GI disorders
What is the feeding technique used for cleft lip and palate prior to surgery?
ESSR stands for the following: Enlarge the nipple. Stimulate the suck reflex. Swallow fluid appropriately. Rest when infant signals with facial expression.
Why are girls more prone to UTIs than boys?
Because the female urethra is short it provides an efficient access route to the bladder for organisms that are common to the perineal and perianal regions.
Hypothyroidism has two forms. What are they?
Primary causes include (1) congenital defects and (2) defective synthesis resulting from an autoimmune process.
Acquired causes of hypothyroidism include (1) insufficient stimulation of the gland by the pituitary gland or the hypothalamus and (2) systemic resistance to thyroid hormone.
What are the 3 major categories of neurologic disorders that affect function?
(1) increased intracranial pressure, (2) hypoxia, and (3) seizure activity.
What is the medical management of contact dermatitis?
The hypersensitive reaction is usually self-limiting; therefore, in most cases, the health care provider directs treatment toward identifying and eliminating the cause and relieving signs and symptoms. Cool, wet dressings dipped in Burow’s solution (solution of aluminum acetate, used as a drying agent for weeping skin lesions) or oatmeal baths help soothe the affected area. Calamine lotion may be recommended to manage pruritus without a prescription. It is acceptable to apply topical, over-the-counter steroid creams to mild contact dermatitis areas. In more severe cases, health care providers often prescribe systemic corticosteroids. Oral antihistamines such as diphenhydramine (Benadryl) are helpful in controlling pruritus.
What is the post operative care for a child that has just have a surgical repair of a cleft palate?
Postoperative care after surgical repair of cleft palate is similar to that after cleft lip repair. A child with cleft palate repair should lie on the abdomen, because this will facilitate drainage of mucus and serosanguineous exudate from the oral cavity. Administer analgesics as ordered. Liquid nourishments usually are provided by cup. Use of straws, pacifiers, and eating utensils is not advisable because they may injure the suture line. The child should advance gradually from a liquid diet to a blenderized diet, and parents are instructed to continue this diet after discharge until the surgeon instructs them otherwise.
Nephrotic Syndrome is characterized by what 3 things?
proteinuria, edema, hyperlipidemia, and hypoproteinemia
What is the medical management for hypothyroidism?
The treatment of choice for congenital and acquired hypothyroidism is oral thyroid hormone replacement therapy. Prompt treatment is especially critical in an infant with congenital hypothyroidism to avoid permanent cognitive impairment.
What are the clinical manifestations of meningitis?
Meningitis manifests sometimes insidiously and sometimes suddenly, beginning with fever, vomiting, headache, irritability, photophobia, and nuchal rigidity (pain and stiffness in the neck when flexed) or opisthotonos (arched back); level of consciousness may decrease, and seizures may occur. Affected infants typically exhibit a bulging fontanelle and a characteristic high-pitched cry. Classic signs of meningeal irritation include a positive Kernig’s sign (resistance to knee extension in the supine position with the hips and knees flexed against the torso) and a positive Brudzinski’s sign (flexion of the knees and hips when the neck is flexed rapidly onto the chest). Meningococcal meningitis, the most readily transmissible type of meningitis, sometimes also produces petechiae and rapidly progresses to death if proper treatment is not initiated promptly.
What are the common causes of diaper dermatitis?
The most common irritating agents include prolonged exposure to urine or feces; inadequate cleaning of the diaper area; soaps, detergents, or fabric softeners; excessive use of powders or ointments; and the use of plastic pants. Fair-complexioned infants tend to have more sensitive skin and are more vulnerable to diaper rash than are infants with darker complexions. The occurrence peaks at 9 to 12 months of age, and the incidence is higher in formula-fed infants than in breast-fed infants.
What is the biggest complication a child may have with diarrhea?
Fluid deficits and electrolyte imbalances
When does Acute glomerulonephritis manifest? What are the clinical manifestations?
Manifestations of APSGN usually appear 10 to 14 days after the streptococcal infection occurs. Initial characteristics are a sudden onset of hematuria, proteinuria, and oliguria. The child’s urine sometimes appears cloudy, smoky brown, or what parents describe as tea or cola colored. Edema, abdominal pain, pallor, low-grade fever, anorexia, vomiting, and headache are sometimes present. Hypertension and heart failure are possible results of hypervolemia.
What is the most common hyperthyroidism in children?
Graves disease
What is the medical management of hydrocephalus?
Treatment of hydrocephalus is aimed at relieving the pressure on the ventricles and correcting the cause of the ventriculomegaly. Complica-tions that occur as a result of the hydrocephalus must be identified and treated. If a tumor is the cause of hydrocephalus, the surgeon removes it. If the cause of the hydrocephalus is obstruction, the treatment involves surgical diversion of excess CSF from the ventricles to the peritoneum with a ventriculoperitoneal shunt. Revisions in the ventriculoperitoneal shunt are needed when the shunt malfunctions, becomes infected, or becomes too short as the child grows.
What are some of the nursing interventions for eczema?
The nurse’s role in caring for a child with atopic dermatitis involves measures to control pruritus, promote skin integrity, and provide emotional support to the child and family. Compresses with Burow’s solution (aluminum acetate) soothe itching and moisten skin. Hot baths and hot showers should be discouraged because of their drying effect on the skin. Suggest adding cornstarch to tepid bath water to provide some relief from itching, as well as to hydrate skin. Teach the child and the family to use only a mild, unscented soap such as Dove or Neutrogena, if they use any soap at all. To prevent new lesions or secondary infection, it is essential to minimize scratching. For the infant, covering the hands with mittens or socks helps reduce scratching. For the older child, gloves allow for more dexterity. At times, it may be necessary to use safety reminder devices to discourage scratching; however, it is important that the infant or child be free from these restrictions periodically.
What are some of the instructions a nurse should give a patient when their child has diarrhea?
Parents should be instructed to avoid the use of antidiarrheals such as diphenoxylate (Lomotil) or kaolin and pectin (Kaopectate). Discuss hygiene practice and instruct the parents on hand washing after changing diapers to prevent the spread of infection. It is necessary to dispose of properly or thoroughly clean soiled diapers, bed linens, and clothes.
What is the medical management for Wilms Tumor?
Treatment of Wilms tumor involves surgical resection as soon as possible after diagnosis, usually within 24 to 48 hours of admission. The surgeon performs an exploration of the abdomen to determine the extent of the disease and whether the tumor has metastasized. If one kidney is affected, the surgeon removes the tumor, the kidney, and the adrenal gland, with meticulous care during resection to avoid rupture of the capsule and spread of cancer cells throughout the abdomen. If both kidneys are involved, the surgeon removes part of the kidney on the less affected side and the entire kidney on the opposite side. Most children with Wilms tumor receive radiotherapy after surgery. Chemotherapy is indicated for all affected children. The usual course of treatment ranges from 6 to 15 months.
When does type 1 and type 2 diabetes occur?
Type 1 diabetes usually begins in childhood or early adulthood, but its onset can occur in adults. In type 1 diabetes, there is destruction of the pancreatic beta cells that produce insulin, which generally results in total insulin deficiency.
In the past, type 2 diabetes was most common in people who were older than 40 years, had a family history of diabetes, and were overweight. Type 2 diabetes results from insulin resistance and the body’s improper use of insulin with relative—not absolute—insulin deficiency.
What are the causes for cerebral palsy?
Antenatal factors include maternal infections, maternal drug ingestion, hypoxia in utero, and blood incompatibilities. Perinatal factors include cerebral trauma and anoxia during birth.
What is the medical management for seborrheic dermatitis?
Management of seborrheic dermatitis consists of treating the signs and symptoms and simple preventive measures. The nurse and the parents can remove crusty, scaly patches by applying mineral oil to soften the affected areas (except the eyelids) and help loosen crusts, followed by shampooing with a mild, tear-free shampoo and thoroughly rinsing. Then a soft baby brush or a soft toothbrush is used to brush the hair and remove flakes from the hair. A fine-tooth comb also works well. Preventive measures include daily shampooing with an antiseborrheic shampoo. Topical corticosteroids are rarely needed.
What are the clinical manifestations of Hypertrophic Pyloric Stenosis and what are the diagnostic tests performed?
Initially, the signs begin asregurgitation that progresses to projectile vomiting 30 to 60 minutes after feeding. As the condition progresses, the affected infant exhibits lethargy, weight loss, poor skin turgor, sunken fontanelles, and loss of subcutaneous tissue as dehydration ensues.
Examination of the abdomen is often a key assessment that assists in the diagnosis and reveals signs of HPS. Peristaltic waves that move from left to right across the epigastric region are sometimes visible, and palpation sometimes reveals an olive-shaped mass in this area to the right of the midline. Ultrasonography demonstrates an elongated sausage-shaped mass with an elongated pyloric channel. If ultrasonography fails to demonstrate hypertrophy of the pylorus, health care providers order upper GI radiography to rule out other causes of vomiting.
What should the nurse teach parents to prevent UTIs in infants and children? What are the signs and symptoms?
In infant boys, it is necessary to retract and cleanse the foreskin with each diaper change. When older boys begin bathing themselves, it is necessary for parents to monitor this cleaning. For girls, cleansing the perineal area from front to back helps prevent UTIs from Escherichia coli. Some children also have a congenital anomaly such as urethral stenosis or vesicoureteral reflux (backward flow of urine from the bladder to the ureters) that can lead to urinary stasis and the development of a UTI.
In affected infants, fever, weight loss, failure to thrive, feeding difficulties, vomiting, and diarrhea are common. In affected children, urinary frequency, pain during urination, foul-smelling urine, incontinence after successful toilet training, abdominal or flank pain, hematuria, and vomiting are common signs and symptoms.
What is ketoacidosis?
The excessive ketone bodies in the blood (ketonemia) are toxic to the body and create strong acids (hence the term acidosis), thus resulting in ketoacidosis. As the serum pH decreases during acidosis hyperventilation, occurs to help the body eliminate carbon dioxide (acid) from the body. The characteristic Kussmaul respirations (abnormally deep and rapid respirations) are present during ketoacidosis. Diabetic ketoacidosis is a life-threatening condition. The blood glucose level continues to rise during diabetic ketoacidosis and can reach levels that result in coma and death.
What is the medical management for seizures?
The treatment of seizure disorders primarily involves drug therapy. Anticonvulsants that are most valuable in controlling partial or generalized seizures include carbamazepine (Tegretol), phe-nytoin (Dilantin), fosphenytoin (Cerebyx), and valproic acid (Depakote or Depakene). The drugs of choice for absence seizures, which belong to the class of partial seizures, are ethosuximide (Zarontin) and valproic acid. Additional seizure management has been achieved with gabapentin (Neurontin), lamotrigine (Lamictal), and felbamate (Felbatol).
What skin condition is a chronic, proliferative skin disorder characterized by thick, scaly patches and inflammation. Psoriasis usually is not seen in children younger than 6 years of age. The disorder has characteristic remissions and exacerbations. Affected people are otherwise healthy. Humidifiers sometimes help in winter.
Psoriasis