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PEDs final Chpt 40, 43, 44, 45, 48 Questions With Complete Solutions
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PEDs final Chpt 40, 43, 44, 45, 48 Questions With Complete Solutions
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PEDs final Chpt 40, 43, 44, 45, 48 Questions With CompleteSolutions
Acute Poststreptococcal Glomerulonephritis (APSGN) #
Correct Answers - Condition in which immune processes injure
the glomeruli
- caused by an antibody-antigen reaction secondary to an
infection with a nephritogenic strain of group A streptococcus
- Usually occurs 1-2 weeks after strep infection (Skin OR throat)
Acute Poststreptococcal Glomerulonephritis (APSGN)
pathophysiology # Correct Answers • The antibodies formed
by the body in response to Strep combine with bacterial antigens
to form immune complexes.
• These complexes become trapped in the glomerulus & activate
an inflammatory response.
• This damages the capillaries → a ↓ in GFR leading to renal
insufficiency.
→ Sodium & fluid are retained, and the damaged capillaries
allows RBC & proteins to pass into the urine
Acute Poststreptococcal Glomerulonephritis Clinical
Manifestations # Correct Answers •*Hematuria: microscopic to
tea-colored*
• Proteinuria
•*Edema -periorbital*
•*Hypertension*
•cardiopulmonary congestion; crackles
•Renal insufficiency (usually ↓ in urine output)
,Acute Poststreptococcal Glomerulonephritis: Management #
Correct Answers - Antihypertensives or diuretics PRN to ↓ BP
- Antibiotics
- Fluid & electrolyte management
- Sodium and fluid restrictions during edematous phase
- I/O, DW
NOTE: Avoid use NSAIDs in children with questionable renal
function, as they may cause a further ↓ in the GFR
Asthma patho # Correct Answers - A chronic reversible
inflammatory airway disorder characterized by:
• airway hyperresponsiveness
• airway edema
• mucus production
• Bronchospasm resulting from constriction of bronchial smooth
muscle
Asthma Therapeutic and nursing education: Peak flow meter
education (Green, yellow, red zones; PEFR Percentages,
symptoms, and actions) Correct Answers - SABA: Actue,
LABA: Prevention
- Peak flow meter education:
*Green: Good control*
PEFR: >80% personal best
S/S: None
Action: Take usual medications.
*Yellow: Caution*
PEFR: 50-80% personal best
S/S: Possibly present
Action: Take SABA STAT. Talk to your HCP.
,*Red: Medical alert*
PEFR: <50% personal best
S/S: Usually present
Action: Take SABA STAT. Go to office or ED
Atopic dermatitis description, complications, and therapeutic
management # Correct Answers *Description:*
- AKA eczema; chronic, inflammatory disorder of the skin
characterized by severe pruritus, and inflamed, erythematous,
swollen skin. Lichenification
- Usually disappears by age 2-3; Exclusive breast feeding ↓ the
incidence.
*Complications:*
- Psychological distress from chronic itching and difficulty
sleeping
- Self image issues
- irritable and has difficulty concentrating
*Therapeutic management*
- good skin hydration
- Topical corticosteroids
- oral antihistamines for sedative effects
- Antipruritics
- antibiotics if secondary infection occurs.
Atopic dermatitis nursing management: Maintaining skin
integrity and preventing infection # Correct Answers - Cut the
child's fingernails short and keep them clean. Avoid tight
clothing and heat. Use 100% cotton bed sheets and pajamas.
- Keep skin well moisturized to prevent scratching → leads to
infection
- Pressing the skin or clenching the fist may replace scratching.
, - Behavior modification; It is important for the child to stay
active to distract his or her mind from the itching
Atopic dermatitis nursing management: Promoting Skin
Hydration Correct Answers - avoid hot water and any skin or
hair product containing perfumes, dyes, or fragrance.
- Bathe the child twice daily in warm (not hot) water.
- Use a mild soap to clean only the dirty areas.
- Slightly pat the child dry after the bath, do not rub the skin
with the towel.
- Leave the child moist.
- Apply prescribed topical ointments or creams such as
corticosteroids in affected areas
- Apply fragrance-free moisturizer over the prescribed topical
medication and all over the child's body
- Apply moisturizer multiple times throughout the day.
= Avoid clothing made of synthetic fabrics or wool.
Atopic dermatitis pathophysiology # Correct Answers - Has a
relapsing and remitting nature.
- Skin reaction that occurs in response to allergens
- When the child encounters a triggering antigen, the skin begins
to feel pruritic and the child starts to scratch.
- *Sweating and excessively humid or dry environments causes
atopic dermatitis to worsen*
Bryant's traction description and nursing implications Correct
Answers *Description:*
- Both legs are extended vertically, with child's weight serving
as countertraction.
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