GI/GU
Name the "characteristic" trait of hypertrophic pyloric stenosis.
What is projectile vomiting.
When would you hold Digoxin in infants and children?
What is hold digoxin for infants HR <110/min, younger child’s HR < 90/min, and older child <70/min hold medication
Name at least two clinical manifestations of Developmental Dysplasia of the Hip (DDH)?
What is asymmetrical gluteal folds, shortened femur on affected side that may make affected side look shorter, and limited abduction of affected side.
What risk nursing diagnosis is the priority when caring for a child diagnosed with hemophilia?
What is risk for bleeding.
What disorder has to eliminate gluten products?
What is Celiac Disease.
Name two treatments for intussusception.
What is a barium enema, air into bowel, water-soluble solution to reduce invagination, SURGICAL EMERGENCY to prevent necrosis, and monitor x24 hours because can reoccur in this timeframe.
What position is helpful for a child experiencing a Tet spell (hypercyanotic)?
What is squatting/ knee-to-chest position.
Name at least two management strategies for a child with spina bifida.
What is prevent infection or injury to the sac (Protection from injury and maintenance of a sterile environment for the open lesion/sac is critical), Correct positioning to prevent pressure on the sac (Upon delivery, the newborn is placed in an incubator in prone position. Place a moist, sterile dressing of saline or an antibiotic solution to prevent drying of the sac), Good skin care, Prevent development of contractures with use of splints, Adequate nutrition, Accurate observations and charting, Education of the parents, Continued medical supervision.
Name 1 risk factor for sickle cell crisis.
What is GI infection, respiratory infection, idiopathic, and strenuous exercise.
Name two treatments for epiglottitis.
What is administer IV fluids, antibiotics, oxygen, and insert an alternative airway.*DO NOT ELEICT A GAG REFLEX, DO NOT USE A TONGUE BLADE TO INSPECT THE THROAT, AND DO NOT OBTAIN A THROAT CULTURE OF A CHILD SUSPECTED OF EPIGLITTITIS (dysphasia, hoarseness, cough, fever, inspiratory stridor) UNLESS AN ARTIFICAL AIRWAY IS AVAILABLE*
Calculate the daily fluid requirements and hourly fluid rate in ml/hr for a child who weighs 35 kg.
100 x 10 (for 1st 10 kg of body weight) = 1000
50 x 10 (for 2nd 10 kg of body weight) = 500
20 x 15 (for remaining kg of body weight) = 300
1000+500+300 = 1800 ml daily fluid maintenance requirement
1800ml/ 24hr = 75 ml/hr
If a child is not adequately treated from his streptococcus pharyngitis, the child could be at risk for what diagnosis?
What is rheumatic fever.
Name at least two clinical manifestations of Cerebral Palsy.
What is delayed gross motor development, abnormal motor performance, alterations in muscle tone, abnormal posture, reflex abnormalities, associated disabilities, manifestations vary with each child and can range from mild to severe. May have speech or vision difficulties, seizures, cognitive challenges, mental retardation, hyperactivity, and/or muscle spasticity.
Name the three priority goals for treating sickle cell crisis.
What is hydration, pain relief, and oxygenation.
Name two treatments/nursing interventions for a child with DKA.
What is Isotonic intravenous fluid (Normal Saline) and electrolytes and IV insulin is administered at 0.1 unit/kg/hr to treat the hyperglycemia. The correction of hyperglycemia must be gradual to prevent cerebral edema. Nursing care: Monitor VS, respiratory status, perfusion, cardiac status, and mental status.
Name at least two clinical manifestations of nephrotic syndrome (nephrosis).
What is frothy urine, decreased urine, swelling of genitals, ascites, LE edema, periorbital and facial edema that gets better throughout the day, lethargy, vomiting, anorexia, diarrhea, weight gain noted in a few days or weeks, dyspnea, BP within normal range or slightly lower than normal range, irritability, and muehrcke lines on fingernails.
Name two clinical manifestations of left-sided heart failure.
What is retractions, dyspnea, tachypnea, orthopnea, (rales) crackles, tachycardia, and SOB.
Name at least two clinical manifestations of increased ICP.
What is hyperreflexia, decreased HR, increased BP, decreased RR, increased temperature, optic atrophy, strabismus, decreased LOC, slow and sluggish pupillary response, excessive sleeping, bulging fontanels, separated cranial sutures, distended scalp veins, and coma.
Name at least two management strategies/treatments for eczema (atopic dermatitis).
What is hydrate the skin, relieve pruritus, reduce inflammation, prevent/control secondary infection ( symptoms will include low-grade fever, pus-filled lesions, and enlarged (localized) lymph nodes)
Medications that can be used include: Corticosteroids, Antibiotics, Anti-itching medications
Prescription ointments/creams should be completely washed off between applications.
Elbow splint (restraint) can be used prevent an infant/toddler from scratching while allowing freedom of movement of arms.
Bath oil helps keep skin moist and should be added to bath after the child has soaked for a while and skin is hydrated; the oil will help hold the moisture in the skin.
If in chlorinated swimming pool, child should shower thoroughly and then moisturize.
Name two management/treatment strategies that are important in controlling asthma attacks.
What is allergen control and drug therapy
(Short-acting beta2-agonists (albuterol),
corticosteroids (Flovent, Deltasone), anticholinergic (Atrovent), long- acting beta2-
agonist (Formoterol),Theophylline (side
effects not commonly used), Leukotriene
receptor antagonist (Singular).
Name at least two clinical manifestations of acute glomerulonephritis.
What is
•Tea-colored, cloudy urine, proteinuria, hematuria, dysuria, and urine output is decreased
•Worse facial edema present in the am then progresses to the abdomen and extremities as the day goes
•Swelling present in the gonads/genital area
•Vomiting, anorexia, abdominal pain
•Headache, seizures, irritability --> encephalopathy
•HTN
•Irritability
•Lethargy
•General ill looking appearance
•Low-grade fever
Name at least two clinical manifestations of right sided congestive heart failure.
What is ascites, enlarged liver, tachycardia, JVD in children that are older from the increased venous pressure, and periorbital edema (infants), weight gain
Name three clinical manifestations of hydrocephalus.
What is a shiny scalp, prominent scalp veins, suture lines are separated, increased ICP, bossing, sunset eyes, high-pitched cry, shrill, lethargy, irritable, increased OFC, and enlarged fontanelles.
Name at least two clinical manifestations of Acute Lymphocytic (Lymphoblastic) Leukemia (ALL).
What is bleeding, easy bruising, petechiae (low platelet count), anemia, lethargy, pallor, low-grade fever (Decreased RBC), joint and bone pain (overproduction of lymphocytes), anorexia, abdominal pain, and vomiting (spleen and liver enlarge), swollen lymph nodes, unsteady gait and headache (CNS involvement).
Name at least two management strategies to help a child with cystic fibrosis to manage their airway.
What is humidified oxygen, chest physiotherapy daily (3-4x), lung transplant, avoiding cough suppressants, nebulized/aerosols (bronchodilators & antibiotics).