Homework: Worksheet 5

Posted on: 29th May 2023


Worksheet # 5

1.    Briefly describe the following:

· Sickle Cell Anemia

o Complications and management

· Aplastic anemia

· Iron deficiency anemia

· Hemophilia

· Immune thrombocytopenia

· Thalassemia major

2.    Explain care management of a child with leukemia—symptoms, chemotherapy side effects and management of symptoms

3.    What are the side effects of chemotherapy on a child with leukemia?

4.    Describe care management for Osteogenic sarcoma

5.    What are the signs and symptoms of Hodgkin’s disease?

6.    Wilms tumor –  Clinical manifestations and nursing care management

7.    Discuss the causes and mechanism of edema formation in nephrotic syndrome

8.     Discuss Idiopathic nephrosis, childhood nephrosis, and minimal-change nephrotic syndrome

9.    Discuss the effect of decreased colloidal osmotic pressure in the capillaries of a child with nephrotic syndrome.

10. How does this impact the vascular hydrostatic and the pull of the colloidal osmotic pressure?

a.    Relate this information to cause of  fluid accumulating in the interstitial spaces (edema) and body cavities, particularly in the abdominal cavity (ascites).

11. Compare clinical manifestations therapeutic  management of a child with nephrotic syndrome and acute glomerulonephritis.

a.    What are the similarities and differences in manifestations?

12. Discuss the reasons for proteinuria, edema and ascites as seen in a child with minimal change nephrotic syndrome

13. List the signs and symptoms of acute renal failure compared to chronic renal failure.

14. Identify the primary nursing intervention in an unconscious child.

15. Differentiate between concussion and contusion

16. Discuss nursing care intervention of a child experiencing seizure

17. Discuss  the manifestations of viral and bacterial meningitis and preventions.

18. What is Reye’s syndrome? What are the clinical manifestations preventive strategies?

19. Differentiate between types 1 and 2 diabetes mellitus. Discuss complications, preventions, patient educations and self-care management appropriate to a child’s developmental level.

20. Differentiate between hypoglycemic and hyperglycemic reaction. Discuss treatment for diabetic ketoacidosis

21. Discuss post-operative care of a child with neural tube defect.

22. What is a fracture? Discuss the care interventions of a child in a cast

23. Discuss patient education for a child being discharged in a full cast.

24. Describe skin and skeletal fraction

25. What is compartment syndrome?

Discus treatment options for congenital hip dysplasia and talipes equinovarus

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Homework: Worksheet 5

1. Sickel cell anemia is a genetic condition affecting the shape of red blood cells. It may complicate anemia, and avascular necrosis leading to bone tissue death, acute chest syndrome, fever, infection, and kidney failure. The condition is managed through drug administration and blood transfusions. Stem cell or bone marrow transplant in children cures the disease.

Aplastic anemia is a condition characterized by the inability of the body to produce new blood cells due to damage to stem cells in the bone marrow.

Iron deficiency anemia is low blood hemoglobin levels due to insufficient iron used in forming hemoglobin.

Hemophilia is a blood disorder where the blood fails to clot due to insufficient clotting factors in the body and is characterized by excessive bleeding.

Easy bruising and bleeding are standard features of immune thrombocytopenia, a condition caused by low platelet levels.

Thalassemia is a hereditary blood condition where the hemoglobin genes faultily present with such severe symptoms.

1. Leukemia is cancer of the cells that form blood cells, and its symptoms in a child include fever, paleness, recurrent infections, headaches, dizziness, difficulty in breathing, and easy bruising. Analgesics manage symptoms of fever and pain, drugs to kill leukemia cells, antibiotics treatment for infections, and fluid balance and regulation.

2. Leukemia’s primary treatment is chemotherapy which may cause hair loss, mouth sores, infections, skin changes, easy bruising, and tiredness.

3. Management of osteogenic sarcoma involves chemotherapy and surgery as the definitive management.

4. Hodgkin’s lymphoma may present with fever, unintentional loss of weight, lymph swelling on the neck, armpits, and groin, fatigue, and severe itching.

5. Wilms’ tumor presents with a swelling on the abdomen, abdominal pain, fever, constipation, shortness of breath, blood in urine, and elevated blood pressure. Nursing care should be focused on preventing injury, protection from infection, anxiety management, and maintenance of oral mucosa.

6. Edema is a joint presentation in nephrotic syndrome caused by the damaged glomerulus, causing the protein to be present in urine. Fluid leaks out of the blood vessels into the neighboring tissue when protein is lost from the body leading to tissue swelling and edema. The edema is more on the lower extremities, abdomen, scrotum, and periorbital area.

7. Idiopathic nephrosis is the development of edema, proteinuria, and hypoalbuminemia with no known cause. Childhood nephrosis is a condition in children with too much proteinuria, swelling on body parts, and weight gains, also referred to as childhood nephrotic syndrome. On the other hand, minimal change nephrotic syndrome is a condition in which the kidney loses a large amount of protein in the urine.  

8. Decreased colloidal osmotic pressure leads to increased fluid movement within the capillary wall leading to edema. Additionally, decreased colloidal pressure leads to decreased tissue fluid protein, leading to edema and a fall in blood volume.

9. Vascular hydrostatic pressure increases capillary outflow, decreases colloidal osmotic pressure, and increases hydrostatic pressure, leading to fluid movement outside the cell to the surrounding tissues causing edema. In addition, increased plasma protein like albumin causes more fluid to be drawn out of the cell leading to ascites.

10. Acute glomerulonephritis may present with hematuria, proteinuria, and hypertension, while in nephrotic syndrome, there is heavy proteinuria, and edema is evident. In addition, the child may present with hypoalbuminemia. The similarities are proteinuria and edema. The difference is hematuria and hypoalbuminemia, respectively. Glomerulonephritis is treated with a corticosteroid, dialysis, diuretics, and diet change. Blood thinners and steroids are effective in nephrotic syndrome treatment.

11. A child with minimal change nephrotic syndrome will present with proteinuria due to loss of glomerulus function. Increased protein loss will decrease colloidal osmotic pressure, leading to fluid movement from vessels to surrounding cells and edema and ascites.

12. Acute renal failure will clinically present with reduced urine output, swelling of the feet, fatigue, confusion, weakness, nausea, and fatigue compared to chronic renal failure, which will manifest with decreased mental alertness, chronic urinating problems, and muscle cramps, and massive edema.

13. The nurse should assess for airway patency, breathing, and circulation. Elevated bed, remove airway obstruction, suction airway, and administer oxygen. Assess for increased intracranial pressure, and maintain head and neck position. If present, administer diuretics and stool softeners for bowel movement. The nurse should assess the risk for injury and prevent them: intravenous fluid control input and output chart.

14. A concussion is a brain injury caused by trauma affecting its functioning and may present with headache and balance problems. At the same time, a contusion is a brain bruise causing bleeding and swelling of the brain.

15. The nurse should maintain the child in a lying position to avoid injury, loosen the child’s clothing, administer oxygen marinating airway patency, administer seizure drugs, and maintain breathing.

16. Viral and bacterial meningitis may present similarly, but bacterial meningitis is more severe and life-threatening than viral, which may be self-limiting. Common signs and symptoms include neck swelling, headaches, lethargy, fever, and seizures. Meningococcal vaccine is the primary preventive measure for meningitis in addition to certain practices like maintaining hand hygiene, avoiding close contact with infected people, and cleaning surfaces with disinfectant.

17. Reye syndrome is a severe condition characterized by brain and liver swelling. A child with the condition may present with increased acidosis, ammonia levels, and low blood sugar. Abdominal swelling due to liver fatty deposits and brain swelling are expected. Prevention strategies include varicella vaccine, flu vaccine, and avoiding aspirin therapy.

18. Type I diabetes mellitus is an increased blood sugar level due to a lack of insulin production and is common in children. In contrast, type 2 diabetes mellitus is characterized by high blood sugar levels due to insulin resistance by body cells and is common in adults. Complications of diabetes in children may include diabetic ketoacidosis, hyperglycemia, loss of vision, renal failure, and heart diseases. Patient education on prevention strategies includes a healthy diet, the need for physical activity, monitoring of blood sugar levels, and weight control.

19. Hypoglycemia is low blood sugar levels leading to loss of energy and weakness. In contrast, hyperglycemia is increased blood sugar levels above regular, leading to irritability, shortness of breath, and confusion. Diabetic ketoacidosis is managed through intravenous fluid replacement and insulin therapy. Potassium levels should also be monitored.

20. Sterility should be maintained in wound care to avoid infection, physical therapies, and shunt for hydrocephalous and bladder and bowel control.

21. A fracture is a discontinuation of the bone because of a break. Care intervention for a child’s cast includes immobilization, elevating the affected limb, maintaining hygiene, and watching out for complications like skin infections.

22. The child should not draw marks on the cast, the parent should avoid water contact and maintain it dry to avoid infections, the cast should not be cut, the child should avoid picking pads to form the cast or sticking things in, and the parent should ensure exercise to the joints not immobilized by the case.

23. Skin traction is a pull of a limb in a specific direction using a splint applied to the skin, while in skeletal traction, the pull is attached to the one using a pin.

24. Compartment syndrome is when tissues within a muscle compartment are applied with a pressure that exceeds normal, resulting in restricted blood flow and tissue and muscle damage.

25. Talipes equinovarus is treated with bracing and casting by manipulating the child’s foot into a better position. In contrast, congenital hip dysplasia is treated with Pavlik harnesses, a soft brace that holds the ball and socket joint to its potion for several months. 

Andrea Gibson

Andrea Gibson

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