Peds Test 4
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The bladder capacity of a child can be determined by what formula?
age in years + 2 = ounces of bladder volume or capacity
Inflammation of the bladder:
Bacteria in the urine:
Infection of the kidney and the renal pelvis:
Infection of the ureters:
Infection of the urethra:
Backward flow of urine into the ureters:
What can result if not treated?
- vesicoureteral reflux
- pyelonephritis and scarring
Normal urine specific gravity:
It is __________ when dehydrated.
It is __________ when overhydrated.
How is a child's urinary system different from an adult?
- kidneys are immature
- dehydrated quickly
- higher risk of fluid overload
- bladder capacity smaller
What is the most reliable indicator of the GFR?
creatinine clearance (24 hr urine)
__________ is the most common organism that causes a UTI.
- wipe front to back
- avoid bubble baths
- wear white, cotton underwear
- wear loose-fitting pants
- increase fluid intake
- have child urinate immediately after a bath
Nephrosis is a chronic renal disease characterized by:
- heavy proteinuria (protein gets through glomerulus)
- severe generalized edema - anasarca
- hyperlipidemia (liver tries to bulk up blood)
__________ or nephroblastoma is a common neoplasm of the kidney in children, develops from abnormal __________ tissue, and most often, affects the __________ kidney.
- Wilm's tumor
Wilm's tumor is a highly __________ and fragile tumor. The exact cause of this tumor is unknown, but it could be from a possible __________ abnormality.
Wilm's tumor is __________, but there are no tests to identify carriers.
S/s of a Wilm's tumor:
- mass in flank area
- abd distention
If a child has Wilm's tumor, do not:
palpate the abd
__________ is an excessive amount of fluid in the scrotum that causes swelling.
A hydrocele is evident in a __________ or shortly thereafter as testicles descend through the inguinal ring into the scrotum.
A hydrocele is dx by:
__________ is also known as undescended testes and is the failure of testes to descend into the scrotal sac. Descent occurs from __ to __ months intrauterine to __ weeks after birth.
- 7-9 months
- 6 weeks
What are some causes of a cryptorchidism?
- band of fibers at inguinal canal blocking descent
- spermatic cord not long enough to reach
- decreased testosterone level
Which side does cryptorchidism usually occur in an infant?
There is an increased incidence of cryptorchidism in __________ infants.
An infant with cryptorchidism may have spontaneous descent within the __ year, but other tx options include:
- orchiopexy at age 1-2
- suture undescended testicle into scrotal sac, repair hernia if present, close inguinal canal
What should you teach the parents of an infant with cryptorchidism?
- increase risk of cancer and infertility
- TSE when child is older
What are some s/s of HYPOthyroidism in a newborn/infant?
- dry, cool skin
- dry, brittle hair
- puffiness around eyes
- large tongue and head
- excessive sleepiness "good baby syndrome"
- constipation and enlarged abd
- umbilical hernia
- hypotonia/floppiness (rag doll appearance)
- feeding difficulties
- growth problems/FTT
What are some s/s of HYPERthyroidism?
- excessive sweating
- restlessness, nervousness, emotional lability
- declining school performance
- increased appetite with weight loss
- wide-eyed, staring expression (exophthalmos)
- tremors of tongue, hand
- heat intolerance
A complication of HYPERthyroidism is a thyroid __________. It occurs when there is a sudden release of the thyroid hormone. The s/s can include:
What is the tx?
- delirium, seizure, stroke, coma; possible death
- same as hyperthyroidism, but with higher doses of meds
Some s/s of type __ diabetes include increased infections such as UTI/vaginal infections and slow healing.
What are the 3 goals of tx for type 1 diabetes mellitus?
- ensure normal growth and development through metabolic control
- enable child to cope with chronic illness, have happy and active childhood, and be well integrated into family
- prevent complications
When a child is in diabetic ketoacidosis (a form of metabolic acidosis) their ABG levels are all _________.
- types, action/onset/peak/duration
- drawing up- NRRN
- site selection/rotation
- insulin pump if needed
What should you teach a parent/child with diabetes about nutritional management?
- importance of spacing meals throughout day
- importance of snacks/carrying snacks
- myplate, glycemic index
- high fiber foods
What is Cushing syndrome caused by?
excessive circulating free cortisol; cortisol overproduced by adrenal cortex
The bones of kids are:
soft and flexible
Kids have __________ joints that allow for increased range of motion.
__________ is one of the most common deformities of the skeletal system, and characterized by a foot that has been twisted inward or outward.
Talipes equinovarus is:
feet are turned inward, child walks on toes/outer borders of feet
Hip dysplasia is more common in __________.
__________ test is performed to detect an unstable hip in the newborn. The physician extends the hips while stabilizing the pelvis.
__________ sign is when the physician can actually feel and hear the femoral head slip back into the acetabulum under gentle pressure.
__________ dislocation of the hip is more common.
In infants more than 2 months of age, soft tissue contractures prevent stabilization of the hip, and longer-term immobilization with a __________ may be required.
The body __________ cast encircles the waist and extends to the ankles or toes.
What are some early signs of dislocation of the hip?
- limitation of abduction
- asymmetry of skin folds
- shortening of femur
A spica cast maintains the legs in a __________ position and is used to treat developmental hip dysplasia. The infant is able to move toes freely.
__________ skin traction is a type of skin traction used in fractures of the femur and in hip and knee contractures.
Bucks traction (Buck's extension)
__________ traction uses a sling that is positioned under the knee, which suspends the distal thigh above the bed.
Skin traction is applied to the __________ extremity.
Checklist for a traction apparatus:
- weights hanging freely
- body in alignment
- HOB no higher than 20 degrees
- heels elevated off of bed
- monitor skin
- pain/relief recorded
- measures to prevent constipation
- trapeze for change of position
- neuro checks regularly
__________ is an infection of the bone that generally occurs in children younger than 1 year of age and between 5-14 years of age and is more common in __________.
Characteristics of a child with muscular dystrophy:
- onset usually between 2-6
- calf muscles hypertrophy/pseudohypertrophic
- weakness- falling, clumsiness, contractures of ankles/hips,
- Gowers' maneuver
Juvenile arthritis care:
- moist heat/exercise are advised
- whirpool baths
- hot packs
Commonly called "sway back," often seen during pregnancy:
Also known as "hunchback," and is an increased roundness in the thoracic curve commonly found in the elderly.
An abnormal side to side curvature of the spine:
S/s of scoliosis develop __________ and are not painful so that detection is usually via an incidental screening at school. The __________ are different heights. Dx is made by __________ photography that highlights the asymmetry and a spinal x-ray study.
- moire photography
Tx for scoliosis is aimed at correcting the __________ and preventing more severe scoliosis.
A __________ brace exerts pressure on the chin, pelvis, and convex side of the spine. It is worn __ hrs a day and is worn over a t-shirt.
The __________ brace is proving effective for pts with ______ curvatures, and is more acceptable to the self-conscious young person.
- boston brace
- low curvatures
Severe scoliosis necessitates ___________ to fuse the bones.
- vital signs
- pupil response
- motor function/reflexes/posturing
S/s of IICP:
- T- increased
- P- decreased
- R- decreased
- BP- increasedh/a
- change in LOC/orientation
- irritability/high-pitched cry
- sunset eyes
- bulging fontanels
- change in pupils (PERRLA)
- seizure activity
Most common head injury:
Nonprogressive d/o of motion and posture resulting from brain injury or insult during pd of early brain growth:
It is considered the most common permanent disability disease in children.
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