Peds test

Endocrine system

The system in the body that consists of glands that secrete hormones to regulate bodily functions.

Hypopituitarism

A condition where there is a deficiency in the secretion of one or more hormones from the pituitary gland.

Pituitary hyperfunction

A condition where there is an excess secretion of hormones from the pituitary gland.

Diabetes insipidus

A disorder characterized by undersecretion of antidiuretic hormone (ADH), resulting in uncontrolled diuresis.

Syndrome of inappropriate ADH secretion (SIADH)

A disorder characterized by the hypersecretion of ADH, leading to hyponatremia.

Thyroid

A gland in the neck that regulates the basal metabolic rate and controls growth and tissue differentiation.

Hypothyroidism

A condition where there is a deficiency in thyroid hormone production, leading to a decreased metabolic rate.

Hyperthyroidism

A condition where there is an excess production of thyroid hormone, leading to an increased metabolic rate.

Adrenal cortex

The outer part of the adrenal gland that secretes glucocorticoids, mineralocorticoids, and sex steroids.

Cushing syndrome

A disorder characterized by the overproduction of cortisol, leading to a variety of symptoms.

Diabetes mellitus (DM)

A chronic condition characterized by high blood sugar levels, categorized into type 1 and type 2.

Childhood cancer

Malignant diseases that occur in children, often requiring multimodal therapy for treatment.

Leukemia

A group of malignant diseases of the bone marrow and lymphatic system, characterized by depressed production of blood cells.

Lymphomas

Neoplastic diseases that arise from the lymphoid and hematopoietic systems, including Hodgkin disease and non-Hodgkin lymphoma.

Tumors of the CNS

Solid tumors that occur in the central nervous system, often requiring a combination of surgery, radiation therapy, and chemotherapy for treatment.

Neuroblastoma

The most common extracranial solid tumor of childhood, often diagnosed after metastasis occurs.

Bone tumors

Malignant tumors that occur in the bones, such as osteosarcoma and Ewing sarcoma.

Wilms' tumor

A kidney tumor that primarily affects children, often treated with surgical resection.

Hepatoblastoma

The most common type of liver tumor in children, treated with surgical resection after chemotherapy.

Radiation therapy

The use of high-energy radiation to treat cancer, often used in conjunction with other treatment modalities.

Long-term consequences of radiation therapy

Tissue necrosis, subsequent malignancies, endocrine dysfunction, and behavioral or intellectual deficits.

Characteristics of infants and young children's skin

More susceptible to superficial bacterial infection, more likely to have associated systemic symptoms with infections, more apt to react to a primary irritant than to a sensitizing allergen, more frequently affected by chronic atopic dermatitis.

Causes of skin lesions

Contact with injurious agents, hereditary factors, external factors that produce a reaction in the skin, systemic diseases.

Various forms of dermatitis

More than half of dermatologic problems, a sequence of inflammatory changes in the skin, grossly and microscopically similar but diverse in course and causation.

Causes of dermatitis skin lesions

Physical, chemical, or allergic irritants, infectious agents such as bacteria, fungi, viruses, or animal parasites, specific infections, drug sensitization, or other allergic phenomena.

Wound healing

Structural or physiologic disruptions of the integument, interventions used to promote healing, emphasis on a moist, crust-free environment that enhances the migration of epithelial cells across the wound and facilitates resurfacing.

Goals of treatment for disorders

Prevent further damage, eliminate the cause, prevent complications, provide relief from discomfort while tissues undergo healing.

Factors contributing to dermatitis

Environmental factors (soaps, bubble baths, shampoos, rough or tight clothing, wet diapers, blankets, toys), natural elements (dirt, sand, heat, cold, moisture, wind).

Home management of small wounds

Wash hands, wash wound gently with mild soap and water or normal saline, avoid povidone-iodine, alcohol, and hydrogen peroxide.

Purpose of dressings for wounds

Provide a moist healing environment, protect the wound from infection and trauma, provide compression, apply medication, absorb drainage, debride necrotic tissue, reduce pain, control odor.

Staphylococcal infections

Common in younger age-groups, importance of careful hand washing and cleanliness to prevent spread of infection.

Dermatophytoses (ringworm)

Infections caused by filamentous fungi, superficial infections, emphasize good health and hygiene, use of ketoconazole and selenium sulfide shampoos.

Scabies

Infestation caused by scabies mite, burrows into the stratum corneum, treatment with permethrin 5% cream.

Pediculosis capitis (head lice)

Infestation of the scalp by head lice, treatment with permethrin 1% cream rinse.

Lyme disease

Tickborne disorder caused by Borrelia burgdorferi, diagnosis based on history, observation of lesion, and clinical manifestations, treatment with doxycycline or amoxicillin.

Contact dermatitis

Inflammatory reaction of the skin to chemical substances, hypersensitivity response or direct irritation, prevent further exposure to offending substance.

Poisonous plant contact

Produces impetiginous lesions, treatment with calamine lotion, Burow solution compresses, or Aveeno baths, use of topical corticosteroid gel for inflammation, oral corticosteroids for severe reactions.

Nonhuman mammal bites

Common injuries, general wound care, medical evaluation for tetanus and rabies.

Diaper dermatitis

Common in infants, caused by wearing diapers, use of cornstarch for treatment.

Atopic dermatitis (eczema)

Chronic relapsing inflammatory lesions, nursing management includes hydrating the skin, relieving pruritus, reducing inflammation, preventing infection.

Seborrheic dermatitis

Chronic, recurrent, inflammatory reaction of the skin, treatment with daily shampooing and cleaning with mild shampoo or soap.

Acne vulgaris

Most common skin condition of adolescence, caused by excessive sebum production, treatment includes gentle cleansing with mild soap and topical/system medications.

Chilblain and frostbite

Skin reactions to cold, management includes analgesics and sedatives for pain relief.

Assessment of children with suspected or diagnosed cardiac conditions

Nutritional state, color, chest deformities, unusual pulsations, respiratory excursion, clubbing of fingers, chest and abdomen inspection, peripheral pulses, heart rate and rhythm, character of heart sounds.

Tests used in assessing cardiac function

MRI, ECG, echocardiography, cardiac catheterization.

Types of cardiac catheterization procedures

Diagnostic catheterizations, interventional catheterizations, electrophysiology studies.

Prenatal factors predisposing children to congenital heart defects

Maternal chronic illness, alcohol consumption, exposure to environmental toxins and infections.

Classification of congenital heart defects based on hemodynamic patterns

Increased pulmonary blood flow, decreased pulmonary blood flow, obstruction of blood flow out of the heart, mixed blood flow.

Clinical manifestations of congestive heart failure (CHF)

Impaired myocardial function, pulmonary congestion, systemic venous congestion.

Nursing measures in the care of a child with CHF

Improve cardiac function, remove accumulated fluid and sodium, decrease cardiac demands, reduce afterload, improve tissue oxygenation, support the child and family.

Clinical manifestations of hypoxemia

Cyanosis, polycythemia, clubbing, delayed growth and development, increased risk for CVAs, brain abscess, and developmental delays.

Care of a child with CHD and the family

Help them adjust to the disorder, cope with the effects of the defect, foster growth-promoting family relationships.

Preoperative care of a child with a congenital heart defect

Introduce to the hospital, prepare for preoperative and postoperative procedures.

Postoperative care of a child with a congenital heart defect

Observe vital signs and pressures, maintain respiratory status, provide rest and comfort, monitor fluids, plan progressive activities, give emotional support, observe and treat complications, plan for discharge and home care.

Acute Rheumatic Fever (ARF)

A systemic inflammatory disease that can damage the cardiac valves and is associated with previous group A strep (GAS) infection.

Rheumatic Heart Disease (RHD)

A condition that can result from recurrent infections in children with ARF, causing further damage to the heart valves.

Nursing care objectives for ARF

(1) Encourage compliance with drug regimens, (2) Facilitate recovery from the illness, and (3) Provide emotional support.

Cardiac Dysrhythmias

Abnormal heart rhythms in children, including bradycardias, tachydysrhythmias, and conduction disturbances.

Heart Transplantation

A treatment option for infants and children with worsening heart failure (HF) and limited life expectancy, indicated for cardiomyopathy, end-stage congenital heart disease (CHD), and certain complex congenital cardiac defects.

Hypertension Education

Focuses on drug therapy, diet control, weight loss, and appropriate exercise.

Kawasaki Disease

An inflammation of small vessels and capillaries that can involve the coronary arteries and cause aneurysm formation. Treatment includes administration of gamma globulin (IVIG).

Emergency Treatment for Shock

Includes ventilation, fluid administration, cardiovascular support, and general support.

Common Allergens associated with Anaphylaxis

Drugs, latex, foods, venom from bees or snakes, and biologic agents.

Septic Shock

Defined as sepsis with organ dysfunction and hypotension. Management includes providing hemodynamic stability, adequate oxygenation, and using antimicrobials.

Toxic Shock Syndrome

Management focuses on prevention, with avoiding the use of tampons being the most certain preventive measure.

Anemia

Defined as a reduction of red blood cells (RBCs) or hemoglobin (Hgb) concentration below normal levels for age. Classified by etiology and physiology or morphology.

Nursing care for Anemia

Assisting in establishing a diagnosis and cause, preparing the child for laboratory tests, administering prescribed medications (oral iron), providing dietary education, decreasing tissue oxygen needs, and preventing complications.

Prevention of Nutritional Anemia

Mainly focuses on parent/family education regarding correct feeding practices.

Sickle Cell Anemia (SCA)

A hemoglobinopathy characterized by abnormal sickle hemoglobin (HbS) replacing normal adult hemoglobin (HbA). Nursing care includes prevention and recognition of sickle cell problems, managing pain during crises, and helping the child and parents adjust to the chronic disease.

β-Thalassemia

A deficiency in the synthesis of the β-chain of the hemoglobin molecule, resulting in defective hemoglobin formation. Nursing care includes promoting compliance with transfusion and chelation therapy, observing for complications of multiple blood transfusions, and assisting with coping and adjustment.

Acquired Aplastic Anemia (AA) Causes

irradiation, drugs, chemicals, infections, and infiltration/replacement of myeloid elements. Therapy focuses on restoring marrow function through immunosuppressive therapy or bone marrow transplantation.

Hemophilia

A group of bleeding disorders characterized by deficiency, dysfunction, or absence of blood coagulation factors. Nursing care involves preventing bleeding, managing bleeding with factor replacement, preventing joint degeneration, and supporting the child and family for home care.

Immunodeficiency Disorders

Can cause profound alterations in the immune system. Nursing care varies depending on the specific disorder and focuses on managing symptoms, preventing infections, and supporting the child and family.

HIV Infection

Primarily acquired in infancy from an infected parent or in adolescence/young adults engaging in high-risk behaviors. Therapy goals include slowing virus growth, treating opportunistic infections, and providing nutritional support and symptomatic treatment.

Severe Combined Immunodeficiency Disease (SCID)

A defect characterized by the absence of both humoral and cell-mediated immunity. Definitive treatment is hematopoietic stem cell transplantation (HSCT) from a compatible donor, with IVIG infusions and PCP prophylaxis used until the transplant.

Wiskott-Aldrich Syndrome

An X-linked recessive disorder characterized by thrombocytopenia, eczema, and immunodeficiency. Blood transfusions can improve quality of life and survival.

Apheresis

The process of removing blood from an individual, separating its components, retaining one or more components, and reinfusing the remainder back into the individual.

Cushing' syndrome s/sx

• Weight gain

• Moon face

• Buffalo hump

• Hypertension

• Muscle weakness

Addison’s disease s/sx

• Fatigue

• Weight loss

• Hypotension

• Hyperpigmentation

• electrolyte imbalance

How do you treat Addison’s disease

Corticosteriod replacement

How do you treat Cushing’s syndrome

May usually involve surgery or medication

How to manage diabetes mellitus in a acute setting

Monitoring bg, administer insulin, dietary control, education

Teaching plan for parents of a child with DM

• Educate on disease process

• Teach proper bg monitoring

• Explain insulin administration and dosage

• provide a balanced diet plan

• Importance of exercise

• Teaching hypo/hyperglycemic reactions

• Follow ups

Hypoglycemic Reactions (low blood sugar)

Shaky, sweaty, confusion, irritability

Hyperglycemic Reactions (high blood sugar)

Excessive thirst (polydipsia), Frequent urination (polyuria), fatigue, excessive hunger (polyphagia)

What can cause Hypopituitary dysfunction?

Tumors. head trauma, or radiation therapy

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