Exam 1: NUR254/ NUR 254 (Latest 2024/ 2023 Update)
Childbearing and Child Caring Families Review| 100%
Correct| Grade A- Galen
iron deficiency anemia - ANSWER SXS: lethargic, pallor, increased bleeding,
murmur, (tachycardia), cyanosis, polycythemia, PICA
Tx: iron rich diet, supplements
NI: cbc, coagulation, food diary, fix underlying cause, maintain o2, hydration, tx
infection/bleeding, **avoid with dairy, take with citrus**
**most common**
sickle cell anemia - ANSWER s/s: hypoxia, splenomegaly, pain, retinopathy, CVA,
chest pain,
Tx: IV, blood, abx, rest, pain meds
NI: rest, hydrate, oxygenate, abx, electrolyte imbalance, avoid stress/infection, pain
mgmt, education
**HA, SOB, FEVER**
Hemophilia - ANSWER SXS: pallor, fatigue, weakness, cool skin, tachycardia,
decreased peripheral pulse, low BP, bruising
Tx: platelets, desmopressin, amniocaproic acid, **replace factors**
NI: prevent bleeding, **RICE**, avoid things that can cause harm(move tables),
avoid sports, dental hygiene
Food rich in iron - ANSWER - red meat
- tuna/ salmon
- eggs
- tofu
- grains
- dried beans, peas, and fruit
- leafy greens
- iron fortified cereals
Lukemia ALL/ AML - ANSWER - proliferation of immature WBC (bands)
S/S: infections, pain, fractures, anemia, bleeding, cell starvation, hematomas, pallor
Tx: chemo
NI: monitor cbc, **reverse isolation, AVOID FRESH fruits, veggies, flowers, no
invasive**
**nutropenia**
**STERILE**
Neuroblastoma - ANSWER **primary site is abd**
, s/s: firm non-tinder mass, resp obstruction, periorbital edema
Tx: removal of tumor, chemo, radiation
NI: monitor I&O, infection, pain, hydration, bowel function
Younger= better survival
**DO NOT PALPATE**
Osteogenic Sarcoma - ANSWER - **mostly in the LE/ near growth plate**
S/S: pain, limping, mass, swelling, fever
Tx: surgery, radiation, chemo, possible amputation
NI: s/s of chemo, skin care radiation, loose clothing, cool temps, wrap stump, stump
elevation (24hrs)
Ewing Sarcoma - ANSWER - **long and trunk bones most common**
- minimal s/s
Tx: surgery, radiation, chemo, possible amputation
NI: s/s of chemo, skin care radiation, loose clothing, cool temps, wrap stump, stump
elevation (24hrs)
Wilms tumor (nephroblastoma) - ANSWER - Most common kidney tumor in children
s/s: painless mass, firm non-tender, discovered during general care
Tx: removal of tumor, chemo, radiation
NI: monitor I&O, infection, pain, hydration, bowel function, kidney function
**DO NOT PALPATE**
Retinoblastoma - ANSWER - in the retina
s/s: white glow in pupil, strabismus, blindness
Tx: remove tumor, chemo, irradiation, cryotherapy, photocoagulation
NI: show pictures, sphere in eye, eye patch, clean eye, prosthetic,
InterCranial Pressure (ICP) - ANSWER s/s: change in personality (school age),
bulging fontanels (infant), high pitched cry, lethargy, headache, projectile vomiting,
inability to follow simple commands
Tx: drains, surgery
NI: reflexes, neuro check, **elevate HOB 30**, midline minimal stimulation, VS, I&O,
dimmed light
**tx underlying cause infection/trauma**
**seizure**
**Late s/s= DECREASED EVERYTHING**
Hydrocephalus - ANSWER s/s: lg shape head, lethargy, high pitch cry, seizures
Tx: VP shunt
NI: monitor drain, infection (abx,ebd)
**VP shunt no high picthed cry**
**monitor infection**
Decorticate posturing - ANSWER
Childbearing and Child Caring Families Review| 100%
Correct| Grade A- Galen
iron deficiency anemia - ANSWER SXS: lethargic, pallor, increased bleeding,
murmur, (tachycardia), cyanosis, polycythemia, PICA
Tx: iron rich diet, supplements
NI: cbc, coagulation, food diary, fix underlying cause, maintain o2, hydration, tx
infection/bleeding, **avoid with dairy, take with citrus**
**most common**
sickle cell anemia - ANSWER s/s: hypoxia, splenomegaly, pain, retinopathy, CVA,
chest pain,
Tx: IV, blood, abx, rest, pain meds
NI: rest, hydrate, oxygenate, abx, electrolyte imbalance, avoid stress/infection, pain
mgmt, education
**HA, SOB, FEVER**
Hemophilia - ANSWER SXS: pallor, fatigue, weakness, cool skin, tachycardia,
decreased peripheral pulse, low BP, bruising
Tx: platelets, desmopressin, amniocaproic acid, **replace factors**
NI: prevent bleeding, **RICE**, avoid things that can cause harm(move tables),
avoid sports, dental hygiene
Food rich in iron - ANSWER - red meat
- tuna/ salmon
- eggs
- tofu
- grains
- dried beans, peas, and fruit
- leafy greens
- iron fortified cereals
Lukemia ALL/ AML - ANSWER - proliferation of immature WBC (bands)
S/S: infections, pain, fractures, anemia, bleeding, cell starvation, hematomas, pallor
Tx: chemo
NI: monitor cbc, **reverse isolation, AVOID FRESH fruits, veggies, flowers, no
invasive**
**nutropenia**
**STERILE**
Neuroblastoma - ANSWER **primary site is abd**
, s/s: firm non-tinder mass, resp obstruction, periorbital edema
Tx: removal of tumor, chemo, radiation
NI: monitor I&O, infection, pain, hydration, bowel function
Younger= better survival
**DO NOT PALPATE**
Osteogenic Sarcoma - ANSWER - **mostly in the LE/ near growth plate**
S/S: pain, limping, mass, swelling, fever
Tx: surgery, radiation, chemo, possible amputation
NI: s/s of chemo, skin care radiation, loose clothing, cool temps, wrap stump, stump
elevation (24hrs)
Ewing Sarcoma - ANSWER - **long and trunk bones most common**
- minimal s/s
Tx: surgery, radiation, chemo, possible amputation
NI: s/s of chemo, skin care radiation, loose clothing, cool temps, wrap stump, stump
elevation (24hrs)
Wilms tumor (nephroblastoma) - ANSWER - Most common kidney tumor in children
s/s: painless mass, firm non-tender, discovered during general care
Tx: removal of tumor, chemo, radiation
NI: monitor I&O, infection, pain, hydration, bowel function, kidney function
**DO NOT PALPATE**
Retinoblastoma - ANSWER - in the retina
s/s: white glow in pupil, strabismus, blindness
Tx: remove tumor, chemo, irradiation, cryotherapy, photocoagulation
NI: show pictures, sphere in eye, eye patch, clean eye, prosthetic,
InterCranial Pressure (ICP) - ANSWER s/s: change in personality (school age),
bulging fontanels (infant), high pitched cry, lethargy, headache, projectile vomiting,
inability to follow simple commands
Tx: drains, surgery
NI: reflexes, neuro check, **elevate HOB 30**, midline minimal stimulation, VS, I&O,
dimmed light
**tx underlying cause infection/trauma**
**seizure**
**Late s/s= DECREASED EVERYTHING**
Hydrocephalus - ANSWER s/s: lg shape head, lethargy, high pitch cry, seizures
Tx: VP shunt
NI: monitor drain, infection (abx,ebd)
**VP shunt no high picthed cry**
**monitor infection**
Decorticate posturing - ANSWER
