Exam (elaborations)
NR 602 Final Exam Chamberlain Spring 2024
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NR 602 Final Exam Chamberlain Spring 2024
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NR 602 Final Exam ChamberlainSpring 2024
COLIC
Unknown abdominal discomfort;
"cries for more than 3 hours a day, for more than 3 days a week, and more
than 3 weeks"
Colic Management
Probiotics may be offered; Consideration of hydrolyzed protein formula
DEHYDRATION Management
Commercially available oral hydration solutions (ORS)
Continue breastfeeding with ORS supplementation
Offer young children 20 ml/kg per hour
Offer older children 100 mL of ORS every 5 minutes
Combine with IV therapy as needed
Reassess after 4 hours; repeat if needed
Avoid juice, soft drinks, and sports drinks
Appendicitis S/S
Presence of involuntary guarding,
RLQ rebound tenderness, maximal pain over McBurney point
Heel-drop jarring test
inability to stand straight or climb stairs; winces when getting off
examination table or riding in a car over bumps;
child most comfortable with bent knees.
Positive psoas sign or obturator sign
Rovsing sign or rebound tenderness strongly suggests peritoneal
irritation.
Tenderness and possibly a mass (abscess) on the right side on rectal
examination.
McBurney point/sign
Pain w/ palpation and release; Rebound tenderness is most reliable.
1.5 to 2 inches in from the right anterior superior iliac crest (on a line
toward the umbilicus) on abdominal examination (most reliable finding
positive psoas sign
, retract R thigh while on left side; illicit pain consistent with appendicitis
Positive Rovsing Sign
Pain RLQ w/ pressure and release of LLQ; R/O appendicitis
Positive Obturator Sign
Supine; bend R leg and rotate inward; illicit pain in RLQ
Intusscuception
Anterograde intestine into proximal bowel; Most common cause of for
Pediatric GI obstruction
S/S of intussusception
S/S of intussuception
intermittent abdominal pain
currant jelly stools
Dance Sign (sausage like mass)
Management of Intussusception
Therapeutic Air Contrast Enema under fluoroscopy
Failure to Thrive (FTT)
The most common cause is nutritional deficiency without an underlying
medical condition (greater than 80%).
Asymptomatic bacteriuria
bacteria in the urine without other symptoms, is benign, and does not
cause renal injury.
Cystitis
an infection of the bladder that produces lower tract symptoms but does
not cause fever or renal injury.
Pyelonephritis
most severe type of UTI involving the renal parenchyma or kidneys and
must be readily identified and treated because of the potential
irreversible renal damage.
"When was your last menstrual period (LMP)?"
A healthy 14-year-old female has a dipstick urinalysis that is positive for
56RBCs per hpf but otherwise normal. What is the first question the
primary care pediatric nursepractitioner will ask this patient?
Monitor for proteinuria at each annual well child examination.
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