Difficulty breathing - evidenced by retractions or upward movement of rib cage by contracting neck muscles.
OXYGEN SATURATION LEVEL
When a child has a respiratory disorder, the nurse should monitor this:
Course sounds in breathing, formerly called rales
Coarse, moist, rattling sounds (in lungs), usually caused by secretion in a bronchial tube, common in the child with respiratory disorders
High pitched blowing sounds (in lungs)
High pitched inspiratory crowing sound caused by severely narrowed airways
NASOPHARYNGITIS (aka rhinitis or coryza)
Inflammation of the nasal mucosa, often caused by a viral infection such as the common cold
RHINITIS (aka nasopharyngitis or coryza)
Inflammation of the nasal mucosa, often caused by a viral infection such as the common cold; classic symptoms include redness and swelling of the nasal and pharyngeal mucosa
CORYZA (aka rhinitis or nasopharyngitis)
Inflammation of the nasal mucosa, often caused by a viral infection such as the common cold.
Inflammation of the palatine and pharyngeal tonsils. Caused by viral or bacterial infections. Colds can turn into this too! Inflammation causes enlargement, results in pain & difficulty swallowing & risk for airway obstruction.
Tonsillitis is often accompanied by what other infection?
ACETAMINOPHEN (Tylanol) & SALT WATER GARGLE
When Tonsillitis is caused by a virus treat with:
When tonsillitis is caused by a bacteria, treat with:
Tonsillitis swelling can cause obstruction of Eustachian tubes, trapping fluid in middle ear. This can cause what?
Surgical removal of the tonsils
After a tonsillectomy, generally do not give this (to drink) because it will increase mucus production. Also do not give RED popsickles because they will mask color of blood.
24 & 5-7
Bleeding is the primary complication of Tonsillectomy in first _____ hours or around days ____ when scabs fall off. Bleeding will continue to be a concern until completely healed, approx 10-14 days.
TACHYCARDIA, >HR, >RESPIRATIONS, RESTLESS, FREQUENT SWALLOWING
Signs of hemorrhaging (bleeding) after a tonsillectomy are:
Excessive ________ is indication of bleeding after a tonsillectomy.
It is good to do this with tonsillitis but DO NOT do it after a tonsillectomy, while it is healing.
Inflammation of the epiglottis caused by a bacterial infection of the pharynx and soft tissue of the larynx. Has a Rapid Onset and can cause COMPLETE respiratory obstruction - can be life threatening! Commonly caused by HIB, most common in 3-6 year olds. Will probably have trache tube inserted.
This position is when the child sits upright, leaning forward with the chin thrust forward, mouth open & tongue protruding. It helps keep the epiglottis from obstructing the airway, especially helpful in cases of epiglottitis
This is a bacterial infection of pharynx & larynx, commonly caused by HIB. Epiglottis swells, child has high fever (>102), sore throat, hoarse voice (dysphonia), difficulty swallowing (dysphagia) and inspiratory stridor. Drooling (because does not swallow) and Orthopnea (diff breathing lying down).
Drug of choice for Epiglottitis. Give on empty stomach w/glass of water. Start IV and then go home on PO. This is also the drug of choice for HIB.
Visual inspection of child with epiglottitis is contraindicated because of the danger of triggering ___________ and obstruction in child's throat. Throat culture is postponed for the same reason, until trachea tube is in place.
Child with epiglottitis must be kept calm. ______ stimulates the airway, increases oxygen consumption & causes respiratory system to work harder and could cause laryngospasm.
Muffled or hoarse voice, present with Epiglottitis
TRACHEOESOPHAGEAL FISTULA (TEF)
Potentially life-threatening defect when a connection between the trachea & esophagus is present, is the most common congenital anomaly affecting the respiratory system.
This is an inherited (genetic) recessive disorder of the EXOCRINE glands. Causes secretions of thick mucus that blocks the respiratory and GI system. This clogs up the alveoli (poor oxygenation) and GI system (blocks production of pancreatic enzymes so cannot absorb nutrients). Diagnosed by positive sweat test. Child may have had meconium ileus (small bowel obstruction) as newborn. May be placed on prophylactic antibiotics.
Blood flows from the right ventricle to the pulmonic arteries to the:
Blood comes from the lungs to the left atrium, to the left ventricle and then to the Aorta to the:
Blood from the right side of the heart goes where?
Blood from the left side of the heart goes where?
Blood leaves the heart via:
Blood comes to the heart via:
this (child's body posture) is often seen in a child with Tetralogy of Fallot
HYPEREXTENSION OF THE NECK
This (child's body posture) is often seen in child with hypoxia
Children with ___________ problems will show weakness & fatigue upon physical exertion, cyanosis, edema, dizziness & poor weight gain. Will also tire out during feeding.
GROWTH RETARDATION & DYSPNEA
Classic signs of congenital heart defects are:
TRANSPOSITION OF THE GREAT ARTERIES
Condition in which the aorta is attached to the right ventricle, and the pulmonary artery is attached to the left ventricle, causing the blood to be insufficiently oxygenated
A red skin rash that sometimes occurs with rheumatic fever, characterized by nonpruritic, red, macular lesions that blanch in the center; on chest, abdomen, buttocks & proximal limbs.
ST VITUS'S DANCE (aka Syndeham Chorea)
occurring chiefly in children and associated with rheumatic fever, means CNS is involved. Child experiences involuntary facial & upper extremity movements. Abnormal EEG findings. Can last as long as a few weeks or 2 years.
Involuntary, spasmodic movements of the limbs and face
Tetralogy of Fallot (TOF) causes _______ pulmonary blood flow.
TETRALOGY OF FALLOT (TOF)
This is a combination of four defects: pulmonary stenosis, VSD (Ventricular Septal Defect), right ventricular hypertrophy & overriding aorta.
TETRALOGY OF FALLOT (TOF)
In this (heart) condition, the right ventricle tries to push blood thru the tight pulmonary valve, causing right ventricular hypertrophy. As pressure rises in R ventricle, blood is pushed thru a ventricular septal defect (hole between the ventricles - VSD), it mixes with oxygenated blood from L ventricle & pumped to the body, mixing oxygenated & unoxygenated blood and showing up as cyanosis.
TETRALOGY OF FALLOT (TOF)
this heart condition causes unoxegeanted blood to enter systemic circulation, causing cyanosis, hypoxia, delayed growth, polycythemia, metabolic acidosis, exercise intolerance & clubbing of fingers. Surgery should be done by 6 months if severe, if not severe can wait 1-2 years.
This is a classic sign of Tetralogy of Fallot (TOF) and is common w/exertion, feeding & playing.
A child with Tetralogy of Fallot (TOF) responds to this by squatting, which will increase blood flow back to the heart. It is a period of cyanosis.
TRANSPOSITION OF THE GREAT ARTERIES
This is when the Aorta is connected to the Right ventrical (instead of left) and pulmonic artery is connected to the L ventrical (instead of the right). No amount of oxygen will relieve the cyanosis. Unoxygenated blood moves in and out of the heart to the body. Oxygenated blood moves thru heart & lungs.
BLUE & RED
Right side of the heart is _____, Left side of the heart is _____.
This med is given to newborns IV to maintain patency of the ductus arteriosus, prior to surgical intervention (arterial switch) when the child has Transposition of the Great Arteries.
It is vital to keep this shunt open in the child who has Transposition of the Great Arteries.
This is when the heart fails, cardiac output and blood pressure decrease. Blood backs up into lungs, causing pulmonary edema. Inadequate amounts of oxygen reach the myocardium, impairing heart's pumping action.
Congestive Heart Failure (CHF). 3 categories. This category symptoms are: Tachycardia, poor capillary refill, peripheral edema, fatigue, restlessness & cardiomegaly
Congestive Heart Failure (CHF). 3 categories. This category symptoms are: Dyspnea, Tachypnea, cyanosis, feeding difficulties (tires out), crackles, wheezing on auscultation
Congestive Heart Failure (CHF). 3 categories. This category symptoms are: Slow weight gain, perspiration (infant should not sweat).
This category of meds increase myocardial contractility
This condition is treated with diuretics, potassium supplements & inotropic meds. Monitor for fluid overload
When monitoring for this, check daily weights same time each day, I & O's and monitor for edema
sign of digoxin toxicity is:
This drug is used to increase myocardial contractility (cardiac output). Given IV & PO. Check apical pulse before giving. <100 (newborn) do not give. <70 (child 1 yr & up) do not give
This drug is used to remove extra fluid. Reduces Venus & systemic congestion. Route PO IV. Monitor I/O, daily weights, give potassium foods.
KAWASAKI SYNDROME (aka mucocutaneous lymph node syndrome)
The cause of this is unknown, but both infectous & immune mechanisms have been proposed. Is the most common cause of acquired heart disease in children. Causes inflammation in walls of small and medium sized arteries throughout the whole body. Has 3 phases: Acute, subacute & convalescent. Most typically, children will fully recover.
This syndrome will present as fever, conjuctival hyperemia & red throat, strawberry tongue, swollen hands & feet and a rash. Enlarged cervical lymph nodes. In second phase, skin on lips, hands & feet slough off in layers, leaves fissures (open to infection). Joint pain, thrombosis of heart, causes aneurysms of coronary arteries & myocardial infarction. Will be admitted to hospital in initial phase. Give IV immunoglobulins and large doses of aspirin to prevent heart damage - 80-100mg/kg/day. Most children fully recover, but damage to heart is permanent.
ACUTE RHEUMATIC FEVER (ARF)
this is not common in the US. Usually occurs 6-15 years of age. Follows 1-4 weeks after a strep infection. Autoimmune response damages heart, joints, CNS & skin. Presents with enlarged, painful inflamed joints (Knees, elbows & wrists), red rash & temp 100.4 or higher. Rash called Erythema marginatum.
ACUTE RHEUMATIC FEVER (ARF)
Diagnosis of this is done by clinical manifestations & antistreptolysin O titer (antistrep antibody) rising or elevated. Elevated C reactive protein or Sed Rate. Administer antibiotics, anti-inflammatories & steroids for severe carditis.
Patients who have had Acute Rheumatic Fever will be prescribed prophylactic ______ in the future for invasive procedures.
This is evidenced by bulging fontanels, fewer than 6 wet diapers per day, moist lung sounds & generalized tissue edema.
Signs of this are Tachypnea, orthopnea, grunting, flaring nostrils & chest retractions.
symptoms of ____ _____ (which side) heart defects (in children) are: cyanosis, dyspnea, respiratory rales, orthopnea, tachycardia, fatigue & restlessness.
Symptoms of ______ ______ (which side)heart defect (in children) are: distended neck veins, tachycardia, liver enlargement, weight gain & edema.
Polyarthritis of ARF responds better to the anti-inflammatory effects of _____ than to acetaminophen or ibuprofen. But be careful, can cause Reye's syndrome
Systemic reaction to an allergen that occurs within minutes or up to 2 hours after exposure
Sickle cell disease is Inherited or acquired?
This is a rare hereditary X-linked recessive disorder causing a deficiency in specific blood clotting factor. Almost exclusively affects males. S & S bleeding into soft tissue & joints or prolonged bleeding. Labs show decreased Factor VIII or IX and activated partial thromboplastin time. Do NOT give aspirin. Son gets it from the Mom.
This is a deficiency of specific clotting factor VIII (and or IX)
Classic sign of this is bleeding into soft tissues and joints, causes tenderness to area & pain.
do this in cases of bleeding (non meds) in a Hemophiliac
Children with this should NOT HAVE: rectal temperatures, rectal suppositories, Frequent blood pressure monitoring, unnecessary invasive procedures, meds containing aspirin and no contact sports.
DDAVP (desmopressin acitate)
This drug is used to treat mild cases of hemophilia, it is a synthetic drug that increases factor VIII activity. Serious cases need transfusions of the missing clotting factor.
this drug is used to stop bleeding for hemophiliacs
IDIOPATHIC THROMBOCYTOPENIA PURPURA (ITP)
This is a bleeding disorder of unknown cause that leads to a decrease in number of platelets in blood. More common in 2-5 year olds. Child had recent viral infection like chickenpox or rubella.
A rash in which blood cells leak into the skin
Symptoms of this idiopathic disease are: Purpura, Petechiae, hematuria, blood in stool, nosebleeds & ecchymosis. May spontaneously go into permanent remission. If condition continues long term, may perform a Splenectomy. Can be detected with direct Coomb's test.
IDIOPATHIC THROMBOCYTOPENIC PURPURA
Classic (blood) findings for this disease are DECREASED platelets and DECREASED antiplatelet antibodies, with PRESENCE of antinuclear antibodies.
This is a decrease in # of RBCs, a decrease in hemoglobin or both. Can be caused by blood loss, destruction of RBCs or decrease in production of RBCs
IRON DEFICIENCY ANEMIA
this happens when the demand for stored iron is greater than the body can supply. Most commonly found in infants who were switched to whole milk too soon (<1 yr). Will cause growth retardation, mental delays, tachycardia, muscle weakness & systolic heart murmur. Child will be pale, tired, irritable & cranky.
If this is low, it will result in decreased oxygen carrying capacity (of the blood) (anemia)
anemia may be associated with _____. A child who is seen eating dirt, clay, chalk, glue, ice, starch or hair should be assessed to determine whether anemia is the cause.
Anemia classification. Hemoglobin = 9.5-11 g/dl
Anemia classification. Hemoglobin = 8-9.4 g/dl
Anemia classification. Hemoglobin = <8 g/dl
IRON DEFICIENCY, SICKLE CELL & THALASSEMIA
Three types of anemia are:
IRON DEFICIENCY ANEMIA
DECREASED hemoglobin, hematocrit, reticulocyte count and DECREASED serum ferritin, and serium iron concentration WITH INCREASED RBC count & total iron binding capacity are indications of what?
CEREAL & RAISINS
Treatment of Iron Deficiency anemia for children are oral supplements and enriched breads and these two foods.
ORANGE JUICE & STRAW
Administration of oral supplemental iron preparations (for Iron Deficiency Anemia) should be given with ______, to increase absorption and drunk thru a _______, to prevent staining of teeth.
S & S of this overdose are: abdominal pain, vomiting, bloody diarrhea, shortness of breath & shock.
IRON DEFICIENCIES (anemia)
Feosol (ferrous sulfate), Feostat (ferrous fumerate) & Fergon (ferrous gluconate) are drugs given for what?
SICKLE CELL ANEMIA
this is a recessive hereditary disorder affecting the formation of HEMAGLOBIN and causes the RBC to form an S or C shape, preventing normal flow thru capillaries, resulting in decreased blood flow & decreased oxygen-carrying capacity.
SICKLE CELL ANEMIA
If BOTH parents carry the recessive gene (for this anemia) there is a 25% (1 in 4) chance that each child will have this disease.
The infant with sickle cell anemia will be asymptomatic until __ - __ months of age because sickling is inhibited by fetal hemoglobin. Not all RBCs will be misshapen and the infant will be healthy much of the time.
SICKLE CELL ANEMIA
RBCs of patient with this are normal shaped until they are off loaded of their oxygen. When this happens, the cell crystallizes into a rod-like structure. Conditions causing high tissue oxygen demands cause sickled erythrocytes to adhere to capillary walls and to each other, obstructing blood flow and cell damage (due to lack of oxygen). Causes microinfarcts in joints & organs, slowly destroys organs & tissues. The spleen and kidneys are especially prone to damage.
SICKLE CELL ANEMIA
For this you will do blood transfusions with whole blood, packed RBCs, fresh frozen plasma, cryoprecipitate, clotting factors & albumin. Give analgesics, IV fluids O2, prophylactic antibiotics & lots of pain meds.
Child with Sickle Cell, will release more sickle-shaped cells into _____ during periods of stress, such as periods of growth, or illness.
Sickle cells have short life span, living ______ days, vs. the normal 120 days of normal RBCs.
SICKLE CELL CRISIS
This is an acute episode of severe symptoms, brought on by fever, dehydration, altitude, vomiting, emotional distress, fatigue, alcohol consumption, pregnancy or excessive physical activity.
Iron overload due to increased number of blood transfusions. Give iron-chelating agent such as defroxamine, which binds to iron so it can be excreted by the kidneys. Vitamin C may also be used to promote iron excretion.
LUQ (Left Upper Quandrant)
during a sickle cell crisis, child will experience severe pain, localized to area of vaso-occlusion. If the obstruction is in the spleen, the pain will be where?
During sickle cell crisis, if occlusions (vaso-occulsion) is here, there will be discoloration, pallor & coolness in the area. Nausea, fever, swelling & pain in the joints, vomiting, anorexia & diarrhea may also be present.
SICKLE CELL CRISIS
Three types of Sickle Cell Crisis: Vaso-occlusive (thrombotic Crisis) - most common type. Splenic Sequestration & Aplastic Crisis.
Diagnosis of sickle cell anemia for infants 0-6 months is done thru this test.
Diagnosis of sickle cell anemia for infants >6 months is done thru this test. If test is positive will be verified by a hemoglobin electrophoresis
Adverse Reactions to this are: urticarial, respiratory distress, fever, chills, headache, chest or back pain, hypotension, nausea, productive cough & distended neck veins
This is an INHERITED disorder caused by abnormal hemoglobin synthesis. Classified as either beta or alpha. Both are defects in production of hemoglobin. In BETA the RBC's are fragile and can be easily destroyed. Common in Mediterranean & Middle east, Asian or African children. Beta is an autosomal recessive disorder, if both parents are carriers, each child has a 25% chance of having the condition.
This is a by-product of hemolysis (destruction of RBCs), which can be deposited in skin of child with Thalassemia, creating a tanned appearance.
This is an iron-containing pigment derived from hemoglobin from disintegration of red blood cells. It is one form in which iron is stored until it is needed for making hemoglobin.
LIVER & SPLEEN
In Thalassemia these two organs may become enlarged, because of deposits of hemosiderin ending up in these organs.
Children with this type of anemia will have a tanned appearance, can have pathologic fractures & skeletal deformities. Pallor, lethargy, activity intolerance, headache & bone pain & jaundice. Liver and spleen may also become enlarged.
Patients with thalassemia will have blood transfusions every how often?
Patient with Thalassemia will have blood transfusions every 2-4 weeks. Their RBC's break down quickly and release iron into their system, which has to be removed frequently so they have to have this done.
These tests are done on children of parents of Mid East, Asian or African decent to check for _______. Genetic testing in pregnancy, hemoglobin electrophoresis, CBC (complete blood count), chest X-ray, MRI of the liver.
this is a rare malignant disorder of the lymphoid system. More common in 15 year old males.
S & S of this disease are: Nontender, firm, enlarged lymph nodes usually in cervical & supraclavicular area. May experience fever, night sweats & weight loss. If mediastinal (in throat) lymph nodes are involved may have respiratory distress.
This is diagnosed thru family history, Elevated erythrocyte sed rates, leukocyte counts, Reed Sternberg Cells, lymph node biopsy, staging laparotomy, CT or MRI scans, lymphangiogram, Blood counts & bone marrow biopsy.
Treatment for Hodgkin's Lymphoma usually consists of a combination of 4-5 antineoplastic agents (chemotherapy) and possibly low-dose radiation. It is important to wear these when handling fluids because these chemicals will be in the body fluids and waste products.
This is a cancer of the blood-forming organs. Bone marrow, spleen, lymph system, characterized by abnormal increase of WBCs. Most common form of cancer in children.
LYMPHOBLASTIC & MYELOID
Two types of acute leukemia's common in children:
ACUTE LYMPHOBLASTIC LEUKEMIA (ALL)
This is the overproduction of immature lymphocytes. The lymphocytes divide rapidly but fail to mature. Lymphoblasts rise and crowd out normal WBCs, RBCs & platelets. The most common leukemia of childhood has highest incidence in Caucasian boys 3-4 years of age.
What kind of leukemia is the most common type of leukemia in children and most common cancer affecting children younger than 5 years?
ACUTE MYELOGENOUS LEUKEMIA (AML)
This cancer occurs when cancer cells develop in the bone marrow (myeloid tissue). In this cancer, the cancer cells replace normal cells of the bone marrow.
S & S of this cancer are: child easily develops infections, Respiratory infections. Low RBC count, Anemia, low platelet count, bleeding gums & bruising are common.
Lab results for this disease will show elevated leukocytes, <platelets, < hemoglobin (RBCs). Abnormal lymphoblasts in bone marrow aspirate.
for this treat with antibiotics, blood replacement, chemo, radiation, bone marrow transplant (only if in remission). Maintain sterile environment after transplant.
Chemo agents used to treat Leukemia are __________ (toxic), monitor for bruising, bleeding, fever, infection, Specific gravity, I & Os, Daily weight, N & V, constipation, mouth sores. Give high calorie foods, soft & easy to digest (no fats).
child undergoing bone marrow transplant is kept in what kind of environment?
Large meals can increase fatigue, so _____ such as fruits, vegetables, soups, cheese, peanut butter and nuts should be readily avialble.
Ring surrounding the opening between the esophagus and the stomach that prevents food and gastric acid from being pushed from the stomach into the esophagus
Ring of smooth muscle fibers around the opening of the stomach into the duodenum
Passage at the lower end of the stomach that opens into the duodenum
A fold, crease, or wrinkle, as in the lining of the mucus membranes of the vagina (or stomach)
Potentially life-threatening defect when a connection between the trachea and esophagus is present. Oral intake will not enter the stomach, resulting in vomiting, instead it will enter the trachea causing aspiration.
S & S of this are copious amounts of thin mucus shortly after birth, reappears after suctioning. Stomach may become distended with trapped air. Infant will regurgitate the feeding or it will be aspirated into the lungs. Severe respiratory distress, aspiration pneumonia and excessive drooling may be present.
A child may be born with Esosphageal Atresia or Tracheoesophageal fistula. For this reason the first feeding should be ______ ______. If this goes into the lungs it will not cause infection.
After surgery for Tracheoesophageal fistula the infant should not be fed orally for who many days? Will be fed by a gastrostomy tube. Child should be held during these feedings and given something to suck on so they don't forget how to suck.
To diagnose a Tracheoesophageal fistula, Dr will attempt to pass what size nasogastric tube into the stomach? Will also do an X-ray, ultrasound and echocardiogram to confirm diagnosis.
Inflammation of the stomach, may be caused by bacteria, such as Escherichia coli or salmonella; virus, such as rotavirus; as well as toxins & allergies. May resolve without complications or cause mild to severe dehydration.
FLUID & ELECTROLYTE IMBALANCES
With gastroenteritis child can have N & V, diarrhea & fever. If symptoms do not resolve in 24-48 hours, can develop severe dehydration. Also if bleeding (vomiting can cause this) is present, physician should be consulted immediately. Child is as risk for:
Infant with dehydration, an outward sign will be sunken _______.
Child with dehydration, an outward sign will be sunken _______.
GOWN & GLOVES
Child with severe Gastroenteritis, being cared for in the hospital is placed on enteric precautions and these are required (for the nurse) when caring for the child.
Diet consisting of Bananas, Rice, Applesauce & Toast is called the what diet?
FULL LIQUID TO SOFT FOODS
Child recovering from Gastroenteritis should have a _____ _____ diet, progressing to _____ ______.
Foods or supplements containing live, beneficial organisms
Inflammation of the vermiform appendix, a small sac at the end of the cecum. Most common in boys between 10- 16. Initially there is a blockage of the lumen of the appendix (usually by fecal matter) followed by infection & inflammation. There is risk of rupture and peritonitis.
Appendicitis is most common in boys between what ages? Rarely occurs below 2 years of age.
RLQ (right Lower quadrant)
Child with Appendicitis will present with constant pain where?
A child with this usually exhibits fever, nausea & elevated WBC count. May prefer side-lying position with knees flexed (fetal position)
A sudden relief of pain (in appendicitis) may indicate the appendix has ___________.
This location is located halfway between the umbilicus and the right iliac crest. Common location of pain for appendicitis.
An elevated WBC count in a child is what number?
The (veriform) appendix is a small, slender tube attached to the ______, at the beginning of the Large intestine (colon), located at the lower right quadrant of the abdomen.
Following palpation, the increase in discomfort when abdominal pressure is released
Gluten-sensitive enteropathy or sprue; a chronic malabsorption syndrome in which one is unable to digest gluten, a protein found in wheat, barley, rye and oats
This disease is the inability to digest gluten, which results in increase in amino acid glutamine (which is toxic to the mucous membrane in small intestine). Over time this damages the intestinal villi, so fat absorption affected, leading to malabsorption of protein, carbs, calcium, iron & fat soluble vitamins.
Fat in the stool
These symptoms do not begin until usually the 1-5 years of life. Will have chronic diarrhea, vomiting & failure to grow (low on growth chart). Stools are large, foul-smelling, greasy & frothy and are watery & pale.
With celiac disease, Amino acid glutamine will cause the intestinal villi to ____, which affects the absorption of ingested nutrients.
For this disease, eliminate gluten from diet, give vitamin (ADEK - fat soluble) supplements. Can have rice & corn.
Celiac disease patients eating gluten are at risk for growth retardation and _____ _____ as an adult.
Mayonnaise, vinegar, catsup, canned soup, wheat, barley, rye & oats, ice cream & pudding, all contain what?
A child with Celiac disease WILL or WILL NOT outgrow the disease?
Children with sickle cell disease or hemophilia are at risk for developing what form of hepatitis? (due to blood transfusions)
Progressive hypertrophy of the pyloric sphincter resulting in obstruction. Thickening of the pyloric sphincter narrows passageway between the stomach & the duodenum. As stomach tries to push food thru narrowed lumen, mucous membrane becomes inflamed & swollen, narrowing the lumen further & causing total obstruction.
the pyloric sphincter enlarges and squeezes shut the stomach outlet in this condition. Food cannot get out of the stomach. Most common in 5 week old first born boys.
this presents (at about 5 weeks - boys) with projectile vomiting. Infant becomes dehydrated, loses weight & passes fewer & smaller stools. Small round mass may be felt in RUQ & peristaltic waves may be seen across abdomen.
The child with this condition becomes very ill with dehydration in just a few days, because nothing is passing out of the stomach so nutrients & fluids are not getting into the intestines for absorption.
Surgical widening of the pyloric canal to facilitate emptying of gastric contents into the duodenum. Should be kept NPO after surgery. IV therapy for fluid & electrolyte balance.
After surgery for correction of Pyloric Stenosis (pyloroplasty), Diaper should be slid under the buttocks. You should not _____ the legs to change diapers.
Condition that occurs when one portion of the intestine telescopes INTO another portion. Mechanical obstruction of the SMALL bowel. Most common site is the ileocecal valve. More frequently in boys 2 months to 5 years. Cause unknown but thinks associated with viral infections.
This will cause walls of intestine to rub together, producing inflammation, swelling & obstruction. Swelling causes decrease in blood flow, resulting in ischemia, necrosis, perforation & hemorrhage.
S & S of this are sudden severe abdominal pain, vomiting & passage of brown/currant jelly stool. May have a palpable abdominal mass.
Diagnosis of Intussusception is done thru a ____ enema. In some cases the ____ moves the intestine back into place. IF not, surgery may be done to reduce or remove the damaged tissue.
Most common site for intussusceptions is the _____ _____.
MEGACOLON (aka Hirschprung's disease)
A condition in which the autonomic parasympathetic ganglion that normally causes peristalsis in the intestine is absent, causes mechanical bowel obstruction of large intestine. More common in boys and often occurs with congenital heart defects, Down's syndrome & other neurologic syndromes.
Ingestion of a toxic substance and common cause of injury or death in children between 1 & 4 years of age.
Boston ivy, poinsettia, philodendron, lily-of-the-valley, daffodil, azalea, rhododendron are _____ if ingested.
Most common form of poisoning in children is:
This type of poisoning is the most common in children, will lead to toxic amounts of this in the blood, interferes with normal cell function, particularly the nervous system, blood cells, kidneys & vitamin D & calcium metabolism. Deposits in bones & teeth.
this blood test is the most useful tool in screening, diagnosis & monitoring of lead poisoning.
This can be caused from lead-based paint, drinking water thru lead pipes, lead holding tanks or pipes and tanks soldered with lead, food grown in lead-contaminated dirt & airborne lead from smelters & battery manufacturing plants.
This mnemonic stands for S = Stabilize, I = Identify, R = Reverse effects, E = Eliminate substance from body, S = Support physically & psychologically
This agent binds with poisonous chemicals to slow or prevent absorption.
If a child is poisoned and vomits, the ____ should be brought to the emergency department with the child.
Administration of a chemical that will bind to the lead and increase the rate of excretion. Uses Calcium disodium, dimercaprol, d-penicillamine or succimre alone or in combination. There will be a rest period and then repeated.
Symptoms of this include cognitive deficit, learning disabilities, hearing impairment & growth delays. Can also cause fetal malformation, low birth weight & premature birth if ingested by pregnant women.
NO VOMIT, DILUTE & CHARCOAL
Corrosives Poisoning: acids & alkaline: Cleansers, toilet & drain cleaners, bleach & batteries. Will have burns, respiratory obstruction, drooling & pain. Treat how?
NO VOMIT, DECONTAMINATE SKIN
Hydrocarbons Poisoning: distillates of petroleum. Symptoms: coughing, vomiting, respiratory distress, lethargy. Treat how?
VOMIT, BICARBONATE, VITAMIN K
Salicylates Poisoning: Symptoms: Nausea/vomiting, tinnitus, bleeding, convulsions. Treat how?
VOMIT,LAVAGE, CHARCOAL OR MUCOMYST
Acetaminophen Poisoning: Symptoms: N&V, pallor, hepatic involvement. Treat how?
REMOVE AGENT, CHELATION
Heavy Metal Poisoning (mercury & lead): Symptoms: Tremors, memory loss, cognitive defects. Treat how?
This occurs when the membrane between the anal pit and the colon fails to break down. A thin membrane may be seen covering the anus or an obvious malformation can be seen, including a flat anus or deep dimple.
If meconium is not passed within 24 hours of birth, this should be suspected. Meconium may also be present in the urine.
Feeding an infant with uncorrected Imperforate Anus will stimulate peristalsis and could cause rupture of what? If surgery is delayed, IV fluid & nutrition will be necessary.
Intestinal parasites occur where ______ is not treated, poor sanitation or foods are not properly cooked. Children also exposed to larva or eggs from playing in contaminated dirt & sandboxes.
This intestinal parasite is caused when eggs are inhaled or hand to mouth ingestion. Eggs hatch in intestine in 15-28 days and migrate to cecum. After mating, female leaves out of the anus. Can move to the vagina & urethra.
This intestinal parasite S & S are: worm movement causes intense itching, especially at night when the female leaves the anus. Use tape to catch it.
the drug of choice for "worms" is:
Povan, used to treat worms causes stool to turn what color?
LIVER & LUNG
Severe infections of intestinal parasites (worms) can cause intestinal obstruction and ____ & ______ involvement.
This type of blood transfusion reaction (occurs in first 10-15 minutes or first 50 cc of blood), present as itching, facial flushing, hives & rash
This type of blood transfusion reaction (occurs in first 10-15 minutes or first 50 cc of blood) presents as headache, tachycardia, Tachypnea, fever, chills & anxiety
This type of blood transfusion reaction (occurs in first 10-15 minutes or first 50 cc of blood) Presents as headache, chest pain, apprehension, low back pain, chills, fever, tachycardia < BP & > Resp.
STOP & NS
With all Blood transfusion reactions ______ blood transfusion immediately and maintain line with ____.
Don't give charcoal until after vomiting ______, aspiration of charcoal can damage the lung.
Combining form meaning "iron"