Download Pediatric Conditions Pathophysiology Specific Assessment Findings

Pediatric Conditions
Pathophysiology
Reactive Airway
Disease
The site of the
problem is obstruction
to airflow in the lower
airways of the lungs.
The obstruction to airflow is
due to narrowing of the
airways by constriction of
muscles around the airways
as well as swelling of the lining
of the airway and collection of
secretions within the lumen of
the airway.
Wheezing is a
reaction that can be
triggered by many
factors (such as viral
upper respiratory
infections, inhalant
allergies to pollens
and molds, cold air,
exercise, emotion,
cigarette smoke, paint
fumes, ozone).
Gastroenteritis
Femur Fracture
Specific Assessment
Findings
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An inflammation of the
mucous membranes lining the
stomach and intestine
resulting from viral or
bacterial infections or toxins.
Enterotoxins produced by
infectious agents or the
cytotoxins damage the
intestinal lining, producing
inflammation. Fluid doss and
electrolyte losses result from
decreased intake, vomiting ,
and diarrhea
Indirect force or direct force
in which bone is subjected to
stress beyond what it can
endure.
Spontaneous fracturing
associated with an underlying
disease process -
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increased work of
breathing
increased respiratory
rate
retractions
frequent and repetitive
cough
vomiting; decreased oral
intake due to fatigue and
cough.
use of the muscles of
the abdomen, neck and
nose to assist in
breathing
inability to lie down due
to respiratory distress
Cyanosis (a bluish color
about the mouth).
Laboratory
Findings
 Peak flows
 Chest xray
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Severity of dehydration
o Sunken eyes
o Wgt. Loss
o Dry mucous
membranes
o Decreased urine
output
Fever
Diarrhea
Vomiting
Abdominal pain and
cramping
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Tenderness at site
Limb
Limited mobility
Swelling
Deformity
Decreased vascularity
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UA
Gastrocult
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Treatments /
Medications
SVN
Bronchodilators/
Albuterol,
Atrovent
Anti-inflammatory
agent/
prednisolone,
solumedrol
Hydration
Antiemetics
(Phenergan,
Compazine,
Zofran)
Antidiarrheal
(Lomotil,
Imodium)
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X ray
Bone scan
MRI
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Immobilizing the
fractured limb or
site
Traction
Surgery
Assess neuro
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Discharge Teaching for
caregivers & patients
Teach family to identify
and avoid potential
triggers
Recognizing signs and
symptoms of an
impending attack
Peak flows
Review families
understanding of
medication
administration.
Good hand washing
Pedialyte 5-10ml’s wait
5- 10 mins then repeat
Slowly increase as
tolerated.
Advance diet as
tolerated with easily
digested foods
BRAT diet
Cast care
Educate on assessment
of skin at cast site.
Elevate, ice, and rest
Adequate nutrition to
promote healing
Osteogenisis Imperfecta
Closed head injury
Child abuse
Cancer; sarcomas
Any injury to the head that
does not penetrate skull.
Closed head injuries range
from mild skull injuries to
traumatic brain injuries.
Different types include:
 Concussion
 Brain contusion
 Diffused axonal injury
 Hematoma
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and neurological
function distal from the
site
Headache
Dizziness
Nausea
Ringing in the ear
Slurred speech
Vomiting
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CT scan
Neuro
Assessment
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vascular status
Pain medication
Maintain
cardiopulmonary
function
Monitor neuro
signs
(protein & vitamins)
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Primary injuries develop at
time of trauma when initial
tissue damages takes place.
Sickle Cell Anemia
Secondary brain trauma
develops as a result of body’s
response to injury, this can
occur from a few hours to a
few weeks after the injury.
An autosomal recessive
condition where normal
hemoglobin is partially or
completely replaced by sickle
shaped abnormal hemoglobin
S (Hgb S).
When exposed to diminished
levels of oxygen, hemoglobin
develops a sickle or crescent
shape; these cells are rigid
and obstruct capillary blood
flow, leading to congestion
and tissue hypoxia, cyclically,
this hypoxia causes additional
sickling and extensive
infarctions
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Fatigue
Shortness of breath
(hypoxia)
Pain
Dizziness
Headache
Coldness in the hands
and feet
Pale skin
Chest pain
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Newborn
screening
Sickle cell
test
(sicklidex)
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Hydroxyurea
Antibiotics
Blood transfusions
Oxygen
Pain medication
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Minor injuries, teach
what behaviors to
expect from child and
symptoms to monitor
(mild headache
expected, focal deficits
are abnormal)
Recovery period up to
6 weeks, children may
tire easily have
memory loss or
forgetfulness, are
easily distractible, have
difficulty concentrating
of following directions,
irritability or short
temper, and need help
starting and finishing
tasks
Folic acid supplements
Plenty of water
Avoid temperature
extremes
Reduce stress
Exercise regularly
Use caution with OTC
(decongestant,
pseudoephedrine, can
constrict blood
vessels).
May need
supplemental oxygen
in high altitudes