Peds C39-40 LAST

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Functions of the kidneys?
-Excrete excess water and waste products.
-Maintain balance of electrolytes and acid/base.
-Regulate BP through angiotensin.
-Manufactures erythropoietin (RBCs).
Why are kids at higher risk for kidney trauma?
The kidneys are lower in relation to ribs than adults
When do kidneys achieve full size and function?
Attain full size and function by adolescence 13
When does a newborn's bladder empty?
Reflex action at about 15 mL
Cryptorchidism
One or both testes do not descend
Tx for cryptorchidism?
-Give hormones to promote dissension.
-Orchiopexy-a surgical correction.
Acute glomerulonephritis?
Allergic reaction to specific infection (Group A beta-hemolytic streptococcal-ear or throat) around 3 weeks after
Cause of acute glomerulonephritis?
Strep
Symptoms of acute glomerulonephritis?
Grossly bloody (Smoky) urine, Headache, periorbital edema, high fever that then comes down to around 100 degrees F, mild HTN
Who gets acute glomerulonephritis?
6-7 years old, more often boys
Enuresis
Involuntary urination beyond the age when control of urination commonly is acquired.
Physiological causes of enuresis?
Deep sleep
Psychological causes of enuresis?
Sexual abuse
Symptoms you would see in a child with nephrotic syndrome?
Presenting edema (Eyes, ankles), progresses to generalized edema, appetite loss, irritability, ascites
Risks of UTI?
Females
After 4 months of life
Diaper age 2-6
Causes of UTI?
Bacteria travels to bladder
Symptoms of UTI?
Fever, Nausea, vomiting, foul-smelling urine, weight loss, increased urination
Diagnosis of UTI?
Urinalysis (Clean-catch)
Culture-usually intestinal bacteria
Treatment/nursing interventions of UTI?
Observe for increased symptoms, monitor intake and output, increased fluids to dilute urine and flush bladder
Pyelonephritis
Inflammation of the kidney and renal pelvis (Typically from bad UTI that moves up ureter)
Symptoms of pyelonephritis?
Similar symptoms of UTI with flank and abdominal pain
Amenorrhea
Absence of menstruation
Amenorrhea S&S?
Primary-Hasn't happened at all
Secondary-Missing 3 or more periods after menses (Emotional stress)
Mittelschmerz
Pain of ovulation
Recommended treatment for PMS?
Reduced salt intake, mild analgesics, local heat, oral contraceptives
Functions of joints?
Connect bones in body, bone to bone
Functions of cartilage?
Flexible connective tissue found in body, bend, connect bones together, Found in rib cage, ear, nose, throat, etc
Function of the soft spot?
Bones of skull not fused at birth to accommodate a narrow birth canal
Significance of epiphyseal plate?
Bone growth takes place between birth and puberty, When epiphyseal plate cartilage no longer present, bone growth complete
When does bone growth stop?
Most growth completed by age 20
Cast care?
Don't stick anything down the cast, use blow dryer if itching occurs.
What to assess with casts?
Five Ps-Pain, pulse, paresthesia, paralysis, pallor
Odor, drainage, hot spots, cast fit, fever
Types of fractures?
Complete, incomplete, greenstick, simple/closed, spiral
Complete fracture?
Separated fragments of bone
Incomplete fracture?
Bones partially joined
Greenstick fracture?
Common in children
Compound/open fracture?
Fractured bone penetrates skin
Simple/closed fracture?
Single break in bone without skin penetration
Spiral fracture?
Wrenching force fracture, frequently associated with child abuse.
Compartment syndrome?
Once a fracture is immobilized, any report of pain could be a sign of this.
-Serious neurovascular concern when increased pressure within the muscle compartment causing a decrease in circulation.
Skeletal symptoms of child abuse?
Spiral fracture
Osteomyelitis?
Infection of bone
S&S of osteomyelitis?
Fever, malaise, pain, localized tenderness, limited joint motion, typically manifests from an injury or puncture or invasive procedure.
Diagnosis of osteomyelitis?
CBC
Activity level of a child with Muscular dystrophy?
Encourage normal activity as possible, delay muscle atrophy/contractures
Ewing sarcoma?
Malignant tumor found in bone marrow of the long bones of older school-aged or adolescent boys
Ewing sarcoma S&S?
Pain at tumor site
Juvenile rheumatoid arthritis?
Connective tissue disease
Juvenile rheumatoid arthritis S&S?
Joint inflammation
Juvenile rheumatoid arthritis Tx?
Drugs (NSAIDS & ASA)
teach never to STOP drugs!
When and who is screened for scoliosis?
Screened in 5th and 8th grade
-More frequent in girls
What do you promote with scoliosis?
Mobility, positive body image, therapy compliance