PEDS Exam II- CH.73 CARE OF THE SCHOOL-AGED CHILD OR ADOLESCENT

The common cold is what type of infection?

A viral infection [symptomatic]

**Treat the symptoms

__ ,also known as "pink eye", is a very common inflammatory highly contagious infection among all age groups

Conjunctivitis

"Kissing Disease"

Mononucleiosis

Mono is a viral infection transmitted by droplets in __, coughs, and sneezes, and by direct contact with mucous membranes (mouth-to-mouth)

SALIVA

How will the physician determine mono?

o CBC test

o Mono test

Bobby has mono with an enlarged spleen and loves recess. What will you educate the parents on for Bobby's condition?

N/C

Since Bobby has an enlarged spleen, he is restricted from strenuous activities which includes recess

**His spleen can rupture resulting in hemorrhaging

Do we give antibiotics to treat mono?

No, mono has to run its course you only treat the symptoms

**Can last up to 6 months

People who love the outdoors and spends most of their time in woods with deers are at risk for what disease?

LYME Disease

What is the causative agent of lyme disease that is a bacterial infection

Deer tick

For those who show signs of Lyme disease, what is the distinct indication that a person may have this disease?

What is the Tx?

o A bull's eye type of rash

o Antibiotics

If Lyme disease goes untreated because of no signs and symptoms it can lead to what?

ANGINA AND FACIAL PALSY

Lyme disease is difficulty to determine by physicians without a __ present and can be mistreated for the flu.

RASH

T r F

Lyme disease can cause miscarriage, stillbirth, or fetal abnormalities in pregnant women

TRUE

Name some preventive measures for Lyme Disease (deer tick)

o Wear long sleeves, tuck pants into socks

o Wear light-colored clothing to see ticks

o Check skin and clothes frequently

o Use insect repellant with DEET

o Remove ticks carefully including the head

o Keep grass and fields cut

o Place flee and tick collars on pets

Why do you want to protect your pets from Lyme disease even though they do not carry the bacteria?

They can pick up deer ticks if they are around infested areas outdoors

__ is the inflammation of brain tissue and occasionally the meninges

ENCEPHALITIS

During the summer, the most dangerous time to contract encephalitis, what carries the causative agent for this disease?

Mosquitoes

T r F

Treat meningitis immediately because it can lead to severe encephalitis

TRUE

What is Acne?

Over secretion of sebum which results in pimples, blackheads, etc.

The nurse explains to an adolescent that acne is primarily caused by__

o Hormonal changes

T r F

Diet plays a significant role in the development or progression of acne

FALSE

It does not

Nursing considerations for using

Tetracycline to treat Acne

N/C:

o Avoid sunlight

o Take 1 hr before or 2 hrs after meals

What causes acne flare-ups?

STRESS

__ is a surgical means of smoothing the skin of acne patients

DERMABRASION

A child with multiple honey-colored crusted lesions on the legs, arms, and face comes to the clinic and is diagnosed with IMPETIGO. The nurse should place priority on teaching the mother to ___

PREVENT THE SPREAD OF INFECTION

**Discourage the child from scratching or touching infected sites

Tinea pedis AKA __, is a common fungal infection that attacks the skin between the toes.

athlete's foot

Why do you want to encourage adolescents to wear shower shoes when taking a shower after gym?

Because the bacteria is found on the floors of public baths, showers, locker rooms, and pools

Name some education tips for preventing athlete's feet

o Expose the feet to air when possible

o Wash feet daily

o Apply antifungal medication after each bath and continue meds as prescribed

o Wear shower shoes in public areas

o Keep shoes ventilated

This postural defect is seen mostly in obese people and pregnant women resulting in a "sway-back" of the spine

LORDOSIS

__ is an abnormal curvature of the thoracic spine that results in a "hunchback" appearance

KYPHOSIS

**Poor posture may also be a result of this

Which postural defect results in the spine resembling an S-shape?

Scoliosis

FUNCTIONAL- POOR POSTURE

STRUCTURAL- DEFECTS IN SPINAL CORD

When are school-aged children normally checked for SCOLIOSIS

During school screenings

If SCOLIOSIS is not severe, what are the treatments?

o Exercise

o Braces

What is the treatment for severe SCOLIOSIS?

Surgery with implantation of Harrington Rods

If a client is designated to wear a brace to correct SCOLIOSIS, what should you educate them on to prevent skin breakdown?

Wear a thin t-shirt underneath the brace

An adolescent girl has painful joint movement and subcutaneous nodules on her hands. What might she be diagnosed with?

Juvenile Rheumatoid Arthritis

What can be given to treat juvenile rheumatoid arthritis?

NSAID's [anti-inflammatory]

What can the child do to ease the pain from juvenile arthritis other than NSAID's?

o exercise the limbs

o applying heat packs, hot baths, or whirlpool treatment

__ results from lack of blood supply to the hip joint, causing joint necrosis causinf the child to have a limp.

LEGG-CALVE' PERTHES DISEASE

**Usually one hip is affected

What can be some causes to Legg-Calve Perthes Disease?

o Low birth weight babies

o Injuries

o Other disease processes

__ refers to faulty tooth positioning, which results in improper alignment of the jaws and teeth. which makes cleaning teeth difficult

Dental Malocclusion

What is the correction measures used to treat dental malocclusion?

Braces

Which sarcoma involves cancer of the bone marrow and effects the long and flat bones?

Ewing Sarcoma

This sarcoma involves the diaphysis of the long bones and metasizes to the lungs first

Osteogenic Sarcoma

What is diabetes mellitus type 1?

The child lacks production of insulin or produces too little of insulin from the pancreas

Name the 3 classic symptoms in Diabetes Mellitus

o PolyURIA [too much urine output]

o PolyDIPSIA [abnormal thirst]

o PolyPHAGIA [increased hunger]

Can diabetic children eat the same foods as other children?

Yes, it has to be regular and consistent though

**Increase nutrient intake for the athletic diabetic child

S/Sx of Hypoglycemia

"Need to eat"

o Weak, cold

o Hungry, nervousness

o Trembling, perspiring

o Headache, N/V

S/Sx of Hyperglycemia

"Too much sugar"

o Weakness, drowsiness

o Frequent urination, blurred vision

o Vomiting- may have sweet smelling breath

o Tachypnea/ Tachycardia

o Low blood pressure

Too much fluid in the eye causing high intraocular pressure of the eye in the child is called ___

Juvenile Glaucoma

What symptoms will the child show if they have juvenile glaucoma

o Cloudiness of the cornea

o Sensitivity to light

o Frequent tearing

Inflammation of the colon and the rectum is called __

Chronic Ulcerative Colitis

S/Sx of Ulcerative Colitis

o Severe diarrhea which may be bloody

o Weight loss

Tx of Ulcerative Colitis

o Corticosteroid Administration

o Colectomy [removal of diseased portion of the colon]

Susie goes to the schoo nurse. She has a fever of 100 and states that her right side hurts mainly in the lower part. She may have what?

Appendicitis

Primary dysmenorrhea is painful menstruation. What can be given to treat this?

o NSAID's (ibuprofen, etc.) 1-2 days before menses

What is the term used for early sexual development?

Precocious

The teacher notices that Amber consistently falls asleep in class with no warnings. Each time she falls asleep for about 2 minutes. Amber may have

NARCOLEPSY

Uncontrollable urge to sleep for long periods of time between 12-18 hours is known as __

HYPERSOMNIA

What is the term used for "sleep walking"?

Do you want to wake the sleep walking child?

Somnambulism

Never wake the sleep walking child

Bobby screams throughout the night and constantly screams for his mother. Bobby is experiencing __

NIGHT TERRORS

Mrs. Roberson notices that her husbands talks in his sleep. The next day she tells him you need to get checked for what sleep disorder?

Somniloquism

Which eating disorder is characterized by the adolescent being obsessed with weight loss?

Anorexia

What are some life-threatening complications as a result of Anorexia?

o Low blood pressure

o Bradycardia

o Hypokalemia

o CHF

Ashley notices that Brittany ate a whole box of twinkies only to make herself throw up. What is Brittany suffering from?

Bulimia

What are some complications of Bulimia?

o Throat irritation

o Dental caviities

o Electrolyte imbalance

What is the medical term used for bedwetting?

Term for involuntary bowel movements?

Enuresis

Encopresis

N/C- Never shame or belittle the child for either disorder

__ intake is important for the school aged child to prevent iron-deficiency anemia

IRON