Neuro
Bacterial Meningitis
Remember, Bacterial is BAD!
Bacterial: Thick discolored CSF fluid, high mortality and morbidity, can cause neurological defects, must be treated with antibiotics
Viral: Symptoms are managed but has to run its course for 3-10 days, does not cause seizures or neuro symptoms, CSF fluid is CLEAR, NO high mortality or morbidity.
If meningitis is suspected patient will be treated with antibiotics until CSF comes back. If viral then antibiotics will be d/c'd
If a child has a significant injury to their epiphyseal plate what does this put them at risk for?
If a child has a significant injury to the epiphyseal plate, this can stunt the growth of the bone.
What condition presents with "projectile vomiting" after meals and an "olive-shaped" abdominal mass?
Pyloric Stenosis
This presents with the child projectile vomiting after meals, weight loss, malnutrition, an olive shaped mass, and child will appear constantly hungry. This is usually diagnosed by an abdominal ultrasound.
A child with type 1 diabetes presents with pallor, shakiness, and sweating. The nurse anticipates what when checking the blood glucose?
Hypoglycemia
An infant is observed and is noted to have an absence of the "red reflex" in the right eye. The physician tells the parents that a referral for ophthalmology is warranted. What is the highest risk due to the abscence of the red reflex?
Retinoblastoma
What 3 elements are a part of the "Cushing's Triad"?
Bradycardia
Irregular Respirations
Increase in Systolic BP with a widened pulse pressure
With an increase in intercranial pressure (ICP) think trauma (shaken baby syndrome) or infection (meningitis) that has caused the pressure in the brain to increase. Babies will have that bulging fontanelle.
This is an "s" or "c" shaped curvature of the spine?
Scoliosis
Scoliosis screenings are usually done on adolescence at their well child visits. Patient will be asked to stand with feet together, put their hands out, and bend forward. This allows for visualization of the spinal alignment
What condition presents with a "sausage-shaped" abdominal mass, and bloody or red jelly like stools?
Intussusception
This is where the bowel telescopes into itself and can become ischemic. Usually treated with an "air contrast enema" or surgery.
When educating a parent on care of a type 1 diabetic child, the nurse states that blood glucose should be checked often, testing for urine ketones should be done every 2-4 hours, and insulin administration should be continued even without intake of food. These are examples of what?
Sick Day Rules
What is an intrarenal tumor that can cause hypertension, blood in the urine, and should not be palpated once diagnosed?
Wilm's Tumor
What type of seizures are the most common in the pediatric population?
Febrile Seizures
Remember the goal is to reduce the fever, keep the child safe (no tub bathing and turn them on their side when they seize), if they have a febrile seizure, they can have them again, but it does NOT increase their risk for a seizure disorder, so no medications are needed on a daily basis.
What laboratory test are most commonly used when diagnosing Osteomyelitis?
ELISA Test
C-Reactive Protein (CRP)
ASO Titer
This GI condition can cause intense vomiting and diarrhea placing the infant at high risk for dehydration?
Gastroenteritis
They can become severely dehydrated with this. You may see a sunken fontanelle, a 10-15% weight loss, and dry skin and mucous membranes. It's important to monitor I&O to ensure child is voiding appropriately
A 2-year-old child with a strep infection presents with edema and tea-colored urine. The child is admitted for glomerulonephritis. What is one important nursing assessment that needs to be done daily?
Daily Weights
This is the most common tumor affecting the skeleton of children?
Osteosarcoma
What are some key factors to remember with a myleomeningiocele?
It involves the spinal cord and spinal fluid in the sac.
Make sure you are monitoring for leakage, head circumference measurements if they are under 2 years of age, keep them prone or lateral (no pressure on the sac), keep the diaper off of the sac, neuro checks pre and post surgery.
This musculoskeletal disorder would present with a child having a limp and has hip pain with no history of trauma?
Legg-Calve-Perthes Disease
A child presents to the ER with lower right abdominal pain and high fever. In the triage room the child suddenly states the pain has stopped. What would be the priority concern with this patient?
Ruptured Appendix
With Nephrotic Syndrome you will see hyperlipidemia, hypoalbuminemia, hypoproteinemia, and proteinuria on laboratory tests. One distinct physical assessment finding with nephrotic syndrome is what?
Periorbital Edema
You are caring for a patient who states they have had night sweats and pain that wakes them up in the middle of the night. As the nurse what concern do you want on your priority list?
Cancer
What neuromuscular disorder presents with a non-progressive lesion on the brain, reflexes that persist through their life, does not have a high risk of mortality, and does not have a specific pattern of progression?
Cerebral Palsy
Cerebral Palsy: Primitive reflexes last, poor tone, may not be meeting milestones on time, non-progressive plaque on the brain, not a high mortality, and not a specific pattern of progression.
Duchenne's (DMD): High rates of mortality (usually in their 20's), starts in their legs then progresses upward, Gower's Maneuver is noticed with DMD
What condition presents with an Absence or Asymmetrical Gluteal Fold?
Developmental Hip Dysplasia
The infant will have an absence or asymmetrical gluteal fold, this is not a genetic condition but more of a hip dislocation, does not increase their risks of any musculoskeletal issues, does not require medications, will use a pavlik harness or spica cast to correct. With any harness or cast, skin and neuro checks should be done.
This condition destroys the villi within the intestines which interferes with absorption of nutrients and cause significant GI disturbances?
Celiac disease
Remember that wheat, barley, and rye are all foods that contain gluten and if the patient has celiac disease, gluten foods will continue to destroy remaining villi in the intestines.
With recurrent or chronic UTI's it can increase the risk for what Kidney issue and how is this issue diagnosed?
Vesicoureteral Reflux (VUR)
Diagnosed by a VCUG
This type of cancer affects the bone marrow, is malignant, and can cause the bone marrow to not fully mature white blood cells before putting them into circulation.
Leukemia