Ricci, Kyle & Carman: Maternity and Pediatric Nursing, Fourth Edition Ch.42 GI Ch.43 GU CH.41 Cardio Correct Question and Answers

Ricci, Kyle & Carman: Maternity and Pediatric Nursing, Fourth Edition Ch.42 GI Ch.43 GU CH.41 Cardio Correct Question and Answers When should a cleft lip be corrected?Ans- 2-3 months When should Cleft palate be corrected ?Ans- 6-9 months Rule of 10's for cleft repairAns- 10 weeks 10pounds 10 hemaglobin hypertrophic pyloric stenosisAns- a defect in the relaxation of the pyloric sphincter that leads to the enlargement of the pyloric muscles and closure of the pyloric sphincter hypertrophic pyloric stenosis treatmentAns- Treatment is surgical relief of obstruction: pyloromyotomy Restoration of hydration status Gradual reintroduction of feedings Hypertrophic Pyloric Stenosis s/sxAns- Vomiting that leads to projectile vomiting IntussusceptionAns- telescoping of a segment of the intestine Intussusception symptomsAns- intermittent abdominal pain, vomiting, brown stools changing to red/currant jelly type stools, mass RUQ Sausage shape mass right upper abdomen Intussusception treatmentAns- Diagnosed by xray, ultrasound, air or barium contrast enema, which sometimes reduces the obstruction without need for surgery Surgery is indicated when barium or air contrast enema does not reduce the intussusception AppendicitisAns- inflammation of the vermiform appendix Appendicitis S/SAns- RLQ pain, low grade fever, nausea, rebound tenderness at McBurney's point. Hirschsprung disease treatmentAns- surgical resection Hirschsprung disease (congenital aganglionic megacolon)Ans- absence of nerve stimulation to the bowel, which produces normal peristalsis Hirschsprung disease symptomsAns- no meconium stool in 48 hours, abdominal distention, bilious vomiting. Ribbon like stools Older child: failure to thrive, constipation Short bowel syndromeAns- malabsorption and malnutrition disorder created by the loss of a significant portion of functioning bowel Short bowel syndrome treatmentAns- Manage fluid and electrolytes Oral rehydration solutions Medications for motility and diarrhea and gastric hypersecretion hypospadiasAns- abnormal congenital opening of the male urethra on the undersurface of the penis Corrected at 12 months of age using foreskin EpispadiasAns- congenital defect in which the urinary meatus is located on the upper surface of the penis Corrected at 12 months of age using foreskin Obstructive neuropathy treatmentAns- Give prophylactic antibiotics to prevent a UTI or hydronephrosis Surgical interventions vesicoureteral reflux (VUR)Ans- backflow of urine from the bladder into the ureters Vesicoureteral reflux treatmentAns- Treat infections aggressively; treat mild reflux with daily prophylactic antibiotics (amoxicillin if 2 months of age; otherwise TMP-SMX or nitrofurantoin) until reflex resolves Surgery (ureteral reimplantation) is generally reserved for children with persistent high-grade (III to V) reflux Inadequate treatment can lead to progressive renal scarring and ESRD UTI s/s in childrenAns- -younger children: irritability, lethargy, fever (no obvious focal infection) -older children: abd pain, unexplained fever, or both -as children approach puberty, flank pain becomes more common - UTI considered in infants and 2 mons-2 yo w/ unexplained fever Mimick GI symptoms in ages 0-24 months primary enuresisAns- bed wetting in children who have never been dry for extended periods Enuresis treatmentAns- 1. reassurance, resolves spontan, normal 4-5 yo 2. *desmopressin* (DDVAP) 3. imipramine Secondary enuresisAns- occurs in a child who has had at least 6 months of nighttime dryness nephrotic syndromeAns- group of clinical signs and symptoms caused by excessive protein loss in urine Nephrotic syndrome s/sxAns- - frothy urin