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Week 9 TUES Flashcards

Peds elimination

1
Q

How to diagnose a UTI

A

Get a urine culture

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2
Q

A child is taking an antibiotic for UTI and has a white coating covering her mouth. Is this concerning

A

Can be, it is not unusual for fungal infections to occur while taking antibiotics
- but they can spread and become a secondary infection

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3
Q

What is the plan of care for a child with the rotavirus

A
  • maintain IV Fluids
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4
Q

What is a way to help prevent preschoolers from getting a uti?

A

teach them to wipe front to back and never hold urine in

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5
Q

The nurse is providing care to a child with an intussusception. The child has a bowel movement and the nurse inspects the stool. The nurse is most likely to describe the stool as having what quality?
A. Greasy
B. Clay-colored
C. Currant jelly-like
D. Firm

A

C!
Currant jelly-like is a common s/s of intussusception

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6
Q

A child required significant bowel resection following a bowel perforation. After recovering from the post-op period, what will the nurse expect to be included in this patient’s long-term plan of care? Select all that apply.
A. Antibiotics
B. Immunosuppressants
C. Vitamin supplements
D. Total parenteral nutrition
E. Laxatives

A

A, C, D
pg. 1610

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7
Q

Obstructive Uropathy is a _____1_____disorder and the therapeutic management includes_____2_____.
Options for #1: Acute, Chronic, Structural, Acquired
Options for #2: Antibiotics, Surgical Repair, Dialysis, Intravenous Fluids

A
  1. Structural
  2. Surgical Repair
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8
Q

Which of the following features are considered part of the “triad” of Hemolytic Uremic Syndrome? Select all that Apply.
A. Hemolytic Anemia
B. Edema
C. Diarrhea
D. Thrombocytopenia
E. Urinary Tract Infection
F. Acute Renal Failure

A

A, D, F
- triad of HUC

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9
Q

the removal of waste products from the body through the skin, lung, kidneys, and intestines via the process of perspiration, expiration, urination, defication

A

elimination

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10
Q

what parts of the GI system are different from children to adults

A
  • mouth
  • esophagus
  • stomach
  • intestines
  • biliary system
  • fluid balance and losses
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11
Q

primary functions of the GI system

A
  • digestion, elimination, secretions
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12
Q

Nursing GI assessment

A
  • health hx
  • physical exam; inspect, auscultate, percussion, palpation
  • lab and diagnostic testing; occult blood, rbs, WBC, ect
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13
Q

Acute GI disorder in peds

A

intussusception

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14
Q

Chronic GI disorder in peds

A

short bowel syndrome

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15
Q

T or F the GI tract is from mouth to anus?

A

TRUE
- from ingestion to elimination

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16
Q

What GI disorder is; intussusceptiona proximal segment of the bowel “telescopes” into more distal segment resulting in obstruction

A

intussusception

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17
Q

T or F intussusception is the least common cause of intestinal obstruction is infants and young kids

A

FALSE; it is the MOST common cause!

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18
Q

most common cause of intussusception

A

often unknown in children

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19
Q

Possible complications of intussusception

A
  • edema, vascular compromise, and potentially partial or total bowel obstruction
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20
Q

Risk factors for intussusception

A
  • siblings w intussusception
  • intestinal malformations already diagnosed
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21
Q

Nursing assessment intussusception

A

Health hx;
- description of present illness
physical exam;
- palpate abdomen for the presence of a sausage-shaped mass in the upper midabdomen
lab/ diagnostic tests;
- air or barium enema

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22
Q

Common s/s of intussusception

A
  • sudden onset of intermittent, crampy, severe abdominal pain esp after eating
    - guarding, crying, putting legs up
  • vomiting, diarrhea
  • currant jelly stools; gross blood, hemoccult pos stools
  • lethargy
  • s/s will typically flare and regress
23
Q

Nursing management of intussusception

A
  • IV fluids and antibiotics
  • lab tests; WBC, electrolytes
  • post op care of child
  • emotional support and education for the family
24
Q

Therapeutic management for intussusception

A
  • barium enema is successful at reducing a large percentage of intussusception cases
  • if unsuccessful> reduced surgically
  • if bowel necrosis occurs> bowel resection
25
Syndrome of nutrient malabsorption and excessive intestinal fluid and electrolyte losses
Short Bowel syndrome
26
Risk factors for Short Bowel syndrome
- massive small intestinal loss or surgical resection
27
Possible complications of Short Bowel syndrome include
- bacterial overgrowth - vitamin deficiency - poor intestinal motility
28
Therapeutic management of Short Bowel syndrome
- antibiotics; treat bacterial overgrowth - antidiarrheals - vit and mineral supplements - TPN/Lipids - slow to oral foods
29
Nursing assessment of Short Bowel syndrome
health hx; - note past history of bowel disease or resection physical exam; - diarrhea is primary symptom, hydration status, inspect stool, wt loss lab/diagnostic tests; - electrolyte to evaluate hydration status, liver function tests
30
Nursing management of Short Bowel syndrome
- encouraging adequate nutrition; strict I&O, assess stool, consult / dietitian, monitor s/s of infection - promoting effective family coping
31
Common s/s of Short Bowel syndrome
- diarrhea> #1 - wt loss - dehydration - nutritional deficiency
32
GU differences in children vs adults
- structural differences; kidneys are large and less protected from injury and urethra is shorter in children - urinary concentration is higher in children - urine output is more frequent in children> less bladder capacity - reproductive organs are not mature in children
33
Alterations in urinary elimination occur as a result of
- infectious processes - trauma - neurologic deficit - genetic influence
34
GU assessment
- health hx> hydration status, # of wet/poopy diapers - physical exam; inspection, auscultation, percussion, palpate> kidneys impact cardiac system and can cause murmurs - labs and diagnostic test> BUN, creat, flank pain
35
Most common bacterial infection
Urinary tract infection
36
How to prevent UTI's in children
- girls wipe front to back - cotton underwear - ease constipation - avoid bubble baths> high risk kids - encourage hydration
37
Structural GU disorder in peds
Obstructive uropathy
38
Acquired GU disorder in peds
hemolytic-uremic syndrome
39
Obstruction at any level along the upper or lower urinary tract
obstructive uropathy
40
possible complications of obstructive uropathy
recurrent UTI's, renal insufficiency, progressive damage to the kidney
41
Nursing assessment for obstructive uropathy
Health hx; - description of present illness and chief complaint physical exam; - palpate the abdomen for the presence of an abdominal mass(hydronephrotic kidney) and assess BP lab/ diagnostics; - prenatal ultrasound
42
Risk factors for obstructive uropathy
- chromosomal abnormalities - anorectal malformations - ear defect
43
Common s/s of obstructive uropathy
- frequent UTI's - change in urinary pattern - fever - flank or abdominal pain - hematuria - urinary frequency and urgency - dysuria
44
Therapeutic management of obstructive uropathy
Surgical correction; - specific to the type of obstruction consists of removing the obstruction and reimplantation of the ureters - occasionally results in a urinary diversion
45
Nursing management of obstructive uropathy
post op care; - monitor I &O, assess urine for color, clarity, clots, pain management, encourage fluids once child can tolerate them Family education; - child may be d/c'd w/ vesicostomy or drainage tubes> pus/ blood know what is normal/abnormal
46
What GU disorder is characterized by hemolytic anemia, thrombocytopenia, and acute renal failure and is typically the result of a diarrheal illness
hemolytic uremic syndrome
47
T or F features of HUS are primarily caused by microthrombi and ischemic changes w/in the organs
TRUE!! - small obstruction> acclusion> kideny can't function properly> renal failure
48
Possible complications of HUS
- chronic renal failure - seizures and coma - rectal prolapse - cardiomyopathy -CHF - acute resp distress syndrome
49
Nursing assessment for HUS
Health hx; - decreption of present illness and cheif complaint physical exam; - pallor, toxic appearance, edema, oliguria - elevated BP - tenderness in the abdomen - neuro involvement> irritability, seizures, alter LOC Lab and diagnostics; - urinalysis> blood, protein, pus - serum labs> elevated BUN, Cr, anemia and thrombocytopenia, hyponatremia, hyperkalemia, hyperphosphatemia, leukocytosis, increased bili
50
Risk factors of HUS
- ingestion of ground beef - visits to water parks or petting zoos - not washing hand properly
51
Common s/s of HUS
- watery diarrhea - cramping - vomiting
52
Therapeutic management of HUS
- no known treatment can stop the progress of the syndrome once it has started - ease s/s and prevent complications - maintain fluid balance - correct hypertension, acidosis, and electrolyte abnormalities - replenish circulating rbcs> transfusion - provide dialysis if needed
53
Nursing Management of HUS
- close observation and monitoring the child's status> often ICU - institute and maintain contact precautions to prevent spread of e. coli fluid volume status; - strict I&O, IV infusions and diuretics as ordered, assess BP> hypertensive as prescribed, monitor for bleeding> possible blood transfusions preventing (future) hemolytic- uremic syndrome - proper handwashing!! thoroughly cook all meets, wash fruits/ veggies, drink properly treated water

Complex Care (26 decks)

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