NURS 211 - Module 2

Oral rehydration therapy allowed fluids?

Oral rehydration therapy allowed fluids?

Pedialyte, glucose, sodium chloride

Oral rehydration therapy typical IV rate?

50-100 ml/kg over 4 hours

Insensible fluid loss

Fluid loss that cannot be measured aka sweating due to fever

Hypertrophic pyloric stenosis S/S:

Three week old baby that is forceful vomiting across the room, emergent situation that requires surgery

aka

Non-bilious vomiting starts 3-6 weeks of life/ frequent, forceful to projectile

Hypertrophic pyloric stenosis solution?

Surgery called pyloromyotomy

What does pyloric stenosis place infants at risk for?

Aspiration and throat ulcers

What is intussusception?

When a section of the bowel flips over on itself aka telescopes

S/S of intussusception:

Child is crying out -Super painful, everything gets inflamed

also

Poop looks like currant-jelly, dark cranberry color with jelly consistency

Intussusception typical age range?

Toddlers aged 1-2

How do we fix intussusception?

Fixed by air (or barium) enema, kid is asleep and we pump belly with air in hopes it will fold - Can also fix itself

What is a cleft lip or palate?

Cleft lip: There's a hole between baby's lip and nose (slept area)

Palate: Hole in the roof of the mouth

How do we fix cleft lip and palate?

Can be fixed with surgery - Child then needs put in elbow restraint so they don’t touch their mouth

• Assess skin breakdown, circulation, and ROM

Cleft lip and palate complications?

Feeding difficulties, trouble latching onto nipple

Altered dentition

Delayed or altered speech development 

• Tongue touches roof of mouth when speaking

• Scar tissue can cause mouth to love differently 

Otitis media

What is Hirschsprung disease?

Absence of ganglion cells in colon - This means the sphincter won't relax, causing an accumulation of stool

aka

Failure of sphincter to relax/ accumulation of stool with distension (increase in abdominal girth length)

How do we cofirm Hirschsprung disease?

Confirm with rectal biopsy

How do we fix Hirschsprung disease?

Two stage repair

• Temporary ostomy

• Pull-through procedure - Intestine becomes new sphincter 

Infant skin concerns?

Epidermis thinner, blood vessels closer to the surface

• Loses heat more readily through skin surface

• Substances are more easily absorbed through skin

Skin contains more water

• Epidermis Loosely bound to the dermis

• Friction more easily results in blistering or skin breakdown

Less pigmented

• Increased risk for UV damage

Reaches adult thickness in late teen years

Darker skin: more hypertrophic scarring and keloid

Where is Tinea Pedis?

Fungal infection on the feet

Where is Tinea Corporis?

Other body parts

Where is Tinea Versicolor?

Presents differently; hypopigmented lesions on upper body

Where is Tinea Capitis?

Scalp

Where is Tinea Cruris?

Groin

Acute hypersensitivity reactions examples:

• Diaper dermatitis

• Contact dermatitis

• Urticaria

Chronic hypersensitivity disorder examples:

• Atopic dermatitis

Contact dermatitis treatment?

Oatmeal bath, hydrocortisone cream, clean and dry, open to air

Where do we assess a child’s skin turgor?

Abdomen

At what age can you give ibuprofen? Tylenol?

You can give ibuprofen at 6 months or greater, you can give Tylenol anytime

Where do we take an infants temperature? What about a toddlers?

• Check infant temperatures rectally

• Check toddler's temperature axillary

Bacterial infection: Diphtheria

A sheet of thick, gray matter covers the back of the throat, making breathing hard

Bacterial infection: Pertussis

Whopping cough

Pediculus?

Lice

Lice treatment?

• Machine was all washable clothing, towels, and bed linens

• Vacuum carpets, car seats, pillows, stuffed animals

• Seal non-washable items in plastic bag

• Soak Combs and brushes

• In daycare centers (separate items)

• Discourage the sharing of items (hats, Hair accessories, combs)

• Avoid physical contact with those infected Items (bedding, clothing)

• Inspect Children in a group setting for lice

• Provide education for transmission, detection, and treatment

Scabies?

• Bugs that crawl into skin

• Causes rash and burn 

• Cream is the only treatment, entire family will put this on their whole body and repeat in 7 days

What is the only thing that can kill bedbugs?

Heat

What infants are at the highest risk for anemia? Why?

Premature infants, due to low fetal supply

What points in a child’s growth and development might they become anemic?

• At 12 to 36 months, due to ingestion of large amounts of cow’s milk and diet

• In adolescents, due to rapid growth and poor eating habits 2

Should you give iron with food? If not what should you give it with?

Give iron on a empty stomach and with vitamin C to support absorption

What stools are common with iron supplements?

Green or tarry

Normal WBC range for a 6-month-old infant?

5.0 to 19.0

Iron rich foods?

• Red meats (easiest for the body to absorb)

• Tuna and salmon

• Eggs

• Tofu

• Enriched grains

• Dried beans, peas, and fruits

• Leafy green vegetables

• Iron-fortified breakfast cereals

Anemia caused by nutritional deficiency examples:

• Iron deficiency

• Folic acid deficiency

• Pernicious anemia (b12 deficiency)

Anemia caused by toxin exposure examples:

Lead poisoning

Aplastic anemia examples:

• Acquired as an adverse reaction to medication

• Rare congenital bone marrow failure (Fanconi anemia)

Hemolytic anemia examples:

• Sickle cell anemia

• Thalassemia (body doesn't produce enough hemoglobin)