathy (1 >1.5 cm)
104
What are some s/s of hypertension in kids?
Teens - HA, dizziness, visual changes; Kids - irritability, head banging/rubbing, wake up screaming at night
105
What meds are given for Kawasaki's?
High dose aspirin (antiplatelet) and IV immunoglobulin
106
At what Hgb level is blood shunted to the core?
<8 g/dL
107
What is the treatment for anemia?
IV fluids, O2, bedrest
108
What is sickle cell anemia and what is its cause?
A genetic defect causes "s" shaped Hgb cells
109
What are some consequences of sickle cell anemia?
Growth retardation, chronic anemia, delayed sexual maturity, sepsis, vaso-occlusive crisis, sequestration crisis
110
What are the s/s of a vaso-occlusive crisis?
Pain, ischemia
111
What are the s/s of a sequestration crisis?
Pooling of blood, hepatomegaly, splenomegaly, circulatory collapse
112
How is sickle cell anemia diagnosed?
Neonatal metabolic screening, cycledex test (result in 3 min) if +, then Hgb electrophoresis
113
What is the treatment for sickle cell anemia?
IV fluids/electrolytes, O2, analgesics, blood replacement, antibiotic therapy (bacterial infection is the leading cause of death in these kids)
114
What is hemophilia "A"?
Lack of clotting factor VIII. 80% of cases. X-linked recessive. Only males affected/females are carriers
115
What can precipitate a sickle cell crisis?
Stress, dehydration, accident
116
How is hemophilia treated?
Transfusion, DDAVP increases factor VIII activity
117
What is hypoplastic left heart syndrome?
Critical underdevelopment of the left side of the heart
118
What are some s/s of hypoplastic left heart syndrome?
Tachypnea, cyanosis, poor feeding, cold hand/feet, drowsy/inactive
119
What is a grave complication of hypoplastic left heart syndrome?
If the hole btwn the foramen ovale and the ductus arteriosis is allowed to close, the child may die
120
What kids are at greater risk for ALL?
Kids with trisomy 21 have 20x greater risk for ALL
121
What are "neutropenic" precautions?
Child wears a mask, no flowers or fresh fruit
122
What organs does ALL affect?
Liver and spleen
123
What is the difference between Hodgkin's and non-Hodgkin's lymphoma?
Both are lymphomas (neoplastic disease), Hodgkins is more prevalent in the 15-19 year old range, while non-Hodgkin's is more prevalent in kids <14
124
What genetic defect increases risk for ALL?
Down's syndrome
125
What are the 2 classifications of Hodgkin's? Describe them.
A=asymptomatic. B=temp >38 deg C for 3 days, night sweats, unexplained weight loss of 10% or more over previous 6 months
126
What is done for hypotrophic left heart syndrome?
Mechanical vent, inotropic support, prostaglandin E, surgery

Peds/OB - Nrsg 206 (7 decks)

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