Case Study: Acute Pharyngitis

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STUDY GUIDE FOR TEST #2:
STREP THROAT-Acute Pharyngitis is caused by strep throat. 80% is viral. Tonsils and pharynx may be inflamed-this can appear by day 2.
The child can go back to school 24hrs after medications with bacterial.
Symptoms: Headache, fever, abdominal pain (especially in small children).
For bacterial strep: Oral penicillin’s, and other antibiotics.
Viral: Treat the pain and fever: Tylenol, ibuprofen.
Complications: Rheumatic fever and acute glumerulonphintis. Heart and Kidneys!
Cystic Fibrosis- Endocrine gland dysfunction that has a multisystem involvement.
First sign and symptom: Not passing the first meconium.
Tested by: Sweat test. 2 positives make for a positive outcome for CF.
Patients should eat whatever they want. High Calorie, Fat, Carbs.
No cure.
CPT- Use: Helps to loosen secretions so that breathing becomes easier for child.
Provide Pancreatic enzymes with foods to help with the digestion since this can effect both GI and respiratory.
Infants with drainage: Bulb syringe suction. Babies may not want to eat because they are nose breathers.
How can you tell a child has a swollen epiglottis? Drooling! The child will not be able to swallow appropriately.
Asthma- Goals with asthma: Avoid exacerbation. Avoid allergens. Relieve asthmatic episodes promptly. Relieve bronchospasm. Monitor peak flow meter functions. Self-management of inhalers and devices.
Interventions: Exercise. CPT. Medications (in hospital). Being aware of allergies. Death is rare.
Give medications: Corticoid steroids, anti-inflammatory, broncodialatiors.
Scenario: Patient has crackles in lungs, and green sputum. Friends want to come back to visit patient. What are the nursing interventions: Problem: Pneumonia. 1st- start IV antibiotics. 2nd- then allow friends back once situation is under control. PATIENT COMES FIRST!
Acute Glomerulonephritis: Edema +, Hematuria ++, Proteinuria (Mild), BLOOD PRESSURE ++
Low sodium diet, Fluid restriction (BP).
Medications: Blood pressure medications. Diuretics and antibiotics
Nephritic Syndrome: Proteinuria ++, Blood pressure Normal, Lipids elevated, Hgb and Hct. ++!
Low sodium HIGH protein (due to expelled protein in urine), no Fluid restriction.
Medications: Corticosteroids, immunosupprents, diuretics, antibiotics, albumin.
Example: Patient has facial edema and high blood pressure which disorder is it? Acute Glomerulonephritis—HIGH BLOOD PRESSURE key word!
With both syndromes remember: Strict I & O’s, Daily weights, Activity as tolerable.
Night time Enuresis: Peeing in the bed at night. Mostly with boys. Restrict fluids, help with bladder training, and enuresis alarms are also available. Try to identify problem source. Provide emotional support. Encopresis-poop in pants.
Growth and development: Older sibling hates new baby: At toddler age, this is normal. When child becomes older (5-6 year old) Parents have a big issue!
Neuro- Unilateral fixed pupil BleedingCan be fixed.---Emergency! Surgical fix.
Neuro-Bilateral fixed pupils Brain stem Unfixable!
Neuro- Morro Reflex 2months. Normal  4 months. Delayed development.
Patient has a car wreck, nurse comes to the scene. What is your job?? Stabilize the head and spine!
Child fell into the pool. What is the first thing to worry about? Hypoxia (loss of oxygen)
Neuro defects which vitamin should we take…. Folic Acid.
Decorticate posturing: Arms are pulled tightly into chest area, clinched fist; knees are outward as well as feet are pointed outward. Glaucoma scale of 3 score.
Decerebrate posturing: Arms are down toward the hips as well as feet are positioned in a pointed formation. Caused by brain stem damage. Glaucoma scale of 2. Much more severe. Anytime the patient is pulling away from the body than to the body there are major neuro damage.
Reye’s syndrome: A disorder defined by toxic encephalopathy associated with other organ involvement characteristics. Neuro issue!
Complications: Mental Retardation. What can you give:
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