Study guide pediatric nursing
Terms in this set (144)
family apgar score
Brief screening tool that is designed to assess satisfaction with family functioning.
In Piaget's theory, the period of cognitive development from birth to about 2 years in which the child has not yet achieved object permanence. Babies learn primarily from their senses and their own actions (cause and effect) and display stranger anxiety. Sense of self is directly related to having needs met. No concept of death.
Piaget's second stage of cognitive development, occurring from ages 2 through 7, as the child learns language, symbolic play, and symbolic drawing, but does not grasp abstract concepts, such as conservation (big cup vs small cup with same volume). The child represents ideas through words and images. Children in this phase are egocentric.
Piaget's stage in which children learn such concepts as conservation and mathematical transformations; about 7 - 11 years of age
in Piaget's theory, the stage of cognitive development (normally beginning about age 12) during which people begin to think logically, hypothetically, and morally about abstract concepts.
Birth to 1 year, trust vs mistrust, strength: hope, strong maternal influence
Age 2-3, autonomy vs shame/self doubt, strength: willpower, parental figures are influential. By age 3, offering choices is very helpful. Stuttering also begins at age 3. No concept of death but sensitive to others' emotions.
Age 4-5, initiative vs guilt, strength: purpose, influence from parents, family, and friends. Fear that their insides will come out with intrusive procedures. At age 4 the child exhibits more aggression, but by age 5 becomes more tranquil. Death is impermanent and deliberately caused.
Age 6-11, industry vs inferiority, strength: competence, influenced by school
Age 12-18, identity vs confusion, strength: fidelity, influence from peers
Age 18-35, intimacy vs isolation, strength: love, influence: spouse
a disorder in which the eyes point in different directions or are not aligned correctly because the eye muscles are unable to focus together. Amblyopia may develop if the eyes do not work together. The brain may ignore the visual cues from one eye, resulting in blindness.
When a baby goes from lying down to sitting up, her head will naturally lag, or droop, forward or backward. As she grows stronger, she can control her neck muscles more easily, and this quality should disappear by 4 months.
Doll's head maneuver
a test for central nervous system brainstem damage in a comatose patient. The head is quickly rotated from side to side. Normally the eyes deviate to the opposite direction. Failure of the eyes to make the movement is an indication of severe brainstem damage.
Syringe of icy water into ear. Normal/positive caloric: eyes deviate to side of ice water application. Abnormal caloric: eyes do not deviate
characterized by upper extremities flexed at the elbows and held closely to the body and lower extremities that are externally rotated and extended. occurs when the brainstem is not inhibited by the motor function of the cerebral cortex.
posturing in which the neck is extended with jaw clenched; arms are pronated, extended, and close to the sides; legs are extended straight out; more ominous sign of brain stem damage. MOST SEVERE!!!
Faces to deem pain level 3 yrs or older
Severe dehydration in infants
Tachycardia, irritability, capillary refill greater than 3 seconds, 15% weight loss, and sunken eyes and fontanel. Acute kidney failure and water intoxication.
oral rehydration solution
Means of treating dehydration involving giving by mouth a balanced solution of salts and glucose which stimulates the gut to reabsorb water. Can be given at home.
Virus remains latent in a sensory nerve ending and the dorsal root ganglion and may be reactivated later. Treat itching with diphenhydramine.
Classic signs & symptoms
Prodrome: fever, malaise, none
Rash: macular, papular, vesicular, crusted (itchy, spreads chest to extremities)
Transmitted through respiratory secretions & lesions
Incubation period: 11-16 days
Communicability: 2 days before rash appears until
Complications: Secondary bacterial infection, Pneumonia, Thrombocytopenia, Encephalitis, Shingles Treatment/Prevention: Vaccine, Supportive care
Parvovirus B19. Mild systemic disease with a fiery red edematous facial rash on the trunk and extremities.
Classic signs & symptoms: Fever, runny nose, headache, Slapped cheek appearance, Rash
Transmitted through respiratory secretions, air, blood, placenta
Incubation period: 4-14 days
Communicability: Day 5-12 of infection until rash
Complications: Miscarriage in pregnant women, Joint pain/swelling, Anemia in high risk
The time from exposure to appearance of first symptom.
The interval between early manifestations of the disease and the appearance of overt clinical symptoms.
period of communicability
The time when the child is infectious.
An infection control designed to prevent direct contact with blood and other body fluids and tissues by using barrier protection and work control practices
A mechanical obstruction caused by a lack of motility of a segment of the intestine resulting from the lack of innervation by ganglion cells. There is a lack of peristalsis in the affected segment, which interferes with the evacuation of solid waste. After surgery, keep NPO until bowel sounds return.
Pain dissipates after rupture. The nasogastric tube is used to maintain gastric decompression until the return of intestinal activity.
inflammatory bowel disease
A high-protein, high-calorie diet supplemented with vitamins is needed to help correct nutritional deficits. Fiber is not recommended.
Chronic disease with life-threatening/life-altering complications. The nursing interventions include helping the child cope with stress and learn how to adjust to the illness.
affects terminal ilium, weight loss anorexia, diarrhea, B12 deficient, megaloblastic anemia, iron deficient blood loss, maintain fluid/electrolyte balance, bowel rest, TPN, minimal residue, energy needs according to current BMI limit fat only if steatorrhea, water+fat soluble V, Fe, folate...when under control, high fiber
Contagious disease, transmitted through the fecal-oral route. The nurse should teach infection control measures to family.
A progressive, destructive, sclerosing, inflammatory process that leads to obliteration or discontinuity of the hepatic and/or common bile ducts at any point from the porta hepatis to the duodenum
Congenital defect: fetal or perinatal
Symptoms: Jaundice, dark urine, light stools
Treatment is surgery: Kasai procedure or liver
transplant. Approximately 80% to 90% of children will require liver transplantation.
Manifestations include excessive salivation and drooling. the child has difficulty managing the secretions causing choking, coughing, and cyanosis. Nsg interventions surround prevention of aspiration. Treated with surgery
Passage of a normal stool indicates resolution. Notification of the physician is essential to determine whether a change in treatment plan is indicated.
Characterized by intolerance to gluten, the protein found in wheat, barley, rye, and oats. A low-gluten diet is indicated. Manifestations include irritability, poor appetite and growth, and foul-smelling stools.
Treated with proton pump inhibitors, which block the production of acid. They are well tolerated and have infrequent side effects. Eliminate NSAIDs, cigarettes, and caffeine.
The expected pH is 4.8 to 7.8. Normal specific gravity range is 1.016 to 1.022. Protein and glucose should be absent.
Allows urine flow to be forced back to the kidneys. When the urine is infected, this contributes to kidney infections.
Hypertension results from the cycle of infection/inflammation/scarring/decreased perfusion. Renin-angiotensin is released, which ultimately elevates blood pressure.
Treat with antibiotics or surgery in grades IV-V. Management may take years.
Inflammatory disease: Glomerulus becomes inflamed and allows molecules to pass
Most common in 2-6 year olds
Characterized by: Proteinuria (frothy urine), Hypoalbuminemia, Edema
Hypoalbuminemia is a result of the large amounts of protein that leak through the glomerular membrane into the urine. Measuring weight at the same time each day is the most accurate way to determine fluid gains and losses. The child will have a variable level of tolerance for activity. This will also be affected by the labile moods associated with steroid administration. The nurse should assist the family in adjusting activities for the child.
Tx: Prednisone, diuretics, albumin, low salt diet, ensure position changes, monitor for fever, cough, and abdominal pain.
Immune reaction to group A beta-hemolytic
streptococcal infection. Most common in young children 5-12 yrs. 1-2 weeks after strep throat, 3-6 weeks after skin infection.
Characterized by: Sudden onset, Hematuria, Proteinuria, edema, Renal insufficiency, Hematuria: tea- or cola-colored urine, Hypertension, periorbital edema
Acute hypertension is anticipated and requires frequent monitoring for early intervention.
Tx: Antihypertensives, low salt, diuretics
Congenital defect in which the urinary meatus is located on the lower or underside of the shaft. Surgery is done early to promote healthy body image. Usually done between 6 and 12 months of age. No circumcision until after surgery. Urinary diversion is used after surgery to allow healing (stents or catheters).
Surgery goal: make urinary and sexual function as
normal as possible/improve the cosmetic appearance of the penis. Monitor for urine cloudiness or odor.
congenital defect in which the urinary meatus is located on the upper side of the penile shaft; less common than hypospadias. Surgery is done early to promote healthy body image. Usually done between 6 and 12 months of age. No circumcision until after surgery. Urinary diversion is used after surgery to allow healing (stents or catheters).
Surgery goal: make urinary and sexual function as
normal as possible/improve the cosmetic appearance of the penis. Monitor for urine cloudiness or odor.
The child's own peritoneal cavity acts as the semi-
permeable membrane across which water and solutes diffuse. Glucose solution.
Often initiated in the ICU. Dialysis set-ups are available commercially.
Can be done at home by adolescents.
Neural tube defect that contains meninges, spinal fluid, and nerves. With diet modification and regular toilet habits to prevent constipation and impaction, some degree of fecal continence can be achieved. Assessment of the fontanels and daily measurements of head circumference will aid in early detection of postoperative hydrocephalus.
a urinary problem caused by interference with the normal nerve pathways associated with urination
Self-straight catheterization can be done at age 6.
Apnea of infancy
cessation of breath for longer than 20 seconds in infant. Parents should be taught CPR.
group A beta-hemolytic streptococci
risk for acute rheumatic fever and acute glomerulonephritis.
Caused by untreated group A beta-hemolytic strep
Manifests 2-6 weeks after infection Immune response causes inflammation in heart, brain, skin &
Can cause permanent damage to heart valves
• Arthritis • Carditis • Chorea • Erythema marginatum • Subcutaneous nodules
• Penicillin is the drug of choice; erythromycin
ethylsuccinate in penicillin-allergic children
• Aspirin or corticosteroids are administered to speed
resolution of the inflammatory process
• Antibiotic prophylaxis
Acute, febrile, exanthemous illness Seen most frequently <5, Asian ancestry, boys>girls Peak age 1 yr, mean of 2.6 yrs, uncommon after 8 yrs Winter/Early spring Unknown cause Long term inplications
Acute phase: fever, conjunctivitis, rash, enlarged lymph nodes
subacute phase: desquamation, arthritis, CV (Coronary artery aneurysms)
Tx: ASA, immunoglobulin
Most common cause of pneumonia and bronchiolitis in infants. Prevented with palivizumab (Synagis)
mild intermittent asthma
Asthma with symptoms 2 or less per week w/ nocturnal awakening occuring 2 or less times per month; FEV1 80%+
mild persistent asthma
Asthma: sx 4x/wk, PM cough 2x/mo, normal PFTs.
moderate persistent asthma
Asthma: daily sx, PM cough 2x/wk, FEV1 60-80%.
severe persistent asthma
Asthma: daily sx, PM cough 4x/wk, FEV1 <60%.
Children have thick mucous gland secretions. The viscous secretions obstruct small passages in organs such as the pancreas. A, D, E, and K are the fat-soluble vitamins that need to be supplemented at every meal and snack and increased in the incidence of loose, fatty stools.
Routine airway clearance treatments usually 2-3 times a day.
Diagnosed via sweat chloride.
patent ductus arteriosus
Allows blood to flow from the aorta (high pressure) to the pulmonary artery (low pressure). If the defect stays open, increased pulmonary congestion can occur.
tetralogy of Fallot
1. Ventricular Septal Defect
2. Pulmonary Valve stenosis
2a. Infundibular Stenosis
3. Overriding aorta
4. Right Ventricular Hypertrophy
Boot shaped heart, harsh systolic murmur with palpable thrill, chronic hypoxemia
The squatting or knee-chest position decreases the amount of blood returning to the heart and allows the child time to compensate.
Transposition of the great arteries
Aorta arises from the right ventricle
Aorta is anterior and to the right of the pulmonary artery
Pulmonary artery arises from the left ventricle allows the mixing of blood in the heart.
PDA and/or ASD need to be present for
congestive heart failure
Too much volume entering the heart
Too much resistance to blood leaving the
Weak heart muscle (contractility) Inefficient contraction
Tachypnea is one of the early signs that should be identified. Tachycardia at rest, dyspnea, retractions, and activity intolerance are other physical signs and symptoms. The child needs to be well rested before feeding. The child's needs should be met as quickly as possible to minimize crying. The nurse must organize care to facilitate a decrease in the child's energy expenditure.
sickle cell disease
autosomal recessive disorder; therefore both parents must have the trait for the child to have the disease. Parents need instructions on watching for specific changes in the child's condition, learning how to administer penicillin, keeping the child adequately hydrated, and identifying possible environmental problems. Severe chest pain, fever, a cough, and dyspnea are the signs and symptoms of chest syndrome. The nurse must notify the practitioner immediately.
Pressure should be applied for at least 15 minutes to help control superficial bleeding.
Because this device is totally under the skin, there are no activity limitations for the child, except when the port is in use.
Fatigue is the most common side effect. For children, the fatigue may be especially distressing because it means they cannot keep up with their peers.
These are signs of infiltration of the bone marrow: petechiae from lowered platelet count, infection from the decreased number of effective leukocytes, and fatigue from the anemia.
Good hand hygiene is the most effective means of preventing disease transmission.
Inhibition of bone marrow function - immunosuppressed
Tumors are encapsulated. It is extremely important to avoid any palpation of the mass to minimize the risk of dissemination of cancer cells to adjacent and other sites. Chemotherapy with or without radiation therapy is usually indicated.
Although striated muscle fibers from which this tumor arises can be found anywhere in the body, the most common sites are the head and neck.
Because of the unstable nature of the child's fluid and electrolyte balance, wearing medical identification is an extremely important intervention.
A disease caused by inadequate secretion of antidiuretic hormone (ADH) by the pituitary gland with symptoms of polyuria.
Early diagnosis is imperative. Because brain growth is complete by 2 to 3 years of age, the deficiency must be detected and replacement therapy begun as soon as possible.
Preparations are made for emergency ventilation, including a tracheostomy set at the bedside.
acute adrenocortical insufficiency
During the recovery phase, paralysis may develop. It is a temporary, quickly reversible clinical manifestation.
a description of the clinical manifestations caused by too much circulating cortisol.
type 1 diabetes
characterized by destruction of the insulin-producing pancreatic beta cells.
type 2 diabetes
a result of insulin resistance.
Although the response is variable, most girls will achieve some feminization with estrogen therapy.
Irritability, unequal/sluggish pupils Nursing interventions: reduce pain,
Transmitted through direct contact with respiratory secretions
Incubation period: 4-10 days
Communicability: 7 days before symptoms to 1 day
after receiving abx
Complications: 15% of cases fatal, Amputation of limbs, Shock
Treatment/Prevention: MCV vaccine, Antibiotics, Antibiotic prophylaxis
Nursing Considerations: Droplet isolation, Medications, Fluids, supportive care
Administer antibiotics immediately. Sensitive to noise, bright lights, and other external stimuli. The nurse should keep the room as quiet as possible, with a minimum of external stimuli.
generalized seizure that lasts more than 30 minutes.
the most common of seizures. They have a tonic phase of approximately 10 to 20 seconds. They involve both hemispheres of the brain.
simple partial seizure
characterized by varying sensations.
Patients may feel for a brief moment that their precise location is vague and out of sorts. Often, patients hear and see things that are not there or smell or taste things that are not there or smell or taste things and have an upset stomach. Parts of the body, such as the arms, legs, or face, may start twitching. Symptoms are often not dramatic and may occur without loss of consciousness.
Brief losses of consciousness.
Because of the potentially severe sequelae, symptoms of malfunction or infection must be assessed and treated immediately, if present.
results from faulty development (brain anomalies) during the prenatal period or from damage during the perinatal period, including brain anoxia and cerebral trauma during delivery. The goal of therapy is to promote optimal development. This is done through early recognition and beginning of therapy.
Contains meninges and spinal fluid but no neural tissue. Unless there are associated cutaneous findings, it is often not identified until later.
Spina bifida cystica
cystic formation with an external saclike protrusion.
Spina bifida occulta
completely enclosed. Often this defect will not be noticed.
Fetal ultrasonography and elevated concentrations of alpha-fetoprotein in amniotic fluid may indicate the presence of neural tube defects. Providing a latex-free environment is the most important nursing intervention. From birth on, the limitation of exposure to latex is essential in an attempt to minimize sensitization.
Muscle function will gradually return, and recovery is possible in most children.
a disorder in which the body's immune system attacks part of the peripheral nervous system; symptoms can increase in intensity until certain muscles cannot be used at all and, when severe, the person is almost totally paralyzed; the disorder is life threatening when potentially interfering with breathing and, at times, with blood pressure or heart rate. Ascending paralysis
acute, preventable disease caused by an exotoxin produced by an anaerobic spore-forming, gram-positive bacillus, Clostridium tetani.
Caused by ingesting spores of Clostridium botulinum and the resultant release of toxin. The bacterium has been found in honey and corn syrup that was fed to affected infants.
Acute signs of fever, pharyngitis, lymphadenopathy, and hepatosplenomegaly continue for 2 to 4 weeks, followed by a gradual recovery. Complications include splenic rupture. Offer child soothing liquids and bland foods for sore throat.
Classic signs & symptoms: Catarrhal stage (1-1.5 weeks): Upper respiratory infection symptoms
Paroxysmal stage (1-6 weeks): Characteristic whoop cough, Post cough vomiting
Convalsecent stage (1-1.5 weeks): Cough improves Transmitted through respiratory tract
Incubation period: 5-21 days (typically about 10)
Communicability: Greatest in Catarrhal stage (unless rx), 4 weeks from cough onset
Complications: Death, Secondary infections (ear/pneumonia), Dehydration/Malnutrition, Hypoxemia, pneumothorax, Epistaxis, hernia, rectal prolapse
Treatment/Prevention: Immunization (DTaP), Antibiotics, Hospitalization if necessary, Droplet precautions
Nursing Considerations: < 6 months most risk, Take immunization history, Immunize parents/caregivers of young children, Assessment, Respiratory: O2, suction, monitor sats, Quiet environment, Monitor nutrition/hydration (I/O), Allow for rest
group A streptococcus with erythrogenic toxin; strawberry tongue, sandpaper rash
rocky mountain spotted fever
Classic signs & symptoms: Headache, fever, anorexia, nausea, vomiting.
Rash appears within 2-5 days: extremities inward.
Transmitted through tick bite.
Incubation period: 2-14 days days (36-48 hours for
Communicability- none. Complications: Vasculitis, Necrotic lesions, Amputation, Death (5-7%).
Treatment/Prevention: Doxycycline, Tick avoidance/repellant/Safe tick removal
Nursing Considerations: History/thorough exam, Treatment, Education, Prevention (people/pets/yard)
Sexual abuse is suspected
A bacterial STD that usually affects mucous membranes
Can be transmitted from mother to fetus via the placenta.
Major clinical manifestations: Cutaneous lesions Hepatosplenomegaly Jaundice Saddle nose Saber shins Hutchinson teeth CN VIII deafness Rhinitis (snuffles) Which ToRCHeS organism is this?
Classic signs & symptoms: No symptoms, Dysuria, urinary frequency, Discharge, Purulent eye d/c.
Transmitted through sexual contact, birth
Incubation period: 7-21 days
Communicability: Varied, until treated (7 days)
Complications: PID, reproductive problems, Neonatal pneumonia, Neonatal conjunctivitis, Preterm delivery.
Treatment/Prevention: Screening, Antibiotics, "Safe sex"/"no sex"
Nursing Considerations: Partner notification, Treatment, Education
Erythematous macula or papule with a clearing in the center.
Classic signs & symptoms: Early localized (3-30 days:) HA,
muscle/joint pain, chills, fatigue, EM rash
Early disseminated (days to weeks): CNS symptoms, swollen nodes, muscle/joint pain, HA, other EM, carditis
Late disseminated (months-years): 60% untreated, intermittent/chronic arthritis/fatigue/neuro problems
Transmitted through tick bite.
Incubation period: 3-32 days (36-48 hours for
Communicability- none Complications: Chronic
Treatment/Prevention: Doxycycline >9/Amoxicillin <9, Tick avoidance/Safe tick removal
Nursing Considerations: History/thorough exam, Treatment, Education, Prevention (people/pets/yard)
Nsg interventions: provide comfort with soothing lotions, restrict activity to quiet activities, encourage drinking of cool liquids.
Common cause of congenital infection in infants.
Infant with purpura, jaundice, hepatoslenomegaly, small gestational age. Brain CT shows periventricular calcifications. Is due to what organism?
Classic signs & symptoms: Prodrome period
Upper respiratory infection
symptoms (3 c's coryza/cough/runny nose); fever, Koplik spots, Macular rash
Transmitted through droplet/airborne
Incubation period: 8-12 days
Communicability: 4 days before 4 days after rash
Complications: Otitis media, pneumonia, croup, Encephalitis, Premature birth/miscarriage
Treatment/Prevention: Immunization (MMR)
Nursing Considerations: Take immunization history, Airborne isolation, Supportive care Monitor for complications
Koplik spots in the buccal mucosa appear 2 days before the red, maculopapular rash.
Rubella (German measles)
Infection during the first trimester of pregnancy has serious consequences for the fetus. May result in cardiac anomalies.
Classic sign is parotid glandular swelling.
Infection may proceed to paralysis.
Vaccine can be given after exposure to the virus.
Human herpesvirus 6
Most cases occur between 6 and 18 months of age.
Classic signs & symptoms: Older infants & toddlers: Sudden high fever, Rash
Transmitted through respiratory secretions
Incubation period: 9-10 days
Communicability: Before rash to when rash appears
Complications: Febrile seizures, Encephalitis (rare)
Treatment/Prevention: Supportive care
Nursing Considerations: Symptomatic care
Immunization after exposure provides protection against a fatal outcome.
-S/S: high fever, fatigue, severe headache, rash (starts centrally and spreads outward) that turns to pus-filled lesions, vomiting, delirium, excessive bleeding
Peak incidence is 4 months of age. Common indication is vomiting after a meal. Use a pacifier to reduce crying. PPI's, position abdomen head up, thicken feeds, surgery - fundoplication
Infiltration of eosinophils in the esophagus in atopic patients. Food allergens dysphagia, heartburn, strictures. Unresponsive to GERD therapy.
Treated with surgery
projecting vomiting, Give IV fluids, NG tube to decompress, monitor hydration, hypokalemia
narrowed condition of the pylorus
Treated with PPIs and antibiotics for H Pylori
stools. BE or surgical
-appendage of ileum near cecum derived from an unobliterated yolk stalk in fetal development.
a serious chronic inflammatory disease of the large intestine and rectum characterized by recurrent episodes of abdominal pain and fever and chills and profuse diarrhea
Transmission through blood and bodily
fluids-sex, needles, tattoos, razors, blood
transfusions, birth, toothbrushes
Medical treatment available not always
Most common form of Hepatitis in the world-
cases decreased in US with vaccinations
Transmission through blood and sex-
contaminated needles, sex, birth
No vaccination available
Medical treatment available but not always
successful- certain genotypes respond better
Can only replicate by attaching to Hepatitis B
Only occurs in presence of Hepatitis B
Vaccination from Hepatitis B
Fluid-filled area obstructing flow in part of the hepatic duct, several different types
Prevents bile from draining out of the liver and into the intestine
Can grow slowly and present later in life
Treatment is surgical resection
Food-borne illness associated with poor hand hygiene. Severe abdominal pain, bloody diarrhea, high fever, headache, and nuchal rigidity.
Incontinence of stool after 4 years of age. Mineral oil is prescribed to eliminate pain associated with bowel movements.
urinary tract infection
Caused by bacteria ascending from outside the
urethra into the bladder/upper urinary tract. Most common serious bacterial infection in infants/children
Highest frequency in infancy
Causes: Neurogenic bladder, Anatomic abnormalities, Voiding issues, Sexual contact, Fecal bacteria most common cause (approximately 80%)
Manifestations in infant: Irritability, fever, dysuria, change in urine odor/color, poor weight gain/feeding
Child: abdominal/suprapubic pain, frequent, painful, urgent urination, enuresis, fever
Involuntary urination after age 5
Inflammation of the urethra due to chemicals or manipulation. Most common in females. Caused by bubble baths, nylon underwear, self manipulation, abuse.
Congenital obstruction at ureteropelvic junction that causes dilation of the kidney. Maintain kidney integrity until normal flow can be established.
Pre-adolescent/adolescent boys incomplete attachment of testes within scrotum. Rotation of the testicle, Spermatic cord twists and obstructs circulation to the testis.
Left testicle affected more. Longer cord on left side. This is an emergency!!!
Testes fail to descend through the inguinal canal into the scrotal sac. Exposes the testes to the heat of the body, leading to low sperm counts at sexual maturity.
Greater risk for torsion and trauma. Frequently associated with an inguinal hernia. Clinical manifestations: Testes that are not palpable or not easily guided into the scrotum
or a previously descended testis that ascends into an extrascrotal position
Treatment: orchiopexy surgery
Hemolytic Uremic Syndrome
An acute renal disease characterized by a triad of
manifestations: acute renal failure, hemolytic anemia, thrombocytopenia
Occurs primarily in infants and small children
between 6 months and 3 years of age
An important cause of chronic renal failure
Disease usually follows an acute gastrointestinal
or upper respiratory infection
Parenteral or enteral nutrition as ordered. Dialysis may be required during the acute period to correct electrolyte and fluid balances while eliminating wastes
Monitor intake and output, Daily weights
Acute Renal Failure
Urine output less than 0.5 to 1 mL/kg/hour
Volume overload due to retained fluid
Hypertension, edema, shortness of breath, reduced appetite, lethargy
Acidosis, elevated BUN Electrolyte imbalance (increased serum potassium) and dehydration
Reduce symptoms Supportive care until renal function returns Medications - corticosteroids Dietary restrictions - sodium Dialysis if indicated
Used in treatment of advanced and permanent
Blood flows through a special filter that removes
waste and extra fluids.
The clean blood is then returned to the body. Done 3 times a week for 3 to 5 hours.
Painless swelling of the scrotum caused by a collection of fluid
narrowing (stricture) of the opening of the prepuce over the glans penis. Can be corrected through gentle cleaning and manual retraction.
ineffective airway clearance
acute viral infection of infants and children with obstruction of the larynx, accompanied by barking cough and stridor
coarctation of the aorta
Narrowing of the lumen of the aorta
Increases resistance to aortic
Blood pressure proximal to defect will be high
Blood pressure distal to defect will be low
bp in arms higher than legs
Pulmonary vascular resistance remains
Shunting of blood can cause elevated PVR Cardiac Output decreases Exacerbated by three H's"
◦Hypoxia ◦Hyperthermia ◦Hypercarbia
Tx: nitric oxide
atrial septal defect
Hole in the atrial
septum that develops during fetal septal formation
Left to Right
Ventricular septal defect
causes enlargement of both ventricles, pulmonary artery
ventricle and pulmonary artery to high pressures
hepatosplenomegaly and periorbital edema indicate heart failure
A condition in which the body stops producing red blood cells; typically caused by infection.
acute chest syndrome
pneumonia due to pulmonary infarction can lead to chronic respiratory insufficiency; leading cause of death in sickle cell disease
acute sequestration crisis
a complication of sickle cell disease. It is characterized by pooling of blood in the spleen, resulting in splenic enlargement.a life-threatening condition if hypovolemic shock occurs. Emergency treatment involves restoring circulating blood volume with a crystalloid and colloid (blood) infusion.
immune thrombocytopenic purpura
This is excessive destruction of platelets in toddlers/preschoolers, characterized by thrombocytopenia, this is the most common bleeding disorder in children, includes other symptoms such as purpura (purpleish bruising), normal bone marrow.
condition of iron overloading caused by the large breakdown of red blood cells. tx: chelation therapy
Acute Lymphocytic Leukemia
Most common kind of leukemia in children Peak age is 2-6 years About 2,000 new cases annually Whites>blacks; boys>girls Highly treatable- overall survival 80% Definitive test is a bone marrow aspiration and
Vincristine, prednisone, L-asparaginase commonly used to
Methotrexate is given intrathecally to prevent CNS disease
Treatment lasts about 3 years
30 months for girls, 36 months for boys
Abdominal mass, either
felt during an examination or seen as a swollen abdomen
Tumors in the face or head
can cause swelling and bruising of the area around the eyes and uncontrolled eye movement
Compression of kidney or
bladder by the tumor may cause changes in urination
Bone marrow involvement
may present as pain, limping, paralysis, or weakness
Diarrhea may be present Fever High blood pressure and
increased heart rate may occur depending on the location of the tumor and the organs the tumor compresses
Staged by whether tumor crosses midline or is resectable
one of the most
common types of bone cancer in children
Usually occurs in the long bones, such as the
arms (humerus), legs (femur/tibia), and pelvis
Pain (sharp or dull) at the site of the tumor Swelling or redness at the site of the tumor Increased pain with activity or lifting Limping Decreased movement of the affected limb Often detected when a child is brought to a
medical facility for an injury and a radiograph indicates suspicious bone lesions
A family of tumors found in bone and soft tissues
Can occur anywhere in the body, but most
commonly in the pelvis and proximal long tubular bones
The diaphysis of the femur is the most common site,
followed by the tibia and humerus