Student Nurse Laura

Orem – "creative effort of one human being to help another human being."

Archive for November, 2010

Weekly Reading

Posted by Laura on November 30, 2010

 

Week 7 Reading 231

 

Posted in NS 231 - Peds, Reading Schedule 231, Semester III | Comments Off on Weekly Reading

Neurological & Sensory Disorders in Pediatrics

Posted by Laura on November 26, 2010

The various items we will be learning in this section of Pediatrics includes:

  • Attention Deficit Disorder
  • Autism
  • Cerebral Palsy
  • Down Syndrome
  • Head Injuries
  • Hearing Impairment
  • Hydrocephalus
  • Increased Intracranial Pressure
  • Meningitis
  • Reyes Syndrome
  • Seizure Disorders
  • Speech Impairment
  • Visual Impairment

Posted in Day-to-Day, NS 231 - Peds, Semester III | Comments Off on Neurological & Sensory Disorders in Pediatrics

Sydenham Chorea – Video

Posted by Laura on November 21, 2010

posted info on youtube:

“Sydenhams Chorea (aka St. Vitus’ Dance) is a manifestation (undeniable proof) of a disease process called Rheumatic Fever. Rheumatic Fever is a “complication” for better lack of a word of a group A Streptococcal Pharyngitis (aka Strep throat) it is rare in the US. but the reason it is recommended to stay on antibiotics for an extended period of time is because of the great risk for Rheumatic Heart Disease which is not only devastating but can also be fatal.”

Posted in Day-to-Day, NS 231 - Peds, Semester III | Comments Off on Sydenham Chorea – Video

Erythema Marginatum

Posted by Laura on November 21, 2010

(my simple drawing)

Wikipedia

Erythema marginatum is described as the presence of pink rings on the trunk and inner surfaces of the limbs which come and go for as long as several months. It is found primarily on extensor surfaces.

Associated conditions

It occurs in less than 5% of patients with rheumatic fever, but is considered a major Jones criterion when it does occur. The four other major criteria include carditis, polyarthritis, Sydenham’s Chorea, and subcutaneous nodules.

It is an early feature of rheumatic fever and may be associated with mild carditis (inflammation of heart muscle).

Types

Some sources distinguish between the following:

  • “Erythema marginatum rheumaticum”
  • “Erythema marginatum perstans”

Posted in Day-to-Day, NS 231 - Peds, Semester III | Comments Off on Erythema Marginatum

Thanksgiving Mini Care Plan

Posted by Laura on November 21, 2010

Mini Care Plan

Student:          Laura Barron                        Date of Care:  11/25 Thanksgiving /10

Patient’s Initials:  Barron Family     Age:  19 – 78 Sex:  M/F

Room Number:   Beds 1-5

Chief Complaint: Hunger

Family Diagnosis: Exacerbation of Comfort Needs

Focused Assessment 

Subjective & Objective Data

 

Healthy group of seven individuals in desperate need for food and social interaction. VS are all WNL though physical assessment showed excessive growling of all 4 quadrants of abdomen. Patients complain of hunger, a need to talk, time restrictions and missing puzzle pieces. Patients are living in a temporary enclosed home normally containing 2 patients with pets. Temporary pets have accompanied patients. Patients all have selective palates, likes and dislikes, and abilities in cooking process.

USCR: Promotion of normalcy with presence of hunger

DSCR: Situational: Temporary Oppressed Living conditions

HSCR: Carry out Family prescribed measures related to prevention, regulation, and compensation for pathology.

 

Self-Care Deficit 

Unable or Unwilling

Patients are unable to start cooking without plan of menu, time schedule and aprons. 

 

Priority  

Nursing Diagnosis

NANDA: R/T Pathology

Ineffective coping related to inadequate coping skills characterized by inability to meet basic health needs of hunger, and inability to problem solve. 

 

Goal 

Short Term & Measurable

Patients will have full tummies of nice rounded proportions and happy hearts, by 1800 11/26/09
Nursing Interventions 

3 nursing actions

Who/What/How/When

1. Patients will organize meal plan with times by 0900 11/26/09. 

2. Patients will cook and talk through day with continuous tasting and drinking to conclude by end of shift 11/26/09 or sleep time – whichever comes first.

3 Patient’s will find comfort and relaxation with others and express their yearly thankful thoughts at dinner table (hear, hear) by 1800 11/26/09.

 

Evaluation 

Of the Goal

Goal met. Patients are full and happy. 11/26/09 

 

Posted in Day-to-Day | Comments Off on Thanksgiving Mini Care Plan

Tetralogy of Fallot

Posted by Laura on November 20, 2010

click on me to go to Cincinnati Children’s Hospital Medical Center Info

Posted in Day-to-Day, NS 231 - Peds, Semester III | Comments Off on Tetralogy of Fallot

Pulmonary Valvar Stenosis

Posted by Laura on November 20, 2010

click on me to go to Cincinnati Children’s Hospital Medical Center Info

Posted in Day-to-Day, NS 231 - Peds, Semester III | Comments Off on Pulmonary Valvar Stenosis

Aortic Stenosis

Posted by Laura on November 20, 2010

click on me to go to Cincinnati Children’s Hospital Medical Center Info

Posted in Day-to-Day, NS 231 - Peds, Semester III | Comments Off on Aortic Stenosis

Patent Ductus Arteriosus

Posted by Laura on November 20, 2010

click on me to go to Cincinnati Children’s Hospital Medical Center Info

Posted in Day-to-Day, NS 231 - Peds, Semester III | Comments Off on Patent Ductus Arteriosus

Ventricular Septal Defect

Posted by Laura on November 20, 2010

click on me to go to Cincinnati Children’s Hospital Medical Center Info

Posted in Day-to-Day, NS 231 - Peds, Semester III | Comments Off on Ventricular Septal Defect

Atrial Septal Defect

Posted by Laura on November 20, 2010

click on me to go to Cincinnati Children’s Hospital Medical Center Info

Posted in Day-to-Day, NS 231 - Peds, Semester III | Comments Off on Atrial Septal Defect

Classifications of Defects in Pediatrics

Posted by Laura on November 20, 2010

Acyanotic (Traditional)

Defects increasing pulmonary blood flow:

  • Atrial Septal Defect
  • Ventricular Septal Defect
  • Patent Ductus Arteriosus
  • Atrioventricular Canal

Obstructive Defects:

  • Aortic Stenosis
  • Pulmonary Stenosis
  • Coarction of Aorta

Cyanotic (Traditional)

Defects decreasing pulmonary blood flow:

  • Tetralogy of Fallot
  • Tricuspid Atresia

Mixed Blood Flow:

  • Transposition of the Great Vessels
  • Total Anomalous Pulmonary Venous Return
  • Truncus Arteriosus
  • Hypoplastic Left Heart Syndrome

 

Hemodynamic Characteristics Classification ♥

Posted in Day-to-Day, NS 231 - Peds, Semester III | Comments Off on Classifications of Defects in Pediatrics

Weekly Reading

Posted by Laura on November 19, 2010

Week 6 Reading 231


Posted in NS 231 - Peds, Reading Schedule 231, Semester III | Comments Off on Weekly Reading

Seasonal URIs

Posted by Laura on November 16, 2010

Seasonal variation of selected upper respiratory tract infection pathogens. PIV is parainfluenza virus, RSV is respiratory syncytial virus, MPV is metapneumovirus, and Group A Strept is group A streptococcal disease.

Posted in NS 231 - Peds, Semester III | Tagged: , , | Comments Off on Seasonal URIs

Asthma Drug Therapy

Posted by Laura on November 15, 2010

Asthma – Drug Therapy

Posted in Drugs, NS 231 - Peds, Resources, Semester III | Tagged: , , , | Comments Off on Asthma Drug Therapy

OM

Posted by Laura on November 15, 2010

OM – Otitis Media: inflammation of middle ear w/o reference to etiology or pathogenesis

AOM – Acute Otitis Media: above w/ rapid onset of s/s: fever, ear pain

Otalgia – ear pain

OME – Otitis Media with Effusion: fluid in middle ear space w/o symptoms of acute infection

COME – Chronic Otitis Media with Effusion: middle ear effusion persisting > 3 months

Otorrhea – purulent discharge

1st line medication: PO amoxicillin

2nd line medicaiton: amoxicillin-clavulanate; azithoromycin and cephalosporins: cefdinir, cefuroxime, and cefpodoxime.

3rd line medication: ceftriaxone – painful at IM site

Antihistamines & decongestants are not recommended.

Antibiotic ear drops have no value in Tx AOM

(Wong’s Essentials of Pediatric Nursing)

Posted in NS 231 - Peds, Semester III | Tagged: , , , , | Comments Off on OM

From Tabers: Why shouldn’t you give Aspirin to a child who has viral symptoms?

Posted by Laura on November 15, 2010

Reye’s syndrome

[R. D. K. Reye, Australian pathologist, 1912–1977]
A syndrome marked by acute encephalopathy and fatty infiltration of the liver and often of the pancreas, heart, kidney, spleen, and lymph nodes.
It is seen primarily in children under age 18, after an acute viral infection such as chickenpox or influenza. The mortality rate depends on the severity of the central nervous system involvement but may be as high as 80%. Fortunately, the disease occurs rarely. The cause of the disease is unknown, but association with increased use of aspirin and other salicylates is evident from epidemiological studies.
See: Nursing Diagnoses Appendix

SYMPTOMS
The patient experiences a viral infection with a brief recovery period, followed in about 1 to 3 days by severe nausea and vomiting, a change in mental status (disorientation, agitation, coma, seizures), and hepatomegaly without jaundice in 40% of cases. The disease should be suspected in any child with acute onset of encephalopathy, nausea and vomiting, or altered liver function, esp. after a recent illness. The severity of the syndrome depends on how badly the brain swells during the illness, reflected in increased intracranial pressure (ICP).

Aspirin and other salicylates should not be used for any reason in treating children under age 18 with viral infections.

TREATMENT
Supportive care includes intravenous administration of fluids and electrolytes, administration of corticosteroids, and ventilatory assistance. Electrolytes should be controlled carefully, along with serum glucose and ammonia levels, and neurological status.

PATIENT CARE
Increased ICP resulting from increased cerebral blood volume results in intracranial hypertension. To decrease intracranial pressure and cerebral edema, fluids are provided at 2/3 maintenance level and an osmotic diuretic or furosemide is prescribed. The head of the bed is kept at a 30-degree angle. Fluid intake should maintain urine output at 1.0 ml/kg/hour, plasma osmolality at 290 mOsm (normal to high), and blood glucose at 150 mg/ml (high), while preventing fluid overload. Proteins are restricted to keep ammonia levels low. Hypoprothrombinemia (resulting from liver injury) is treated with vitamin K, or fresh frozen plasma if needed. Temperature is monitored, and prescribed measures to alleviate hyperthermia are instituted. Seizure precautions are also instituted. Intake and output are monitored carefully. The patient is observed for evidence of impaired hepatic function, such as signs of bleeding or encephalopathy. All treatments are explained to parents and support is provided to them. The National Reye’s Syndrome Foundation provides information and support.

 

All material is from Tabers at: http://www.tabers.com/tabersonline/ub/view/Tabers/143910/24/Reye%27s_syndrome

Posted in NS 231 - Peds, Semester III | Tagged: , , | Comments Off on From Tabers: Why shouldn’t you give Aspirin to a child who has viral symptoms?

Formal Operations

Posted by Laura on November 15, 2010

Adolescent

Posted in NS 231 - Peds, Semester III | Tagged: , , , | Comments Off on Formal Operations

Nurse / Santa Hat

Posted by Laura on November 14, 2010

Posted in Day-to-Day | Comments Off on Nurse / Santa Hat

7 Toddler Tasks

Posted by Laura on November 14, 2010

click here for an .pdf

Posted in NS 231 - Peds, Semester III | Comments Off on 7 Toddler Tasks