Microsoft Word - Peds Exam 3.docx.pdf

Disease: Patho Signs or Symptoms Dx Tx Nursing GI Tract Overview Disease: Esophageal atresia (tracheoesophageal fistula) Patho Signs or Symptoms Dx Tx Nursing Congenital disorder Prenatal Sur...

Disease: Patho Signs or Symptoms Dx Tx Nursing GI Tract Overview Disease: Esophageal atresia (tracheoesophageal fistula) Patho Signs or Symptoms Dx Tx Nursing Congenital disorder Prenatal Surgery Prevent pneumonia, * polyhydramnios ay chocking, apnea. A fistula is like a shunt 14 famniotic fluid) Large fistula might where there is a Newborn vomiting and need a thoracotomy. NPO passageway between choking with feeding. the esophagus to the Airway suctioning trachea. Drooling Upright position Food going from the Crying, choking, esophagus to the cyanosis, apnea Assess during feeding. lungs. (connect to lungs) Abdominal distention Post op Could be a fistula to cempty cavity) - Fluid the lungs or nothing - Electrolytes there to connect. - Nutrition - TPN until healed Disease: Imperforate Anus Patho Signs or Symptoms Dx Tx Nursing The perforation No meconium in the Surgery Report if the first X a between the anus and first 24 hours. y meconium is not lower GI tract does not passed within the first happen ending in a Absence of the anus 24 hours. blind pouch. Abdominal distention Preop Can be a fistula (meconium stays in - NG tube for connecting to the the abdomen) decompression urinary structures. - Educate on potential for colostomy Postop - Temporary colostomy - Education of E colostomy Disease: Pyloric Stenosis Patho Signs or Symptoms Dx Tx Nursing The sphincter from the Symptoms might not Pyloromyotomy Fluid and electrolyte stomach to the small appear till 2-3 weeks. balance. intestine does not Post op: allow for movement. Projectile Vomiting - Small feeds of IV hydration - undigested glucose - Water slowly Burp before and during Hungry increasing to feedings. - nothing was formula digested. Fowler’s position Dehydration Place on RIGHT side - sulked after feeding. fontanelle - inelastic skin I & Os - decreased urination. Frequent position - Fewer wet changes diapers May feel an olive shaped mass in RUQ Disease: Celiac Disease Patho Signs or Symptoms Dx Tx Nursing Inability to digest FTT (failure to thrive) Gluten free diet gluten. gluteen testing lifelong Educate on gluten free Stool is… diet. - Large Gluten is in… - Smelly Educate on how to - Wheat - Frothy read a label. - Barley - Bulky - Oats - Rye Irritability - Candy - Ice cream Abdominal distention - Food starch with atrophied buttocks Disease: Hirschsprung Disease Patho Signs or Symptoms Dx Tx Nursing Absence of ganglionic Failure to pass Surgery Detection of the innervation in a part of meconium in 24-48 - Impaired part of symptoms the bowel. hours. colon is - There is not removed. If enema is needed paralysis. Constipation - Re use NS. anastomosis Ribbon like stool - Might need a Educate on the - Seeping around colostomy possibility of the blockage. colostomy that might W be just temporary. Abdominal distention Vomiting Anorexia-FTT Disease: Intussusception Patho Signs or Symptoms Dx Tx Nursing A slipping of one part Severe abdominal pain Enema of air guided Medical EMERGENCY !!! of the intestine into - Colicky X-ray another part just - Sudden Surgery if that does not below it. - Loud cries CT get fixed. - Straining e_ort Obstruction occurs - Kicking and first drawing the legs up towards Might lead to this the abdomen bursting which could cause peritonitis Vomiting (inflammation of the abdomen lining) Stomach contents are green or yellow. - Billius vomiting. BM and gas diminished. Currant jelly stools (blood and mucus) Disease: Meckel’s Diverticulum Patho Signs or Symptoms Dx Tx Nursing Pocket of intestine Painless bleeding from Ultrasound Surgically removed the rectum (bright red CT blood) Disease: Hernias Patho Signs or Symptoms Dx Tx Nursing Inguinal: protrusion of Mass in area Herniorrhaphy Change wet diapers part of the abdominal (surgery) often. contents through the May be irritable or inguinal canal in the constipated groin. Strangulated hernia Umbilical: protrusion - Vomiting, through the umbilical severe pain, ring liquid stool Disease: Gastroenteritis Patho Signs or Symptoms Dx Tx Nursing Acute inflammation of Identifying and Educate about the stomach eradicating cause prevention of viruses. - Colitis (colon) - Enterocolitis Restoring fluid and (colon and electrolyte imbalance small intestine) I&O After virus Weighing diaper Disease: Necrotizing Enterocolitis Patho Signs or Symptoms Dx Tx Nursing Acute inflammation of Abdominal distention the bowel which leads to necrosis. Bloody stools Diarrhea Bilious vomiting (bile) Disease: Gastroesophageal reflux disease Patho Signs or Symptoms Dx Tx Nursing Lower esophageal Vomitting Typically improve as Avoid over feeding. sphincter is relaxed or age not competent Weight loss Proper positioning allowing stomach Medication for severe while and after contents into the FTT - PPI feeding. esophagus - H2 Antagonist Less than 90 degrees Often seen in preterm for 30 minutes after infancy eating to prevent increased abdominal pressure. Disease: Appendicitis Patho Signs or Symptoms Dx Tx Nursing Inflammation of the McBurney’s Point Appendectomy Postop appendics tenderness. - Pain and discomfort Guarding - Tylenol - Might have a Rebound tenderness low-grade fever - Pain after after surgery. Complication removing the - Limit activity for - Rupture pressure on the a little while. site - Don’t submerge sites. 6 Disease: Thrush Patho Signs or Symptoms Dx Tx Nursing Infection of mucous White pateches in Antifungal application Mouth care membranes of the mouth (Nystatin) mouth Infection prevention Painless Might be from the mother of vaginal delivery. Disease: Worms Patho Signs or Symptoms Dx Tx Nursing Pinworms Anthelmintic Cover sandbox. (enterobiasis) medications are given. - Lays eggs Itching around the Scotch tape test. Soil education outside anus anus - Route of entry Wash produce. into the mouth Spread mainly through Round worms waste from other - Larvae animals. penetrate intestinal wall, Chronic cough without Trim nails (scratching) enter into the fever liver, heart, and Bathing with mitt. lungs. Complete full medications. Disease: Poisoning Patho Signs or Symptoms Dx Tx Nursing Lead poisoning Remove the poison. Drug poisoning antidote Prevent further - Acetaminophen absorption. and acetocytoline. Call the poison control center. Provide supportive care. Activated charcoal or decompression. Disease: Cleft Lip Do not go to bed with a Patho Signs or Symptoms Dx Tx bottle in the mouth. Nursing Fissure between the Surgery within first Getting proper lip to the nare year of life. nutrition Logans bow to prevent Educate on tension on the dehydration S/S incision. No pressure to the surgical incision Feeding by dropper until incision is healed Disease: Cleft palate Patho Signs or Symptoms Dx Tx Nursing Fissure from the palate Surgery Proper nutrition to the nares. Educate on (inside mouth) dehydration S/S If connected to nares Respiratory symptoms. Rinse with water after feeding. No pressure on incisions. Educate on feeding Disease: Otitis externa Patho Signs or Symptoms Dx Tx Nursing Outer ear infection Pain and tenderness AKA swimmers’ ear on manipulating the pinna or tragus. Prolonged exposure to moisture generally precipitating factor. Disease: Otitis media Patho Signs or Symptoms Dx Tx Nursing Inflammation of the Redding and bulging Antibiotics if that is the Prevention of middle ear. tympanic membrane. cause. respiratory infections - S/S Infection of the throat In pain, poor sleep. Ear drops - Use full can easily spread to treatment dose. the middle ear. Rubbing or pulling at Surgical the ear. - Myringotomy Complications Rolling the head from - Eardrums can side to side rupture Hearing loss Loud speech Inattentive behavior Articulation problems Speech and development problems Disease: Hearing impairment Patho Signs or Symptoms Dx Tx Nursing Routine newborn Hearing aids Eye level of child hearing screens Cochlear implant Face to face Lack of response of the infant to loud Establish eye contact. sounds or music. Talk in short The lack of a startle sentences. reflex in infants under 4 months of age is the Avoid using first sign. exaggerated face or lip movements. EYES Overview Disease: Dyslexia Patho Signs or Symptoms Dx Tx Nursing Di_iculty with IEP (individualized Early detection is key language skills in education plan) reading and writing. Tutoring Instruction Disease: Amblyopia (lazy eye) Patho Signs or Symptoms Dx Tx Nursing Weaker eye of visual Patch over the good acuity. eye to force the weaker one to get stronger. Disease: Strabismus (cross eye) Muscles I Strong Patho Signs or Symptoms Dx Tx Nursing Muscles of the eye Squinting Patching the stronger Reaching for objects eye. and missing Surgery Covering one eye to see Tilting the head to see Dizziness and head ache Disease: Conjunctivitis (pink eye) Patho Signs or Symptoms Dx Tx Nursing Inflammation of the Itching Antibiotics Eye hygiene conjunctiva or mucous - Inner to outer membrane that lines Tearing of one or both Drop instructions the eye. eye No contacts Could be caused from Drainage - Infection Warm or cool - Blocked Redness compress lacrimal duct Edema of the eyelid and periorbital tissue Child might be distracted or irritable. Disease: Hyphemia Patho Signs or Symptoms Dx Tx Nursing Blood is around the iris Symptom HOB elevated 30-45 management degrees Typically from a w trauma to the eye Insure there is not an Prevent increase in pressure ↑ ICP Disease: Retinoblastoma Patho Signs or Symptoms Dx Tx Nursing Tumor of the retina Yellow-white reflex on Laser therapy If enucleation occurs pupil exam. - Go after the there is no vision in Hereditary and blood vessels that eye. spontaneous onset. Poor vision of the tumor. Chemo Eye swelling or Radiation redness Enucleation surgery Post op care May have pain (removal of the eye) - Elbow restraint. - Observe bandage for bleeding - Monitor VS - Dressing removed and eye patch applied. - Eye prothesis is fitted once socket has healed. Nervous System Overview Patho Signs or Symptoms Dx Tx Nursing Acute non- Persistent vomiting Hx inflammatory · Clinical finding Pharmacology - Osmotic Was to decrease ICP - Elevate HOB encephalopathy and Fatigue Serum levels diuretic 45-30 degrees. hepatopathy that (hyperamniomnia) - Lasix’s - Natural follows a viral infection Diarrhea Blood tests, liver tests alignment to in children. Decompressive allow things to Change in mood or Spinal/lumbar craniotomy. flow. Brain and liver swelling ability. - puncture which can lead to - Impulsivity Fluid restriction Fluid restriction - damage - Violence ↑ ALT.AST Monitor liver function. Ammonia - Bleeding liver swelling accumulates in the PT 4 (coagulation) - Glucose blood. ↓ - Cerebral Ask ways to make manifestations metabolic acid child more brain swelling causing ALOC, comfortable, blanket, CyperAmniomonia) behavioral stu_ed animal, changes, support. irritability, seizures, coma Preventative education - No aspirin usage in children and salicylate contaminating things. meds Viral illness - xw/ salicylate  - Read medication labels before giving. Disease: Reyes Syndrome Disease: Sepsis Patho Signs or Symptoms Dx Tx Nursing Fever Monitor neuro function, VS, s/s of Chills shock Tachypnea Tachycardia Neurological symptoms Disease: Meningitis Patho Signs or Symptoms Dx Tx Nursing Inflammation of the Muchal rigidity (neck) Lumbar puncture Antibiotics (if Droplet isolation until meninges, bacteria bacterial) 24 hours of invade from the blood Petechiae appropriate antibiotics stream. have started. Opisthotonos in Causes… severe cases Neuro checks - Bacteria - Glasgow coma - Viral Kernig’s sign scale - Fungal Bruztinskis sign VS, I&O , IV fluids Quiet environment: decrease stimuli. Decrease ICP - Seizure precaution - Suction Assess appearance of fontanels Head circumference Monitor for IICP - Bulging fontinales Disease: Encephalitis Patho Signs or Symptoms Dx Tx Nursing Inflammation of the Headache followed by brain drowsiness Proceed to coma Convulsions are seen Fever Cramps, abdominal pain, vomiting, nuchal rigidity, delirium, muscle twitching, Disease: Seizure Disorders Patho Signs or SymptomsDx Tx Nursing Abnormal electrical CT Initially aimed at trying Priority is safety Auras (before stage) firing in the brain MRI to determine type, site, EEG or cause Seizure first aid Causes => Generalized - Remove any - Intracranial (both nem) Ketogenic Diet dangers. - Extracranial - High in fat, low - On side · sudden impair - Toxic in carb - Suction · Tonic-Clomic equipment. ↳ contract + Types - Nothing in the ↳ tense relax - Febrile mouth - Generalized: - Document the Tonic-clonic · Absence times. - Absence: Petit 2) breif LOC mal - Partial focai nemb · , Pharm Do not abruptly stop - Dilantin: Vit D seizure medication as & pilepsy-2 + Sep for intake, no milk, it can lead to status 24 H weird side epilepticus. ↳ family#x. Postical Phase e_ects with catter fatigued) dentition - Phenobarbital: Educate - Pool and water can be drowsey safety - Gabapentin: - Driving can be drowsey Disease: Cerebral Palsy (CP) Patho Signs or Symptoms Dx Tx Nursing Nonprogressive motor Vary with each Pharm (symptom Support growth and disorders caused by a individual. #X : physical based) - development as much - lesion in the various - Botulinum as possible. motor centers of the Feeding problems, Neuro development - Baclofen muscl relat developing bran. seizures not - Levodopa Adaptive coping associated with high - Gabapentin mechanisms Really e_ects fevers and - MiraLAX movement, balance, developmental delays. Work on strengths. and coordination PT Spasticity Speech Child as an active - Tension in member. certain muscle Skin care groups. Encourage mobility. PROM Athetosis - Involuntary. Orthopedic surgery Purposeless movements Assistive devices · Dystonia twisting : , repentative painful movements · Attestosiso · Chorea: Short movements Disease: Hydrocephalus Patho Signs or Symptoms Dx Tx Nursing Increase in CSF Increased BP Transillumination Shunt Frequent position changes Decrease HR Echoencephalography Reduce CSF Head support at all Decrease RR CT scan times High pitched cry MRI Measure head circumference. Unequal pupil size or Ventricular tap or response to light puncture The pump and how to Sunsetting eyes pump it. Bulging fontanels Signs of IICP if shunt is clogged. - Headache - Lethargy - Changes in LOC - High pitched cry Disease: Spina Bifida Occulta and Cystica Patho Signs or Symptoms Dx Tx Nursing surgery Types ↳ cath ↳ crutches/wheelchair Meningocele: spinal fluid Myelomenningocele: spinal nerves Occulta: No physical manifestation Cystica: Split Spina outside (sac of skin) 4 Myeomeningocelle : Spinal cords meninges meningocelle only meninges , bit h : hairdimple < occulta"hidden" Asymptomatic - > Spina bitida : cause-unknown (folate deficency) Disease: Down Syndrome Patho Signs or Symptoms Dx Tx Nursing Chromosomal Close set and upward Counseling abnormality of 21 slanting eyes Small head Empathy and Round face encouragement Flat nose Protruding tongue Involve in care Transverse palmar crease Wide space between 1 and 2 toes Borderline IQ level Congenital Heart deformities