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42 Cards in this Set
- Front
- Back
congenital Hypothyroidism Patho
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The thyroid is controlled by the pituitary gland which releases TSH.
TSH produces T4 and T3. After a newborn birth TSH is increased greatly. within 1st week of life TSH gradually falls. Underdevelopment of Thyroid leads to low T4 levels. If T4 thyroxine is not fixed it leads to growth, developmental and brain retardation. Although it can be avoided with hormone replacement thearpy |
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congenital Hypothyroidism manifestations and evaluation
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Manifestations: Skin mottling, large fontanel, large tongue, hypotonia, slow reflexes, distended ABD and prolonged jaundice.
Thyroid=metabolism Evaluation: TSH test between 2-6 days any sooner you will get a false high TSH level. HIGH TSH with LOW T4 (thyroxine) confirms diagnosis |
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congenital Hypothyroidism Management
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Lifelong thyroid hormone replacement thearpy usually Levothyroxine and titrated until T4 levels are WNL
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Congenital Hypothyroidism Nursing assessment and interventions
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Assessment: Growth and development, adhearence to Rx regime head circumference each visit
Interventions: Instruct family importance of Rx regime. can give meds in little forumla or food. Need to teach s/s hypo/hyperthyrodism because too much levothyroxine can cause hyperthyroidism |
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Acquired Hypothyroidism (Hashimoto thyroiditis) Patho
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Antibodies called thyroid-blocking-immunoglobins decrease T3 and T4 levels. Antibodies bind to the TSH receptor. Antibody cause is unknown
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Acquired Hypothyroidism manifestations and evaluation
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Goiter (one lobe larger than the other) dry thick skin; dull hair, fatigue cold intolerance, weight gain, edema of face, feet, eyes and hands, iregular or delayed mensus
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Acquired hypothyroidism Management
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Thyroid replacement hormones until T3 and T4 levels are normal
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Acquired Hypothyroidism nursing assessment and interventions
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Thyroid levels checked q 3-4 months.
Interventions: Instruct family importance of Rx regime. Need to teach s/s of hypo/hyperthyrodism because too much levothyroxine can cause hyperthyroidism |
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Hypothyroidism nursing diagnosis
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Deficient knowlege r/t congenital/acquired disorder
Constipation r/t decreased metabolic rate Activity/cold intolerance |
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Hyperthyroidism (Graves disease) Patho
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Antibodies stimulate over production of thyroid. antibodies stimulate too much T3 and T4 levels with TSH levels being low. (classic hypothyrodism diagnostic evaluation) These antibodies are transfered through the placenta to the fetus
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congenital Hypothyroidism Patho
|
The thyroid is controlled by the pituitary gland which releases TSH.
TSH produces T4 and T3. After a newborn birth TSH is increased greatly. within 1st week of life TSH gradually falls. Underdevelopment of Thyroid leads to low T4 levels. If T4 thyroxine is not fixed it leads to growth, developmental and brain retardation. Although it can be avoided with hormone replacement thearpy |
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congenital Hypothyroidism manifestations and evaluation
|
Manifestations: Skin mottling, large fontanel, large tongue, hypotonia, slow reflexes, distended ABD and prolonged jaundice.
Thyroid=metabolism Evaluation: TSH test between 2-6 days any sooner you will get a false high TSH level. HIGH TSH with LOW T4 (thyroxine) confirms diagnosis |
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congenital Hypothyroidism Management
|
Lifelong thyroid hormone replacement thearpy usually Levothyroxine and titrated until T4 levels are WNL
|
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Congenital Hypothyroidism Nursing assessment and interventions
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Assessment: Growth and development, adhearence to Rx regime head circumference each visit
Interventions: Instruct family importance of Rx regime. can give meds in little forumla or food. Need to teach s/s hypo/hyperthyrodism because too much levothyroxine can cause hyperthyroidism |
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Acquired Hypothyroidism (Hashimoto thyroiditis) Patho
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Antibodies called thyroid-blocking-immunoglobins decrease T3 and T4 levels. Antibodies bind to the TSH receptor. Antibody cause is unknown
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Acquired Hypothyroidism manifestations and evaluation
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Goiter (one lobe larger than the other) dry thick skin; dull hair, fatigue cold intolerance, weight gain, edema of face, feet, eyes and hands, iregular or delayed mensus
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Acquired hypothyroidism Management
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Thyroid replacement hormones until T3 and T4 levels are normal
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Acquired Hypothyroidism nursing assessment and interventions
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Thyroid levels checked q 3-4 months.
Interventions: Instruct family importance of Rx regime. Need to teach s/s of hypo/hyperthyrodism because too much levothyroxine can cause hyperthyroidism |
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Hypothyroidism nursing diagnosis
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Deficient knowlege r/t congenital/acquired disorder
Constipation r/t decreased metabolic rate Activity/cold intolerance |
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Hyperthyroidism (Graves disease) Patho
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Antibodies stimulate over production of thyroid. antibodies stimulate too much T3 and T4 levels with TSH levels being low. (classic hypothyrodism diagnostic evaluation) These antibodies are transfered through the placenta to the fetus
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Impetigo Etiology
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Cause S. aures, Beta hemolytic strep or combination of the two
Begins in an area of brake skin, such as an insect bite, allowing for a secondary infection. The inflammatory response results in a pustular lesion. The lesion has a honey-colored fluid drainage. Nasal drainage containing the organism can erode the upper lip allowing additional entry |
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Impetigo Manifestations
Two types of lesions |
Bullous: Small vesicles initially filled with serous fluid and later become pustular.
Bullae: Pustular lesions that rapidly rupture leaving a shiny. Lesions can bleed easily when crust is aggitated Hyperpigmentation is sequela in dark skinned children. |
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Impetigo Treatment
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Treatement: Topical and oral antibiotics. Wash lesions gently 3 X Q24H
Good handwashing, child should not go to day care/ school 24 hours after treatment. notify school officials |
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Impetigo diagnosis and Interventions
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Impaired skin intergrity
Deficient knowledge r/t disease Interventions: Teach parents how to soak crust then wash it 3 X daily Apply ABX ointment after area has been air dried Small amounts of bleeding is common. Child should sleep alone and bathed with antimicrobial soap. Care givers should wear gloves |
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Impetigo
Critical to rember |
1. Can spread lesions by touch
2. keep fingernaiils short & wash child's hands frequent. 3. Discourage sharing family towels, combs or eating tools with the infected child |
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Cellulitis Etiology
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Bacterial infection of subcutaneous tissue. Usually arrives from impaired skin, but can affect head and trunk following an URI OM, or tooth abscess.
Caused by Haemophilus influenza Type B Vaccine, Group A Strep, and S aureus |
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Cellulitis Pathophysiology
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Bacteria overwhelm defensive skin defenses. resulting in deeper invasion from the superficial layer of skin to the subcutaneous layers
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Cellutis Manifestations and complications
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Manifestations: Area is hot red and indurated; Fever maliase H/A
IF H influenza is suspeced area will have purple tinge. Lymphangitis with "red streaking" on area and reginal lymph node swelling, Complications: Septic arthritis, meningitis, brain disease. If periorbital cellutis is present and not treated efficiently it can lead to blindness |
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Cellutis assessment/ nursing diagnosis
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Ask parent about ear infections, dental carries, or skin trauma.
Impaired skin intergity Acute pain Deficient knowledge |
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Cellutis interventions
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1. bed rest, elevate the affected extremity & splint
2. Warm moist scoks Q 4 H to increase circulation 3. Monitor S/S of sepsis (increased fever, chills) |
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Lice Infection etiology
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Called: Pediculosos Small blood sucking insects on scalp or face.
Is not associated with poor hygine. Transmitted by direct/indirect contact Girls 2x likely than boys |
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Pediculosis capitus (lice)
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Lice can only live 48 hours off the human host. Eggs of louses incubate for 1 week
Pediculosis pubis usually sexually transmitted. Pubic lice causes intense pruritis (blue spots) may be seen on thighs and trunk. Lice on eyebrows or eyelashes in preadolescent signals potential abuse |
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Pediculosis Evaluation/ treatment
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1. Identifications of nits or lice on scalp, CROWN, behind ears, nape of the neck
RX: Lindane neurotoxic if absorbed through skin OTC: RID tripple X |
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Pediculosis Interventions
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Teach: remove nits by back combing when hair is damp
Apply petrolatum to eyelashes Q12 H x 8 Days. Clean home with antilice sprays: wash sheets. Examine other family members. |
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ACNE Patho
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Sebacous glands stimulated by androgens during puberty secrete large amounts of sebum. Glands become plugged and diliated, eventually leading to rupture r/t pressure.
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Acne etiology
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Abnormal sloughing of skin, overgrowth of normal bacteria. Foods do not cause or increase ACNE
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Acne Manifestations and Treatment
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Closed white heads, black heads, papules, pustules, nodules or cysts.
Treatment is individually based and individual type of acne. Goal of treatment: prevent scarring and promote postitive self image in the adolescent. Initial improvement usually seen 4-6 weeks after thearpy. 3-5 months are needed for optimal results |
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Acne diagnosis and interventions
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Impaired skin r/t increase sebaceous secretions.
Risk for infection Disturbed body image Deficient body image Teaching: long term condition need to provide support and encouragement. Provide written instructions. Do not scrub hard which can rupture ducts and cause secondary infections. Do not over use creams. ONLY WATER BASED makeup |
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Atopic Dermatitis (Eczema)
Patho |
caused by allergic reaction. Affected children release more histamine than regular children. Histamine triggers the inflammatory response resulting in erythema, edema and intense pruritis. Scratching increases itching
S. aureus and secondary infections can occur. Viruses herpes occur frequently |
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Actopic dermatitis (Eczema)
Signs and symptoms and evaluation |
Erythematous, oozing, and crusting areas first on the cheeks then forehead then to arms and legs. INTENSLY PRURITIC. Manifestations of symptoms occur around ages 1-4 months.
EVAL: diagnosis based upon INTENSE PRURITIS appearence of & patterns of lesions, familial history. Esnophils are usually elevated indicating an allergen induced reaction |
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Atopic Dermatitis Eczema
Treatment |
Goal to control itching, scratching, moisturize the skin and prevent secondary infections.
Avoid enviormental triggers Oral histimaines Wet compresses and creams and ointments are mainstream of treatment. Corticosteroid creams: administer after bath for best absorption |
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Atopic Dermatitis Eczema
Diagnosis and Interventions |
Impaired skin integrity/Pain
Risk for infection/ Knowledge, family, body image distrubance Interventions: Keep skin hydrated, apply creams several times a day and after baths. Avoid wool use cotton. Wash clothes in mild detergent. Keep fingernails clean. Avoid using soap, use bath oil |