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NURS 629 Exam 4-GU, GI, psych, neuro, msk, endocrine, hematologic Qs & As
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NURS 629 Exam 4-GU, GI, psych, neuro, msk, endocrine, hematologic Qs & As
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NURS 629 Exam 4-GU, GI, psych, neuro, msk, endocrine,hematologic Qs & As
What are risk factors for dehydration? Correct Ans-GI virus
NVD
What are s/sx of dehydration? Correct Ans--sunken fontanels
-tachycardia and decrease cap refill >2-3 seconds
-decrease urine output is sensitive but nonspecific
-increase in urine specific gravity
-decrease BP- late finding=more than 10% fluid loss
How do you treat dehydration? Correct Ans--if minimal, mild, moderate- oral rehydration
-if severe (drowsy, cold extremities, lethargic, sunken/dry eyes, very depressed anterior
fontanel, no tears, dry mouth/tongue, very decreased skin turgor, rapid/sometimes
impalpable pulse, decreased/unrecordable pulse, deep/rapid respiratory rate, markedly
reduced urine output) - IV fluids
What is emesis? Correct Ans-vomiting=symptom
must distinguish from regurgitation in infants
integrated response to noxious stimuli-coordinated by CNS
What is acute emesis? Correct Ans-short-term
abrupt onset
,NURS 629 Exam 4-GU, GI, psych, neuro, msk, endocrine,
hematologic Qs & As
episodic
What is recurrent emesis? Correct Ans--at least 3 episodes over 3 months
-chronic
-relatively mild but occurs frequently
What is cyclic emesis? Correct Ans--recurrent, intense episodes
-periods of being asymptomatic
How do you treat emesis? Correct Ans-NPO for 1-2 hrs
**rehydrate with small/frequent amounts of clear liquids
avoid dairy and solids for 4-6 hrs and then add bland foods slowly
What are causes of diarrhea? Correct Ans--primarily viral (most common) or bacterial
-bacterial pathogens are usually C. difficile, salmonella, Giardia, Campylobacter
**always serious in infancy due to small ECF reserve, and can dehydrate quickly
Patho of diarrhea Correct Ans-1. retention of water w/in the intestine (malabsorptive
syndrome, lactose intolerance)
2. excessive secretion of water and electrolytes into the intestinal lumen (cholera, e. coli,
chrohn's, laxatives)
,NURS 629 Exam 4-GU, GI, psych, neuro, msk, endocrine,
hematologic Qs & As
3. release of protein and fluid into the intestinal mucosa (ulcerative colitis, Crohn's. infections)
4. altered intestinal motility resulting in rapid transport through the colon (IBS, scleroderma)
What is acute diarrhea? Correct Ans-most likely to be an infectious agent
sudden onset
frequent, loose, watery stools
bloody stools
abdominal cramping
thirst
decreased urination
dizziness
fatigue
What is chronic diarrhea? Correct Ans-1 or more liquid to semi-solid stools passed per day
for 14+days
What is physiological jaundice? Correct Ans--occurs when baby accumulates bilirubin
-secondary to immature liver in newborns
-Risk factor is prematurity
, NURS 629 Exam 4-GU, GI, psych, neuro, msk, endocrine,
hematologic Qs & As
What level is conjugated hyperbilirubinemia? Correct Ans-serum conjugated bilirubin
concentration greater than 1 mg/dL if the total bilirubin is less than 5.0 mg/dL or more than
20% of the total bilirubin if the the total bilirubin is greater than 5 mg/dL (p. 862 AAP book)
What is breastfeeding jaundice? Correct Ans--due to poor intake that causes lack of stools
and urine output
-common in first week and resolves once milk comes in and infant is feeding well-more stools
and urinary output
-peaks around 2-3 weeks
How do you diagnose jaundice? Correct Ans--dx with a bili level of 5 mg/dL
-12 mg/dL threshold for all newborns having jaundiced appearance
-direct/indirect bili levels
-CBC
-reticulocyte count
-use of bilitool.org
How do you treat jaundice? Correct Ans-increased intake, longer feeding
indirect sunlight
phototherapy
IV fluids
Bili lights
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