NUR 254 Pediatrics Final Exam: NUR 254 Pediatrics Final Exam
Study Guide
Iron deficiency Anemia:
Etiology/Diagnostics:
inadequate amount of iron, children 12-36 months at risk
SIS:
tachycardia can be under weight or overweight
Treatment:
t] Iron rich foods (green leafy), supplements, dietary supplements, organ meats, rice cereal at 6 months.
Teaching:
No cow's milk until the baby is 1 years old
NO iron supplements with milk, give on empty stomach acid makes it absorb better.
Liquid supplement can stain teach, use straw or regular iron supplement capsule/pill
Black tarry green stools
Keep away from children, never keep more than a month supply at home
Infants 30 mins before on empty, older child with something citric for the acid*
Dietary counseling
Sickle Cell Anemia
Main goal is to Prevent Dehydration.
Etiology/Diagnostics:
Hereditary, Autosomal recessive trait. Cells are sickle shaped. Repetitive decrease in 02 cell walls become rigid.
Cells are getting jammed, causing an obstruction of RBC's, resulting in PAIN. The normal HGB is replaced with
abnormal HGB. Effects the spleen. Organ that's mostly effected is the spleen* Newborn Screening in the US
SIS:
o Vascular inflammation
Pain-> severe abdominal pain or chest. Mid to severe from 1 min-days -> crisis
o Stroke -> Severe unrelieved headache** Painful Swelling: hands, feet, joint
pain o Headache. Doesn't go away with meds? Possible CVA. EMERGENCY* o One
CVA? R/F (stroke) o Visual disturbances o Obstructive jaundice
Fever 101.3 or higher o
Severe hypoxia
, VASOCCLUSIVE Crisis:
Acute chest syndrome. Mimics pneumonia "very painful episodes". Splenic Sequestration Pooling of blood in the spleen
caused by infection, stress, dehydration, IMMEDIATELY HYDRATE HOP (Hydrate, Oxygenate, Pain)
Treatment:
o DON'T over oxygenate o Heat o Prophylactic antibiotics: R/F infection*
Preventing Infection* Vaccines, Antibiotics (PCN) o If they've had a stroke,
every 3-4 weeks for transfusions* to prevent CVA o Decrease 02 demands o
Oral/lV hydration, Oral at home to prevent hospitalization
Splenectomy (severe) o Stem cell Transplant:
considered curative (severe) o Rest o Control Pain:
Morphine
Electrolyte replacement Teaching:
Prevent hydration
o Rest
Improve oxygen but don't over oxygenate o
Educate importance of vaccines o Know s/s of
a stroke
Child is normal just gets sicker easier
Hemophilia HEMOPHILIA
- No
Cure
- Avoid
Injury
&
Meds
That
Promote
Bleeding
- Good Nutrition
- Good Dental Hygiene
- IV Administration
Of Deficient
Clotting
Factor
Missing clotting factor
EtiologylDiagnostics:
Deficiency of factor Vlll, produced by the liver, bleeding disorder
Education:
Parents -> genetic counseling
SIS:
, PROLONGED bleeding, kid will bleed longer than other kids, gums, cuts, injections Hemorrhage:
At higher risk
Bruising
Hemarthrosis: blood in joints (knees, elbows, ankles)
Spontaneous Hematuria: dark urine, blood
Hematomas -> pain, swelling, limited motion
Headache
Slurred Speech
Loss of Consciousness
Black Tarry Stools= Bleed
Vomiting coffee ground emesis
Bleeding gyms with teeth brushing
Treatment:
NO cure; lifelong o
Replace Vlll factor:
o Prevent bleeding: No 1M vaccines, try subQ or less invasive first
Medications: o
Steroids o
NSAIDS o
DDAVP
Wear helmets
Safety, protective equipment
Regular Exercise and Physical Therapy
Go to doctor for sprains
Control Bleeding
Oncology
Pediatric Oncology
Etiology/Diagnostics: Unknown o Some genetic alterations, chromosomal abnormalities identified o
Lifestyle factors in adult cancer generally aren't present in childhood cancers (lung cancer), but not in
adolescents o Lumbar Puncture: Leukemia, brain tumors, Mets to CNS o Radiology: x-ray, CT, MRI, PET o
Biopsy
Labs:
CBC, CMP, LFT, coags (coagulation profile)
Treatment:
o Surgery, Chemo, radiation, BMT
SIS of treatment from Chemo:
o Infection o Hemorrhage o Anemia o WV
Study Guide
Iron deficiency Anemia:
Etiology/Diagnostics:
inadequate amount of iron, children 12-36 months at risk
SIS:
tachycardia can be under weight or overweight
Treatment:
t] Iron rich foods (green leafy), supplements, dietary supplements, organ meats, rice cereal at 6 months.
Teaching:
No cow's milk until the baby is 1 years old
NO iron supplements with milk, give on empty stomach acid makes it absorb better.
Liquid supplement can stain teach, use straw or regular iron supplement capsule/pill
Black tarry green stools
Keep away from children, never keep more than a month supply at home
Infants 30 mins before on empty, older child with something citric for the acid*
Dietary counseling
Sickle Cell Anemia
Main goal is to Prevent Dehydration.
Etiology/Diagnostics:
Hereditary, Autosomal recessive trait. Cells are sickle shaped. Repetitive decrease in 02 cell walls become rigid.
Cells are getting jammed, causing an obstruction of RBC's, resulting in PAIN. The normal HGB is replaced with
abnormal HGB. Effects the spleen. Organ that's mostly effected is the spleen* Newborn Screening in the US
SIS:
o Vascular inflammation
Pain-> severe abdominal pain or chest. Mid to severe from 1 min-days -> crisis
o Stroke -> Severe unrelieved headache** Painful Swelling: hands, feet, joint
pain o Headache. Doesn't go away with meds? Possible CVA. EMERGENCY* o One
CVA? R/F (stroke) o Visual disturbances o Obstructive jaundice
Fever 101.3 or higher o
Severe hypoxia
, VASOCCLUSIVE Crisis:
Acute chest syndrome. Mimics pneumonia "very painful episodes". Splenic Sequestration Pooling of blood in the spleen
caused by infection, stress, dehydration, IMMEDIATELY HYDRATE HOP (Hydrate, Oxygenate, Pain)
Treatment:
o DON'T over oxygenate o Heat o Prophylactic antibiotics: R/F infection*
Preventing Infection* Vaccines, Antibiotics (PCN) o If they've had a stroke,
every 3-4 weeks for transfusions* to prevent CVA o Decrease 02 demands o
Oral/lV hydration, Oral at home to prevent hospitalization
Splenectomy (severe) o Stem cell Transplant:
considered curative (severe) o Rest o Control Pain:
Morphine
Electrolyte replacement Teaching:
Prevent hydration
o Rest
Improve oxygen but don't over oxygenate o
Educate importance of vaccines o Know s/s of
a stroke
Child is normal just gets sicker easier
Hemophilia HEMOPHILIA
- No
Cure
- Avoid
Injury
&
Meds
That
Promote
Bleeding
- Good Nutrition
- Good Dental Hygiene
- IV Administration
Of Deficient
Clotting
Factor
Missing clotting factor
EtiologylDiagnostics:
Deficiency of factor Vlll, produced by the liver, bleeding disorder
Education:
Parents -> genetic counseling
SIS:
, PROLONGED bleeding, kid will bleed longer than other kids, gums, cuts, injections Hemorrhage:
At higher risk
Bruising
Hemarthrosis: blood in joints (knees, elbows, ankles)
Spontaneous Hematuria: dark urine, blood
Hematomas -> pain, swelling, limited motion
Headache
Slurred Speech
Loss of Consciousness
Black Tarry Stools= Bleed
Vomiting coffee ground emesis
Bleeding gyms with teeth brushing
Treatment:
NO cure; lifelong o
Replace Vlll factor:
o Prevent bleeding: No 1M vaccines, try subQ or less invasive first
Medications: o
Steroids o
NSAIDS o
DDAVP
Wear helmets
Safety, protective equipment
Regular Exercise and Physical Therapy
Go to doctor for sprains
Control Bleeding
Oncology
Pediatric Oncology
Etiology/Diagnostics: Unknown o Some genetic alterations, chromosomal abnormalities identified o
Lifestyle factors in adult cancer generally aren't present in childhood cancers (lung cancer), but not in
adolescents o Lumbar Puncture: Leukemia, brain tumors, Mets to CNS o Radiology: x-ray, CT, MRI, PET o
Biopsy
Labs:
CBC, CMP, LFT, coags (coagulation profile)
Treatment:
o Surgery, Chemo, radiation, BMT
SIS of treatment from Chemo:
o Infection o Hemorrhage o Anemia o WV
