NURS 307 - FINAL REVIEW. FINAL REVIEW (40:39 on BB Collab)

27. FIRST priority for anaphylatic shock AIRWAAAAAY! ABC’S ALSO, Avoidance of allergen 28. Know what to do for anaphylactic shock • Avoidance of allergen • ABC’s • Epinephrine, IV, or IM 29. Pathophysiology for anaphylactic reactions Patho: Anaphylaxis is a severe, systemic hypersensitivity reaction that is rapid in onset and characterized by life-threatening airway, breathing, and/or circulatory problems, and that is usually associated with skin and mucosal changes. 30. Know histamine response (STUDY PICTURE ON SLIDE) Sensitization: Initial exposure to allergen Allergen (ie: pollen, grain) enters into the bloodstream → B cells differentiate into plasma cells and make antibodies → antibodies attach to mast cells Allergic Reaction: Secondary exposure to same allergen Allergen binds to antibodies on mast cells → Histamine is released from the mast cell → an allergic reaction ensues 31. Brain Tumor (SELECT ALL THAT APPLY) 4 things on brain tumor (4 SYMPTOMS) Manifestations: • Behavioral and nervous system changes • Increased ICP (rapid or slowly) o Headache o Nausea o Vomiting o Abnormal gait o Dizziness o Vision changes o Fatigue +mental status changes or educational problems Treatment: • Surgery • Chemotherapy and/or radiation 32. Non-Hodgkins lymphoma that nurse is at high risk for kidney or renal disorders tenks 8===D~~ SMH *He said to focus on the difference between these two. Hodgkin NON-Hodgkin Patho: starts in a single lymph node or chain • Large cell with multiple nuclei Patho: T-cell abnormalities that cause immature, malignant and diffuse T-cells • Often occurs in children with congenital or acquired immunodeficiency, autoimmune diseases. s/s • Nontender, firm lymphadenopathy • May cause resp. Symptoms if pressure is placed on trachea or bronchi • If progressed → fever, night sweats, and weight loss s/s • Fever • Weight loss • Enlarged or nodular lymph nodes may or may not be present o May cause resp. Compromise if trachea/bronchi has pressure • Pain and swelling in lymph nodes • Swelling of face • Enlargement of lymph nodes: o Neck o Armpits o Groin • RESP: o SOB o Chest pain o Difficulty breathing o Coughs • Abdominal pain, distention, bloating and constipation • Loss of appetite, diarrhea, weight loss Management • Chemotherapy and/or radiation • High survival rate Management • Chemotherapy and/or radiation • Hematopoietic stem cell transplant for recurrent disease 33. Diagnosis of acute lymphatic leukemia know diagnosis for this one (PATHO) PATHO: • Stem cells in the bone marrow produce immature WBCs that do not function normally and are produced at a rapid rate that replaces the normal functioning cells leaving the body at an increased risk for infection • ***ALL (acute lymphocytic leukemia) – affects lymphocytes predominantly*** DX: • Initially made by abnormal CBC (anemia, thrombocytopenia and/or neutropenia) • Confirmed by bone marrow aspiration 34. Hodgkins disease patient with hodgkins.. know expected findings • Nontender, firm lymphadenopathy • Respiratory difficulty • Fever • Night sweats, weight loss 35. neuroblastoma study manifestations.. they will have an ELEVATION IN WHAT?????? Tumor markers: Homovanillic acid (HVA) and vanillylmandelic acid (VMA) are by- products of adrenal hormones are usually elevated in the urine and blood -Elevation in dopamine, ferritin, NSE, LDH, and GD2 Manifestations: • Dependent on the location of the mass, but problems are caused by pressure onto organs • Weight loss • Abdominal distension • Irritability, fatigue, fever Elevation in whaaaaat??? 36. Sickle Cell Disease know what it does to the tissue how it causes pain • Obstruct capillary blood flow → tissue ischemia/hypoxia → organ tissues become damaged and impaired function • pain results from avascular necrosis of the bone marrow 37. Lupas.. Know the highest priority nursing diagnosis PAIN? Body Image? Patho: Autoantibodies are produced and immune complexed form and are deporisted into connective tissue, triggering and inflammatory response which overtime damages the connective tissue. • Can affect all organs, but small blood vessels, glomeruli, joings, spleen and heart valves most common Manifestation: • Classic sign: butterfly rash • Fever • Fatigue • Arthritis • Nephritis (leading cause of mortality in children) 38. know if adolescent is hospitalized what are most concerned about? • Body image 39. know what area of PRE-school age, how they view illness • They may view illness as punishment 40. KNOW the N-PASS • Neonatal Pain, Agitation and Sedation Scale • Age range: 23 weeks to 100 days old • Use: Uses behavioral and physiological parameters to assess pain and sedation 41. Know peak occurrence of POISONING in children Peak occurrence of poisoning → 1 - 4 years old*** 42. piaget.. when formal operational thought begins • Formal operation though begins at age 12 to adulthood • Demonstrates abstract thinking, including logic, deductive reasoning, comparison, and classification. (ppt) 43. ERIKSON’S STAGES 1. Trust vs Mistrust o 0-1 yr o Achieve a sense of trust in caregiver and environment 2. Autonomy vs Shame and Doubt o 1-3 yr o Achieve control over bodily secretions ▪ Potty training is the major milestone of the age o Learning to decide for themselves what to do for fun o Testing limits o If constantly being yelled at and not encouraged will develop shame and doubt 3. Initiative vs Guilt o 3-6 yr o Interested in new activities o Wants to help parents and be more involved o Criticism leads to guild and lack of purpose 4. Industry vs inferiority o 6- 12 yr (SCHOOL AGE) o Takes pride in accomplishments o New interests o Sports, clubs, etc. 5. Identity vs role confusion o 12-18 yr (ADOLESCENT) o Becoming an individual with a more defined sense of identity 44. know what an extended family is Relatives (grandparents, aunts, uncles, etc.) 45. Read up on family history 46. data points on developmental scale 47. down syndrome (SELECT ALL THAT APPLY) 4 answers that are right.. know the characteristics Manifestations of DS: 1. flattened face 2. small head 3. short neck 4. protruding large tongue 5. upward slanting eyes (palpebral fissures)