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29 Cards in this Set

  • Front
  • Back

What is the diagnosis for Rheumatic Fever?

Jones Criteria -


1. Strep Throat


2. (Minor Manifestations) low grade fever, abdominal pain, athralgia w/o arthritic changes, loss of appetite, pallor, nose bleeds



(Major) tachycardia, muffled heart sounds, precardial friction rub, precordial pain, change in ECG, new murmur


migratory polyarthrits, erythema marginatum, chorea (St. Vitus Dance, Sydenham Chorea) facial grimaces or speech disturbances,

What is the tested for in rheumatic fever?

strep antibodies


risign antistreptolysin - O (ASO) titer


increased erythrocyte sedimentation rate


ECG/ Radiographic studies


X Ray

What is the therapuetic management for Rheumatic Fever?

Penicillin Salicylates, Bed Rest, Prophylactic treatment for reoccurence of RF( Benzathin Penicillin or Sulfadiazine

What are the nursing considerations for Rheumatic Fever?

Encourage medical compliance, adequate nutrition, adequate rest, and advise activity restriction if carditis is present

What is Kawasaki Syndrome?

Kawasaki disease (KD) is a vasculitis of medium-sized arteries, most significantly the coronary arteries, which are involved in about 20% of untreated patients. Early manifestations include acute myocarditis with heart failure, arrhythmias, endocarditis, and pericarditis. Coronary artery aneurysms may subsequently form. Giant coronary artery aneurysms (> 8 mm internal diameter on echocardiography), though rare, have the greatest risk of causing cardiac tamponade, thrombosis, or infarction. KD is the leading cause of acquired heart disease in children.

What is another name for Kawasaki Disease?

mucosubcutaneous lymph syndrome

What are the first signs and symptoms of Kawasaki Disease?

Fever for five days


Rash on trunk


swollen neck and tongue


Red Eyes


Swollen Palms and Feet

What are the next two phases following the acute phase of Kawasaki Syndrome?

subacute phase has no fever and all signs dissappeared



convalescent phase - when the platelet count drops to normal value.

What is the treatment for Kawasaki Syndrome?

Gamma Globulin and salicylates

What are the nursing care priorities for a patient with Kawasaki syndrome.

Loosen clothing,


Mouth Care


take I & O daily weights too


assess for CHF, decrease in urine output, tachycardia, respirations, gallop rhythm



(ensure quiet environment for carditis


What is the discharge teaching for a patient with Kawasaki Syndrome?

Irritability normal for two months


Peeling of fingernail skin and toes


arthritis remains for several weeks


stiffness may be present in a.m. and during cold weather


defer live vaccines for 11 months after gamma globulin


monitor heart for any changes (heart rate, respiratory difficulty, fatigues.

What causes iron deficiency anemia?

overweight, loss of blood, malabsorption, diet low in iron (formula) not breast milk) or too much milk (fat but no iron), problem synthesizing iron

When is iron transfered to fetus from mother?

last trimester and if premature iron only lasts 2 to 3 months, if full term lasts 5 months

What is the diagnostic evaluation for iron?

Hemoglobin below 10 g



RBC can be reduced with change (size and shape)



MCV infants < 70 mcm


child < 75



serum iron < 70 mcg/dl



Total iron binding capacity (TIBC)


6 months to 2 years 350 mcg/dl


2 year 450 mcg/dl

Signs and symptoms of Iron Deficiency Anemia

glossitis, somatitis, koilonychia, spoon nails, easy to get infected, overweight, porcelain skin, small muscles

What is a good diet for anemia?

folic acid, protein, and iron

What is folic acid for? And protein?

makes iron more available for use and protein is used to build hemoglobin

Nursing consideration?

Give Oxygen when tissue hypoxia,


Iron between meals 2 to 3 times per day and given with absorbic acid (citrus juice)


if vomiting occurs give Iron with meals


give any liquid iron with a straw followed by brushing to prevent staining teeth



Iron IM need Z track and dont' massage


What are some dietary considerations for a patient with Iron Deficiency Anemia?

breast milk or formula for first 12 months of life



4 months old add Iron supplements for full and at 2 weeks for Premies.

What is Sickle Cell Anemia?

Adult hemoglobin A is changed with a abnormal sickled hemoglobin (Hgb S)


What is sickle cell disease type?

genetic an autosomal recessive disorder

Pathophysiology

RBC become rigid and stick to vascular walls causing occlusion and infarction to cells (pain and death) but circulation breaks them apart or thrombosis which moves to another part of body

What are the clinical manifestations of IRON DEFICIENCY ANEMIA?

RETARDED GROWTH


DELAY IN SEXUAL MATURATION


SUSCEPTIBLE TO INFECTION

What are the vaso-occlusive crisis characteristics?

painful swelling of joints of hands and feet or abdomen and chest pain with coughing and fever and liver obstruction and jaundice, hematuria from kidneys

What is a sequestrian crisis?

hepatomegaly, splenomegaly, cardiomegaly

What is aplastic anemia?

lowering RBC production and profound anemia

When is iron deficiency found?

later infancy in toddler and preschool years with a crisis and a GI or URI infection following and Hct and Hgb or low



Sickle turbidity test (Sickledex) done by finger stick in 3 minutes

What is treatment of Iron Deficiency Anemia?

A) Replace fluids


Provide Oxygen


B) Treat medical emergency of crisis


(symptomatic and supportive)


Bed Rest, electrolyte replacement,


antibiotics for infection,


Oxygen for respiratory difficulty


blood transfusion for anemia


exchange transfusion



Pain management


mild to moderate - acetaminophen (codeine added if needed)


severe- opiods (morphine)



NO MEPERIDINE



What are the nursing considerations for Iron Deficiency Anemia?

genetic counseling


screening for sickle cell trait in persons



Patient teaching on genetic counseling, prevent hypoxia, maintain hydration, prevent infection,


and avoid emotional stress, hypoxia and wound healing.



Supportive : Bed rest and passive ROM, and pain control