Peds ch 72

Celiac disease Symptoms-

fatty stools, failure to thrive, appear undernourished, and they have anorexia

Celiac disease treatment

gluten free products for life

Hydrocephalus- - Infant signs and symptoms-

increased head circumference, pressure changes in the brain, irritability, very high pitched cry, sunset eyes

Cataracts-

infants- occurs due to congenital or due to eye disease

cleft palate-

treated with surgery palatosty a graphed is placed where the deformity is. With cleft palate feeding is an issue as well as speech defects also irregular tooth eruption. Feeding is with a special nipple or septo syringe. Small frequent feeding, burp frequently, give a small amount of water last to get any formula out of the area, clean the mouth after each feeding. If taking solids- dilute them

Tonsillitis Diagnosis-

visualization, throat cultures that are performed to determine the cause

Chronic lymphoid leukemia (CLL)-

(Very rare in children) Heredity, difficult to know what causes

Tetralogy of Fallot: There are four defects with the heart.

- 1st: Stenosis (Narrowing) of pulmonary artery - 2d: Hypotrophy (Getting bigger) of the right ventricle - 3rd: Dextra postion (On the right side) of the aorta. Blood from both ventricles enter aorta - 4th: VSD

- Anemia: -Improtant thing to remember for an infant S/S: Diagnosis: Treatment: Parent teaching about

- Anemia: Iron stores are depleted. Results in the reduction and decrease in the size of RBCs o Could be cause by a decrease in the amount of hemoglobin o Although iron causes constipation in infants Iron rich formula is important o S/S: Pallor (Pale), Anorexia due to fatigue, "milk babies", may have a heart murmur o Diagnosis: Made with a CBC and iron testing o Treatment: Oral iron given through a straw (can stain teeth even if they haven't developed and given between meals for better absorption) o Can give inferno IM (Iron injection) Use Z track method o Parent teaching about diet sources o Let parent know that childs stool will be a tarry green o Keep iron out of reach of children because toxic if too much

- Asthma: o S/S: o Treatment:

- Asthma: Reactive air way disease. Most common chronic illness of children. Reversible disease (Symptoms not disease) Commonly caused by physical and chemical irritants in the environment. Ex: Animals, dust, pollen, food, temp changes, stress, activities o S/S: Dsynpnea, hacking productive cough, wheezing, restlessness o Treatment: Bronchodilators (Albuterol- Short acting, Atrovent aka ipratropiumbromide- Longer acting) Corticosteroids- Used for management, Cinglair- mat. Avoid giving oxygen Know symptoms of attacks. Decrease triggers (Pets, dust)

- Bronchiolitis: o Diagnosis: o S/S:

- Bronchiolitis: Inflammation of the bronchial tube (Small airways). Characterized by edema and causes restriction of the air passage. Has thick mucus accumulation that is difficult to couch up. o Diagnosis: Chest X-ray o S/S: Start off like a common cold. Increased resp distress, tachypnea (60-80 resps/min) Wheezing, sternal retractions, nasal flattering, grunting, harsh cough

- Colic: o Treatment:

- Colic: Praoxysmal abdominal pain that occurs during the first 3 months of life. Usually goes away after 4 moths. Symptoms are usually worse at night o Treatment: Decrease the amount of air that the child swallows, slow feeding, rocking, cuddling child close, mylocon drops (gas drops) can be given sometimes, caregiver join support groups

- Diarrhea: o Treatment: o NI:

- Diarrhea: Sudden increase of loose and watery stool. Caused by: Stress, prolonged temp elevation, spoiled foods, some antibiotics, most common cause though is pathogens in the GI tract. Big concern in babies and children. Not so much in adults. Due to them being more water o Treatment: Oral rehydration, clear liquids with sugar or caffeine should be avoided, avoid salty broths, in severe causes the child may become lethargic and irritable, poor skin turgor, mucous membranes will be dry, no tears, eyes and interior fontanels are sunken, urination is decreased, pulse weak and rapid. Must replace water loss so IV fluids are typically used o NI: Maintain I/O records, clear fluids and juices are inadequate, reintroduce foods as soon as possible, good skin care, expose child but to air as much as possible

- Epiglottitis: o S/S: o Treatment/ NI : o Medications

- Epiglottitis: Air ways become narrow which can lead to total obstruction of the airway. Bacterial. Most often caused by hyemephilus infuzena B. Mostly seen it kids age 2-6 years o S/S: Very acute (Abrupt), fever, sore throat. NO cough. Anxiety. Drooling o Treatment/ NI : Be calm. Do not examine the throat unless you have intubation equipment available, a tongue depressor or anything used to examine the throat can be life threatening. Can cause a spasm of the epiglottis which can cause complete airway obstruction o Medications include antibiotics, corticosteroids, IV fluids

- Hernia:

- Hernia: Protrusion of part of an organ in a place that it shouldn't be o

- Idiopathic thrombocytopenic purpura: - Cause is known - S/S: - Treatment: -

- Idiopathic thrombocytopenic purpura: Common bleeding disorder in children (Age 3-7) - Cause is known - S/S: East bruising, petechiae, epistaxis (Nose bleeds), GI or bladder bleeding. Appear suddenly - Treatment: Observation, bed rest, avoid injuries, avoid invasive procedures unless necessary in severe cases gamma globulin meds

- Intussusception: - S/S: - Diagnosis: - Treatment:

- Intussusception: When there is telescoping of one portion of the intestines into another portion just below it. Considered a medical emergency. - S/S: Colicky abdominal pain (comes and goes) vomiting occurs bile stained, currant (Bloody) (mucous) jelly stools, very high temps (106) - Diagnosis: Sausage shaped mass may be felt in the abdominal region upon manual examine - Treatment: Surgery (small cut in intestines an fix, barium enema (Given under pressure and pushes it back into place

- Lactose intolerance: frequent attacks of diarrhea due to inability to metabolize lactose in milk and milk products. Persons body improperly absorbs and metabolizes dairy products and also interferes with the absorption of other foods when those substances are present o S/S: Diarrhea, abdominal pain, vomiting, o Can give yogurt. It has an inactive lactase that is activated by the temp and PH of the duodenum. Good source of calcium

- Lactose intolerance: frequent attacks of diarrhea due to inability to metabolize lactose in milk and milk products. Persons body improperly absorbs and metabolizes dairy products and also interferes with the absorption of other foods when those substances are present o S/S: Diarrhea, abdominal pain, vomiting, o Can give yogurt. It has an inactive lactase that is activated by the temp and PH of the duodenum. Good source of calcium

- Meckel's diverticulum: o S/S: o Diagnosis: o Treatment: o Prognosis:

- Meckel's diverticulum: Congenital disorder. Where a small section of the ilium ends in a blind pouch, just prior to the colon junction o S/S: Bloody, tarry stools when inflammation is present o Diagnosis: Nuclear scan and symptoms o Treatment: Surgical repair o Prognosis: Good

- Megacolon: o S/S: o Diagnosis: o Preop: o Postop: o Prognosis:

- Megacolon: Known as hirschsprung. Childs colon lacks the parasympathetic nerve supply. Because of this they can't poop. o S/S: diarrhea that turns into constipation, nausea vomiting, affects appear shortly after birth when the new born fails to pass myconima (24-48hrs), feeding problems, failure to thrive, dehydration o Diagnosis: Medical history, X-ray studies, palpation of the distended abdomen o Preop: Saline enema to clean the bowl out o Postop: No rectal temp, look for blood in stools o Prognosis: Good. Surgery is delayed up to year if they can. Better surgery outcome

Sickle cell anemia:

- Often heredity. - There are not enough healthy red blood cells to carry adequate oxygen throughout the body. Don't usually see until 6 months of age.

- Pneumonia: o S/S:

- Pneumonia: Inflammation of the alveoli (Air sacs) Can be unilateral or bilateral. Can also affect one of several lobes. Can be primary (Initial illness) or secondary (Complication of another illness like URI). Causes can be bacterial or viral. May also be from aspiration o S/S: Bacterial (Productive cough, temp, resp distress, accessory muscle use) Viral (Nonproductive cough, increased resp rate, crackles, rhonchi Young children may complain of abdominal pain from belly breathing.) Aspiration (Nonproductive couch, fever, increased resp rate, wheezes, crackles)

- Pyloric stenosis: o S/S: o Diagnosis: o Treatment: o Preopt: o Postop: o Prognosis:

- Pyloric stenosis: Hypertrophy (Narrowing) Of the muscles of the pylorus. Food does not empty completely into the duodenum, is possible that it is an inherited disorder o S/S: Vomiting- Mild at first then turns into projectile vomiting. No bile in vomit. Fussy because they are hungry. Not absorbing nutrients, dehydration. Common in first born males. Olive shaped mast in right upper quad where the pylorus is located. Visible paralysis, decrease in stools. Abdominal distension. No weight gain/ weight loss, may develop metabolic alkalosis o Diagnosis: Made with an ultrasound. Noninvasive o Treatment: Pyloromyotomy- make the hole bigger. Cut in the hypopyloric muscle to make hole bigger o Preopt: Strict I/O, daily weight, monitor for dehydration (Look for sunken fontanels) decrease the handling of the baby. o Postop: daily weights, strict I/O, provide small oral feeding 4-6 hours after surgery. Clear fluids gradually advance to formula o Prognosis: Very good with surgery

Sickle cell crisis: - treatment

- Sever painful episode of sickle cell anemia in which the clumping of red blood cells causes occlusions in the blood vessels. With blood vessel occlusions. - No widely available cure. However treatment is available to help relieve symptoms and treat complications such as pain and strokes

Guidelines for abuse

-Believe the child- You must assume that he/she is telling the truth until proven otherwise. Remind the child that you will have to talk about it to others for medical reasons and their protection -Observe the child's reactions- Many times the abused child will draw away when touched or avoid any interaction with others. They may also try to protect the abuser by making excuses for the incident. -Document observations- Making sure that list every detail. Measure all areas of injuries. -Teach the child- Let them know that this treatment is not something that he/she deserves

Contact Precautions:

-Direct contact with infectious agent patient should be placed in private room, transportation limited. ---Use good hand washing and gloves along with a gown

Neglect:

-Emotional neglect- When child is deprived of affection or attention from caregivers or the child is called names or that they are stupid. These children often show self-destructive behaviors or may be withdrawn -Physical neglect: When the child does not receive medical care or food and water. These children tend to appear unclean or malnourished

-Kawasaki disease: -S/S: Diagnosis: Treatment:

-Kawasaki disease: Mucocutenous lympnode syndrome is a feveral multisystem disorder. Inflmation of the blood vessels and platelets become caught in the vessels -S/S: Fever for great than 5 days, red and infected eyes, strawberry tongue, cracked dry lips , edema of hands and feet, swollen lymp nodes. Elevated ESR (Labs) Diagnosis: Based on an HMP and lab work Treatment: Gamma globulin meds and then treat symptoms

MMR:

-Measles, Mumps, Rubella (MMR):

Droplet Precautions:

-Moister droplets that connect with humans through close respiratory to mucus membrane contact. Wear a mask within 3ft of patient, gloves, gown and face shield

Immunizations:

-Provide temp or permeant protection against certain diseases. They begin shortly after child's birth and should be continued on a regular schedule

Airborne Precautions:

-Should be placed in a probate negative measure room and a N95 mask -For respiratory routes

Nursing Considerations for Parasitic Care:

-Teach good personal hygiene. Treat all family members simultaneously. -Teach client or caretaker to avoid food preparation during treatment. -Discuss careful washing and cleaning of all household items and clothing when teaching about treating for lice. -Avoid inhaling the fumes of lindane (chemical used to treat lice or scabies). -Avoid applying parasitic lotions to open lesions, a rash, the face, eyes, mucous membranes, or urethral meatus. -Observe and monitor for side effects: Dry skin, numbness, tingling, seizures (Rare)

number one cause of death

Accident

- Upper respiratory infection: (URI)

Acute inflammation of the upper resp tract. Also known as common cold. Infants- Blockage of airway can interfere with feeds.

Tonsillitis Treatment-

antibiotics, fluids, and rest. Tylenol is used for pain or fever. For repeated infections the child may have tonsillectomy performed

Detect child abuse:

Adults with a history of a decency on others, adults who have suffered from abuse or neglect or rejection in their past, young or immature caregivers

- Laryngotracheobronchitis: o Treatment: o Medications:

Also known as croup. Inflammation of the larynx, trachea, and bronichi. Typically seen in kids 6 months to 5 years. Typically occurs at night. Hoarse voice, harsh couch (Seal braking). May have a fever. Not usually resp distress unless they have strider with it. o Treatment: Mild cause treat at home. Steam, wrap baby up and take them outside in the cold. Push fluids. Hospital monitor for increased symptoms of distress. Give humidified oxygen. If child is in a mist tent there should not be an objects in the tent that might cause a spark (Wind up toys, synthetic material) o Medications: Cough syrups to lose up thick secretions. Antibiotics are given especially if it is bacterial. Bronodilators used to smooth muscles and relieve striped. Corticoid steroids decrease inflammation. If severe racemicepinepher via nebs are used (Race epi)

Epistaxis Treatment-

apply pressure or cold compresses across the bridge of the nose for 5-10 min

signs that may be exhibited in a school aged child that is being abused:

Behavioral problems, law breaking, lying about an injury. In young children injuries at various stages of healing especially an injury that could not have happened at the same time. Attempts to stay away from home. Attempts to hide scars with clothing, fear of being touched.

CHF: - S/S: - Treatment: - Meds:

CHF: If they have any heart condition the can develop this. It is not a disease, but a symptom caused by an underlying heart condition. - When the heart fails to meet the demands of the body - S/S: Tachycardia (160+ at rest), Tachypnea (60 + and usually at night), Dyspnea, difficultly with feeding (Too hard they get tired), periorbital edema - Treatment: Decrease the work load of the heart, improve oxygenation, maintain nutrition - Meds: o Digitals- Dynotion and lannotxin. Strengthens and slows the heart. Check the pulse for one full min before givinLasixis: Diuretic. Can cause fluid and eletrocyle imbalances. Watch I&O and weight and labs

Peds Trauma:

Can include falling, choking, drowned, poisoning, burns

Poisoning:

Can occur from the ingestion of medications, food, or cleaning materials found in the home. In some cases, gastric lavas may be performed in which case you may be responsible for helping with. Not done as much not because of electrolyte imbalance. Typically given charcoal now. Depending on what the child ingested you may be suctioning, applying oxygen, resuscitating, or blood sampling. Monitor for change in level of consciousness and dizziness, nausea and vomiting, extreme drowsiness or extreme excitement.

Suffocation-

Can result in the aspiration of a foreign object or something with a pillow or a plastic bag. Infant suffocation can occur to a upper respiratory infection in which they are unable to cough up the mucus, plugging the bronchi. Another form of suffocation that can occur in young children in one in which they become trapped in refrigerators or freezers that are thrown away.

Chronic myeloid leukemia (CML):

Cause related to an abnormal chromosome. Known as the Philadelphia chromosome

Flat affect:

Child shows no emotional expression when an external stimulation is applied

Coarctation (Tighten) of the aorta: - S/S: - Treatment: - Prognosis:

Coarctation (Tighten) of the aorta: Narrowing of the aorta. Could be any part of the aorta - S/S: Typically not seen until late childhood then you see pounding pulses in upper extremities with weak pulses and cool lower extremities. Hypertension is also noted, CHF symptoms may also be noted - Treatment: Heart surgery in which the narrow area is removed and anastomosis (bringing two things together) is performed. Graphs can be used if the area is very large in which case surgery is not performed until the child is between 3-6 years. This is because the graph does not grow with the person - Prognosis: Good if no other defects are present

- Hydrocephalus- -

fluid in the head- imbalance of absorption and production of CSF.

Fractures:

Common among children because the receive more accidently blows and injuries than adults do. Most common fracture seen in children involve the radius, ulnar, clavicle, tibia, femur. Treatment: Casts and traction. Any child that has a cast or traction you need to watch skin color, Sensitivity, temperature, motion, distal pulse

ASD: - S/S: - Treatment: - Prognosis is

Common congenital anomaly with this the shunt between the right and left atria remains open - The blood that is oxygenated is forced back from the left atrium to the right atrium and the lungs - S/S: cyanosis if child has CHF as well - Treatment: Open heart or patching the area with synthetic material during a cardiac cath - Prognosis is typically good

Streptococcal infections:

Common in those greater than 2. S/S White patches on tonsils, Sore throat, Fever, feeling malice. Treatment: Antibiotics, fluid rest, strep test

Gastrointestinal (GI) tract:

Common parasites invade the human GI tract

Failure to thrive:

Considered inadequate physical growth can involve only weight, but may also include height. Developmental include retarded motor development or delayed language development. Children tend to be withdrawn and do not relate to their environment nor do they tend to cry. Children with FTT had what is known as a flat affect. Which means they show no emotional expression when an external stimulation is applied. May be physical causes for FTT. Most often occurs due to psycho social situation. Most commonly it is due to a child and parent relationship. Another cause could be health beliefs in which the family has certain dietary restrictions that prevent the child from receiving adequate nutrition. Their appearance is one in which there is a loss of subcutaneous fat, muscle wasting and skin break down, tend to have a pot belly spinally legs and arms. Often hospitalized for about two weeks and fed at least every 2-3 hours with daily weights obtained.

Transmission based isolation include

Contact, airborn, droplet

Respiratory syncytial virus (RSV):

Extremely commonly virus. Affects upper resp tract, lungs and bronchioles. Spread by kissing or touching a contained object. S/S runny nose, fever, sneezing, cough. Symptoms show up 4-6 days after exposure. Can remain infectious for up to 3 weeks.

Hep B:

First immunization that is received by infants. Given to new borns prior to hospital discharge only if the mother is hep B surface antigen negative

Meningococcal:

For meningitis. Given in 2 doses 1st 11-12 years with a booster around the age of 16 years

Toxoplasmosis:

From the gondii. People get it from kitty litter or soil

Scarlet fever:

Generalized redness or flushed appearance tongue becomes coated with white patches which leaves papillae. Looks like a strawberry. Syms show up about 1-7 day after incubation period. **Treatment include bed rest until s/s resolve, anitbiotics, fluids

Measles-

Highly contagious difficult to recognize. S/S fever, runny nose, cough (Common cold s/s) followed by a rash all over the body.

SIDS:

Is a sudden unexplained death of a healthy infant. Occurs while the infant is asleep and affects infants 1 month- 1 year of age. Diagnosis can be made following an autopsy forensic and review of history. Causes are generally unknown has been linked to infants being placed in the prone position to sleep. Another theory suggests that there is an abnormality in the brain stem functioning which results in faulty respirations

Plumbism:

Lead poisoning. Results in the ingestion of leaded material. Ex- paint.

Rotavirus:

Leading cause of gastronitis among children worldwide. Given orally in a two or three dose series with doses given at 2, 4 and 6 months

Pediculosis:

Lice infestation. Most common lice is found on the head. Three stages of lice formation.

Hydrocephalus- Diagnosis-

MRI, and or CT scan

Pneumococcal:

Protects young children against serious infections due to streptococcus pneumonia 2, 4, 6 months and then at 12 months

Acute lymphoid (ALL)-

Most common cancer in age 15 under • Acute lymphoid- Most common leukemia in adults (rarely seen in children) • Acute myeloid leukemia (AML)

Leukemia:

Most common cancer in children. 1:3 cancers - Four types:

Acute: Acute lymphoid leukemia (ALL)-

Most common childhood cancer • Occur when normal bone marrow is rapidly replaced by large numbers of immature lymphoid or myeloid cells. WBC can't mature and don't function • Two main types of acute leukemia

Tetralogy of Fallot: S/S Treatment Prognosis

Most common cyanotic heart defect S/S: Cyanosis. Increases with age, Tachypnea, rapid pulse, feeding difficulties, growth retardation, poor weight gain, edema, exercise intolerance, polycythemia (Too many blood cells), may see blackout of convulsions Treatment: Medical treatment until the child can withstand surgery (Usually open heart surgery by age 1-2 years) Prognosis: Good with advance meds

Drowning:

Most common type of drowning with small children is in swimming pool areas as with adults the survival rate of the child depends on how long the child was without oxygen and what the temperature of the water was

Indirect inguinal hernia: -

Most frequent in boys. Protrudes through the round ligament into the inguinal area. May descend into the scrotal sac or ovaries. Ina boy it will typically fix itself in girls you need immediate surgery

Stenosis treatment

Narrowing of the right ventricular outflow track causing decrease in blood flow to the lungs

Lice life stage

Nite 2. Young adult nit 3. Adult lice (Is not white adults are brown or black) They take about 1-2 weeks to hatch. 9-12 days to grow to full size. Both nit and lice feed on blood.

Direct inguinal hernia:

Protrudes through the weakest part of the abdominal wall peritonea covering the abdominal contents is transparent so abdominal content may be seen. Surgery is done very early

Stenosis:

Open or close treatment surgery may be done if the valve is defective

Inactivated poliovirus:

Oral is no longer used in the USA received in four doses 2, 4, 6-18 months, 4-6 years

Phenylketonuria-

PKU- hereditary metabolic disorder which begins during the first few months of life

Burns:

Partial thickness or full thickness. Caused from heat, electricity, chemicals, radiation. A chief concern for treating burns is combating shock, alleviating pain, and restoring fluid and electrolyte imbalance. Secondary interventions preventing infection and contractions, reconstruction or repair of damage. The extent of the burn is determined by a % bases. Each area is given a % number. Treatment of burns depends on the extent of the burn.

Patent ductus arteriosus- S/S: Complications: Treatment: Prognosis:

Patent ductus arteriosus- (Most common anomaly) -In this condition the pathway remains open this allows blood to pass from the aorta to the pulmonary artery. This causes oxygenated blood to recycle through the lungs overburdening the pulmonary circulation and causing the heart to work harder S/S: May go unnoticed during infancy. During childhood you may see dyspnea, growth retardation, and a full pounding pulse on excretion and possibly hear a murmur (Machine like) Complications: May lead to CHF or endocarditis Treatment: Closed heart surgery or a ligation of the PDA via vats (Video assistant) Indomethacin (Anti-inflammatory medication they don't know why it works) is sometimes given to facilitate closure Prognosis: Excellent

Diaphragmatic hernia: o

Portion of the intestines protrudes through the diagram

Hep A:

Recommended for children 2 years of age and older in two doses administered at least 6 months apart

Influenza:

Recommended for kids 6 months of age and older. First time you get shot receive two separate doses two weeks apart (for 8 year of age and younger)

Physical abuse:

Refers to situation where the child has been physically harmed and injury has occurred. The injury its self is inflicted internally and can be anywhere from a bruise to death. Shaking baby syndrome is a form of PA. Symptoms: Unexplained bruises in various stages of healing. Unexplained fracture that have healed. Many times the caregiver of the abused child will refuse to leave the room during the examination.

Report abuse:

Reporting abuse is mandated. You are required by law. Report immediately even if you just suspect it

Diphteria:

Resp disease that can cause breathing problems, paralysis, heart failure and death. Highly contagious.

Roseola:

S/S. Fever and then a rash forms. Is not as communicable as with other diseases. If you get it once you normally will not get it again. Loss of appetite, weight loss. Tired. Irritable aches and joint pain. Elevated WBC, ESR, positive CRP and ASO.

Transmission Based Precautions:

When treating individuals who have highly contagious conditions Includes isolation

Haemophilus influenzae type b:

Serious bacterial infection that may affect many organ systems causing pneumonia ect. Should be given at 2, 4, 6, 12-15 months

Scabies:

Spread by direct skin to skin contact. A very microscopic mite that burrows into the epidermis where it lives and lays its eggs. It is most often seen on the hands in the webbed space between the fingers. Symptoms include intense itching with a pimple type rash.

Sudden unexpected infant death and sudden infant death syndrome (SUID):

Term used when an infant die suddenly and expectantly. The causes of SUID may include metabolic disorders, hypothermia, hyperthermia, neglect, abuse, or the reason may be unknown

Cardiac disorders: Septal defects: Ventricular defect =VSD: - S/S: - Treatment: - Prognosis is - If they are small they typically close on their own

The shunt between the right and left vertical remains open - S/S: Murmur that is loud and hard in sound - Treatment: Surgical repair, however using occluding devices - Prognosis is good - If they are small they typically close on their own

Communicable Diseases:

These are infections or diseases that are transmitted from one person to another

Sexual abuse:

This can range from exposure to fondling, to child pornography or intercourse. Most often the abuser is someone that the child knows well. Can also be caused by an adult or an adolescent (Typically someone older than the child) The abuser may tell the child that it needs to be a secrete or may threaten the child that no one will believe them or that they may be sent away. Some signs include abdominal pain, gastric distress, emotional disturbances, vaginal or rectal bleeding

Emotional abuse:

This may include both social or emotional isolation. Can be defined as intimal omission of positive words or behavior that would increase the child's self-esteem and self-respect

o Croyza:

This means inflammation of the mucous membranes of the nasal passages. With nasal discharge.

Transposition of the great arteries TGA: S/S: Treatment: Prognosis:

Transposition of the great arteries TGA: With this condition the pulmonary artery leaves the left side of the ventricle and the aorta leaves the right ventricle causing the body to receive only desaturated blood. Medical emergency unless there are other defects that can compensate. S/S: If the other defects are large enough you may not see cyanosis. No murmur heard. You will see S/S of CHF Treatment: Indecen given to maintain ductal patience. Depending on the severity of the defect and how mature the infant is surgery is performed in the first two weeks of life Prognosis: If born early very poor.

Lice treatment

Treatment special shampoo, done on two separate occasions, along with washing bedding and clothing that is used by the infected person. All bedding or stuffed animals that cannot be washed need to be put in plastic bags, tide tightly for at least 3 weeks in order to break the cycle. Prevention: Tell kids to not share hats or combs

Tricuspid atresia: - S/S:

Tricuspid atresia: opening between the right atrium and right ventricle is absent so no blood flow occurs between the two. - Only way to get blood to the lungs is another defect - S/S: Cyanotic due to the mixing of oxygenated and unoxygenated blood

o Umbilical hernia:

Umbilical hernia: Portion of the intestine protrudes though a weak umbilical ring producing a bulge below child's naval. Typically fixes itself

Pinworms:

Very common among children. With pinworms the child ingests the eggs which then mature in the cecum hatch eggs lay ova in the anal area which intern causes itching especially at night. Diagnosis is made by a specimen that is collected at night. Don't ever shine a light on them. They will crawl back in. Treatment is with antihelmintic. Given to all family members.

Mumps-

Viral disease that affects the salvary glands. Mild infection in children but can cause serious hard to a pregnant woman. Given in 2 doses 1st given 12-15 months, 2nd 4-6 years. Can not get this vaccine if you are allergic to eggs

Hemophilia: Treatment

X-linked recessive hereditary disorder where factor 8 or 9 is missing (Moms are carries, only man can get it) - Bleeding can be internal or external - Treatment: Replacement of factor 8. Genetically reproduced

- Nevi-

abnormal skin mark can be hereditary or acquired as result of a substance that causes damage during fetal development - can be pigmented or vascular - 2 types of vascular nevi- lymph- overgrowth of lymph tissue.

- Reye's syndrome -

acute rapidly progressing encephalopathy and tympanic dysfunction. Cause is unknown- however most times it is associated with the use of aspirin during a viral infection. Symptoms- fever lethargy, vomiting, elevated liver test. Prognosis is good if caught early.

Meningitis- Treatment for viral-

administer IV fluids, antibiotics, isolation for at least 24 hours, elevate the head of the bed, and measure head circumference in infants. Prognosis is generally good. The HIB vaccine can prevent

-strawberry marks-

are immature hemangiomas generally disappear

Capillary hemangiomas-

are red with purplish legions that do not fade

- Eczema-

atopic dermitius - causes oozing, crusting, excoriation and itching --comes and goes, generally runs in the family with a cause unknown, but it could be due to allergies. Treatment is oatmeal baths or antibiotics or cortisone ointment

- Chronic luekema Risk factors: Diagnostic S/S

being exposed to ionizing radiation and benzene (Chemical found in gasoline) Diagnostic: Go by medical history. WBC is elevated with characteristic abnormal cells. Child will be anemic. Hem would be around 4-8 (Normal 13) Bone marrow and lymph biopsy S/S: Fatigue, pain in bones and joints, headaches, fever, swollen lymph nodes, unexplained weight loss, Loss of appetite, bleeding of gums or nose, bruising with or without known cause, slow healing, swelling of face and arms (Superior vena cava passes next to thymus and thymus grows in size due to leukemia cells growing inside it and pushes on vena cava and blood backs up into veins)

Otitis media Diagnosis-

bulging tympanic membrane. If rupture has occurred you will see blood or drainage Treatment- antibiotics, antipairetics, and surgery. Surgery is done when repeated attracts occur may have myringotomy. An incision is made into the ear drum and plastic tubes are placed in to allow drainage of fluid buildup, they can be temporary or permanent

Otitis media Complications

can be hearing loss, scaring, and rupturing of the eardrum

Tetanus:

caused by a bacteria that one's it enters the body it releases a toxin that attacks the nervous system.

Pertussis

causes coughing spasms so severe that they can't eat or breathe. Given 2,4,6 Months 15-18 months 4-6 years

Ortolani sign-

clicking sound when the physician performs abduction of the hips. Treatment is application of Pavlik harness. Nursing care- handle child carefully, protect the harness from soiling and monitor their skin around the harness

Celiac disease-

common malabsorption syndrome. Possibly a congenital disorder. Children with celiac disease cannot tolerate gluten- wheat, oat, rye

If you suspect abuse you will need to

contact the appropriate authorities

Amblyopia Treatment-

covering the good eye with a patch to force the bad eye to work, as well as glasses

Strabismus Treatment-

covering the unaffected eye to stimulate the unused eye, eye exercises, glasses- change yearly. Or surgery

Strabismus-

crossed eyes- inability to move the eyes appropriately, possibly a congenital disorder

- Mongolian spots-

dark blue green areas found typically on the lower back, irregular shaped, found on Asian and interracial children. These spots disappear about age 3.

o Chronic leukemia

excessive production in abnormal but apparently mature cells. Children with chronic leukemia have wide ranges of life span (Rare in children)

Otitis media-

infection of the middle ear, common in children due to the eustachian tubes being straighter and shorter. Defined as acute sudden onset, subacute- fluid last between 3 weeks and 3 months, and chronic- greater than 3 months

- Meningitis-

inflammation of the meninges of the brain and spinal cord, it can be bacteria or viral in nature. Cause- can be group B strep, or ecoli, HIB B- infants greater than 2 months. Symptoms- poor feeding, vomiting, irritability, bulging fontanels. In older children you will note nuchal rigidity- ridged neck- diagnosis is make by spinal tap which indicates organism is present.

Tonsillitis-

inflammation of the tonsils- could be bacteria or viral infection

Celiac disease Diagnosis-

jejunal biopsy and clinical symptoms

Amblyopia-

lazy eye. One eye does all or most of the work which could result in blindness in the lazy eye

Hydrocephalus Causes-

malformation in the ventricles or meninges

Cleft lip-

malformation of the face and oral cavity, these defects can occur together or separately. Classified as complete or incomplete. Cleft lip is readily apparent

- Spinal bifida-

malformation of the vertebra and spinal cord.

Rheumatic fever:

medium reaction to group A beta hemolytic strepocoo infections.

- meningomyelocele or myelomeningocele-

most serious of all, the sack is visible, and contains meninges, spinal fluid, and nerves, located in lumbar region. Children has paralysis of the legs, poor bowel and bladder control. Other problems- hyperseflus, congenital dislocated hips, club feet

Epistaxis-

nose bleed- common in children

o Rhinorrhea: S/S Treatment Complications

o Rhinorrhea: Thin watery nasal fluid o S/S: Nasal drainage: Clear (Allergies) Green/Yellow (URI/Cold), Irritable, general Malays, cough, fever o Treatment: No cure. Treat symptoms. Rest fluid, nose spray, wash hands, Tylenol o Complications: Bronchitis, ear infections, pneumonia

Tonsillitis Nursing interventions-

observe child for bleeding, frequent swallowing, spitting up coffee ground material, bleeding can occur 5-10 days post op. post op positions- side or abdominal with head turned to side to prevent aspiration

Talipes (clubfoot)-

occurs when the foot is twisted or bend out of shape, most often due to fetal positioning. Could be hereditary. Treatment- splinting or casting. if casting is performed it is changed about every 1-2 weeks, due to changes that can occur quickly. Surgery is performed if the deformity is severe enough. Nursing interventions- teach to keep the cast dry and monitor skin around the cast

Developmental dysplasia -

one or both hips is located improperly in the ball and socket joints. This causes hip dislocation, may be unilateral or bilateral. If only one side is affected, the child will have a additional cress in the buttocks and the knees are not level, when the child lays on their back with their knees bent and hips flexed and their feet flat on the bed, Allis sign.

Spinal bifida occulta-

opening in the vertebral column with no symptoms, found on x-ray upon exam for another issue. They may have a small tuff of hair at the sight, generally the child experiences no problems, most people don't realize they have it

hemangiomas-

over growth of blood vessels

Otitis media Symptoms-

pain, pulling at the ears, irritability, turning there head side to side. Some children have fevers, some have no symptoms at all

Otitis media Causes-

passive smoke, insertion of foreign objects to the ear- follows an upper respiratory infection

Incubation period:

period between exposure to an infection and the appearance of the first symptoms

- meningomyelocele or myelomeningocele-Nursing interventions-

preop- handle infant gently, cover the sack with sterile saline dressings, position the child on their abdomen with legs abducted, and measure head circumference every 8 hour or every shift. Monitor fontanels, and keep the bladder empty. Post op- assess incursion for infection and monitor neuro status

- Encephalocele-

rare condition where the fetal skull doesn't close completely, and a portion of the brain may protrude through the opening. Treatment includes surgery to put the brain back into the skull and close the opening

Tonsillitis Symptoms-

redness of the throat, soreness, painful swallowing, exudate, and bad breath

Cleft lip treatment

surgery -cheiloplasty- done when child is 6-12 weeks. Safety is a big thing with this. Prevent injury. The application of elbow restraints if often applied to keep the child from bringing their hands up to the area

Cataracts Treatment-

surgery to replace the lens

meningocele-

when the layer of meninges herniates an opening in the vertebral column. Diagnosis- visible sack is noted. Symptoms- muscle weakness, bowel or bladder control difficulties, or no symptoms at all. Treatment is surgery to correct.

Varicella-

zoster virus: Vaccine for chicken pox. S/S itchy rash with fever. Eruptions appear like papules (Round elevated areas) Highly contagious. Given 12-18 Months