HESI Family Nursing
Neutropenia and Leukemia - ANSNeutropenia is a common side effect in people with leukemia
Google: Cancer chemotherapy is a common cause of neutropenia. In addition to killing cancer
cells, chemotherapy can also destroy neutrophils and other healthy cells.
Google: the presence of abnormally few neutrophils in the blood, leading to increased
susceptibility to infection. It is an undesirable side effect of some cancer treatments
Hypoglycemia Action DM Type 1 Infant - ANSAn insulin pump is a device that administers a
continuous infusion of rapid-acting insulin. Studies have established it to be a safe and effective
way to improve glycemic control and reduce episodes of severe hypoglycemia in young people
To Do: If the child has a severe hypoglycemic reaction, administer glucagon (a hormone
produced by the pancreas and stored in the liver) either subcutaneously or intramuscularly.
Children under 20 kg receive 0.5 mg; children over 20 kg receive 1 mg. Dextrose (50%) may be
given intravenously if needed.
Hypoglycemia Signs and Symptoms - ANSSigns and Symptoms: Manifestations of
hypoglycemia include behavioral changes, confusion, slurred speech, diaphoresis, tremors,
palpitations, and tachycardia.
VP Shunt-hydrocephalus - ANSTreatment needs to be initiated in order to prevent brain tissue
damage that can result from the increased ICP that hydrocephalus creates. Specific treatment
will depend on the underlying etiology. The goals of treatment include relieving hydrocephalus
and managing complications associated with the disorder, such as growth and developmental
delay. Most cases of hydrocephalus are treated with the surgical placement of an extracranial
shunt. Most often, a ventriculoperitoneal (VP) shunt is placed. The shunt will need to be
replaced as the child grows. Therefore, the child will undergo shunt revision surgery at various
times during his or her life. It is important for health care professionals and parents to be able to
recognize when a shunt needs replacing or when complications are occurring to decrease the
possibility of death or disability that may occur due to increased ICP.
Aplastic anemia - ANSSafety is of the utmost concern in children with aplastic anemia. It is
important to prevent injury in order to avoid hemorrhage.
Risk of epistaxis
Thrombocytopenia Action - ANSMany children require no medical treatment except observation
and reevaluation of laboratory values. Educate the family about avoiding aspirin, nonsteroidal
anti-inflammatory drugs (NSAIDs), and antihistamines because these medications may
precipitate the development of anemia in these children. The use of acetaminophen for pain
control is more appropriate when necessary. Teach the family to prevent trauma by avoiding
, activities that may cause injury, such as contact sports. Instead, encourage activities, such as
swimming, that provide physical activity with less risk of trauma. Explain to parents the signs
and symptoms of serious bleeding and whom to call if it is suspected.
Vomiting & diarrhea-no tears Newborn - bowel - ANSDiarrhea Assessment:
Note the child's general appearance and color. Note decreased tear production, sunken orbits,
or dry mucous membranes with moderate to severe dehydration
Children are at an increased risk for dehydration when they are having diarrhea.
Health History Symptoms of UTI - ANSHealth History. Elicit a description of the present illness
and chief complaint. Common signs and symptoms reported during the health history might
include:
Fever
Nausea or vomiting
Chills
Abdomen, back, or flank pain
Lethargy
Jaundice (in the neonate)
Poor feeding or "just not acting right" (in the infant)
Urinary urgency or frequency
Burning or stinging with urination (the infant may cry with urination, the toddler may grab the
diaper)
Foul-smelling urine
Poor appetite (child)
Enuresis or incontinence in a previously toilet-trained child
Blood in the urine
UTI Assessment - ANSIn the neonate or young infant, observe for jaundice or increased
respiratory rate. In infants and children, inspect the perineal area for redness or irritation.
Observe the urine for visible blood, cloudiness, dark color, sediment, mucus, or foul odor. Note
pallor, edema, or elevated blood pressure. Palpate the abdomen. Note distended bladder,
abdominal mass, or tenderness, particularly in the flank area.
Hearing - assess Communication-hearing impaired - ANSTalk with families about how they need
to learn how to communicate effectively with their child
Teach families that communication may also be enhanced by the use of text telephone service
in the home, closed-caption television, and lights rather than bells or alarms to alert the child.
Provide a sign language interpreter for the child at health care visits if the parent is not present
for interpretation.
Eye Injury Intervention - ANSRefer children with urgent or emergent conditions to an
ophthalmologist immediately to preserve vision. Nonemergent eye injuries usually need only
simple management. Assist the physician or nurse practitioner with positioning and distraction of
Neutropenia and Leukemia - ANSNeutropenia is a common side effect in people with leukemia
Google: Cancer chemotherapy is a common cause of neutropenia. In addition to killing cancer
cells, chemotherapy can also destroy neutrophils and other healthy cells.
Google: the presence of abnormally few neutrophils in the blood, leading to increased
susceptibility to infection. It is an undesirable side effect of some cancer treatments
Hypoglycemia Action DM Type 1 Infant - ANSAn insulin pump is a device that administers a
continuous infusion of rapid-acting insulin. Studies have established it to be a safe and effective
way to improve glycemic control and reduce episodes of severe hypoglycemia in young people
To Do: If the child has a severe hypoglycemic reaction, administer glucagon (a hormone
produced by the pancreas and stored in the liver) either subcutaneously or intramuscularly.
Children under 20 kg receive 0.5 mg; children over 20 kg receive 1 mg. Dextrose (50%) may be
given intravenously if needed.
Hypoglycemia Signs and Symptoms - ANSSigns and Symptoms: Manifestations of
hypoglycemia include behavioral changes, confusion, slurred speech, diaphoresis, tremors,
palpitations, and tachycardia.
VP Shunt-hydrocephalus - ANSTreatment needs to be initiated in order to prevent brain tissue
damage that can result from the increased ICP that hydrocephalus creates. Specific treatment
will depend on the underlying etiology. The goals of treatment include relieving hydrocephalus
and managing complications associated with the disorder, such as growth and developmental
delay. Most cases of hydrocephalus are treated with the surgical placement of an extracranial
shunt. Most often, a ventriculoperitoneal (VP) shunt is placed. The shunt will need to be
replaced as the child grows. Therefore, the child will undergo shunt revision surgery at various
times during his or her life. It is important for health care professionals and parents to be able to
recognize when a shunt needs replacing or when complications are occurring to decrease the
possibility of death or disability that may occur due to increased ICP.
Aplastic anemia - ANSSafety is of the utmost concern in children with aplastic anemia. It is
important to prevent injury in order to avoid hemorrhage.
Risk of epistaxis
Thrombocytopenia Action - ANSMany children require no medical treatment except observation
and reevaluation of laboratory values. Educate the family about avoiding aspirin, nonsteroidal
anti-inflammatory drugs (NSAIDs), and antihistamines because these medications may
precipitate the development of anemia in these children. The use of acetaminophen for pain
control is more appropriate when necessary. Teach the family to prevent trauma by avoiding
, activities that may cause injury, such as contact sports. Instead, encourage activities, such as
swimming, that provide physical activity with less risk of trauma. Explain to parents the signs
and symptoms of serious bleeding and whom to call if it is suspected.
Vomiting & diarrhea-no tears Newborn - bowel - ANSDiarrhea Assessment:
Note the child's general appearance and color. Note decreased tear production, sunken orbits,
or dry mucous membranes with moderate to severe dehydration
Children are at an increased risk for dehydration when they are having diarrhea.
Health History Symptoms of UTI - ANSHealth History. Elicit a description of the present illness
and chief complaint. Common signs and symptoms reported during the health history might
include:
Fever
Nausea or vomiting
Chills
Abdomen, back, or flank pain
Lethargy
Jaundice (in the neonate)
Poor feeding or "just not acting right" (in the infant)
Urinary urgency or frequency
Burning or stinging with urination (the infant may cry with urination, the toddler may grab the
diaper)
Foul-smelling urine
Poor appetite (child)
Enuresis or incontinence in a previously toilet-trained child
Blood in the urine
UTI Assessment - ANSIn the neonate or young infant, observe for jaundice or increased
respiratory rate. In infants and children, inspect the perineal area for redness or irritation.
Observe the urine for visible blood, cloudiness, dark color, sediment, mucus, or foul odor. Note
pallor, edema, or elevated blood pressure. Palpate the abdomen. Note distended bladder,
abdominal mass, or tenderness, particularly in the flank area.
Hearing - assess Communication-hearing impaired - ANSTalk with families about how they need
to learn how to communicate effectively with their child
Teach families that communication may also be enhanced by the use of text telephone service
in the home, closed-caption television, and lights rather than bells or alarms to alert the child.
Provide a sign language interpreter for the child at health care visits if the parent is not present
for interpretation.
Eye Injury Intervention - ANSRefer children with urgent or emergent conditions to an
ophthalmologist immediately to preserve vision. Nonemergent eye injuries usually need only
simple management. Assist the physician or nurse practitioner with positioning and distraction of
