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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, |
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What is the tested for in rheumatic fever? |
strep antibodies risign antistreptolysin - O (ASO) titer increased erythrocyte sedimentation rate ECG/ Radiographic studies X Ray |
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What is the therapuetic management for Rheumatic Fever? |
Penicillin Salicylates, Bed Rest, Prophylactic treatment for reoccurence of RF( Benzathin Penicillin or Sulfadiazine |
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What are the nursing considerations for Rheumatic Fever? |
Encourage medical compliance, adequate nutrition, adequate rest, and advise activity restriction if carditis is present |
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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. |
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What is another name for Kawasaki Disease? |
mucosubcutaneous lymph syndrome |
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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 |
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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. |
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What is the treatment for Kawasaki Syndrome? |
Gamma Globulin and salicylates |
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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
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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. |
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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 |
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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 |
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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 |
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Signs and symptoms of Iron Deficiency Anemia |
glossitis, somatitis, koilonychia, spoon nails, easy to get infected, overweight, porcelain skin, small muscles |
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What is a good diet for anemia? |
folic acid, protein, and iron |
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What is folic acid for? And protein? |
makes iron more available for use and protein is used to build hemoglobin |
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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
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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. |
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What is Sickle Cell Anemia? |
Adult hemoglobin A is changed with a abnormal sickled hemoglobin (Hgb S)
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What is sickle cell disease type? |
genetic an autosomal recessive disorder |
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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 |
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What are the clinical manifestations of IRON DEFICIENCY ANEMIA? |
RETARDED GROWTH DELAY IN SEXUAL MATURATION SUSCEPTIBLE TO INFECTION |
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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 |
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What is a sequestrian crisis? |
hepatomegaly, splenomegaly, cardiomegaly |
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What is aplastic anemia? |
lowering RBC production and profound anemia |
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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 |
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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
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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 |