Surgery: Synovectomy in Arthritis Patients
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Questions and Answers

What is a symptom of allergic rhinitis?

  • Ear pain and delayed speech
  • Tearing and soreness of the eyes (correct)
  • Loss of appetite and depression
  • Wheezing and cough

    • What is a characteristic of asthma?

  • No symptoms, airway constriction, and bronchial responsiveness
  • Recurring symptoms, airway obstruction, and irreversible airflow limitation
  • Rare symptoms, airway dilation, and bronchial hyporesponsiveness
  • Recurring symptoms, airway obstruction, and bronchial hyperresponsiveness (correct)

    • What is associated with asthma episodes?

  • Reversible airflow limitation and bronchodilation
  • Spontaneous airflow limitation and bronchial responsiveness
  • Irreversible airflow limitation and bronchoconstriction
  • Reversible airflow limitation and bronchial hyperresponsiveness (correct)

    • Why is it important to obtain information regarding clinical signs of related disorders?

    <p>To identify middle ear disease and other related disorders</p> Signup and view all the answers

    What is a possible complication of asthma?

    <p>Exercise intolerance and wheezing</p> Signup and view all the answers

    What is a symptom of asthma?

    <p>Wheezing, breathlessness, and chest tightness</p> Signup and view all the answers

    What can cause recurrent episodes of wheezing, breathlessness, and cough?

    <p>Inflammation in susceptible children</p> Signup and view all the answers

    Upon auscultation, what may be heard in the lung fields of an asthma patient?

    <p>Wheezing upon auscultation</p> Signup and view all the answers

    What is the primary use of synovectomy in children with arthritis?

    <p>When all other therapy has been unsuccessful</p> Signup and view all the answers

    What is the effect of histamine on local receptors?

    <p>It produces vasodilation</p> Signup and view all the answers

    What is the result of the cytokines in the late-phase allergic reaction?

    <p>Chronic nasal obstruction</p> Signup and view all the answers

    What is the time frame for the late-phase allergic reaction?

    <p>4 to 8 hours after antigen exposure</p> Signup and view all the answers

    What is the goal of nursing care management in children with JIA?

    <p>Assessment of their general health and the status of involved joints</p> Signup and view all the answers

    What is the alternative to synovectomy in case of synovitis?

    <p>Intraarticular steroid injection</p> Signup and view all the answers

    What is the effect of prostaglandins released by mast cells?

    <p>Vasodilation</p> Signup and view all the answers

    Who is joint replacement suitable for?

    <p>Older children who are fully grown</p> Signup and view all the answers

    What is the estimated time required for the procedure?

    <p>15-30 minutes</p> Signup and view all the answers

    What is the purpose of the doctor grasping the node between thumb and forefinger?

    <p>To insert the needle directly into the node</p> Signup and view all the answers

    What is the name of the diagnostic evaluation that examines the vessels of the lymphatic system?

    <p>X-ray examination</p> Signup and view all the answers

    What is the name of the chemotherapeutic medication that includes doxorubicin, bleomycin, vinblastine, and dacarbazine?

    <p>ABVD</p> Signup and view all the answers

    What is a possible complication of needle biopsy?

    <p>Bleeding of the side</p> Signup and view all the answers

    What is the purpose of the doctor inserting the needle into the node?

    <p>To aspirate the sample</p> Signup and view all the answers

    What is the name of the chemotherapeutic medication that includes cyclophosphamide, doxorubicin, vincristine, and prednisone?

    <p>CHOP</p> Signup and view all the answers

    What is the doctor's role in the procedure?

    <p>Inserting the needle into the node and aspirating the sample</p> Signup and view all the answers

    Where does digestion start?

    <p>Mouth</p> Signup and view all the answers

    What is a common symptom of Hirschsprung disease?

    <p>Failure to pass meconium within the first 48 hours</p> Signup and view all the answers

    What is the purpose of a Barium Enema?

    <p>To check where the constriction is happening in the gastrointestinal tract</p> Signup and view all the answers

    How many parts is the small intestine divided into?

    <p>3</p> Signup and view all the answers

    What is a characteristic of the stool in Hirschsprung disease?

    <p>Ribbon-like and foul smelling</p> Signup and view all the answers

    Where does major absorption occur?

    <p>Small intestine</p> Signup and view all the answers

    What is a common diagnostic tool used in Hirschsprung disease?

    <p>Barium Enema</p> Signup and view all the answers

    What is a symptom of Hirschsprung disease?

    <p>Abdominal distention</p> Signup and view all the answers

    What is the primary goal of managing pruritus in atopic dermatitis?

    <p>To prevent secondary infection and new lesions</p> Signup and view all the answers

    Which antihistamine is preferred for daytime pruritus relief?

    <p>Loratadine</p> Signup and view all the answers

    What is the most common malignant renal and intra-abdominal tumor of childhood?

    <p>Wilms' tumor</p> Signup and view all the answers

    What is a common clinical manifestation of Wilm's tumor?

    <p>Non-tender, painless swelling or mass in the abdomen</p> Signup and view all the answers

    Why is it essential to assess the family's feelings and methods of coping?

    <p>To develop a nursing care plan that addresses the family's needs</p> Signup and view all the answers

    What is the significance of exploring the child's behavior, especially in relation to scratching?

    <p>To develop a plan to manage the child's pruritus</p> Signup and view all the answers

    What is the purpose of examining the skin lesions?

    <p>To assess the type, distribution, and evidence of secondary infection</p> Signup and view all the answers

    Why is a family history important in the assessment of atopic dermatitis?

    <p>To identify evidence of atopy</p> Signup and view all the answers

    Study Notes

    Synovectomy

    • Used primarily in pauciarticular disease when all other therapy has been unsuccessful
    • Alternative to synovectomy: intraarticular steroid injection, may be tried once or twice before surgery
    • Joint replacement is proving to be successful in older children who are fully grown

    Allergic Rhinitis

    • Characterized by: rapid release of mast cell mediators (e.g., histamine, prostaglandins, and leukotrienes)
    • Histamine acts directly on local receptors to produce vasodilation, mucosal edema, and increased production of mucus
    • Cytokines summon cells to the area, responsible for slower late-phase allergic reaction of inflammation and destruction of the mucosal surface

    Asthma

    • Chronic inflammatory disorder of the airways
    • Characterized by recurring symptoms, airway obstruction, and bronchial hyperresponsiveness
    • In susceptible children, inflammation causes recurrent episodes of wheezing, breathlessness, chest tightness, and cough
    • Episodes are associated with airflow limitation or obstruction that is reversible either spontaneously or with treatment

    Wilm's Tumor (Nephroblastoma)

    • Most common intraabdominal and kidney tumor of childhood
    • Malignant tumor in the kidney
    • Clinical manifestations: swelling or mass within the abdomen, firm, non-tender, and confined
    • Other symptoms: secondary anemia, weight loss, and hypertension

    Nursing Care Management

    • Assessment of general health and status of involved joints
    • Emotional responses to ramifications of the disease
    • Important to obtain information regarding clinical signs of related disorders

    Cellular Aberrations

    • Needle biopsy: insertion of a needle directly to the node and aspirate whatever can be aspirated, sent to the lab for diagnosis
    • Usual complications: bleeding of the side, possible infection

    Diagnostic Evaluation

    • X-ray examination of the vessels of the lymphatic system
    • Fluoroscopy of the lymphatic vessels
    • Barium Enema: injecting barium contrast and taking a series of x-rays in the abdomen to check for constriction and gastrointestinal tract issues

    Hirschsprung Disease

    • Failure to pass meconium within the first 48 hours
    • Ribbon-like, foul-smelling stools
    • Abdominal distention
    • Vomiting
    • Constipation

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    Description

    This quiz covers the benefits and uses of synovectomy, a surgical procedure, in treating arthritis patients, particularly children. It also explores the role of IgE molecules in triggering mast cell mediators.

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