Term
|
Definition
| Compensated state that may precede respiratory failure, the patient is able to maintain adequate gas exchange by increasing breathing rate and depth. |
|
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Term
| Signs and symptoms of respiratory distress |
|
Definition
-Diaphoresis
-Pallor/Cyanosis
-Nasal flaring
-Tachypnea
-Noisy breathing
-Retracting
-Grunting |
|
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Term
| What is the difference in respiratory distress in a small child? |
|
Definition
-Smaller and shorter airways
-Airways easily blocked
-Hyper-reflexive = spasms
-Easily fatigued decreases cough
-Immune unsophisticated
-Limited alveolar surface area
-Poor/weak respiratory muscles
-Poor fluid volume control |
|
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Term
| What are possible causes of obstructive respiratory failure? |
|
Definition
-Foreign body (vomitus)
-Infection (epiglottis)
-Tonsils/adenoids
-Laryngospasm |
|
|
Term
| What are possible causes for restrictive respiratory failure? |
|
Definition
-Thick secretions, foreign body
-Infection (Pneumonia)
-Alveolar rupture (pneumothorax)
-Chemical pneumonitis
-Pleural effusion
-Near-drowning event |
|
|
Term
| What are possible causes of primary ineffecient gas transfer respiratory failure |
|
Definition
-Anemia
-Hemorrhage
-Over-sedation
-Cerebral trauma |
|
|
Term
| Upper Respiratory Tract Illnesses |
|
Definition
-URI or URTI
-Nasopharyngitis
-Pharyngitis
-Tonsilitis
-Influenza
-Otitis Media
-Infectious mononucleosis |
|
|
Term
|
Definition
Treat with cool mist or steam therapy
-Can usually be treated at home |
|
|
Term
| Respiratory Syncitital Virus |
|
Definition
-80%-90% cause of bronchiolitis seen in infants
-Seasonal
-Treatment airway management and fluids
-Frequent hospitalization for infants (at risk infants receive Synagis) |
|
|
Term
|
Definition
Inflammatory reponse initiated in airways
-Involves mast cells, eosiniophils, and T lymphocytes
-End result means increased mucous production, inflammation to lower airways and bronchospasm
-When it keeps reocurring is means Asthma |
|
|
Term
|
Definition
-Chronic inflammatory disorder of airways
-Bronchial hyperresponsiveness
-Episodic
-Limited airflow or obstruction that reverses spontaneously or with treatment |
|
|
Term
|
Definition
-Inhalants
-Airborne pollens
-Stress
-Weather changes
-Exercise
-Biral or bacterial agents
-Food additives
-Lots of other things . . . |
|
|
Term
| Reccomendations for asthma care and management |
|
Definition
-Obtain objective tests, physical examination, patient history and patient report, to diagnose and assess the characteristics and severity of asthma and to monitor whether asthma control is achieved and maintained.
-Education for a partnership in asthma care
-Control of environmental factors and comorbid conditions that affect asthma
-Pharmacologic therapy |
|
|
Term
|
Definition
-Corticosteroids-(inhaled) pumicort
-Cromlyn sodium (intal)-Mast cell stabilizer
-Immunomodulators-(Xolair) decrease IgE response
-Leukotreine modifiers-(Accolate)
-LABA's (long-acting bronchodilator) Serevent or Salmeterol (12 hours)
-Methylxanthine-theophyline |
|
|
Term
|
Definition
-Anticholinergics (Atrovent)-blocks constriction (parasympathetic)
-SABA: short-acting bronchodilators (Albuterol)- stimulates dilation (sympathetic)
-Systemic corticosteroids-Methylprednisone/Solumedrol |
|
|
Term
|
Definition
Inherited autosomal recessive trait
-Cystic fibrosis transmembrane Conductance Regulator
--Critical loss of chloride ion transport
--Upsets the sodium and chloride ion balance
--Disrupts the normal, think mucus layer that is easily removed by cilia lining the lungs and other organs |
|
|
Term
| Problems associated with Cystic Fibrosis |
|
Definition
-Thick sticky secretions
-Pool in bronchioles = atlectasis
-Clogs pancreatic ducts, impairs digestion & absorption of nutrients
-Leads to biliary cirrhosis
-Retarded G & D, delayed puberty
-Terminal, median age is 37 |
|
|
Term
| Respiratory management for cystic fibrosis |
|
Definition
-Large amounts of mucous and increased viscosity increase likelihood of respiratory tract infections
-Recurrent pulmonary infection in the child with CF results in damage to the airways. (bronchiectasis)
-Mucolytics, brocnhodilators, kalydeco
-Antibiotics for infections
-Chest PT
-Avoid pulmonary treatments after meal |
|
|
Term
| GI management for Cystic Fibrosis |
|
Definition
-Assess nutritional status
-Provide high protein & calorie diet
-Administer pancreatic enzymes
-Vitamins (esp. fat soluble) |
|
|
Term
| Reasons for vomiting in children |
|
Definition
-Allergies to foods
-Over-eating
-Persistent coughing
-Intestinal obstruction
-Viral illness |
|
|
Term
|
Definition
Rotavirus is very common, especially in children under the age of 2
-Watery diarrhea most common symptom
-Other symptoms include vomiting and fever
-Passed through fecal-oral route
-Also can be passed through indirect contact such as child touches toy or if someone doesn't wash hands after changing a diaper
-Usually develops symptoms 1-3 days after contact
-No specific tx, children usually recover on own
-Can detect antigens in stool
-Diarrhea usually lasts 3-7 days
-Treatment with flavored oral rehydration
-May need IV
-Start back slow with diet (BRAT) |
|
|
Term
|
Definition
Congenital Aganglionic Megacolon
-Absence of ganglioncells in one or more segments of the colon
-Etiology not fully understood
-Symptoms: Dont pass menium; Distension; Ribbon like stools |
|
|
Term
|
Definition
Relaxation or incompetence of the lower esophageal sphincter
-Vomiting
-Weight loss
-Respiratory problems (RAD)
-GI bleeding |
|
|
Term
| 3 Inflammatory GI Disorders |
|
Definition
1. Appedicitis
2. Ulcerative Colitis
3. Crohn's disease |
|
|
Term
|
Definition
Signs and symptoms:
-Abdominal pain-per umbilical to right lower quadrant
-Local rebound tenderness
-Vomiting
-Constipation or diarrhea |
|
|
Term
|
Definition
Acute hepatitis
Cirrhosis
Biliary atresia
-Etiology unknown
-Healthy infant at birth
-Jaundice occurs within 2wk-2mo
-Alcohlic stools (puttylike, clay)
-Increased bilirubin levels |
|
|
Term
| 3 Structural defects in children (GI) |
|
Definition
-Cleft lip and palate
-Esophageal atresia
-Hernias |
|
|
Term
| Structural defects: Cleft lip and cleft palate |
|
Definition
Failure of the premaxillary adn maxillary processes to come together in fetal life
-Cleft lip surgery (first 3 months)
-Cleft palate repair (6mos to 5 yrs) |
|
|
Term
| Esophageal atresia with tracheoesophageal fistula |
|
Definition
-Esophageal atresia: the esophagus ends in a blind pouch or stops; does not connect with the stomach
-Tracheoesophageal fistula: a fistula is present connecting the esophagus with the trachea |
|
|
Term
| 3 GI Obstructive Disorders |
|
Definition
1. Hypertrophic pyloric stenosis
2. Intussusception
3. Malrotation |
|
|
Term
| Obstructive Disorders: Pyloric Stenosis |
|
Definition
Muscle around the pylorus enlarges and leads to obstruction during the first three months of life
-Projectile vomiting
-hunger
-Weight loss
-Dehydration with F/E Disturbances
-Increased Abdominal distention with peristalsic waves
-Palpable Olive Shape Tumor in Epigastric Area
-Diagnosed by ultrasound
-Emphasis on restoring and correcting fluid and electrolyte problems
-POst-op: Infant may still vomit, advance diet as tolerated, rare to have complications |
|
|
Term
|
Definition
Telescoping of one portion of the intestine into another
-Frequent cause of intestinal obstruction
Signs and Symptoms:
-Acute abdominal pain with tender abdomen
-Vomiting
-Normal stool to red currant jelly like stool (lovely!)
-Abdominal distention
-Sausage shape mass in riq
-Child can become acutely ill with fever and S&S fo peritonitis
-Dx is made by xray, ultrasound, or barium enema
-Surgery if b.e. is not successful |
|
|
Term
| Examples of age-related skin mansifestations |
|
Definition
-Infants: birthmarks
-Early childhood: atopic dermatitis
-School-age children: ringworm
-Adolescents: acne |
|
|
Term
|
Definition
-Common peds problem
-Treated with topical antibiotic if localized to small area
-Bacterial: strep or staph
-Wash crust off with soap andwater and apply topical antibiotic
-May be treated with oral antibiotics if has spread (still wash lesions)
-Very contagious |
|
|
Term
|
Definition
-Most communicable diseases of childhood have characteristic rash (rubeola, rubella, chicken pox)
-Other ex: verruca (warts), herpes simplex type |
|
|
Term
|
Definition
Superficial infections that live on the skin
-AKA dermatophytoses
-Transmission from person to person or from infected animal to human
-EX: tinea capitis, tinea corporis, tinea pedis, candidiasis |
|
|
Term
|
Definition
-Inflammatory reaction or skin to chemical
-Initial reaction in the exposed region
-Characteristic sharp delineation between inflamed and normal skin
-Primary irritant
-Sensitizing agent
-Ex: Diaper dermatitis, reaction to wool, reaction to specific chemical |
|
|
Term
|
Definition
A type of pruritic eczema that begins during infancy
-Hereditary tendency
-Often associated with history of food allergies, allergic rhinitis, and asthma |
|
|
Term
|
Definition
Pathophysiology and clinical manisfestations
-Usually from irritation of urine and feces
-Detergents inadequately rinsed from clothing
-Chemical irritation
-Nursing considerations: alter wetness, pH, and fecal irritants
-Differentiate from Candidiasis of diaper area (candidiasis has characteristic excoriated red papules with satellite lesions) |
|
|
Term
|
Definition
-Adverse drug reactions are most often seen in skin (rashes most common reaction)
-May be immediate or delayed following administration of drug
-Treatment: discontinue drug, antihistamines, corticosteroid therapy if very severe |
|
|
Term
|
Definition
-Predominately in adolescents
-Pathophysiology
--Involves hair follicles and sebaceous glands
--Black heads
-Therapeutic management
--General measures/overall health
--Medications |
|
|
Term
|
Definition
-Toddlers: hot water scalds
-Older children: flame-related burns
-Child abuse
-Child with matches or lighters accounts for 1 in 10 house fires |
|
|
Term
| Growth hormone deficiency |
|
Definition
-Hypopituarism
--Failure of the pituitary to produce sufficient growth hormone to sustain normal growth in children.
-Familial patterns
-Review growth charts
-GH products are currently labeled for use in children who have growth failure due to an inadequate of normal GH.
-Administered at night to correspond with normal release time of GH |
|
|
Term
| Growth hormone replacement management |
|
Definition
-Children should be managed by a pediatric endocrinologist
-Height and weight is obtained every 3 months and plotted on the growth chart
-Bone age study yearly |
|
|
Term
|
Definition
-Development of sexual characteristics before the usual age of onset of puberty.
Girls: Breast development, pubic hair, and/or menses before 8 years
Boys: Secondary sexual characteristics before age 9
-Tanner scale: true precocious puberty is characterized by 2 signs of puberty |
|
|
Term
| Pediatric blood glucose target levels |
|
Definition
-Toddler and preschool: 100 to 180 mg/dL
-School-age: 90-180 mg/dL
-Adolescents (13 to 19 years): 90 to 130 mg/dL |
|
|
Term
|
Definition
-Short-acting: often used to cover extra carbohydrate consumption
-Combination of regular and intermediate-acting insulin
-Children on mixed insuling dosage schedules tend to experience hypoglycemic episodes at 11:30 adn 2:30 as peaking of insulin occurs. |
|
|
Term
|
Definition
Symptoms:
-Rapid onset
-Shaky feeling, hunger
-Dizziness
-Headache
-Vital signs-shallow respirations, tachycardia
-Tremors
-Glucose = low, below 60
-Ketones = negative
-Urine output: normal, sugar negative, negative ketones |
|
|
Term
| Treatment of hypoglycemia |
|
Definition
Day time hypoglycemia:
-Simple concentrated sugars such as honey by mouth (older than 1 year), hard candy, sugar cubes, or glucose tablets will elevate the blood sugar immediately. OJ or sugar containing soda or fruit drink.
-Identify reason for hypoglycemia. In children it is often increase in activity without increase in food intake. |
|
|
Term
|
Definition
-Using rapid-acting or Lispro insulin
-Infusion pump (8 to 10 years)
-Night time snack
-Check blood glucose before bedtime. Make sure the blood glucose is 100-120 mg/dL before going to bed.
-Do not skip snacks.
-Eat an extra snack on days of strenuous exercise. |
|
|
Term
|
Definition
Symptoms: Lethargic, confused, weak
-Thirsty
-Abdominal pain often with nausea and vomiting
-Signs of dehydration
-Vital signs: deep, rapid respirations, fruity acetone breath, and weak pulses |
|
|
Term
|
Definition
-Altered LOC
-Dehydration
-Electrolyte disturbances
-Dysrrhythmias
-Shock
-Complete vascular collapse |
|
|
Term
| Life management of patients with DM |
|
Definition
-Management by endocrinologist
-Insulin
-Blood sugar monitoring
-Diet
-Exercise
-Screen for retinopathy: opthalmologic exam annually |
|
|
Term
| Exercise for those with Diabetes Mellitus |
|
Definition
-Vital component to management of child with diabetes
-May decrease the amount of insulin required.
-Enhances insulin absorption.
-Important for normal growth and development |
|
|
Term
|
Definition
-85% of children with Type 2 are obese
-Age of onset is middle to late puberty-around 13 years
-Minority populations have an especially high rate of type 2 diabetes
-Strong family history
-The rate of new cases among youth was 5.3 per 100,000 for type 2 diabetes |
|
|
Term
| Assessment of children with type 2 diabetes |
|
Definition
-Obesity: BMI greater than 30 (normal range is 15 to 17 in the pediatric population)
-Waist to hip ratio: apple shape
-Acanthosis nigricans: hyper-pigmentation and thickening of the skin into velvety irregular folds in the neck and flexural areas
-HTN
-+ family history of type 2 diabetes
-Ethnicity |
|
|
Term
| Interdisciplinary Interventions for children with DM type 2 |
|
Definition
-Comprehensive education on importance of regular exercise and how to self-monitor for blood glucose levels.
-Dietary management
-Glucose-lowering agent: drugs that improve insulin sensitivity such as Glucophage (Metformin)
-A few may need Insulin to initiate control |
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