Fluid and Electrolyte Imbalance and Renal Dysfunction
Normal VS for an adolescent.
What is HR 55-90, R 12-20
BP <120/80
(close to adults)
This laboratory test involves the blood glucose levels being drawn every 30 minutes for 2 hours.
What is the oral glucose tolerance test?
Surgical repair is done between 2 to 3 months of age for this facial disorder and the infant should be rocked and soothed in order to not disrupt the stitches and to decrease overall pain.
What is Cleft Lip?
This medication should always be taken as prescribed (forever) and should never be stopped without physician supervision due to the risk of adrenal crisis.
What is cortisol for Addison's Disease (chronic adrenocortical insufficiency)? (Remember the 'steroid dependent' bracelet)
These are the signs and symptoms of an infant with increased intracranial pressure.
What are a high-pitched cry, poor feeding, agitation, and a bulging fontanel?
In a patient with leukemia and a low platelet count, these precautions should be initiated.
What are bleeding precautions (also they would not be placed with other patients who could possibly be infectious).
What is the greatest predictor of dehydration in infants.
What is weight loss?
Also, sunken fontanels and irritability may be present.
The expected HbA1C range for a child less than 6 years old with diabetes mellitus.
What is 7.5 to 8.5%?
A child with celiac disease can't and can have (food):
What is a child with celiac can't have wheat, barley, and rye.
What is a child with celiac can have corn, rice, mullet.
The number one goal in congenital hypothyroidism is this?
What is early detection?
Patients born with spina bifida are at risk of developing this allergy.
What is a latex allergy?
This is how often a patient in Buck's traction should be turned carefully to avoid pressure ulcers.
What is every two hours?
How would you know if the prescribed treatment of the oral rehydration of 50 ml/kg of fluid within 4 hours was successful or not?
What is normalized labs (serum and urine) and vital signs (know the ranges in peds)?
For what reasons would you need to call the provider during a period of illness with diabetes mellitus?
What is blood glucose greater than 240 mg/dL, positive ketones in the urine, disorientation or confusion, rapid breathing, vomiting occurring more than once, and liquids can't be tolerated?
Hirschsprung's disease can first be identified in the newborn when this does not happen in 24-48 hours.
What is no passage of the meconium stool?
The increase of what in the diet is encouraged for patients with hyperaldosteronism?
Potassium rich foods. (greens, sweet and regular potatoes, many fruit juices)
When caring for a patient after VP shunt placement, the nurse should make sure she never puts the patient in this position.
What is lying on the operative side, trendelenberg, or prone? Patient should be placed on unoperated side.
What age patient would you pretend to cast a doll's leg before you casted the patient's leg?
What is a preschool patient.
This electrolyte, if too high or low can cause heart arrhythmias, and can be dangerously imbalanced when a child has vomiting or diarrhea.
What is potassium?
This type of insulin has an onset of 30 minutes to 1 hour and has a peak of 1 hour to 5 hours.
What is short-acting, regular insulin?
This will cause a child to have sudden, extreme abdominal pain with currant-jelly stool (blood/mucous), and an abdominal sausage-shaped mass.
What is Intussusception?
A patient with scoliosis must wear this for many years, even when they sleep.
What is a back brace?
What medication administration education does the parent need when they give the child phenobarbital and phenytoin for seizures.
What is increase Vitamin D, increase folic acid, and do not take with milk?
This should NEVER be done on a patient with an abdominal mass and pink-tinged urine.
What is palpating the abdomen when there is a concern for a Wilm's tumor (the most malignant renal and intra-abdominal tumor of childhood.
This medication is given for Nephrotic Syndrome and will need to be tapered after 2-5 months.
What is Prednisone?
This term is associated with blood glucose greater than 250 mg/dL, thirst, polyuria early on, dry mucous membranes, rapid, deep respirations, and a weak pulse.
What is hyperglycemia?
This disorder is associated with an olive-shaped mass in the right upper quadrant of the abdomen and involves projectile vomiting.
What is Hypertrophic Pyloric Stenosis?
This may make a patient with juvenile idiopathic arthritis stiff whereas taking this medication every other day may help with stiffness.
What is sleeping and cold packs can cause stiffness and alternate-day prednisone can reduce inflammation?
This movement issue will be present initially in patients with muscular dystrophy, requiring assistance.
What is getting up to standing position?
The manifestations of adolescent depression.
What are critical, irritable, and sarcastic comments, low self-esteem, poor sleeping pattern, and low mood?
These diet restrictions should be followed in patients that have peripheral edema with acute glomerulonephritis.
What are low-sodium and fluid restrictions?
This disorder is associated with hematuria, proteinuria, and edema with increased urine specific gravity and high BP and happens post-streptococcal infection.
This yearly vaccine should be given to diabetic children for this reason.
What is the influenza vaccine because they are more susceptible to complications related to infections?
This is the type and an example of the diet expected after the repair of intussusception.
What is a clear liquid diet with electrolytes and glucose?
This is how often casting is done on an infant with a club foot/feet.
What is every 2-3 weeks?
This sign of a central nervous system infection is only present in infants.
What is a bulging fontanel?
How would you approach death and dying with a teenager?
Do not dismiss feelings or 'pass the buck' (ignore question and tell them to ask someone else), ask open ended questions to gain insight, listen.
This procedure is the preferred means of renal replacement therapy in the pediatric age group.
What is kidney transplantation?
These are signs of hypoglcemia in the pediatric patient.
What is a rapid onset of irritability, shakiness, pallor, sweating, confusion, and dizziness?
A sudden decrease in right lower abdominal pain after intense pain (and then followed by even more intense pain) is a warning for this.
What is a perforated/ruptured/ acute appendix?
These are the expected side effects of long-term steroid therapy in Cushing's Syndrome.
What are moon face, truncal obesity, pendulous abdomen, excessive bruising, and decreased inflammatory response?
Use these measures to keep a patient safe during a seizure.
What is assess for a patent airway, keep them side-lying if possible, and clear their bed of hard objects?
These two cell types are present in Hodgkin's Lymphoma.
What are Hodgkin's and Reed-Sternberg cells?
This disorder manifests as facial and other edemas, decreased urinary output with proteinura, hyperlipidemia and is NOT contagious.
What is Nephrotic syndrome?
These are the sick day rules for patients with type 1 diabetes.
What is making sure to take your insulin and consuming 15g of carbohydrates every 1-2 hours?
This is how a patient with gastroesophageal reflux should be positioned after eating.
What is leaving the infant upright after eating and waiting to lay them down?
A parent should be concerned about this when there is a fracture in the epiphyseal plate.
What is its impact on growth?
This is the recovery position for seizures especially if child is nauseas or vomiting.
What is help the child to lie on their side?
These lab values should be known for the exam.
What are blood glucose and hgb A1C for different ages, vital signs for different ages, potassium, sodium, BUN, calcium, platelets, WBC's, RBC's, and urine specific gravity.
Please learn the signs and symptoms of high and low calcium, glucose, sodium, platelet, and potassium.
This condition which causes urine to flow back to the kidneys can result in a kidney infection which can lead to sepsis.
What is vesicoureteral reflux?
When giving injections we often do this to avoid injecting into a vessel. This is not necessary when giving SubQ insulin.
What is aspirate?
This disorder is present when there is a portion of the intestine that does not have adequate mobility but the rest of the intestine does.
What is Hirschsprung's Disease?
What does an exacerbation of Graves disease feel like?
What is heat intolerance, insomnia/tremors/hyperactivity, weight loss, tachycardia, diarrhea, bulging eyes?
Medical professionals are required by law to report this when any suspicion arises. Also what signs may be present in the patient?
What is child abuse? What is bruises or injuries in various phases of healing, inconsistent stories of what happened or general history, and/ or parents did not seek help right away after injury?
SIDS precautions
1) placing child on back is number one SIDS deterrent and for this reason SIDS has decreased overall 2) no smoking during pregnancy or around child 3) No pillows, heavy blankets, stuffed animals in crib 4) no co-sleeping
Abnormal lab values in chronic glomerulonephritis.
What is elevated BUN, creatinine, and uric acid (evidence of decreased renal fx).
Proteinuria also can be present. Elevated K and Ph, decreased Ca.
This is the order in which you draw up different insulins.
What is fast-acting to long-acting or clear to cloudy?
These are signs of a tracheoesophageal fistula.
What are cough, cynosis, periods of apnea, and frothy saliva?
These are the medication guidelines for levothyroxine use for hypothyroidism.
What is checking routine lab levels (are we overcorrecting and inducing hyperthyroidism?), checking VS (are we overcorrecting and causing hyperthyroidism (tachy?), are they TAKING the med (should never stop without consulting practitioner).
Bacterial meningitis- first thing you do with this patient.
Contagious- place in appropriate isolation.
Serum calcium is low in a patient with hypoparathyroidism. What are the symptoms?
muscle cramps and tremors, tingling, positive Chvostek and Trousseau, HA and vomiting