3600_exam_3_outline.docx.pdf

Review: Know the formula for maintenance requirements. Intake (daily)- Ex: 8kg = 800mL/day. 14kg = 1000+(50x4) = 1200mL/day. 25kg= 1500+(20x5) = 1600mL/day. Output (hourly)- 20kg= 20-60 mL/kg/hr. Appendicitis: When it ruptures, pa...

Review: Know the formula for maintenance requirements. Intake (daily)- Ex: 8kg = 800mL/day. 14kg = 1000+(50x4) = 1200mL/day. 25kg= 1500+(20x5) = 1600mL/day. Output (hourly)- 20kg= 20-60 mL/kg/hr. Appendicitis: When it ruptures, pain goes away. Not good!! Dehydration: Know CM, how to know they are improving, goal is to restore hydration—we can see this in mucus membranes, skin turgor, pulse, labs (electrolytes), daily weights. Labs: Know electrolytes (K 3.4-4.7, Na 135-145, Creatinine 0.3-0.7, Bun 5-18). Pyloric stenosis: Post op- feedings 6hours after, slowly go up in half-strength formula, shouldn’t be vomiting 48 hours after. FTT: Not meeting benchmarks. Less than 5%. Interventions—fortified food (high protein), small frequent meals, don’t make upset/angry before feeding, NG tube if bottle feeding isn’t good, make mealtime happy. Anorectal Disorders: Rectal atresia- complete closure. No opening for stool. Immediate surgery!! Colostomy. Imperforate anus: No rectal opening but fistula somewhere else, stool is going somewhere else. Surgical repair. Imaging to see where it is going before surgery. Rectal stenosis: Opening is narrowed or constricted. Dilate the sphincter. S/S of Celiac Disease: Anorexia, weight loss—usually what brings them in. Abdominal distention/bloating, diarrhea, constipation, fatty stools. Know diet for celiac. Interventions for reflux: upright when eating, burping, small frequent meals, PPIs, upper GI series. How to obtain urine specimen on infant: The U bag. Leave hanging on the side, so it doesn’t get contaminated. Clean before. 3 cleansing wipes. Need order for method of urine specimen. Get to lab within 10 minutes. Start abx after culture is obtained. Prevention of UTI: loose clothes, cotton undies, hand washing, avoid bubble baths Vesto reflex: urine backflows into ureters. Risk for UTI and enlargement of organs. VCUG: Dye in urethra to see how the flow is. Preop- consent, allergies. Post- hydrate and monitor for infection. This study source was downloaded by 100000774827852 from CourseHero.com on 09-02-2024 13:18:44 GMT -05:00 https://www.coursehero.com/file/175175300/3600-exam-3-outlinedocx/  CM for ACG: HTN, edema (behind eyes), headache, blood in urine. ASO titer to see if previous strep. Interventions: treat strep, diuretics, BP every 4hrs, IO, daily weights, don’t give extra fluid. Hemolytic: E.coli. Unclean foods. CM- vomiting, URI, dehydration, decreased LOC, blood & protein in urine. Labs- Everything elevated, platelets down & calcium. Priorities- ICP, heart monitor (K elevated), monitor for bleeding. Nephrotic syndrome: Losing lots of protein in urine. Low albumin in blood & cholesterol is high. Periorbital edema. Interventions- steroids & diuretics. Dipstick. No live immunizations because of long term steroids. Dialysis: Complications of peritoneal dialysis- Infection (s/s fluid should be clear not cloudy, fever), pulmonary infections, catheter dysfunction (pain, correct spot, patent, & decease flow rate). Complications for hemodialysis—anemia, low BP, cramps, bleeding. Hypo/epispadias: Treatment is surgery after 6 months & hold for circumcision. Postop- wound care, UTI, monitor for infection, no bathing right after. Chronic: Focus on developmental considerations & assistive devices. What is a chronic condition, asthma most common. Increased ICP: CM for infants- bulging fontanels, high pitched cry, sunsetting eyes, change in LOC, sutures separated, poor feeding... Older kids—headache, blurred vision, memory loss, irritable, indifferent. Interventions: Neuro assessment (LOC, VS, pupils,) every 15 minutes when unstable & then every2-4, GCS, decrease stimulation, swallow, decrease fluids, HOB midline 15-30. Mannitol is the diuretic. ICP probe to monitor pressure. Meningitis- treatment depends on viral or bacterial. Always treat as bacterial until told otherwise. Broad spectrum until culture results. Prevention of encephalitis- bug spray, STD testing (flare up before labor) Spina Bifida- interventions—Latex allergy, sterile gauze on sac, prone position, no diapers. Sterile dressing change every 2-4hrs unless soiled. Tx- Surgery. Post op at risk for hydrocephalus. Lots of problems with bowel & bladder. Risk for impaction because don’t feel need to go. Abusive brain trauma—poor prognosis. Social work referrals. CM- neuro changes, blindness, shearing of blood vessels, retinal hemorrhage, decease LOC, irritability, bradycardia, poor feeding. No external injuries. Basilar skull fractures: racoon eyes. This study source was downloaded by 100000774827852 from CourseHero.com on 09-02-2024 13:18:44 GMT -05:00 https://www.coursehero.com/file/175175300/3600-exam-3-outlinedocx/ Powered by TCPDF (www.tcpdf.org)