NSG 3600 Exam 3 Review Guide
Meningitis Therapeutic Management - ANSWER Give immunizations, assess neuro status & response to
therapy with every 2 hours if stable and every hour if not stable. Make sure we have a stable a calm
environment. If bacterial give antibiotics and make sure they take all of them. Make sure the child is in
seizure precautions, give NSAIDs for pain. Need to teach parents about early detection of complications
and how to prevent it along with medical follow-up if on sz meds.
Steps that should always be used when assessing a child GI system - ANSWER First step should be to
inspect the child.
Second we are going to auscultation.
Third is percuss.
Fourth is palpate the area through the clothing due to the child being ticklish.
What do we need to worry about then it comes to children and medication? - ANSWER Liver and
pancreas do not mature until about 6 months of age so we need to be concern about toxicity.
Why should we not give children under 1 cows milk? - ANSWER The pancreatic lipase dose not get
adequately secreted until age 1, which means the body can't absorb fats such as those present in cow's
milk.
What kind of stool does an infant have who is breast feeding? - ANSWER The infant will have watery
stool.
What kind of stool does an infant have who is formula feeding? - ANSWER The infant will have soft or
seedy stools.
What do pre-schoolers go through when eating? - ANSWER The pre-schoolers woll fluctuations where
they have periods of overeating or refusal to eat. Very normal but the parents can get upset.
心脏不仅是一个生理器
Dehydration - ANSWER Occurs whenever total output of fluid exceeds intake.
,Dehydration Clinical Manifestations and Therapeutic Management - ANSWER Tachycardia, hypotension,
decreased tears specific in children, weight loss (monitor daily), thirst, irritability, sunken eyes and
fontanels.
Fluid replacement, electrolyte monitoring & replacement, and safety considerations.
What will be elevated in a child who is dehydrated? - ANSWER The sodium, potassium, and creatinine
Blood Urea Nitrogen (BUN) range for child - ANSWER 5-18 mg/dL
Sodium (Na) range for child - ANSWER 135-145 mEq/L
Potassium (K) range for child - ANSWER 3.4-4.7 mEq/L
Creatinine range for child - ANSWER 0.3-0.7 mg/dL
What do we need to look out for with kids with dehydration? - ANSWER Diarrhea, skin break down, falls
risk, dizziness, failure to thrive and grow.
Cyclic Vomiting Syndrome - ANSWER Intense nausea and vomiting 4 times an hour. 5 attacks total or 3
attacks in over 6 months. Could be caused by infection, psychological stress, dietary changes,
menstruation, migraines. These individuals will vomit then be okay for the rest of the day then vomit
again during later in day.
Cyclic Vomiting Syndrome: Clinical Manifestations - ANSWER Vomiting for 24-48 hr, occurs at night or
early morning hours, severe abdominal pain, retching throwing up where there is nothing put clear fluid
coming up, nausea, diarrhea, headache, vertigo
心脏不仅是一个生理器
Cyclic Vomiting Syndrome- Diagnosis - ANSWER Rule out other condition and lab studies. Need to get a
good history and ask if they are asymptomatic and is eat episode the same and do you have at least 3 of
them.
Cyclic Vomiting Syndrome- Prevention - ANSWER Balanced nutrition (no cheese, cured meat, and
chocolate), get a lot of sleep and rest, and void triggers, and do stress management.
, Cyclic Vomiting Syndrome- Therapeutic Management - ANSWER Supportive management (meeting with
a therapist), fluid replacement (IV fluids), rest, pharmacotherapy (Zofran)
Cyclic Vomiting Syndrome- Patient/Family Education - ANSWER Increase exercise, balanced diet, good
hydration, sleep routines, avoid triggers (need to keep a health food diary along with sleep and food
cycles).
Acute Diarrhea - ANSWER Increased frequency of bowel along with vomiting, fever, pain. Occurs from
diet, toxic substances, infections(viral infection, eye infection), and medications that may be used.
Acute Diarrhea Diagnosis - ANSWER Need to get a history on the patient and see if they have traveled
anytime in the past, do a physical exam on the abdomen and look for skin breakdown around the
perineum.
Acute Diarrhea Prevention - ANSWER Good hand hygiene, good and clean food handing, making sure the
diapers are changed right away and clothes are clean properly. Give Metronidazole (Flagyl) if it caused by
bacteria, give Lactobacillus probiotics, monitor strict I & O, monitor electrolytes can give PEDOLIGHT,
give IV and PO fluids risk for dehydration, daily weight needs to be taken naked or with the least amount
of clothes on with the same scale and first thing in the morning.
How can we tell that child is improving from acute diarrhea? - ANSWER When they withhold a stable
weight and have stable fluid intake.
Chronic Diarrhea - ANSWER 3 or more stools passed per day for 14 days or longer. Will have abdominal
distention, hyperactive bowel sounds, dehydration, perineal irritation, and blood in the stool (dark
blood)
Chronic Diarrhea Diarrhea - ANSWER Collect stool for a culture and study, do an occult blood test which
心脏不仅是一个生理器
test for blood in the stool not seen by the naked eye. Clinitest for reducing substance (its a test where we
see of the body is absorbing the right nutrients in the stool and can see if there are dietary issues).
Chronic Diarrhea Prevention - ANSWER Good hand hygiene, proper food handling, washing clothes and
changing diapers, limit exposure to others, educate on primary prevention, hydrate, identify underlying
cause, reduce fruit juice, daily weight, strict I and O.
Meningitis Therapeutic Management - ANSWER Give immunizations, assess neuro status & response to
therapy with every 2 hours if stable and every hour if not stable. Make sure we have a stable a calm
environment. If bacterial give antibiotics and make sure they take all of them. Make sure the child is in
seizure precautions, give NSAIDs for pain. Need to teach parents about early detection of complications
and how to prevent it along with medical follow-up if on sz meds.
Steps that should always be used when assessing a child GI system - ANSWER First step should be to
inspect the child.
Second we are going to auscultation.
Third is percuss.
Fourth is palpate the area through the clothing due to the child being ticklish.
What do we need to worry about then it comes to children and medication? - ANSWER Liver and
pancreas do not mature until about 6 months of age so we need to be concern about toxicity.
Why should we not give children under 1 cows milk? - ANSWER The pancreatic lipase dose not get
adequately secreted until age 1, which means the body can't absorb fats such as those present in cow's
milk.
What kind of stool does an infant have who is breast feeding? - ANSWER The infant will have watery
stool.
What kind of stool does an infant have who is formula feeding? - ANSWER The infant will have soft or
seedy stools.
What do pre-schoolers go through when eating? - ANSWER The pre-schoolers woll fluctuations where
they have periods of overeating or refusal to eat. Very normal but the parents can get upset.
心脏不仅是一个生理器
Dehydration - ANSWER Occurs whenever total output of fluid exceeds intake.
,Dehydration Clinical Manifestations and Therapeutic Management - ANSWER Tachycardia, hypotension,
decreased tears specific in children, weight loss (monitor daily), thirst, irritability, sunken eyes and
fontanels.
Fluid replacement, electrolyte monitoring & replacement, and safety considerations.
What will be elevated in a child who is dehydrated? - ANSWER The sodium, potassium, and creatinine
Blood Urea Nitrogen (BUN) range for child - ANSWER 5-18 mg/dL
Sodium (Na) range for child - ANSWER 135-145 mEq/L
Potassium (K) range for child - ANSWER 3.4-4.7 mEq/L
Creatinine range for child - ANSWER 0.3-0.7 mg/dL
What do we need to look out for with kids with dehydration? - ANSWER Diarrhea, skin break down, falls
risk, dizziness, failure to thrive and grow.
Cyclic Vomiting Syndrome - ANSWER Intense nausea and vomiting 4 times an hour. 5 attacks total or 3
attacks in over 6 months. Could be caused by infection, psychological stress, dietary changes,
menstruation, migraines. These individuals will vomit then be okay for the rest of the day then vomit
again during later in day.
Cyclic Vomiting Syndrome: Clinical Manifestations - ANSWER Vomiting for 24-48 hr, occurs at night or
early morning hours, severe abdominal pain, retching throwing up where there is nothing put clear fluid
coming up, nausea, diarrhea, headache, vertigo
心脏不仅是一个生理器
Cyclic Vomiting Syndrome- Diagnosis - ANSWER Rule out other condition and lab studies. Need to get a
good history and ask if they are asymptomatic and is eat episode the same and do you have at least 3 of
them.
Cyclic Vomiting Syndrome- Prevention - ANSWER Balanced nutrition (no cheese, cured meat, and
chocolate), get a lot of sleep and rest, and void triggers, and do stress management.
, Cyclic Vomiting Syndrome- Therapeutic Management - ANSWER Supportive management (meeting with
a therapist), fluid replacement (IV fluids), rest, pharmacotherapy (Zofran)
Cyclic Vomiting Syndrome- Patient/Family Education - ANSWER Increase exercise, balanced diet, good
hydration, sleep routines, avoid triggers (need to keep a health food diary along with sleep and food
cycles).
Acute Diarrhea - ANSWER Increased frequency of bowel along with vomiting, fever, pain. Occurs from
diet, toxic substances, infections(viral infection, eye infection), and medications that may be used.
Acute Diarrhea Diagnosis - ANSWER Need to get a history on the patient and see if they have traveled
anytime in the past, do a physical exam on the abdomen and look for skin breakdown around the
perineum.
Acute Diarrhea Prevention - ANSWER Good hand hygiene, good and clean food handing, making sure the
diapers are changed right away and clothes are clean properly. Give Metronidazole (Flagyl) if it caused by
bacteria, give Lactobacillus probiotics, monitor strict I & O, monitor electrolytes can give PEDOLIGHT,
give IV and PO fluids risk for dehydration, daily weight needs to be taken naked or with the least amount
of clothes on with the same scale and first thing in the morning.
How can we tell that child is improving from acute diarrhea? - ANSWER When they withhold a stable
weight and have stable fluid intake.
Chronic Diarrhea - ANSWER 3 or more stools passed per day for 14 days or longer. Will have abdominal
distention, hyperactive bowel sounds, dehydration, perineal irritation, and blood in the stool (dark
blood)
Chronic Diarrhea Diarrhea - ANSWER Collect stool for a culture and study, do an occult blood test which
心脏不仅是一个生理器
test for blood in the stool not seen by the naked eye. Clinitest for reducing substance (its a test where we
see of the body is absorbing the right nutrients in the stool and can see if there are dietary issues).
Chronic Diarrhea Prevention - ANSWER Good hand hygiene, proper food handling, washing clothes and
changing diapers, limit exposure to others, educate on primary prevention, hydrate, identify underlying
cause, reduce fruit juice, daily weight, strict I and O.
