Pedi test 5

• materiall fill up appendix
• ferments
• bact
• infection
• -once cecum opening obstructed -> issues

• flu like s/s
• abd tender
• lowgrade fever (99-100)
• draw legs toward abd
• alt diarrhea & constipation
• unbulicus rebound
• Berny sign

surgery

• basics /surg care
• GI H_x
• maintain fluid balance
• ccomfort through positioning
• teach
• I/O/ check dressing

• H& H ,
• cbc
•   spec WBC up

• lowfowlers
• NPO
• no pain med w/ uexplained abd pain-mask s/s
• -NG tube if ape ruptur or lots N/V
• triple abx- gentimycin,almemcyi

• airway
• change possitioin frequently
• report 1st void
• accurate I/O
• assess bowel sounds/incision for inf/bleed
• meds as ordered
• splint if can't cough

Surg= perose drain

• wait few wks
• 1st put i IV abx
• may wait few wks for surgery
•   meds-to get infection under control 1st
•   abd filed w/ infection
• elevate HOB slighly for comfort & drawing

• antibiotix
• aalgesic
• clear liquid progress as tolerated

• storage hormone
• key to unlock cells
• boost inermitence  glucose
• get energy from food-->
• need enough insuli to pick up glucose & put ito cell
• produces fatty acid& stores as adipose tissue
• prevents protein conversion to glucose

• usually prior to age 30
• may be before puberty
• ~5-15

• inlets of lngerhas -virtually o beta cells
•    or are dead

rapid

• HA1C--confirms
• fast blood glucose >100mg/dL
• random glucose > 160 mg/dL

• c peptide blood test
• honeymoon phase ca last 1-3mo or up to 1 yr after or till stop producing insulin

• polyuria
• polydipsea
• polyphagia
• will loose wt even when eating
• lack energy
• only type prone to DKA

not show till at least 90% beta cells gone

• drowsiness
• dry skin
• flushed cheeks
• cherry red lips
• acetone breath-fruity smell
• kusmaul breathing

• replace lost fluid w/ dextrose free IV
• moniter blood sugar Q 1-2 hr
• regular insulin

usually  over 45 and overweight

gradual onset

• same as DMI
• no polyphagia

care for feet- nuropathy numbness

• perfer complex carbs to simple sugars
• more fiber lower blood sugar

best use 31g needle

change make up

• best use 31g needle
• now type etc given
• have food i system prior
• kids >7yr can give own shots

lipoatrophy/distraphy-won't absorb, too much fatty tissue

• the cloudy
•   air 1st / draw last

• if can't keep anything down- can't take oral meds or isulin b/c hypoglyc
• sick day chck blood sugr at least Q8 hr

when >240 & <70 cap blood

up carb intake based on amount & type exercise

• insulin shock
• hypoglyc
• hyperglycem

• antisocial behavior
• irritabl
• wk
• hungrea
• sweat
• blurred vis
• tachycard

worry of AM hypoglyc in kid and teen

once Tx should feel better w/i 5-10min reck 15

• rebound hyperglycemia
• hypoglyc evently get hyperglyce

• early AM hyperglycemia--not result of hypoglycemia
• main cause--> growth hormone
• Tx up to Dr
•    change pm insulin   chck early AM blood sugar
• usually see s/s 4-7am
• split pm dose of insulin

• befor & after surg may need special Tm
• if NPO-- ring lactate
• during recovery period may need higher doses of insulin till heal

• iscemic aseptic necrosis at head of femur
• epfacial

may heal on own

• highest incidence white boys
• 3-11yr

confirmed w/ xray & bone scan

• ab walk-one leg shorter
• Hx pain
• limp
• limited hip movement

may be mistaken for inflimatio of synovian synovitis

• focus on contaiig femoral head w/i the acetabulum during revasculation
• weight baring
• med
• to mobalize pt-need distracion

• cast/brace care-chk
• may last up to 2 yr

• have prob keep head femur i socket
• adductin last

focus on helping kid & cargiver manage corrective device & importance of compliance

parental /emotional support big part

• on spec ensepholopathy
• distruction of vicisul of brain
• affects liver & brain
•    liver is 2ndary affecte area

exact cause unknown

one main viral trigger---flue

up ammonia / liver ezyems / hypoglyce

• cerebral edema--effects CNS
• fluid/electrolyte imbalance
• acid based imbalance
• progressin of neuro disunction
• alt coagulation
• metab acidosis w/ resp alkidosis

• lab values,
• ct scan
• r/o brain tumor
• eeg
• liver Bx
• lliver function test
• serum bili
• amoia
• pt/PTT
• glucose

monitor neuro status

• averagte 4-12yr
• peak    6-7

• HOB at least 30^o
• kids padded side rails    don't compress neck
• parents--lots teaching
• **prevet further brain insult
• give O₂ prn

• 1-lethargy-lifver diffuc
• 2 deep liver defunc
• 3  abtunded  /hig coma-cloudy cognition
•      difficult to arouse
• 4 deep coma
• 5 coma-loose deep reflexes 
•      can't feel or acknoledge pai

• check deep tenden reflex
• progress depends on severity