NURS 629 Exam 4 Pediatric Nursing Concepts and Clinical Manifestation Questions & Answers 2024/2025

NURS 629 Exam 4 Pediatric Nursing Concepts and Clinical Manifestation Questions & Answers 2024/2025 What is physiological jaundice? - ANSWER--occurs when baby accumulates bilirubin -secondary to immature liver in newborns -common first 2-4 days of life and resolves by 2 weeks What level is conjugated hyperbilirubinemia? - ANSWER-serum conjugated bilirubin concentration greater than 1 mg/dL if the total bilirubin is less than 5.0 mg/dL or more than 20% of the total bilirubin if the total bilirubin is greater than 5 mg/dL (p. 862 AAP book) What is breastfeeding jaundice? - ANSWER--due to poor intake that causes lack of stools and urine output -common in first week and resolves once milk comes in and infant is feeding well-more stools and urinary output -peaks around 2-3 weeks How do you diagnose jaundice? - ANSWER--dx with a bili level of 5 mg/dL -12 mg/dL threshold for all newborns having jaundiced appearance -direct/indirect bili levels -CBC -reticulocyte count How do you treat jaundice? - ANSWER-increased intake indirect sunlight phototherapy IV fluids What are other causes of jaundice? - ANSWER-abnormal blood cell shapes (like sickle cell) Rh incompatibility cephalohematoma polycythemia (increased RBCs, SGA infants, twins) infection specific enzyme disorders What is biliary atresia? - ANSWER--life-threatening condition causing a blockage of bile ducts inside or outside of liver -leads to build-up of toxins (like bilirubin) -malabsorption of fat-soluble vitamins A,D,E,K -scaring of the liver, loss of tissue, cirrhosis -not inherited What are the two types of biliary atresia? - ANSWER-fetal- noted in womb (other defects like heart, spleen, intestines) perinatal- appears 2-4 weeks after birth What causes biliary atresia? - ANSWER--infection after birth (cytomegalovirus or rotavirus) -autoimmune disorder -developmental issue in womb -exposure to toxic substances What are symptoms of biliary atresia? - ANSWER-jaundice dark urine light to white stools poor wheight gain and growth How do you diagnose biliary atresia? - ANSWER-any infant with jaundice present 2-3 weeks after birth -direct and indirect serum bilirubin -LFTs -abdominal x-ray -abdominal US -liver bx How do you treat biliary atresia? - ANSWER-surgery (Kasai procedure) liver transplant What are risk factors for dehydration? - ANSWER-GI virus vomiting/diarrhea What is s/sx of dehydration? - ANSWER-sunken anterior fontanel tachycardia and decrease cap refill decrease urine output is sensitive but nonspecific increase in urine specific gravity decrease BP- late finding=more than 10% fluid loss How do you treat dehydration? - ANSWER-if minimal, mild, moderate- oral rehydration if severe (drowsy, cold extremities, lethargic, sunken/dry eyes, very depressed anterior fontanel, no tears, dry mouth/tongue, very decreased skin turgor, rapid/sometimes impalpable pulse, decreased/unrecordable pulse, deep/rapid respiratory rate, markedly reduced urine output) - IV fluids What is emesis? - ANSWER-vomiting=symptom must distinguish from regurgitation in infants integrated response to noxious stimuli-coordinated by CNS What is acute emesis? - ANSWER-short-term abrupt onset What is recurrent emesis? - ANSWER-at least 3 episodes over 3 months chronic, relatively mild that occurs frequently What is cyclic emesis? - ANSWER-recurrent, intense episodes separated by asymptomatic periods How do you treat emesis? - ANSWER-NPO for 1-2 hrs **rehydrate with small/frequent amounts of clear liquids avoid dairy and solids for 4-6 hrs and then add bland foods slowly What are causes of diarrhea? - ANSWER--primarily viral (most common) or bacterial -bacterial pathogens are usually C. difficile, salmonella, Giardia, Campylobacter **always serious in infancy due to small ECF reserve, and can dehydrate quickly Continues...