II. UWORLD CONCEPTS
The nurse is planning care for a child being admitted with Kawasaki disease and should give priority to which nursing intervention?
Monitor for a gallop heart rhythm and decrease urine output Kawasaki disease (KD)- condition inflammation of arterial walls (vasculitis). The Coronary arteries affected= some develop CORONARY ANEURYSMS.
Coarctation of the aorta (COA)- abnormal aortic narrowing- results in decreased cardiac output HALL MARK SIGN
Weak lower and strong upper extremity pulses
DDH AFTER > 3 MONTHS:
- Limited hip abductions (contractures developed > 3 months not treated) -One side DDH- Leg is shorted- after >3 months -DDH not corrected in infancy- walking- notable limp, walking on toes, positive TRENDELENBURG SIGN (pelvic titles down on unaffected side when standing on the affected leg); Bilateral DDH- child may develop waddling gait and severe lordosis
INTUSSUSCEPTION MANIFESTATIONS:
- Palpate sausage shaped abdominal mass -Stool mixed with blood and mucous= Red, "currant jelly" stools. - Screaming and drawing of the knees up to the chest - episodes of sudden, crampy, abdominal pain Others- inconsolable crying , vomiting ( bilious**** non projectile vomiting. )
manifestations of Acute Glomeularnephritis? (AGN)
- Periorbital and facial/ generalized edema, -hypertension***** -oliguria (Fluid retention); - Tea Colored (cola)/ cloudy Urine (protein and blood)- hematuria
other assessments with ICP other than Fontanelll assessment (hydrocephalus)
- Pulse pressure- Widening of pulse pressure- sign of Cushing's Triad ( widen pp, bradycardia, respiratory depression)- LATE sign of increased ICP - Pupillary light - LATE complication of hydrocephalus (fontanelles- early sign)
Scarlet fever manifestations
- SAND PAPER RASH -fever and pharygiitis -Tonsillar erythema and exudates -Strawberry tongue -tender anteior cervical nodes
A single rescuer responding to an unwitnessed infant arrest- CPR
- START CPR= perform 2 minutes of CPR before retrieving a defibrillator (call help; rate of at least 100 / min before retrieving AED) -assess the infant's brachial pulse for no longer than 10 seconds
ROTAVIRUS - transmission - s/s -priority?
- Spread: fetal oral route; transmission- contact with food, toys, diapers, hands - Symptoms- foul smelling, watery diarrhea that lasts 5-7 days, fever, nausea, vomiting. - Complications- Dehydration- report to HCP - lack of tears, extremely fussy, sleepy, decreased urination, dry mucous membranes.-
Manifestations of Bacterial Meningitis infants < 2 yrs:
- fever or possible hypothermia - Irritability, - frequent seizures -High pitched cry -Poor feeding and vomiting -Nuchal rigidity -Bulging fontanelle (not always present- CSF/ ICP)
Varicella zoster virus (VZV)- (chicken pox) - characteristic:
- lesions that again as maculopapular rash, - progressed to weeping vesicular lesions, = typically crust over within approximately one week. - pruritic or painful (Diphenhydramine (benadryl), OAT BATH) + have a fever (ACETOMOINOPHEN)
PYLORIC STENOSIS MANIFESTATIONS:
- olive shaped mass palpated in the epigastric area= RUQ - nonbloody projectile vomiting (3-4 ft)(Emesis is nonbilious (formula in and out)= followed by hunger "hunger vomiter"- - poor weight gain and dehydration ( sunken fontanelle, decreased skin turgor, delayed capillary refill)
Fetal Alcohol Syndrome (FAS)- ;leading cause of intellectual disability and developmental delay MANIFESTATIONS
- severe Growth deficiency= -neurological symptoms (microcephaly), -Facial characteristics (indistinct philtrum, thin upper lip, epicanthal folds, flat midface, short palpebral fissures)
fingers for infant compressions
- two thumbs- support back - two middle and index
PRIORITY ASSESSMENT WITH BACTERIAL MENINGITIS?
1. Fontanel assessment (earliest sign of increased ICP acute complication of bacterial meningitis= HYDROCEPHALUS- increased intracranial pressure Bulging / tense fontanelles and increasing head circumference are important early indicators of increased ICP in children.
4 classic manifestations of nephrotic syndrome:
1. Massive proteinuria- increased glomerular permeability 2. Hypoalbuminemia- excess protein loss in the urine 3. Edema- periorbital and peripheral edema and ascites; low protein and album 4. Hyperlipidemia- increased compensatory protein and lipid production by the liver. Additional- decreased urine output, fatigue, pallor, weight gain
LEFT TO RIGHT HEART SHUNT (ACYANOTIC)
1. Patent ductus Arteriosis -PDA, 2. Atrial Septal Defect (ASD).- ASD, 3. VENTRICULAR SEPTAL DEFECT- VSD) left to right (ACYANOTIC)- increase pulmonary conjestion- increase work of breathing/ lungs= CHF MANIFESATIONS
VARICELLA VACCINE CONTRAINDICATIONS
- Immunocompromised clients (cancer- AML, low CD4, HIV etc)- contraindication four live attenuated vaccines ( varicella, MMR). - varicella vaccine is contraindicated for patients who already developed VZV infection
CF: Pancreatic enzymes- enteric coated beads
- (cannot be CHEWED, swallowed whole (excess= fibrosing colonopathy) - ONLY MIXED WITH ALKALINE contents- apple sauce, yogurt, not with MILK )
MEASLES Precautions/ transmission? hallmark signs? incubation? exposure to others?
- AIRBORNE PRECAUSTIONS; N95; Negative presure room (highly contagious) -Erythematous, maculopapular, morbilliform rash - not pruritic**; Fever and rash 2 clinical signs of of measles; clinical indicators of measles would not be seen after only 2 days of exposure= Measles incubation is 7-21 days. -Advise measles vaccine for susceptible family members (prophylaxis)-72 hrs of exposure - Administration of Vitamin A supplements- prevent severe measles induced Vitamin A deficiency (blindness)
a child with acute myelogenous leukemia (AML) Who is admitted with varicella-zoster virus. the client has multiple lesions that have not crusted. Which of the following instructions should the nurse include?
- Apply Diphenhydramine (benadryl) creme sparingly to lesions after beating your child - Keep giving your child the acyclovir* at home as prescribed to fight the virus (immunocompromised- AML) - you can give acetaminophen for pain and fever - your child will no longer be infectious after all the lesions have crusted over
Depth of chest compressions for infants= fingers location for infant cpr= ratio of chest compressions to breaths during CPR=
- Depth is ⅓ of AP (1.5 in) - Correction- two finders or thumbs on sternum below** the nipple line - ( Single* recruiter is 30: 2; Two recruiters 15: 2)
SCARLET FEVER HALL MARK SIGN
- Distinctive red rash- begins on the neck and chest and spreads to the extremities, resembles a bad sunburn, blanche's with pressure, has Fine bumps like SAND PAPER RASH***
OTITIS MEDIA Manifestations:
- High fever (104) - Ear pain - Irritability/ restlessness - Loss of appetite - Pulling on the affected ear - Tympanic membranes- bulging and very red; If tympanic membrane ruptures from build up of fluid- pt will experience immediate pain relief and a decreasing fever - Purulent drainage- external ear
VARICELLA ZOSTER VIRUS (VZV- CHICKEN POX) transmission? contagious?
-AIRBORNE PRECATOINS (N95/ negative pressure room) - your child will no longer be infectious after ALL the lesions have crusted over
TEACHING WITH HEMOPHILIA
-Avoid medications (platelet inhibition: ibuprofen***, aspirin ) -Avoid IM injections- SUBQ is preferred (immunizations) -No contact sports (non contact- swimming, jogging, tennis) and use of protective equipment -Soft toothbrush -Med alert bracelet
what is infant is exposed to Measles- what to tell parents?
-Bring the baby into the clinic for the MMR vaccine - MMR dose: 12 - 15 months (safe for children <12 months- can provide protection from the disease if administered 72 hours (3 days) of the child's initial measles exposure; Immunoglobulin (IVIG)- administered within 6 days of exposure- prophylactically A child who receives the MMR vaccine before 1st birthday= revaccinated at age 12-15 months and again 4-6 years
Hypothyroidism Manifestations: (DOWN- -HYPO) (asymptomatic at birth)
-Difficulty awakening- lethargy, poor feeding -hyporeflexia due to alterations in CNS -Bradycardia -Dry skin -Constipation (slowed metabolism ) -Enlarged fonatanells -Protruding tongue, puffy face, umbilical hernia -Prolonged jaundice -Hoarse cry- from swelling of vocal cords due to fluid retention
PDA - side of heart? -patho? TX>
-LEFT TO RIGHT (acyanotic) Fetal circulation- transition to- Pulmonary circulation= Ductus arteriosus- close spontaneously (extrauterine life)- closed by increase O2 PDA= blood will shunt from the aorta- back to the PULMONARY arteries via open ductus arteriosus TX_ surgical ligation or IV Indomethacin
what is the HALLMARKS OF KAWAKAIS?
-Lips swollen and cracked; TONGUE= STRAWBERRY TONGUE; -hand foot swelling and a rash, irritability (hall mark finding with KD). -Desquamation (skin peeling- not painful- new skin is red and sore)
what foods should celiac patients not eat?
-NO BROW (BARLEY, WHEAT, OATS, WHEAT) - can* eat rice, corn and potatoes are gluten-free - processed food has hidden gluten
DDH Manifestations in infants <2-3 months
-Presence of extra gluteal folds on right side - Presence of EXTRA INGUINAL OR THIGH FOLD - Laxity of hip joint/ Instability= Barlow and Ortolani maneuvers- performed by HCP. DDH not treated - the signs disappear after 2-3 months due to the development of muscle contractures =
FIFTH DISEASE HALL MARK?
-Red rash on cheeks (slapped cheeks) -rash spreads to the extremities and maculopapular rash develops - proximal/ distal; malaise, joint pain
what are other expected findings with Sickle cell anemia?
-Stroke =Fatigue; Right arm weakness - could indicate new onset stroke; -Dactylitis- Swelling of hands and feet (no blood flow to hands and feet- first sign detected in babies)
Manifestations ACYANOTIC DEFECTS:
-Tachypnea -Tachycardia -Diaphoresis during feeding or exertion -Heart murmur or extra heart sounds - Increased metabolic rate- poor weight gain
Which behaviors by the client Duchenne muscular dystrophy? (x-linked recessive)
-frequent trips and falls at home -places hands on the thighs to push up to stand (GOWERS SIGN) -walks on tiptoes and has disproportionately large calves
clinical manifestations EA/ TEF-
-frothy saliva, - coughing, choking and a drooling. -Patients may also develop apnea and sinuses during feeding; aspiration is the greatest risk- put patient on NPO -distended abdomen (air)
Hirshcsprugs Disease (HD) - Symptoms of Distal intestinal obstruction;
-mild/ moderate distended abdomen (report to HCP increase distention; -will not pass meconium in the expected 24-48 hours; -Difficulty feeding, excessive crying; vomit green bile*
Wilms Tumor (nephroblastoma) MANIFESTATION? TX?
-observes unusual contour in the child's abdomen- unusual bulging/ swelling unilateral (bathing); TX- nephrectomy
FIFTH DISEASE -cause? - transmission -contagious
-viral illness caused by Human Parvovirus- affects school age (6-12 yrs) -Isolation, airborne -respiratory secretions - child is NO LONGER INFECTIONS UNTILL AFTER= developing SYMPTOMATIC= RASH, JOINT PAIN Recovery 7-10 days
KD has 3 phases:
1. Acute- sudden onset of high fever - does not respond to antibiotic or antipyretics. - Irritable, swollen red feet and hands; - Lips swollen and cracked; - TONGUE= STRAWBERRY TONGUE; (inv- skin discomfort- cool compress, lotions & low stimuli environment- irritability may last up for 2 months; Soft foods and clear liquids ) 2. Subacute- skin begins to peel from hands and feet (desquamation) - irritable 3. Convalescent- Symptoms disappear slowly. Temperament is normal (no tx- new skin may be tender) Not contagious
CYSTIC FIBROSIS (autosomal recessive) effects 3 body systems:
1. Pulmonary- alterations in respiratory secretions (thick sputum)- difficult to clear the airway and result in frequent respiratory infections and sinusitis= chronic hypoxemia 2. GI- block pancreatic enzymes - malabsorption of fat soluble vitamins (ADEK)= High PRO, CAL, FAT; Diabetes mellitus; weight loss (FTT) 3. Reproductive- thickened reproductive secretions or the absence of the vas deferens in men- CF related infertility
Classic Triad of intussusception=
1. abdominal pain, 2. "currant jelly" stools (blood and mucous) 3. sausage shaped abdominal mass. also*- Episodes of sudden abdominal pain, inconsolable crying and Vommitting- followed by periods of normal behavior
VSD HEART SOUND
A HARSH SYSTOLIC MURMUR - auscultated near the sternal bored at the third or fourth intercostal spaces a
1 year old with VP shunt who has lethargy and a pulse of 78
A ventriculoperitoneal shunt- used to treat hydrocephalus and is placed at 3-4 months. Complications- blockage or infection= increase ICP; Normal pulse of =1
temporary colostomy for hirschsprung's disease-which assessment is finding postoperatively?
ABNORMAL= Stoma is gray tinged at the edges but pink at the center on post op day 5 NORMAL= Expectations post op- Beefy red post op 1; Post op day 6- stool; Bleed small amount, Blood tinged mucus first few days)
PRIORITY WITH HEMOPHILIA: Hemophilia A
ADMINISTER FACTOR Hemophilia A= lack factor VIII (8); Hemophilia B (Christmas Disease= Lack factor IX (9)
The nurse assesses a child with intussusception. Which assessment finding require priority intervention?
Abdominal rigidity with guarding Tissue dead, PERFORATION risk of = PERITONITIS (peritoneum) inflamed- infection- sepsis- MODS) Peritonitis (fatal) manifestation- fever, abdominal rigidity, guarding, rebound tenderness
what is the Priority for infant with BACTERIAL MENINGITIS?
Administer 400 mg ceftriaxone IV every 12 hrs treat the cause (bacterial meningitis)- #1 INITIATE ANTIBIOTICS (bacterial meningitis can lead to death!
acute glomerulonephritis. Frequent monitoring of which of the following is a priority?
Blood Pressure SEVERE HYPERTENSION (anticipated complication)- identify early*- prevent further progression of kidney injury and development of hypertensive encephalopathy and pulmonary edema.
MUFFLED HEART TONES
Cardiac tamponade- - heard post surgical intervention
possible esophageal atresia what is still on. Which of the findings is the nurse most likely to observe?
Choking in cyanosis during feeding
Thin, ribbon like stool. Bowel obstruction is caused by failure of the internal sphincter to relax.
Hirschsprung Disease (congenital aganglionic megacolon) -
Bacterial Meningitis- inflammation of the meninges and spinal cord- caused by types of bacteria- Group B streptococcal, meningococcal, por pneumococcal pathogens transmission?
DROPLET PRECAUTIONS- nurse wear mask- patient wear mask outside of room);
What is a major comlication/ emergency with child with Sickle cell anemia?
Enlarged spleen on palpation - sickle cell patient NORMALLY have a small spleen (autosplenectomy -abnormal- Spelnomegalyly= Splenic sequestration crisis- large number of sickle cells are trapped in the spleen=life threatening emergency- Hypovolemic (hypotensive) shock.
The nurse is caring for an infant with Hirschsprung's disease who is awaiting surgery. Which assessment requires the nurses immediate action?
Episodes of foul smelling diarrhea and fever (Hirschsprung Enterocolitis Hirshcsprugs Disease (HD) - occurs when a child is borne with some sections of the distal large intense is missing nerve cells- internal anal spincter unable to relex= no peristalsis and no stool is passed
Kawasaki disease. The nurse informs apparent that the presence of which symptoms should be immediately reported to the health care provider?
Fever KD discharge teaching- monitor for Fever by checking temperature every 6 hours for The First 48 hours= may indicate an acute phase of KD recurrence= child and may need additional treatment with IVIG to prevent the development of coronary artery aneurysms and occlusions
nephrotic syndrome. Which most clearly reflects which physiologic process r/t nephrotic syndrome?
Glomerular injury; nephrotic syndrome- autoimmune disease
The nurse is gathering data on a 5 week old and admitted - suspected diagnosis of pyloric stenosis. The nurse should expect which of the laboratory values?
HCT of 57% Rationale- projectile vomiting = DEHYDRATION Labs: - also- Elevated blood urea nitrogen (BUN) - metabolic alkalosis (ph >7.45) - Hypokalemia (vomiting)
cystic fibrosis - will advise the parents to choose foods? In CF a protein responsible for electrolytes=
High CAL, high PRO, high FAT + fat soluble vitamins (ADEK); Sodium and chloride (hyponatremic, hypochloremia)-I will increase my child's salt intake during hot weather
suspected meningitis and preparing for a lumbar puncture. What is the appropriate position for LP?
Hold the child with the head and knees tucked in and back rounded out Rationale- protect child from moving: Flexed sitting with arms and legs immobilized or Side lying an infant with suspected meningitis and preparing for a lumbar puncture. What is the appropriate nursing intervention? with head and knees tucked
TX of intussusception (- without surgery)=
Hydrostatic ( Saline) or Pneumatic (air) enema.
Loss of albumin in urine= Hypoalbuminemia (decrease in plasma oncotic= fluid leak out of vascular spaces);
Hypovolemia= edema, weight gain, loss of appetite (ascites) and oliguria
what is the priority with Duchenne Muscular Dystrophy (DMD)
INV-PREVENT INJURY- avoid clutter (rugs) and prevent falls; non weight bearing
what is a VSD complication seen in childnre
Infant client with ventricular septal defect (VSD) with reporting grunting during feeding s Left to right shunting- leading to excess blood flow to the lungs Risk- Congestive Heart Failure (CHF), pulmonary hypertension
diagnosed with Wilms Tumor (nephroblastoma). The child is scheduled for a right nephrectomy in the morning. Which action is a priority in the preoperative care plan?
Instructions not to palpate the abdomen-can disrupt the encapsulated tumor-
3 year old client in the ED and finds dyspnea, high fever, irritability and open mouthed drooling while leaning forward. The parents report that the symptoms started rather abruptly. The client has not received age appropriate vaccinations. Which set of actions should the nurse anticipate?
Intubation (ENDOTRACHEAL intubation) in the OR with a prepared tracheostomy kit standing by (emergency airway prepared- sudden obstruction)
LONG term complication of hemophelia?
JOINT DESTRUCTION Priority- Injury/ trauma ( falling etc)- risk for permanent joint destruction- frequent bleeds into joint spaces; INV= Monitor for external and internal bleeding. The most frequent sites are the JOINTS - KNEE Hemarthrosis- can occur with minimal or no* Trauma; over time chronic swelling and deformity can occur
PDA HEART SOUND
LOUD MACHINE LIKE MURMUR
what are children with Nephrotic syndrome at risk for? loss of (albumin, immunoglobulins, natural anticoagulants)
Loss of immunoglobulin= immunocompromised= risk of INFECTIONS
Kawasaki disease disease IV immunoglobulin ( IVIG) 2 months ago. the child is in the clinic for a follow-up and school schedule the immunization. Which vaccinations are delayed?
MMR, VARICELLA Rationale: Kawasakis- treated with aspirin and IVIG to prevent coronary artery aneurysm. IVIG therapy will remain in the body for 11 months- interfere with live vaccines- delay vaccines for 11 months
ASD SOUND
MURMUR ; defect with abnormal opening between right and left atria; blood from the higher pressure left atrium to flow into the lower pressure atrium.
What is a very late sign of increase ICP?
Manifestations- Bulging fontanelles, increasing head circumference and SUNSET EYES (sclera visible above the iris) - from ICP- paralyze the upward gaze (LATE SIGN OF INCREASED ICP)= TIMED interventions(SHUNT REPLACEMENT)
What pain medication is contraindicated with Sickle cell anemia?
Meperidine (Demerol)- contraindicated with sickle cell crisis- results in normeperidine (toxic metabolite) accumulation. Symptoms- tremors and seizure
DIASTOLIC murmur-
Mitral Stenosis or Aortic regurgitation
OTITIS MEDIA cause
Occurs ages 2 yrs- following a past respiratory tract infection / exposure to secondhand smoke (TEACH SMOKING CESSATION)
The nurse is assessing a 4 week old infant during an office visit. Which assessment finding is most likely to alert the nurse to presence of right Hip developmental Dysplasia ((DDH)?
Presence of extra gluteal folds on right side
POST OP CARE - CLEFT LIP REPAIR
Protecting the surgical site from trauma; -position upright/ supine (aiwar)- avoid prone or side of incision *bumbing) - Expected- edema, - bilateral restraint elbow, - adhesive strips over incision - avoid pacifiers/ straws- truama)
A systolic Ejection Murmur-
Pulmonic Stenosis (Right ventricular Hypertrophy- if defect is not repaired)
The HCP Prescribed amoxicillin for 1 year old diagnosed with acute otitis media (AOM). which instruction is most important for the nurse to review with the child's parents?
Return to the office if the child does not improve within 48 to 72 hours Rationale: amoxicillin is the standard treatment for AOM; if symptoms do not improve within 48 to 72 hours- patient return for assessment of symptoms and see drug-resistant organisms
Kawasaki disease(KD) manifestations-
STRAWBEERY TOUNG; HAND FOOT SWELLING; DESQUAMATION; systemic vasculitis, presents with> 5 days fever, non exudative conjunctivitis, lymphadenopathy, mucositis,
TX FOR VARICELLA ZOSTER VIRUS (supportive) (pharm) fever? -immunocompromised clients (AML)
TX (supportive)- -Cool oatmeal baths can topical antihistamines -(Diphenhydramine)- -Acetaminophen as needed for fever or pain -immunocompromised clients (AML)- at risk for severe varicella (disseminated, pneumonia) = antiviral agents ( Acyclovir).
what iterm-68s the TX for Kawakakis Disease?
TX: IVIG (IV gamma globulin- causes high plasma oncotic pressure- signs of fluid overload and pulmonary edema- large quantities- INV- monitor for signs of HF= decreased urinary output, additional heart sounds, tachycardia, dyspnea)) = and +ASPIRIN* (FEVER) is the only exception when to use!
Hyperthyroidism (Graves Disease)- increased production of TH. Neonates; Graves disease- uncommon - occurs secondary to maternal hyperthyroidism;
Tachycardia, Increased bowel motility (frequent or loose stools)
- caregivers of a child with a VP shunt must understand symptoms of increased intracranial pressure(ICP)- indicate shunt malfunction.
Vomiting, headaches, vision changes, changes in mental status- is a symptom
What is the cuase/ history with REYES SYNDROME?
cause- recent viral infections (varicella (chicken pox) or influenza= Increase risk- use of *ASPIRIN* therapy (to treat fever from varicella or influenza);
What is a distnt sign with Duchenne muscular dystrophy-
classic Gower sign/ maneuver- will raise themselves to standing position using the ( placing hands on thighs push up to stand) and walk with tip toes;
epiglotitis 4 d's Symptoms- high grade fever with toxic appearance, severe sore throat,
dysphonia( muffled voice), Dysphasia, drooling, depressed respiration Effort; Epiglottitis- considered first in a 6-7 year old with ARD, toxic appearance (sitting up, leaning forward, drooling), stridor and high grade fever; tachycardia, tachypnea
Epiglottitis ( supraglottitis) - inflammation by bacteria of the tissues surrounding epiglottitis ( long narrow structure that closes the glottis during swallowing)
edema can rapidly develop (mins) obstruct the airway (PEDIATRIC EMERGENCY) by ecluding trachea-
The after the infant is successfully treated for epiglottitis, the parents wonder how this could have been avoided. What most appropriate response?
epiglottitis are preventable by standard immunizations the majority of cases of epiglottitis are caused from Haemophilus influenzae Type B (HiB)- vaccinations given during the 2 and 4 month. (epiglottitis is rarely seen in vaccinated children- it is preventable*
Steatorrhea- Oily or bulky, foul smelling stool-
excess fat in stool from malabsorption. (Pancreatic insufficiency, Cystic fibrosis, or celiac disease)
REYES SYNDROME- Manifestations-
fever, lethargy, acute encephalopathy, altered hepatic function (elevated serum ammonia); vomiting, severe altered LOC- seizure, coma
Hirshcsprugs Disease (HD) - COMPLICATION Hirschsprung Enterocolitis (inflammation of the colon= sepsis and death- rapidly worsening abdominal distention. Symptoms of Hirschsprung Enterocolitis -
fever, lethargy, explosive, foul smelling diarrhea, rapidly worsening abdominal distention
Melena (dark red or black, sticky stool) -
indication of an upper GI (UGI) bleed. Gastritis is a common cause of UGI bleeding in infant and toddlers
Bacterial meningitis- PATHO
inflammation of the membranes covering the brain and spinal cord ( meninges) caused by bacterial infection. The information process is and bacterial growth within the meninges increases volumes of the cerebral spinal fluid (CSF)= increased intracranial pressure (ICP)= = Nerve ischemia, permanent functional impairment (hearing impairment, visually impaired) , brain damage, herniation and death
teaching for Reyes syndrome to parents?
instead use acetaminophen or ibuprofen for fever management, not ASPIRIN (STOP!) Incorrect- use of ASPIRIN to treat (kawasaki's disease)
What is an intervention to keep in mind when managing pain in sickle cell anemia patients?
may need HIGHER doses of pain medications= Needs Continuous* PCA is recommended (opiods not nsaids) - its common to have intense PAIN- do not under treat pain
what is the cause of Acute Glomeularnephritis? (AGN)
past Group A beta hemolytic streptococcal infection of the Skin/ Throat. A latent period 2-3 weeks occurs between the streptococcal infection and symptoms of AGN
severe sore throat and fever of 102.9 F. the nurse notes that the child is drooling with distress respiration in inspiratory stridor. Which action should the nurse take first?
position the client in a tripod position on the parent's lap (AIRWAY)
8 year old client 4/4 sore throat and has a great red, pruritic rash on the chest that feels like fine bumps and looks like a sunburn. Which diagnostic tool does the nurse anticipate the HCP ordering?
rapid streptococcal antigen test Scarlet fever- complication of a group a streptococcal infection (streptococcal pharyngitis)
