PEDIATRICS UNIT 3 - PowerPoint PPT Presentation

About This Presentation
Title:

PEDIATRICS UNIT 3

Description:

pediatrics unit 3 revised 2012 ... – PowerPoint PPT presentation

Number of Views:105
Avg rating:3.0/5.0
Slides: 113
Provided by: ClaudiaS45
Category:
Tags: pediatrics | unit | skin

less

Transcript and Presenter's Notes

Title: PEDIATRICS UNIT 3


1
PEDIATRICS UNIT 3
  • Revised 2012

2
MUSCULOSKELETAL DISORDERS
3
Developmental Hip Dysplasia
  • Head of femur displaced due to shallow hip socket
  • Causes
  • Heredity, environmental

4
Treatment
  • Pavlik Harness to maintain abduction
  • Casting

5
Nursing Interventions
  • Box 31-8
  • Care of the Child in a Cast pg 1036

6
Legg Calve Perthes Disease
  • Decreased blood supply to femoral head
  • Tissue death
  • Tissue regeneration

7
Clinical Manifestations
  • Insidious
  • Pain
  • Limp
  • Limited ROM

8
Medical Managment
  • Bedrest
  • Traction
  • Brace/harness
  • Nursing Interventions are???

9
Scoliosis
  • Lateral curvature of the spine
  • Diag
  • Screening exams
  • xray

10
Medical Management
  • lt 20 - no tx
  • Moderate brace
  • Severe - surgery

11
Nursing Intervention
  • Family education and support
  • Skin care (Box 31-8)
  • Pre/post op care

12
Talipes
  • club foot
  • Idiopathatic
  • Genetic or environmental
  • TX? Casting change q wk, corrective shoes
  • Nrsg Interventions are ???

13
Nursing Interventions
  • Parent education
  • Cast care

14
Duchennes Muscular Dystrophy
  • Gradual progressive skeletal muscle wasting and
    weakness
  • Sex linked inherited

15
Clinical Manifestations
  • Weakness
  • Falling
  • Gowers sign
  • Dx? Muscle bx electromylogram

16
Treatment
  • No cure
  • Prevent infection

17
Nursing Interventions
  • Family teaching
  • ROM exercises
  • Nutrition/discourage obesity
  • Maintain independence
  • Refer to MDA

18
Septic Arthritis
  • Infection in joint
  • Irritation and damage to synovial membrane

19
Signs Symptoms
  • Pain
  • Edema
  • Redness / warmth
  • Decrease ROM
  • Fever

20
Treatment
  • Aspirate and irrigate in OR
  • ABX

21
Nursing Interventions
  • Pain meds
  • Joint immobilization
  • ROM

22
Meningitis
  • Infection of meninges
  • Bacterial most common

23
Signs Symptoms
  • Kernig sign
  • Brudzinski sign
  • Photophobia

24
  • Bulging fontanels
  • Nuchal rigidity
  • Fever
  • HA
  • Vomiting

25
Diagnostic tests
  • CSF
  • for culture, WBC, protein

26
Nursing Interventions
  • Prevention with Hib vaccine as early as 2 mos.
    old
  • Isol. for 24h after start of ABX
  • Decrease stimulation, neuro checks, observe for
    seizures

27
  • Decreased stimulation
  • Neuro checks
  • Observe for seizures

28
Hydrocephalus
  • Increased CSF in ventricles of brain
  • Bulging fontanels
  • Dilated scalp veins
  • head size/ ICP

29
Medical Management
  • Tumor removal
  • Ventriculoperitoneal shunt

30
Nursing Interventions
  • Pre/post op care
  • Assess ICP
  • Position on non-operative side

31
Cerebral Palsy
  • Motor neuron impairment
  • Difficulty controlling muscles
  • Chronic disability

32
Signs Symptoms
  • Arching of back
  • Involuntary movements
  • Extension and scissoring of legs
  • See Box 31.9

33
Medical Management
  • No specific treatment
  • Botox
  • Baclofen Pump

34
Nursing Interventions
  • Encourage independence
  • Encourage mobility
  • Protective head gear
  • Praise
  • Teach ROM appropriate play activities to parents

35
Seizures
  • Excessive abnormal brain activity
  • Most are idiopathic
  • Petit Mal
  • Grand Mal
  • EEG

36
Medical Management
  • Drug Therapy (pg. 1046)
  • Single drug therapy
  • Dosage modifications
  • Normal EEG and seizure free x 2 yrs

37
Nursing Interventions
  • O2 and suction at bedside
  • Side lying during seizure
  • Protect from injury, note begin end time,
    clinical manifestions of seizure and post seizure
    behavior

38
Spina Bifida
  • Neural tube deficit
  • Occulta
  • Meningocele
  • Myelomeningocele

39
Clinical Manifestations
  • No sensory or motor function below deficit
  • May have paralysis, incontinence, clubfoot or
    subluxated hip

40
Medical Management
  • Surgery to replace contents
  • VP Shunt
  • Corrective surgeries
  • Continuous neurological assmts
  • Assist family to cope

41
Nursing Interventions
  • See Box 31-10 pg. 1047
  • Pre-op? cover lesion w/ saline soaked gauze
  • Post-op? Prone for 10-14 days

42
Neuroblastoma
  • Tumor growth from nerve cells
  • Location retroperitoneal, usually in adrenals or
    liver
  • Mets? head, neck, chest, pelvis
  • s/s depend on location

43
(No Transcript)
44
Medical Management
  • Surgery ( if localized )
  • Radiation
  • Chemo

45
Nursing Interventions
  • Same as for other cancers i.e. psych support,
    allow expression of fears concerns
  • Be a good listener

46
Lead Poisoning
  • Serious preventable health problem
  • Sources?Inhaled / ingested
  • Stored in bones
  • Leads to anemia

47
Clinical Manifestations
  • Anemia
  • Abdominal pain, lethargy
  • Learning difficulties
  • Decreased attention span hearing
  • G D failure

48
Diagnostic Tests
  • 1) Blood levels
  • 2) H P w/ environment assmt.
  • 3) x-ray of stomach long bones
  • 4) Urine studies
  • Tx? Chelation Therapy

49
Nursing Interventions
  • Environmental health questionaire
  • Education for prevention(Box 31-10)
  • Provide support, understanding and resources

50
Strabismus
  • Results in cross-eyed
  • Extra ocular muscles lack coordination

51
Pictures Images
Pictures Images
52
Signs Symptoms
  • Squinting
  • Closing of one eye
  • Tilting head to side
  • Difficulty focusing or picking up objects

53
Medical Management
  • Botox
  • Occlusion Therapy
  • Glasses
  • Surgery

54
Nursing Interventions
  • Teach importance of complying with corrective
    plan to prevent visual acuity loss

55
Otitis Media
  • Middle ear infection
  • Linked to feeding practices
  • Pulling on ear, fever, irritable, otalgia,
    decreased appetite
  • Membrane may rupture

56
(No Transcript)
57
(No Transcript)
58
Medical Treatment
  • ABX for 10 dys
  • Acetaminophen
  • Myringotomy

59
Pictures Images
60
Myringotomy
  • Incision of tympanic membrane and placement of
    tubes

61
Nursing Interventions
  • Position on surgical side
  • Apply heat or cold for comfort
  • No water in ear, hold upright to feed

62
Integumentary Disorders
63
Dermatitis
  • Contact
  • Diaper
  • Atopic ( Eczema)
  • Seborrhic

64
Contact Dermatitis
  • Sensitivity to environmental cause
  • Common in infants toddlers
  • Face, neck, hands, feet legs
  • What are common allergens??

65
Dermatitis, Contact
66
Signs Symptoms
  • Macula-papula rash
  • Weeping and oozing
  • Pruritis
  • Dx? is made by observation, history and skin
    testing may be helpful

67
Nursing Interventions
  • Keep fingernails short
  • Loose cotton clothing
  • Keep history of possible causative agent

68
Medical Management
  • Burows Solution
  • Aveeno Baths
  • No Caladryl or Benadryl lotion, use Calamine
    lotion
  • Self-limiting w/I 2 wks.

69
Diaper Dermatitis
  • A.K.A. Diaper Rash
  • Urine, stool
  • Inadequate cleaning
  • Plastic pants
  • s/s ? fussy, crying

70
Diaper Rash
71
Nursing Interventions
  • Clean and dry
  • Expose to air / no plastic pants
  • Cornstarch
  • Zinc oxide
  • Desitin or A D ointment

72
Atopic Dermatitis (Eczema)
  • Allergic response
  • Cause is unknown
  • Infantile, childhood or adolescent onset

73
Pictures Images
74
Nursing Interventions
  • Light weight, loose cotton clothing
  • Relieve puritis
  • Thin coat of topical steroids
  • Prevent scratching
  • Creams/lotions

75
Clinical Manifestations
  • Erythemadous lesions, vesicles, papules
  • Oozing, crusting
  • Cheeks, scalp, trunk, elbows, knees, ankles, and
    hands
  • Lichenification
  • Intense pruritus
  • 90 children outgrow

76
Seborrheic Dermatitis
  • cradle cap
  • Eyebrows, eyelids, postauricular, nasolabial
  • Mineral oil over night
  • Shampoo and soft brush
  • Lesions can occur to old-age

77
Acne Vulgaris
  • Inflammation of sebaceous glands and hair
    follicles
  • Peak incidence bet. 16-18
  • Face, neck, shoulders, back and chest

78
Treatment
  • Benzoyl Peroxide
  • Retin A
  • Antibiotics

79
Nursing Intervention
  • Emotional support
  • Med instruction
  • Balanced diet

80
Tinea
  • ringworm
  • Fungal infection

81
  • Capitis
  • Corporis
  • Cruris
  • Pedis

82
(No Transcript)
83
Tinea Corporis (Ringworm) on the chest
Ringworm, Tinea Corporis on the Chest
84
Tinea Pedis (Athletes Foot)
85
  • Treated with antifungal medication
  • Keep area clean, dry, well ventilated

86
Candidiasis
  • thrush
  • Oral fungal infection

87

88
Nursing Interventions
  • Parent teaching
  • Meds for full 7 days
  • Breast hygiene
  • Sterilization

89
Communicable Diseases
  • Stress immunizations to prevent
  • Measles, Mumps, Rubella
  • Chicken pox

90
Cognitive Impairment
  • Formerly called mental retardation
  • Basic Criteria? Is an IQ of 70 or less

91
Clinical Manifestations
  • Failure to achieve developmental milestones
  • Delays in motor, social, cognitive or language
    skills

92
Nursing Interventions
  • Promote optimal development
  • Family referrals
  • Family education
  • See Safety Alert pg. 1069

93
Down Syndrome
  • Extra chromosome on 21st pair

94
Characteristic Findings
  • Low set ears
  • Slanting eyes
  • Protruding tongue
  • May also have congenital heart defects

95
Nursing Intervention
  • Same as for cognitive impairment

96
ADHD
  • Attention Deficit Hyperactive Disorder

97
Signs Symptoms
  • Decreased attention span
  • Hyperactive
  • Poor school performance
  • Sleep disturbances
  • Aggression

98
Medical Management
  • Behavior counseling
  • Educational interventions
  • Meds CNS stimulants
  • Ritalin, Dexedrine

99
Nursing Interventions
  • Parent counseling-allay feelings of guilt
  • Teach discipline techniques
  • Accident Prevention

100
  • Medication education
  • Do not give at bedtime
  • Medical evaluation Q6 mo.

101
Anorexia/Bulimia
  • Psychiatric disorder
  • Anorexia?self imposed starvation
  • Affects mostly teen girls
  • Bulimia?Binge,purge

102
Signs Symptoms
  • Severe wt loss
  • exercising
  • Disturbed body image

103
Nursing Interventions
  • Be alert for s/s
  • Nutrition and electrolytes
  • Admin. Meds as ordered
  • Psychotherapy, Behavior and Family Therapy

104
Child Maltreatment
  • Abuse physical, emotional, sexual
  • Neglect physical, emotional

105
Causative Factors
  • Parent factors
  • Child factors
  • Situational factors

106
Nursing Interventions
  • Observe for s/s of maltreatment such as
    unexplained injuries
  • Florida Law? must report if you suspect or know

107
School Avoidance
  • Most common cause of vague physical sx
  • s/s abd pain, diarrhea, hyperventilate
  • No organic cause found
  • Tx? educate parents

108
Recurrent Abdominal Pain
  • If no physiologic cause, it is due to emotional
    factors
  • Tx counseling

109
Suicide
  • Third leading cause of death ages 10-19
  • Multiple factors usually involved
  • Drug overdose most common method

110
Clinical Manifestations
  • Depression
  • Preoccupation with death
  • Social isolation

111
Nursing Interventions
  • Assess for s/s
  • Take threats seriously and report
  • Ask if they have thoughts of suicide
  • Never leave unattended

112
CLASS ACTIVITY
  • JUVENILE RHEUMATOID ARTHRITIS
  • RESPIRATORY DISTRESS SYNDROM
  • ASTHMA
  • CYSTIC FIBROSIS
  • BRONCHITIS
  • CROUP
  • TONSILITTIS
  • SIDS
  • PNEUMONIA
Write a Comment
User Comments (0)
About PowerShow.com