Juvenile Idiopathic Arthritis (JIA)

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Questions and Answers

What is juvenile idiopathic arthritis (JIA)?

JIA is a chronic autoimmune inflammatory disease of unknown origin that affects joints and tissues in children.

What two laboratory markers are typically elevated in juvenile idiopathic arthritis due to inflammation?

Elevated C-reactive protein (CRP) and elevated White Blood Cells (WBCs).

What laboratory test related to autoantibodies is usually positive in juvenile idiopathic arthritis, although it can sometimes be negative?

Antinuclear Antibody (ANA).

What laboratory test related to autoantibodies is typically negative in juvenile idiopathic arthritis?

<p>Rheumatoid factor (RF).</p> Signup and view all the answers

What non-pharmacological nursing intervention can help manage joint pain in juvenile idiopathic arthritis?

<p>Applying warm packs or recommending warm baths for painful joints.</p> Signup and view all the answers

What type of therapy is often beneficial for maintaining joint function and mobility in juvenile idiopathic arthritis?

<p>Physical therapy.</p> Signup and view all the answers

What should be taught to patients with juvenile idiopathic arthritis to help manage the psychological impact of a chronic illness?

<p>Teach relaxation techniques.</p> Signup and view all the answers

What class of medication is commonly used as a first-line treatment for pain and inflammation in JIA?

<p>Nonsteroidal anti-inflammatory drugs (NSAIDs).</p> Signup and view all the answers

What important instruction should be given to patients taking NSAIDs for juvenile idiopathic arthritis?

<p>NSAIDs should be taken with food.</p> Signup and view all the answers

What specific monitoring is required when using Disease-Modifying Antirheumatic Drugs (DMARDs) for juvenile idiopathic arthritis?

<p>Liver function tests should be checked regularly.</p> Signup and view all the answers

Under what circumstances are steroids typically used in the management of juvenile idiopathic arthritis?

<p>Steroids are reserved for severe pain or inflammation flare-ups.</p> Signup and view all the answers

What type of diet is generally recommended for patients with juvenile idiopathic arthritis?

<p>A well-balanced diet.</p> Signup and view all the answers

What should parents be educated about regarding exacerbations in juvenile idiopathic arthritis?

<p>Parents should understand that exacerbations (flare-ups) worsen the illness temporarily.</p> Signup and view all the answers

What is important for caregivers to allow children with juvenile idiopathic arthritis to do regarding their daily activities?

<p>Be patient and allow the child to perform self-care activities as independently as possible.</p> Signup and view all the answers

What specific eye condition is a potential complication for patients with juvenile idiopathic arthritis?

<p>Uveitis (inflammation of the uvea in the eye).</p> Signup and view all the answers

What treatment is typically given short-term for uveitis associated with juvenile idiopathic arthritis?

<p>Steroid eye drops.</p> Signup and view all the answers

What are key nursing care priorities for a child post-scoliosis surgery?

<ul> <li>Monitor and manage pain (e.g., using pain tools, PCA pump).</li> <li>Perform frequent neurological checks and monitor vital signs.</li> <li>Log roll the patient as prescribed to maintain spinal alignment.</li> <li>Encourage coughing and deep breathing (use incentive spirometer).</li> <li>Monitor bowel sounds for paralytic ileus before starting oral intake.</li> </ul> Signup and view all the answers

For what degree of scoliosis curve is bracing typically used?

<p>Bracing is generally used for moderate scoliosis, typically defined as curves between 25 and 45 degrees.</p> Signup and view all the answers

What is the most common type of brace used for scoliosis, and how does it work?

<p>The Boston Brace is the most common. It corrects scoliosis by applying pressure on the outer aspect of the curve, guiding the spine towards a straighter alignment.</p> Signup and view all the answers

What is the Wilmington Brace for scoliosis, and how is it designed?

<p>The Wilmington Brace is a custom-fitted brace. Specific corrective forces are built into the brace based on the patient's individual spinal curve pattern.</p> Signup and view all the answers

What is leukemia?

<p>Leukemia is a type of blood cancer that originates in the blood-forming tissues, specifically the bone marrow.</p> Signup and view all the answers

What is the most definitive diagnostic procedure for leukemia, and what finding confirms the diagnosis?

<p>Bone marrow aspiration is the most definitive procedure. A positive result shows prolific quantities of immature leukemic blast cells and protein.</p> Signup and view all the answers

What is the purpose of performing a CSF analysis via lumbar puncture in a patient diagnosed with leukemia?

<p>To assess if there is Central Nervous System (CNS) involvement by leukemia cells.</p> Signup and view all the answers

What are the typical findings in the complete blood count (CBC) and blood smear for a patient with leukemia?

<p>Typical findings include anemia (low red blood cells), thrombocytopenia (low platelets), neutropenia (low neutrophils), the presence of leukemic blasts (immature white blood cells) on the blood smear.</p> Signup and view all the answers

What are some early classic signs and symptoms of leukemia?

<p>Low-grade fever, increased bruising and petechiae, and abdominal, leg, or joint pain.</p> Signup and view all the answers

What are some later classic signs of leukemia?

<p>Significant pain and hematuria (blood in the urine).</p> Signup and view all the answers

Outline basic nursing care principles for a child undergoing chemotherapy.

<ul> <li>Control nausea and vomiting by administering antiemetics before chemotherapy.</li> <li>Monitor closely for signs of infection and skin breakdown.</li> <li>Promote adequate nutrition.</li> <li>Prepare the child and family for expected hair loss (alopecia).</li> <li>Assess for bleeding and implement bleeding precautions (due to thrombocytopenia).</li> </ul> Signup and view all the answers

What is a critical precaution when caring for a child suspected or known to have a Wilms tumor?

<p>NEVER palpate the abdomen or the suspected Wilms tumor.</p> Signup and view all the answers

What is a Wilms tumor?

<p>A Wilms tumor is a solid malignant tumor of the kidney, typically presenting as a firm, nontender, unilateral abdominal mass in children.</p> Signup and view all the answers

Why is prednisone often included in treatment regimens for leukemia alongside chemotherapy?

<p>Prednisone (a corticosteroid) is thought to help destroy abnormal white blood cells (leukemic cells) and reduce inflammation.</p> Signup and view all the answers

Flashcards

Juvenile Idiopathic Arthritis (JIA)

Chronic auto-immune inflammatory disease that affects joints/tissue with unknown origin.

Elevated Labs in JIA

Elevated C-reactive protein and WBCs due to inflammation.

ANA in JIA

Presence of autoantibodies, but can be absent.

Rheumatoid Factor in JIA

Autoantibodies are not present.

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Warm Packs/Baths for JIA

Applying warmth to alleviate joint pain.

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Physical Therapy for JIA

Helps maintain joint function and mobility.

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Relaxation Techniques for JIA

Techniques to reduce stress, which can exacerbate symptoms.

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Pain Management in JIA

Medications to alleviate pain associated with JIA.

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NSAIDs with Food

Reduces gastric irritation.

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Monitor Liver Function with DMARDs

Assess for liver toxicity.

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Steroids in JIA

Reserved for severe pain due to side effects.

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Well-balanced Diet for JIA

A nutritious and balanced diet is important.

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Exacerbations impact on JIA

Worsening of symptoms makes the illness worse.

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Allow Self-Care in JIA

Encourage independence in daily activities.

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Uveitis in JIA

Inflammation of the uvea (middle layer of the eye).

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Steroid Eye Drops for Uveitis

To reduce inflammation.

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Post-Op Scoliosis Surgery Care

Pain management, neurological assessments, pulmonary hygiene, and monitoring bowel function.

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Bracing for Scoliosis

Used to halt the progression of moderate scoliosis.

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Boston Brace

Applies pressure to correct spinal curvature.

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Wilmington Brace

Corrective forces based on the patient's specific spinal curve.

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Leukemia

Cancer of the blood and bone marrow.

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Bone Marrow Aspiration for Leukemia

Shows immature leukemic blast cells and protein.

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CSF Analysis in Leukemia

To see if the cancer has affected the central nervous system.

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Labs for Leukemia

Low counts of red blood cells, platelets, and neutrophils, with immature blood cells.

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Early Leukemia Signs

Fever, bruising, and pain.

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Late Leukemia Signs

Pain and blood in urine.

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Basic Chemotherapy Care

Manage nausea, prevent infection, promote nutrition, and prevent bleeding.

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Wilms Tumor Consideration

Do NOT palpate the mass, which can cause seeding.

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Wilms Tumor

A solid tumor of the kidney or abdomen.

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Prednisone for Leukemia

Helps destroy abnormal WBCs.

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Study Notes

  • Study notes regarding pediatric conditions, their management, and related nursing care.

Juvenile Idiopathic Arthritis (JIA)

  • JIA is a chronic autoimmune inflammatory disease impacting joints and tissues, with an unknown cause.
  • Elevated C-reactive protein and WBC counts are indicative of inflammation in JIA.
  • ANA is usually positive due to the presence of autoantibodies, but can be negative.
  • Rheumatoid factor is typically negative in JIA.
  • Applying warm packs or taking warm baths can help alleviate pain.
  • Physical therapy is a beneficial treatment.
  • Relaxation techniques should be taught for stress management.
  • Pain medications are commonly used for pain relief.
  • NSAIDs should be administered with food.
  • Liver function needs monitoring when using DMARDs.
  • Steroids are reserved for severe pain cases.
  • A well-balanced diet is recommended.
  • Exacerbations can worsen the condition.
  • Caregivers should be patient and allow for self-care.
  • Uveitis, an eye condition, can develop.
  • Steroid eye drops are a short-term treatment for uveitis.

Post-Scoliosis Surgery Care

  • Pain should be monitored using pain scales; PCA explanations should be repeated as needed.
  • Frequent neurological checks and vital signs monitoring is essential.
  • Log rolling should be performed as prescribed.
  • Coughing and deep breathing exercises using an incentive spirometer are important.
  • Bowel sounds should be monitored before feeding, to watch for paralytic ileus.

Scoliosis Bracing

  • Braces are used for moderate scoliosis (25-45 degrees).
  • The Boston Brace corrects scoliosis by applying pressure to the outer curve.
  • The Wilmington Brace is custom-fitted, applying specific corrective forces based on the patient's spinal curve.

Leukemia

  • Leukemia is a blood cancer originating in the blood and bone marrow.
  • A bone marrow aspiration is the most definitive diagnostic procedure.
  • A positive bone marrow aspiration will show high quantities of immature leukemic blast cells and protein.
  • CSF analysis via lumbar puncture assesses CNS involvement.
  • Labs show low or immature results, including anemia, thrombocytopenia, neutropenia, leukemic blasts, and abnormal blood smear.
  • Early signs include low-grade fever, increased bruising/petechiae, and abdominal, leg, and joint pain.
  • Late signs include pain and hematuria.
  • Nausea can be controlled with antiemetics given before chemo.
  • Essential to observe for infections and skin issues.
  • Promote proper nutrition.
  • Expect hair loss.
  • Assess for bleeding and apply corresponding precautions.
  • Prednisone is administered with chemo because it destroys abnormal WBCs.

Wilms Tumor

  • Wilms tumor is a solid tumor of the kidney or abdomen that presents as a firm, nontender, unilateral abdominal mass.
  • Never palpate a Wilms tumor.

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