Primary dietary prescription for calcium nephrolithiasis (kidney stones) ? PG. 85
Low calcium diet
For client with nephrolithiasis the diet should be _ ash
Acid
If kidney stone is calcium phosphate the diet must be low in _ too
Phosphorus
Primary diet tx for uric acid nephrolithiasis is _ ___
Low purine
Client with uric acid nephrolithiasis should have a diet low in __
Methionine
What is methionine?
Precursor of the amino acid cystine
2 foods high in methionine?
Eggs, milk
Clients with cystine nephrolithiasis should have an __ ash diet
Alkaline
Inc. fluids over 3000 cc /day is more effective in treating renal calculi than ANY dietary modification, T/F?
True. Want to flush tract than worry about diet
What is the common name for Laryngotracheobronchitis – LTB
Croup
What is the typical temp elevation in croup?
Low grade, usually below 102, but can go up to 104.
Are ATBs helpful for croup? For epiglottits?
For croup, no. Epiglottitis, yes
Is croup viral or bacterial?
Viral
With which condition is croup most often confused?
Epiglottitis
Can croup be managed at home? Can epiglottitis be managed at home?
Yes. No, epiglottitis is a 911 emergency
Are sedatives used for kids with croup?
No, bc this would mask the signs of respiratory distress
What causes epiglottitis? A virus or bacteria?
H. influenza BACTERIA
What is the best tx for croup?
Cool moist air
What should never be done to a child with epiglottitis?
Never put anything in the child’s mouth, ie, a tongue blade can lead to obstruction
What are the typical signs and symptoms of croup?
Barking cough, inspiratory stridor, labored resp. pattern
What 3 signs tell you that the child has epiglottitis instead of croup?
Muffled voice, drooling, increased fever
When is croup bad enough to be evaluated by a doc?
When retractions, and high pitched stridor are present
What lead level needs intervention?
50-60 micrograms/ dl
With which class of drugs will a child with lead poisoning be treated?
Chelating agents
What do chelating drugs do?
They increase the excretion of heavy metals
The most freq. cause of lead poisoning is…
Ingestion of lead-based paint chips
Name 3 common chelating agents for lead poisoning
EDTA, desferal, BAL in oil
S&S of lead poisoning
Drowsiness, clumsiness, ataxia, seizures, coma, resp. arrest
Sx of lead poisoning show up in the __ system
Neuro
Leukemia is cancer of the _ forming tissues
Blood
The type of cell that is most common and problematic in leukemia is __
Immature WBC
In leukemia the RBC count is …
Low, bc the bone marrow is going “wild” producing all those immature WBC – no energy or nutrients to make platelets
In leukemia, the platelet count is …
Low, bc the bone marrow is going “wild” producing all those immature WBC – no energy or nutrients to make platelets
Bc the RBCs are low, the pt will exhibit _ and _
Pallor and fatigue
Bc of the immature WBCs, the pt is at risk for _
Infection
Bc of low platelets, the pt is at risk for , , and _
Bruising, ecchymosis, bleeding, petechiae
What causes lymph gland enlargement in leukemia?
All those small immature WBC clog the lymph system
Should you take a rectal temp on a child with leukemia?
No
Should you take an oral temp on a child with leukemia?
Yes, as long as they are over 4 years old, in remission, and have no sores in their mouth
Should the child with active leukemia use straws, forks, cups?
NO straws, NO forks, YES cups
RN’s priority in tx a child with newly diagnosed leukemia is…
Dec. risk of infection
When the leukemia child’s platelets and WBC’s are low, his activities should be …
Limited
When the platelet and WBCs are low the nurse should not insert a..
Suppository
Are IM injections and IV sticks permitted on a child with leukemia?
When labs are low IMs avoided and IVs limited; only done when absolutely necessary (to give chemo or measure blood counts)
Why are kids on chemo also on allopurinol
To prevent uric acid kidney stones (remember when chemo kills cancer cells, purines and uric acid build up and could cause kidney stones
Why do some kids with leukemia have joint pain?
The immature WBCs infiltrate the joint and cause inflammation
Why is a child with leukemia at risk for neuro sx due to ICP
The immature WBCs infiltrate the brain and cause inflammation
What is alopecia?
Hair loss
If the platelet count is low what drug should the child not take?
Aspirin
Is the alopecia from chemo permanent?
No. It will grow back. (Alopecia of radiation therapy is permanent bc the follicle is destroyed)
What does ANC mean?
Absolute Neutrophil Count
What is the ANC used for in leukemia?
If ANC <500, then pt will be on protective isolation
Which is used more commonly to decide if the pt should be on isolation: WBC or ANC
ANC is more reliable and valid
By the end of the 1st 6 months of life an infants birthweight should __
Double
By the end of the first year of life an infants birthweight should _
Triple
Ideal food for infants is _
Breast milk
Breast milk contains substances that increase immunities T/F?
True
Bottle-fed infants dont bond well with their moms T/F?
False
The 1 nutrient that commercial formulas are typically low in is _
Fe
Breast milk does not contain iron T/F?
False. However, it does not contain enough iron- so they should be fed iron fortified cereal starting at 6 months
At what age should the infant be fed cows/goats milk?
Not before 12 months
What is the major problem with feeding an infant skim milk?
They dont get enough calories and dont grow. Dehydration from excessive solute load and inability to concentrate urine
When should the infant be introduced to textured solid foods?
4-6 months
What is the first food that an infant should be introduced to?
Iron fortified rice cereal
When forced to eat, the preschool child will…
Rebel
Parents of preschool children should be taught that as long as the child eats _ good nutritious meal per day, they should not make eating food an issue
One
Refusal to eat is common in preschoolers T/F?
True, but still offer a variety
Youngsters develop food preferences by..
Observing significant ppl in their environ
School-age kids grow at a slower rate than infants, toddlers, or adolescents T/F?
True
What dietary strategy is most appropriate for the industrious school-age child?
Wholesome snacks, bc they are often too busy too eat
Girls in adolescence need more calories than adolescent boys T/F?
False, boys need more cals
Adolescents should take vitamin supplements T/F? PG. 90
True
Mastitis and breast engorgement are more likely to occur in…
Primipara
Where does the organism that causes mastitis come from?
The INFANTS nose or mouth
Which organism most commonly causes mastitis
Staph
Prolonged intervals between breast-feeding (dec/inc) the incidence of mastitis
Increase
Cant too-tight bras lead to mastitis?
Yes, by preventing emptying of ducts
Mastitis usually occurs at least _ days after delivery
10
When mastitis is present the breasts are , , and ___
Hard, swollen, warm
Mastitis is accompanied with a fever over _
102
If mastitis is caused by an organism , what causes breast engorgement
Temporary increase in vascular & lymph supply to the breast in preparation for milk production
If mastitis occurs 1+ weeks after delivery, when does breast engorgement occur?
2-5 days after delivery
Does breast engorgement interfere with nursing?
Yes, the infant has a difficult time latching on
What class of drugs is used to treat mastitis?
ATBs
ATBs are used to treat breast engorgement (T/F)?
False
Application of (warm H2O compresses/ice packs) is the preferred tx for breast engorgement
Ice packs to dec swelling
The mother with mastitis should stop breast feeding (T/F)?
False. The mother must keep breast feeding. (Offer unaffected breast first).
If the mother has an open abscess on her breast, she must not breastfeed (T/F)?
True
For breast engorgement, the non-breastfeeding mother should be told to express milk (T/F)
No, that would increase milk production and would make the problem worse (warm compresses or a warm shower to let milk “leak” is okay – Ice is best
What is the best tx for breast engorgement?
Breast feeding – it will balance supply and demand
What is mastoiditis?
Inflammation / infection of the mastoid process
What is the most common cause of mastoiditis?
Chronic otitis media
What are the 4 S&S of mastoiditis?
Drainage from ear, high fever, HA, and ear pain, tenderness over mastoid process
What unusual post-op complication can result from mastoidectomy?
Facial nerve paralysis d/t accidental damage during surgery
What should you do to assess for facial nerve paralysis post-mastoidectomy?
Have the patient smile and wrinkle forehead
What is the medical tx of mastoiditis?
Systemic ATBs
What is the surgery for mastoiditis called?
Simple or radical mastoidectomy
Will a simple mastoidectomy worsen hearing?
No, a radical mastoidectomy may
Should the nurse change the post-mastoidectomy dressing?
No, reinforce it. Physician changes first post-op dressing
What is a common side effect of mastoidectomy?
Dizziness (vertigo)https://learnexams.com/category/nclex-exam