1. Hematological Disorders: Determining Priority Client
A. Acute vs. chronic, urgent vs. nonurgent, stable vs. unstable
-A client who has an acute
... [Show More] problem takes priority over a client who has a chronic problem.
-A client who has an urgent need takes priority over a client who has a nonurgent need.
-A client who has unstable findings take priority over a client who has stable findings.
B. Sickle Cell Anemia- Vaso-occlusive crisis (painful episode)
-Acute (related to dehydration and decreased oxygen)
-Severe pain, usually in bones, joints, and abdomen
-Swollen joints, hands, and feet
-Abdominal pain
-Hematuria
-Obstructive jaundice
-Visual disturbances
-Chronic
-Increase risk of respiratory infections and osteomyelitis
-Retinal detachment and blindness
-Systolic murmurs
-Renal failure and enuresis
-Liver cirrhosis; hepatomegaly
-Seizures
-Skeletal deformities; shoulder or hip avascular necrosis
2. Pediatric Emergencies: Planning Interventions for Lead Exposure
-Nursing Actions
-Provide prevention measures to families
-Routine screening for lead levels at 1, 2, and 3 years of age
-Provide case management for children who have elevated lead levels
-Make appropriate referrals (community nurse, teacher, early intervention)
3. Acute Neurological Disorders: Findings that Indicate Bacterial Meningitis
-CSF analysis indicative of meningitis
-Bacterial
-Cloudy color
-Elevated WBC count
-Elevated protein content
-Decreased glucose content
-Positive Gram stain
-Viral
-Clear color
-Slightly elevated WBC count
-Normal or slightly elevated protein content
-Normal glucose content
-Negative Gram stain
4. Cardiovascular Disorders: Planning Care for a Child Who Has Heart Failure
Nursing Care:
-Remain calm when providing care
-Keep the child well-hydrated
-Conserve the child’s energy by providing frequent rest periods; clustering care; providing small, frequent meals; bathing PRN; and keeping crying to a minimum in cyanotic children
-Perform daily weight and I&O to monitor fluid and nutritional status
-Monitor heart rate, blood pressure, blood electrolytes, and kidney function to assess for complications
-Provide support and resources for parents to promote developmental growth in the child
-Monitor family coping and provide support
-Administer prescribed medications
-Maintain fluid and electrolyte balance
-Decrease workload of the heart
-Provide adequate nutrition
-Increase tissue oxygenation
5. Asthma: Evaluating Understanding of Asthma Attack Prevention
-Triggers to Asthma:
-Allergens
-Indoor: mold, cockroach antigen, dust, dust mites
-Outdoor: grasses, pollen, trees, shrubs, molds, spores, air pollution, weeds
-Irritants: Tobacco smoke, wood smoke, odors, sprays
-Exercise
-Cold air or changes in weather or temperature
-Environmental change (new home or school)
-Infections/viruses (colds)
-Animal hair or dander
-Medications: Aspirin, NSAIDs, antibiotics, beta blockers
-Strong emotions: fear, anger, laughing, crying
-Conditions: Gastroesophageal reflux, tracheoesophageal fistula
-Food allergies or additives (sulfites)
-Endocrine factors: menses, pregnancy, thyroid disease
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