Peds Hesi

The clinic nurse is reviewing the health care provider's prescription for a child who has been diagnosed with scabies. Lindane has been prescribed for the child. The nurse questions the prescription if which is noted in the child's record? 1. The child is 18 months old. 2. The child is being bottle-fed. 3. A sibling is using lindane for the treatment of scabies. 4. The child has a history of frequent respiratory infections.

1 Rationale: Lindane is a pediculicide product that may be prescribed to treat scabies. It is contraindicated for children younger than 2 years because they have more permeable skin, and high systemic absorption may occur, placing the children at risk for central nervous system toxicity and seizures. Lindane also is used with caution in children between the ages of 2 and 10 years. Siblings and other household members should be treated simultaneously. Options 2 and 4 are unrelated to the use of lindane. Lindane is not recommended for use by a breast-feeding woman because the medication is secreted into breast milk.

interventions

1. Admin blood transfusions - monitor for transfusion reactions. 2. Monitor for iron overload; -chelation therapy with deferasirox or deferoxamine may be prescribed to treat iron overload 3. If the child has had a splenectomy=report any signs of infection because of the risk of sepsis. 4. importance of receiving pneumococcal and meningococcal and annual influenza vaccine and the regularly scheduled vaccines. 5. Provide genetic counseling to parents.

Scabies is transmitted by

byclose personal contact with an infected person. Household members and contacts of an infected child need to be treated simultaneously

353. The nurse is providing home care instructions to the parents of a 10-year-old child with hemophilia. Which sport activity should the nurse suggest for this child? 1. Soccer 2. Basketball 3. Swimming 4. Field hockey

353. 3 Rationale: Hemophilia refers to a group of bleeding disorders resulting from a deficiency of specific coagulation proteins. Children with hemophilia need to avoid contact sports and to take precautions such as wearing elbow and knee pads and helmets with other sports. The safe activity for them is swimming.

The nurse is monitoring a child with burns during treatment for burn shock. Which assessment provides the most accurate guide to determine the adequacy of fluid resuscitation? 1. Skin turgor 2. Level of edema at burn site 3. Adequacy of capillary filling 4. Amount of fluid tolerated in 24 hours

3. think ABC -vital sign is a good indication

impetigo common sites

around face & mouth; then neck, hands & extremities being- vesicle or pustule then- vesicle ruptures leaving honey- colored crusts

1-3 year old is capable of what speech

capable of making a 3 word sentence

iron rich foods

Breads and cereals ▪ Dark green, leafy vegetables ▪ Dried fruits ▪ Egg yolks ▪ Iron-enriched infant formula and cereal ▪ Kidney beans ▪ Legumes ▪ Liver ▪ Meats ▪ Molasses ▪ Nuts ▪ Potatoes ▪ Prune juice ▪ Raisins ▪ Seeds ▪ Shellfish ▪ Tofu ▪ Whole grains

brain tumor is diagnosed by tx

MRI Therapeutic management includes surgery, radiation, and chemotherapy; the treatment of choice is total removal of the tumor without residual neurological damage.

A child with a bleeding disorder need to wear

MedicAlert bracelet

teaching on iron supplement administration

a. Give between meals for maximum absorption. b. Give with a multivitamin or fruit juice because vitamin C increases absorption. c. Do not give with milk or antacids because these items decrease absorption. d. quid iron should be taken through a straw- stain teach and brush after

Impetigo causes

contagious bacterial infection caused by β-hemolytic streptococci or staphylococci caused by: poor hygiene, break in skin, insect bite, or at a site w/ prior rash ex. atopic dermatitis or poison oak

Aplastic Anemia

deficiency in circulating erythrocytes- of all formed blood elements -cells don't develop in bone marrow causes: exposure to myelotoxic agents, virus/infection, autoimmune disorder, allergic states

why is scabies an endemic among schoolchildren

due to close personal contact

Hemophilia

group of bleeding disorders resulting from a deficiency of specific coagulation proteins= factor VIII or IX transmited by X-linked recessive

iron deficiency clinical manifestations

1. pallor 2. weakness & fatigue 3.Low hgb & Hct 4 mycrolytic or hypochromic rbcs

osteosarcoma clinical interventions

1. prepare of prosthetic fitting as necessary 2. instruct pt about potential phantom pain

hemophilia pt. teaching

1. signs of bleeding 2.how to control bleeding 3.avoidance of contact sports= protective devices while learning to walk 4.wear protective devices= helmets, knee & elbow pads

Integumentary Eczema (Atopic Dermatitis) description & tx Goal

1. superficial skin inflammation due: alergies, asthma, fam hx, allergic rhinitis 2.Goal tx: stop itching, lubricate the skin, and reduce inflammation -can led to secondary infection so what to prevent that

scabies teaching

1. tx frequent handwashing 2. wash clothing w/ hot water, hot dryer, & IRON 3. place non-washable toys in plastic bag for 4 days

von Willebrand's Disease interventions

1. tx similar to Hemophilis measures= Admin clotting factor 2. emotional support during episode

wilms tumor=2 main clinical signs and precautions

1. unilateral abd mass 2. HTN-secretion of excess renin -BP monitoring q4h & NO PALPATE abd = rupture and cause spread of tumor

Impetigo infection spread pt. teaching

1. wash hands thoroughly 2.don't share towels, linens, and dishes 3. comply w/ antibiotics= risk of strep traveling to nephrons= glomerulonephritis 4.all linens and clothing used by the child should be washed with detergent in hot water separately

Clinical manifestations wilms tumor

1.Abd mass- firm, non tender, unilateral, deep w/ flank pain 2. Urinary retention & hematuria= involves kidneys 3Anemia- hemorhage w/in humor 4.pallor, anorexia, lethargy- anemia 5. lung involvement symptoms= dyspnea, SoB, chest pain-w/ mestatsis

severely burned children are at risk for what physiological complications

1.Fluid & heat loss 2.dehydration 3.metabolic acidosis 4.cardiovascular complications= increased fluid to body mass

Theophylline normal range

10-20 mcg/mL

362. The nurse is monitoring a child for bleeding after surgery for removal of a brain tumor. The nurse checks the head dressing for the presence of blood and notes a colorless drainage on the back of the dressing. Which intervention should the nurse perform immediately? 1. Reinforce the dressing. 2. Notify the health care provider (HCP). 3. Document the findings and continue to monitor. 4. Circle the area of drainage and continue to monitor.

362. 2 Rationale: Colorless drainage on the dressing in a child after craniotomy indicates the presence of cerebrospinal fluid and should be reported to the HCP immediately. Options 1, 3, and 4 are not the immediate nursing intervention because they do not address the need for immediate intervention to prevent complications.

meperidine for pain in sickle cell children

meperidine for pain is avoided because of the risk of normeperidine-induced seizures.

Osteosarcoma (Osteogenic Sarcoma)

most common bone cancer in children -cancer usually in long bones -esp lower extremities-femur

rule of nine for child burn victim

not used in children due to difference in body proportions -burn is expressed in % of total body surface area-using age related charts

anterior fontanel opens and closes

open at 6mon & close at 18

Scabies

parasitic skin disorder- infection= sarcoptes scabiei due to: close personal contact; schools; daycare incubation= female mite burrows in skin, lays eggs, dies after 4-5 wks & eggs hatch in 3-5days infectious= during entire period

Hodgkin's disease characterized by what

presence of Reed-Sternberg cells noted in a lymph node biopsy specimen.

primary hodgkins treatment modalitties

radiation chemotherapy -can be used alone or in conjunction with

how should restraints be removed

remove one at a time & provide RoM exercise

hemophilia common tx

replace missing clotting factor

Thalassemia Major Results in

severe anemia requiring transfusion support to sustain life (also known as Cooley's anemia)

abnormal hgb causes what in blood stream?

sickle shape= rigid RBCs that clump and obstruct cap BF

iron supplement teaching SE

side effects of iron supplements (black stools, constipation, and foul aftertaste).

A child with an integumentary disorder needs to be monitored for signs of

skin infection or systemic infection

Burn victim priority is

stop the burning= smothering flames & not face then ABCs -keep child warm due to hypothermia risk

therapeutic managment of wilm's tumor

surgery= nephroctomy chemotherpay w/ or w/out radiation= depends on stage

tx for osteosarcoma

surgical resection of limb salavge- remove affected tissue, amputation, and chemo

Brain tumors

the most common brain tumor, is located in the posterior third of the brain (primarily in the cerebellum or brainstem) and accounts for the frequency of symptoms resulting from increased ICP.

Hodgkin's Disease

type of lymphoma: malignancy of lymph node mestastasizes to spleen, liver, bone marrow, lungs and mediastinum pk-incidence mid-adolescence

3 types of acute exacerbations

vaso-occlusive crisis, splenic sequestration, hyperhemolytic crisis, and aplastic crisis.

Impetigo Nursing interventions

1. CONTACT isolation- extremely contagious 2. asist w/ daily antibacterial soap bathing 3. Apply warm SALINE compless 2-3x daily to crusts= removal aids in healing 4. apply topical antibiotic w/ swap= infection communicable for 48h beyond antibiotic inititation -contagious w/ vesicles not crusted

von Willebrand's Disease clinical manifestations

1. Epistaxis 2. Gum bleeding 3. Easy bruising 4. Excessive menstrual bleeding

clinical manifestations of brain tumor

1. HA worse on awakening and improves during the day 2. Vomiting that is unrelated to feeding or eating 3. Ataxia-involuntary movement 4. Seizures 5. Behavioral changes 6. Clumsiness; awkward gait or difficulty walking 7. Diplopia 8. Facial weakness

clinical manifestations of hodgkins

1. painless -enlarged lymph nodes -Enlarged, firm, non-tender, movable nodes in supraclavicular area 2. mediastinal lymphadenopathy= non productive cough 3.abd pain- enlarged retroperitoneal nodes 4.lymph node involvment systemic symptoms= fever, anorexia, malaise, nause, wt. loss, night sweats, rash

The mother of a 3-year-old child arrives at a clinic and tells the nurse that the child has been scratching the skin continuously and has developed a rash. The nurse assesses the child and suspects the presence of scabies. The nurse bases this suspicion on which finding noted on assessment of the child's skin? 1. Fine grayish red lines 2. Purple-colored lesions 3. Thick, honey-colored crusts 4. Clusters of fluid-filled vesicles

1. Scabies appears as burrows or fine, grayish red, threadlike lines.

sickle cell interventions

1. Maintain hydration- IV access, electrolyte replacement-pain can't be controlled without 2.admin Oxygen & blood transfussions 3. Admin painmeds-around the clock 4.Assit w/ comf position- elevate head no more than 30 degrees- avoid putting strain on joints -keep extremities extended= promote venous return 5. encourage high calorie protein w/ folic acid sup 6.admin antibiotics as prescribed to prevent infection

interventions for hemophilia

1. Monitor for bleeding 2. Admin Factor VIII 3.Admin vasopressin= DDAVP= increases plasma factor VIII 4. Assess for Neuro- risk for intracranial hemorrhage 5.Monitor for joint pain & immobilize if present 6. Monitor for joint bleeding= immobilize, elevate, apply ice, and apply pressure for 15min for superficial bleeding 7. monitor hematuria

aplastic anemia manifestations

1. Pancytopenia (deficiency of erythrocytes, leukocytes, and thrombocytes)= low wbc, rbcs, and platelets 2. Petechiae, purpura, bleeding, pallor, weakness, tachycardia, and fatigue

aplastic anemia interventions

1. Prepare the child for bone marrow transplantation if planned. 2. Administer immunosuppressive medications as prescribed; anti-lymphocyte globulin or antithymocyte globulin may be prescribed to suppress the autoimmune response. 3. Colony-stimulating factors may be prescribed to enhance bone marrow production. 4. Corticosteroids and cyclosporine may be prescribed. 5. Administer blood transfusions if prescribed and monitor for transfusion reactions.

Eczema (Atopic Dermatitis) clinical manifestations

1. Redness 2. Scaliness 3. Itching 4. Minute papules (firm, elevated, circumscribed lesions < 1 cm in diameter) and vesicles (similar to papules, but fluid-filled) 5. Weeping, oozing, and crusting of lesions 6. Adolescent and early adult forms: Commonly occur in antecubital and popliteal areas

hemophilia clinical manifestations

1. abnormal bleeding after trauma or surgery 2.epistaxis 3. joint bleeding= pain, tenderness, swelling, and limited ROM 4. tendency to bruise easily 5. CBC: trombocytopenia= decreased clotting

Lice interventions

1. all contacts of infested child should be checked & treated 2. Use a pediculicide product 3. daily removal of nits w/ extra-fine-tooth comb after pediculicide product-gloves; discard com or brushes or soak in boiling water for 10min or lice killing product for 1h

scabies interventions

1. apply topical scabicide=kills mites 2. Lindane shampoo- don't use in children <2yr=seizures/neurotoxicity

interventions

1. avoid skin irritants= soaps, detergents, fabric softners , diaper wides, powder 2. avoid excessive bathing: LUBRICATE right after tepid bath 3.Apply cool, wet compress to soothe skin & alleviate itching 3. Admin antihistamines for itching & topical corticosteroids 4. prevent scratching; sock over hand can help 5. monitor skin for signs of infection= honey crusted lesions

Lice teaching

1. bedding & clothing used should be changed daily, laundered in hot water with detergent, and dried in a hot dryer for 20 minutes; this process should continue for 1 week. 2. Instruct parents that nonessential bedding and clothing can be stored in a tightly sealed plastic bag for 2 weeks and then washed. 3. Instruct parents to seal toys that cannot be washed or dry-cleaned in a plastic bag for 2 weeks. 4. furniture and carpets need to be vacuumed frequently & that the dust bag from the vacuum should be discarded after vacuuming. 8. Teach the child not to share clothing, headwear, brushes, and combs.

Hodgkin's disease interventions

1. early stage- external radiation of lymph node involved 2. extensive disease= radiation & multidrug therapy 3. monitor for medical induces- panocytopenia= infection, anemia, and bleeding risk 4protect child from infection 5. monitor for AE of chemo-malaise is big one

factors that trigger sickle cell acute exacerbation

1. fever or infection 2.dehydration 3.high altitudes=low 02 4.emotional & physical stress

Leukemia Clinical Manifestations

1. fever-infection-neutropenia 2. fatigue & anorexia 3. pallor - low rbc 4. bleeding/ petechiae- thrombocytopenia 5. Bone/ joint pain- proliferation of malignant cells PT: can also have CNS involvement (lumbar puncture); bone aspiration= yellow, hepatosplenomegaly-removing bad cells; lymphadenopathy- infiltrates

what is necessary in the first 24h period after burn injury

1. fluid replacement- due to fluid shift that occur due to damaged tissue- cry -colloid solutions are used too-initial stage- to aid in maintaining plasma volume

β-Thalassemia Major clinical manifestations

1. frontal bossing 2. green yellow skin tone 3.maxillary prominence 4. wide-set eyes w/flattened nose 5. Hepatosplenomegaly 6. Severe anemia 7. Microcytic, hypochromic red blood cells

sickle cell care is focused on

1. hydration 2.adequate oxygenation 3 pain mangament/analgesics 4. bed rest

main 2 tx for aplastic anemia

1. immunosupressive therapy & bone marrow transplantation(tx of choice) 2.if caused by medication= stop administration

interventions of iron deficiency anemia

1. increase oral intake of iron: iron fortified formula for infant 2. admin iron supplements 3.IM injections w/ z-track

Leukemia main pt teaching and complications

1. infection risk-immunocompromised -teach hand hygiene, immunizations (none live/MMR), avoid public transport 2. bleeding risk- educated on signs of bleeding & bleeding percautions, blood transfussion may be needed with extreme blood loss 3.Nutrition- well balanced, small frequent meals-no oral irritating, 4. Rest : adequate sleep and rest periods

osteosarcoma clinical manifestations

1. local pain at affected site-severe of dull -pt may complain of growing pains -pain often relieved by flexion 2.palpable mass 3.limping of wt bearing limb 4.inability to hold heavy objects 5.pathologic fractures at site

β-Thalassemia Major tx goal

1. maintain normal hgb- via blood transfusions 2. bone marrow transplant can be used 3. splenectomy= if multiple transfusion are required

sickle cell crisis teaching

1. measures to prevent crisis 2. vaccines to prevent infection= crisis

leukemia labs

1. normal or elevated wbcs 2. low hct & hgb 3.decreased platelet

347. The school nurse has provided an instructional session about impetigo to parents of the children attending the school. Which statement, if made by a parent, indicates a need for further in struction? 1. "It is extremely contagious." 2. "It is most common in humid weather." 3. "Lesions most often are located on the arms and chest." 4. "It might show up in an area of broken skin, such as an insect bite."

3 Rationale: Impetigo is a contagious bacterial infection of the skin caused by β-hemolytic streptococci or staphylococci, or both. Impetigo is most common during hot, humid summer months. Impetigo may begin in an area of broken skin, such as an insect bite or atopic dermatitis. Impetigo is extremely contagious. Lesions usually are located around the mouth and nose, but may be present on the hands and extremities. Test-Taking Strategy: Note the strategic words, need for further instruction. These words indicate a negative event query and ask you to select an option that is an incorrect statement. Think about the pathophysiology associated with impetigo. Knowledge regarding the cause and manifestations of impetigo will direct you to the correct option.

349. A topical corticosteroid is prescribed by the health care provider for a child with atopic dermatitis (eczema). Which instruction should the nurse give the parent about applying the cream? 1. Apply the cream over the entire body. 2. Applya thick layer ofcream to affected areas only. 3. Avoid cleansing the area before application of the cream. 4. Apply a thin layer of cream and rub it into the area thoroughly.

349. 4 Rationale: Atopic dermatitis is a superficial inflammatory process involving primarily the epidermis. A topical corticosteroid may be prescribed and should be applied sparingly (thin layer) and rubbed into the area thoroughly. The affected area should be cleaned gently before application. A topical corticosteroid

352. The nurse analyzes the laboratory results of a child with hemophilia. The nurse understands that which result will most likely be abnormal in this child? 1. Platelet count 2. Hematocrit level 3. Hemoglobin level 4. Partial thromboplastin time

352. 4 Rationale: Hemophilia refers to a group of bleeding disorders resulting from a deficiency of specific coagulation proteins. Results of tests that measure platelet function are normal; results of tests that measure clotting factor function may be abnormal. Abnormal laboratory results in hemophilia indicate a prolonged partial thromboplastin time. The platelet count, hemoglobin level, and hematocrit level are normal in hemophilia. Test-Taking Strategy: Focus on the subject, laboratory tests used to monitor hemophilia, and note the strategic words, most likely. Recalling the pathophysiology associated with this disorder and recalling that it results from a deficiency of specific coagulation proteins will direct you to the correct option. Review: Laboratory tests used to monitor h emophilia

354. The nursing student is presenting a clinical conference and discusses the cause of β-thalassemia. The nursing student informs the group that a child at greatest risk of developing this disorder is which of these? 1. A child of Mexican descent 2. A child of Mediterranean descent 3. A child whose intake of iron is extremely poor 4. A breast-fed child of a mother with chronic anemia

354. 2 Rationale: β-Thalassemia is an autosomal recessive disorder characterized by the reduced production of 1 of the globin chains in the synthesis of hemoglobin (both parents must be carriers to produce a child with β-thalassemia major). This disorder is found primarily in individuals of Mediterranean descent. Options 1, 3, and 4 are incorrect.

355. A child with β-thalassemia is receiving long-term blood transfusion therapy for the treatment of the disorder. Chelation therapy is prescribed as a result of too much iron from the transfusions. Which medication should the nurse anticipate to be prescribed? 1. Fragmin 2. Meropenem 3. Metoprolol 4. Deferoxamine

355. 4 Rationale: β-Thalassemia is an autosomal recessive disorder characterized by the reduced production of 1 of the globin chains in the synthesis of hemoglobin (both parents must be carriers to produce a child with β-thalassemia major). The major complication of long-term transfusion therapy is hemosiderosis. To prevent organ damage from too much iron, chelation therapy with either Exjade or deferoxamine may be prescribed. Deferoxamine is classified as an antidote for acute iron toxicity. Fragmin is an anticoagulant used as prophylaxis for postoperative deep vein thrombosis.Meropenem is an antibiotic. Metoprolol is a beta blocker used to treat hypertension.

356. The clinic nurse instructs parents of a child with sickle cell anemia about the precipitating factors related to sickle cell crisis. Which, if identified by the parents as a precipitating factor, indicates the need for further instruction? 1. Stress 2. Trauma 3. Infection 4. Fluid overload

356. 4 Rationale: Sickle cell crises are acute exacerbations of the disease, which vary considerably in severity and frequency; these include vaso-occlusive crisis, splenic sequestration, hyperhemolytic crisis, and aplastic crisis. Sickle cell crisis may be precipitated by infection, dehydration, hypoxia, trauma, or physical or emotional stress. The mother of a child with sickle cell disease should encourage fluid intake of 1½ to 2 times the daily requirement to prevent dehydration.

357. A 10-year-old child with hemophilia A has slipped on the ice and bumped his knee. The nurse should prepare to administer which prescription? 1. Injection of factor X 2. Intravenous infusion of iron 3. Intravenous infusion of factor VIII 4. Intramuscular injection of iron using the Z-track method

357. 3 Rationa le: Hemophilia refers to a group of bleeding disorders resulting from a deficiency of specific coagulation proteins. The primary treatment is replacement of the missing clotting factor; additional medications, such as agents to relieve pain, may be prescribed depending on the source of bleeding from the disorder. A child with hemophilia A is at risk for joint bleeding after a fall. Factor VIII would be prescribed intravenously to replace the missing clotting factor and minimize the bleeding. Factor X and iron are not used to treat children with hemophilia A.

361. The nurse is conducting staff in-service training on von Willebrand's disease. Which should the nurse include as characteristics of von Willebrand's disease? Select all that apply. 1. Easy bruising occurs. 2. Gum bleeding occurs. 3. It is a hereditary bleeding disorder. 4. Treatment and care are similar to that for hemophilia. 5. It is characterized by extremely high creatinine levels. 6. The disorder causes platelets to adhere to damaged endothelium.

361. 1, 2, 3, 4, 6 Rationale: von Willebrand's disease is a hereditary bleeding disorder characterized by a deficiency of or a defect in a protein termed von Willebrand factor. The disorder causes platelets to adhere to damaged endothelium. It is characterized by an increased tendency to bleed from mucous membranes. Assessment findings include epistaxis, gum bleeding, easy bruising, and excessive menstrual bleeding. An elevated creatinine level is not associated with this disorder.

363. A child undergoes surgical removal of a brain tumor. During the postoperative period, the nurse notes that the child is restless, the pulse rate is elevated, and the blood pressure has decreased significantly from the baseline value. The nurse suspects that the child is in shock.Which is the most appropriate nursing action? 1. Place the child in a supine position. 2. Notify the health care provider (HCP). 3. Place the child in Trendelenburg position. 4. Increase the flow rate of the intravenous fluids.

363. 2 Rationa le: In the event of shock, the HCP is notified immediately before the nurse changes the child's position or increases intravenous fluids. After craniotomy, a child is never placed in the supine or Trendelenburg position because it increases intracranial pressure (ICP) and the risk of bleeding. The head of the bed should be elevated. Increasing intravenous fluids can cause an increase in ICP.

346. Permethrin is prescribed for a child with a diagnosis of scabies. The nurse should give which instruction to the parents regarding the use of this treatment? 1. Apply the lotion to areas of the rash only. 2. Apply the lotion and leave it on for 6 hours. 3. Avoid putting clothes on the child over the lotion. 4. Apply the lotion to cool, dry skin at least 30 minutes after bathing.

4. Rationale: Permethrin is massaged thoroughly and gently into all skin surfaces (not just the areas that have the rash) from the head to the soles of the feet. Care should be taken to avoid contact with the eyes. The lotion should not be applied until at least 30 minutes after bathing and should be applied only to cool, dry skin. The lotion should be kept on for 8 to 14 hours, and then the child should be given a bath. The child should be clothed during the 8 to 14 hours of treatment contact time.

β-Thalassemia Major

autosomal recessive disease= both parents are carriers = abnormal hgb is produced

MMR is given between

between 12-15mon

definitive diagnosis of aplastic anemia is by

bone marrow aspiration- will be yellow & shows conversion of red bone marrow to fatty

hemodynamics Sickle Cell Anemia patho, testing

group of diseases -Hgb replace w/ ABNORMAL HGB -inherited screening= sickle-turbidity test (sickledex)=finger stick=results w/in 3min -if positive= electrophoresis-distinguish if carrier or have DISEASE

von Willebrand's Disease

hereditary bleeding disorder deficiency of or a defect in a protein termed von Willebrand factor. - causes platelets to adhere to damaged endothelium = increased tendency to bleed from mucous membranes

Wilm's Tumor Interventions pre & post OP

immediate surgery is needed 1. Monitor BP 2.No palpation abd; Do Not Palpate Abdomen 3. measure abd girth 1. Temp & BP-monitor 2.Signs of infection & hemorrh 3.strict I & O 4. assess bowel signs-risk of intestinal obstruction, abd distention;

Pediculosis Capitis (Lice)

infestation of the hair and scalp with lice= transmission direct or indirect via brush, hats, towels, and bedding common locations: occipital, behind ears, and nape of the neck incubation= 7-10 days

Nephroblastoma (Wilms' Tumor) peak incidence age

intrabdominal & kidney tumor-unilateral, bilateral- can metastasize to other organs 3yr

Iron Deficiency Anemia patho and common causes

iron stores are depleted= decreased supply of iron for production of HgB in Rbcs -blood loss, inadequate diet intake, Gi malabsorption, and increased metabolic needs

Oncology Leukemia

malignant increase in WBC/leukocytes in bone marrow -cause anemia due to bone marrow malfunction -neutropenia-infection -thrombocytopenia-bleeding -anemia (low erythrocytes)