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NCTC Pedi Unit 3
| Question | Answer |
|---|---|
| Tonsillitis and adenoiditis | T and A are lymph tissues in the throat |
| Indications for T and A | Recurrent strep throat Marked hypertrophy Malignancy Diphtheria carrier Chronic otitis media from hypertrophy Persistent mouth breathing and recurrent rhinitis related to infected T and A |
| Contraindications for Tonsillectomy | Cleft palate Leukemia Under 3 Hemophilia |
| Tonsillectomy | Monitor for evidence of bleeding (hemorrhage is most common complication) Monitor for Increased pulse and respiratory rate Restlessness Frequent swallowing (from blood trickling down the back of throat) Vomiting bright red blood |
| Discharge teaching for Tonsillectomy | Tylenol should be used for pain of throat or earache that sometimes accompany the procedure Notify physician for - fresh bleeding, chest pain, persistent cough, fever |
| Croup syndrome | Is nonspecific term applied to conditions whose chief is brassy, barky-like cough When epiglottis is involved, danger of airway obstruction is evident Caused by wide variety of organisms |
| Benign crouplike conditions | Congenital laryngeal stridor (laryngomalacia) Infants are born with weak airway walls and floppy epiglottis Causes crowlike noises Condition spontaneously clears as the child grows and muscles mature |
| Spasmodic laryngitis (spasmodic croup) | Occurs in children aged 1 –3 Usually results from virus, allergy, or psychological triggers Has sudden onset, usually at night Characterized by hoarse, barky cough Treat with increasing humidity and giving fluids |
| Acute croup - Laryngotracheobronchitis | Viral condition Manifested by edema, destruction of respiratory cilia, resulting in respiratory obstruction Produces brassy, barklike cough Stridor and orthopnea are common Can result in hypoxia, tachycardia, and diminished breath sounds |
| Acute croup - Treatment and nursing care | Treatment is aimed at reducing laryngospasm and maintaining a patent airway At home take child to bathroom and turn on hot shower to make moist air |
| Acute croup -Meds | oxygen to reduce hypoxia (monitor O2 sats) corticosteroids to reduce inflammation racepinephrene (Vaponefrin) decrease edema vasoconstriction (monitor closely for rebound congestion) |
| Epiglottitis | Is swelling of the tissues above the vocal cords (supraglottal) that results in narrowing of the airway with possibility of complete obstruction Course is rapid and progressive to a life-threatening medical emergency Onset is abrupt |
| Epiglottitis s/s | Child sits up and forward difficulty swallowing croaking sounds on inspiration no Cough Epiglottis is swollen and “beefy red” don't touch back of throat can cause spasm Have tracheostomy set at bedside for emergency airway management |
| Epiglottis Treatment | Nasotracheal intubation is the treatment of choice until inflammation diminishes |
| Epiglottis Prevention | Immunizations against H. influenza |
| Bronchitis | Infection of the bronchial tree usually as a secondary infection to cold or communicable disease Caused by variety of organisms May be precipitated by poor nutrition, allergy, and chronic URI |
| Bronchitis Manifenstations | Dry cough that becomes looser as disease advances, large amounts of sputum develop, fever, sore throat |
| Bronchitis Treatments | Rest with warm moist compresses over sinuses as needed Hydration Meds - Tylenol for pain and fever Nose drops for congestion, especially before feedings of infants Cough suppressants to assist with rest, especially at night Humidified air |
| Bronchiolitis Manifestations | Cold symptoms followed by wheezing cough and respiratory distress Difficulty breathing causes infant to be irritable and dehydrated May develop into dyperreactive airway or asthma later in life |
| Bronchiolitis Treatment | Symptomatic and similar to croup: semi-Fowler’s positioning, IV support, bronchodilators, increased humidity, O2 sats |
| Respiratory syncytial virus (RSV)- Transmission | Most frequent cause of viral pneumonia Single most important respiratory pathogen in infancy Spread by direct contact, usually contaminated hands to mucous membranes Can survive >6 hrs on countertops, tissues, and soap |
| RSV Diagnosis | Examine nasopharyngeal washings for RSV antigens |
| RSV - Precautions | Good infection control techniques Mask, gown, gloves for direct care Use liquid soap |
| RSV Nursing Support | Report tachycardia and tachypnea Monitor breath sounds and report respiratory distress Monitor O2 sats Suction prn Monitor I&O and daily weights |
| RSV Medication | Ribovirin (Virazole) is prescribed for severely ill children but not used prophylactically Administered by inhalation in the mist tent Is teratogenic so pregnant moms should not be present during therapy |
| RSV - Complications | May be at risk for hyperreactive airways and asthma later in life |
| Asthma | recurrent and reversible obstruction of the airways characterized by bronchospasm, mucosal edema, and plugging by mucus secretion with subsequent impaired gas exchange Leading cause of absenteeism, ER visits, and hospitalization |
| Asthma Triggers | Onset can be caused by variety of agents: allergens, physical activity, cold or rapid changes in temperature, and emotional upset Family history of allergies is often seen |
| Asthma Diagnosis | History, PE, and response to bronchodilator therapy Elevated eosinophils in sputum and blood |
| Asthma Manifestations | Cough, wheezing, dyspnea especially on expiration, itching, air hunger (flaring nostrils, cyanosis), orthopnea, vomiting, rales Often happen at night and are frightening for child and parents Repeated attacks often lead to emphysema |
| Asthma Complications | pneumonia, atelectasis, mucus plugs, and status asthmaticus (medical emergency that may lead to death) Chronic asthma manifested by discoloration below eyes, slight eyelid eczema, and mouth breathing |
| Asthma Medications | acute attacks, epinephrine subcutaneously aminophylline IV Theophylline may be given prophylactically Administer with meals to prevent GI upset Monitor for signs of toxicity: Requires periodic blood levels |
| Asthma Inhalers | Bronchodilator inhalers: Ventolin, Proventil (albuterol), Alupent (metaproterenol), and Breathine (terbutaline) Steroids: cromolyn sodium (Intal) is prophylactic inhaler Other forms of steroids (IV and PO) may also be used |
| Asthma Teaching for home care | Remove- live Christmas trees, plants, pets, stuffed animals Avoid damp areas like basements NO SMOKING!! Use air conditioning during the summer Continue activity that is not intense swimming is good due Pretreat with inhalers before activity |
| Hospital care - asthma | O2 therapy Position for comfort and to facilitate breathing and chest expansion Assess lung sounds frequently Serve beverages at room temp Avoid carbonated beverages and milk Provide rest |
| Asthma Self care | Teach importance of exercise like swimming to strengthen lungs Avoid triggers to attacks Teach proper use of inhalers Review signs and symptoms of respiratory infection and how to get help Encourage use of medic-alert identification |
| Inhaler therapy | Clean daily with soap and water Near-empty canisters float in a bowl of water Breathe deeply in an out Inhale and puff inhaler Hold breath and exhale slowly through pursed lips Wait 2 minutes before second dose – it may not be necessary |
| Status asthmaticus | Medical emergency when severe respiratory distress does not respond to rescue drugs Required monitoring in ICU: O2, IV therapy and meds, ventilator support Teaching: Comply with medical regimen Wear medic-alert information |
| Cystic fibrosis | Most common fatal genetic disease in the US Parents are heterozygous (carriers); affected child is homozygous for the CF trait Found in chromosome 7 Basic defect · Increased viscosity of mucous gland secretion · Loss of electrolytes in sweat |
| Cystic Fibrosis· Respiratory system | – dyspnea, respiratory infections from mucous media, hypoxia that results in heart failure, emphysema, wheezing, respiratory distress |
| Cystic Fibrosis· Digestive system | – secretions prevent flow of digestive enzymes from pancreas to GI tract, foul/bulky/foul-smelling stool that can cause rectal prolapse, pancreatic/liver/biliary obstruction |
| Cystic Fibrosis · Skin | – excessive sweating causes “salty” skin surface, electrolyte imbalances during summer |
| Cystic Fibrosis · Reproductive system | – decreased sperm mobility, thick cervical mucous that inhibits sperm from reaching fallopian tubes |
| Cystic Fibrosis - Complications | Rectal prolapse, sclerosing of the liver, edema of the extremities, retinal hemorrhage, eye damage from inflammation and swelling, corpulmonale, osteoporosis, delayed sexual development, sterility in males, secondary amenorrhea in females |
| Cystic Fibrosis - Respiratory relief | Antibiotics for acute infection, aerosols, nebulizers, expectorants, bronchodilators Chest physiotherapy should be done after nebulizer treatments Postural drainage, chest-clapping General exercise stimulates coughing Pursed-lip breathing exercises |
| Cystic Fibrosis - Diet | High calories (as much as 50% above normal) High carbohydrate High protein Low to moderate fat Exceptions in the diet are necessary from time to time to keep meals interesting and "normal" - need to administer extra Pancrease |
| Cystic Fibrosis - General hygiene | Skin care to prevent skin break down and diaper rash Frequent position changes to prevent pneumonia Mouth care important due to nutritional problems Important to perform after postural drainage |
| Bronchopulmonary dysplasia | Thickening of bronchial walls caused by excessive O2 levels (above 40%) or mechanical ventilation over time Respiratory obstruction, mucous plugs, and atelectasis results |
| Sudden infant death syndrome (SIDS) - AKA "crib death" | sudden, unexpected death of an apparently healthy infant between 2 weeks and 1 year Peak incidence is between 2 and 4 months of age Routine autopsy fails to identify a cause of death |
| SIDS Clinical features: | Death occurs during sleep Infant does not cry or make other sounds of distress Infants that appear to be at greater risk: Low-birth weight babies, those who become overheated, those whose mothers smoked during pregnancy |
| SIDS Prevention | Babies with infantile apnea and sibs of babies who died of SIDS are closely monitored at home until past the age of danger Position babies on back or side Avoid use of fluffy blankets or soft pillows |
| Things to convey to grieving parents after the death of an infant to SIDS | The disease cannot be predicted or prevented Parents are not responsible for the death Encourage parents to say good-bye to the deceased infant Encourage the parents to hold and rock the infant Give permission to cry and grieve |
| Defect that decreases pulmonary blood flow: Tetralogy of Fallot | Stenosis of the pulmonary artery Hypertrophy of the right ventricle Dextroposition of the aorta Aorta is displaced to the right so it receives blood from both ventricles Ventral septal defect Abnormal opening between the right and left ventricle |
| Tetralogy of Fallot s/s | dyspnea, cyanosis, clubbing of the fingers, squatting position to facilitate breathing, feeding problems, growth retardation, frequent URI, severe dyspnea on exertion |
| Tetralogy spells (“tet” spells or paroxysmal hypercyanosis) | cyanosis, irritability, pallor, blackouts, and convulsions Recovery is usually rapid Polycythemia occurs when the body attempts to compensate for the lack of oxygen |
| Tetralogy of Fallot : diagnosis | Diagnosis is confirmed by chest xray that shows a “boot-shaped” heart, EKG, echocardiogram, and cardiac cath |
| Kawasaki disease (mucocutaneous lymphnode symdrome) | Occurs worldwide and is leading cause of acquired cardiovascular disease in US Strawberry” tongue Skin rash with swollen hands and desquamation of the palms and soles |
| Blood dyscrasias | disorders that occur when blood components fail to form correctly or when blood values exceed or fail to meet normal values |
| Iron-deficiency anemia | - most common nutritional deficiency in children, particularly adolescent females Results from decrease of oxygen-carrying capacity of the blood characterized by reduction in the amount and size of RBCs or amount of hemoglobin, or both |
| Anemia Causes | hemorrhage, inability to absorb iron, inadequate diet (changing to whole cow's milk precipitates lactose intolerance induced GI bleeding) |
| Sources of Iron | - iron-fortified formula, egg yolk, leafy green vegetables, Cream of Wheat cereal, dried fruits, dry beans, whole grain breads |
| Anemia : Manifestations, Diagnoses, Treatment | Pallor, irritability, anorexia, decreased activity, murmur, enlarged spleen, heart failure CBC, H&H, and iron concentrations Oral iron supplement between meals with orange juice Imferon can be administered IM by Z-track technique |
| Anemia: Parent education | Breast feed or iron-fortified formula for the first 6 months, then iron-fortified formula for the rest of the first year Limit milk intake to 1 pt/day Do not administer milk with iron supplements stool may be tarry black-green when on iron supplement |
| Sickle cell anemia | Is an inherited defect of the hemoglobin in the RBC Affects mainly African-American population Occurs in the absence of sufficient oxygen which causes the hemoglobin S to change shape into a characteristic sickle |
| Sickle cell disease | Severe form of the disease when the abnormal trait is inherited from both parents Each offspring has a one in four chance of manifesting the disease Each offspring has a two in four chance of being a carrier |
| Sickle cell disease - initial symptoms | Symptoms do not generally appear until the end of the first year of life May be unusual swelling of fingers and toes Small children may wet the bed for years and be difficult to toilet train |
| Sickle Cell disease - Anemia | Chronic anemia is evidenced by Hgb from 6 - 9 gm/dl Child is pale, tires easily, and has anorexia Complication of the anemia is a sickle cell crisis that can be fatal |
| Sickle Cell Crisis | May be the first symptom Patient appears acutely ill, has severe abdominal pain, muscle spasms, leg pains, swollen and painful joints, fever, vomiting, diarrhea,hematuria, convulsions, stiff neck, coma, paralysis, jaundice, cardiac enlargement, murmurs |
| Sickle Cell Diagnosis | Sickeldex is screening test Hemoglobin electrophoresis distinguishes sickle cell trait from sickle cell disease |
| Hemophilia | Inherited disorder in which the blood does not clot properly is confined almost entirely in males but is transmitted by asymptomatic females on the X-chromosome |
| types of hemophilia | Hemophilia B (Christmas Disease) is deficiency of factor IX Hemophilia A is deficiency in clotting factor VIII (84% of cases) Can be diagnosed by partial thromboplastin time (PTT) |
| Clotting times and Hemophilia | Normal clotting usually take 3 - 6 minutes In hemophilia, clotting may take up to an hour or longer Spontaneous hematuria may be noted Bleeding into the spinal column may instigate paralysis Death can result from excessive bleeding |
| Some Nursing Guidelines for Hemophilia | Control active bleeding episodes with pressure, cold, and elevation For hemarthrosis immobilize, ice, elevate, analgesics,administer clotting factor Inform dentist of bleeding status Avoid use of aspirin in OTC meds - avoid injections whenever possible |
| leukemia | Malignancy disease of the blood-forming organs of the body resulting in uncontrolled growth of immature WBCs |
| Leukemia Manifestations | Initial signs may include low-grade fever, pallor, tendency to bruise, leg and joint pain, listlessness, abdominal pain, and enlargement of lymph nodes Physiologic fractures Ulcerations of the mouth and anal regions prone to infections |
| Leukemia Diagnosis | History, extensive blood tests, bone marrow biopsy, x-ray, kidney and liver function tests |
| Chemotherapy is given in cycles | 1) Induction period - 2) CNS prophylaxis for high-risk patients - administered intrathecal 3) Maintenance - includes methotrexate 4) Reinduction therapy for relapse 5) Extramedullary disease therapy |
| Leukemia treatment and nursing care | Chemotherapy Antibiotics prevent or control infection Whole blood or packed cells prevent or treat anemia Analgesics to control pain Antiemetics to control nausea and vomiting TPN may be necessary to support nutritional needs |
| Hodgkin’s Disease | Malignancy of the lymph system, primarily the lymph nodes Presence of Reed-Sternberg cells with two nuclei is diagnostic of the disease Mets to spleen, liver, bone marrow, lungs, or other body parts Twice as common in boys as girls |
| Hodgkin's Disease Manifestation | Presenting symptom is usually painless lump along the neck Advanced cases show low-grade fever, anorexia, weight loss, night sweats, malaise, rash, and itching of the skin Diagnosis is confirmed by x-ray, body scan, lymphangiography, and biopsy |
| Stages of Hodgkin's Disease | I Restricted to single site or localized group of nodes, asymptomatic II 2 or more nodes in the area or on the same side of the diaphragm III Involves nodes on both sides of the diaphragm with mets to adjacent organs IV Diffuse disease |
| Treatment of Hodgkin's Disease | Radiation and chemotherapy according to the staging of the disease Prognosis is favorable for remission with cure related to the stage of the disease at diagnosis |
| Facing death | Understand the dying and grieving processes Show compassion in a clinically competent, professional manner Use nonjudgemental approach with personal or cultural practices at time of death Support the family’s efforts to cope, adapt, and grieve |
| Self-exploration - Death of a child | Explore your own attitudes about life and death Recognize that coping is an active and ongoing process Find constructive outlets |
| The child’s reaction of death | Each child approaches death in an individual way, drawing upon limited experience Approach children honestly and inform them about upcoming procedures Encourage expression of feelings Give as much control over what is happening as possible |
| Physical changes of impending death | Cool, mottled, cyanotic skin Slowing of all body processes Losing of consciousness Rales Intact hearing |
| Pyloric stenosis | narrowing of the pylorus that becomes partially blocked Caused by overgrowth of the circular muscles of the pylorus or by spasms of the pyloric sphincter the most common surgical condition of the GI tract in infancy |
| Manifestations of Pyloric Stenosis | Projectile vomiting after feedings contains mucus and may be blood-streaked Baby is hungry and will want to eat again immediately after vomiting Dehydration and malnutrition are evident |
| Pyloric Stenosis Diagnosis | Palpation of olive-shaped mass in URQ of abdomen Barium x-ray confirms difficulty of passage into duodenum Ultrasonography confirms stricture of the pylorus |
| Treatment of Pyloric Stenosis | Surgery is pyloromyotomy - surgical incision into the pyloric muscle to enlarge the opening |
| Celiac disease | Description – Also known as SPRUE and GLUTEN ENTEROPATHY Is the leading malabsorption problem in children |
| Celiac disease : Manifestations | Manifests between 6 months and 2 years Food is malabsorbed due to damage of the villi in the mucous membranes of the intestines Infant presents with failure to thrive Stools are characteristically large, bulky, and frothy from undigested contents |
| Celiac disease: Treatment and nursing care | Lifelong diet restriction of wheat, barley, oats, and rye Teach importance of dietary compliance Long-term bowel pathology can result from failure to comply with diet Refer to nutritionist or dietician |
| Hirschsprung’s disease (Aganglionic Megacolon) | Absence of ganglionic innervation to a portion of the colon - usually the lower Sigmoid colon (portion of the bowel nearest the obstruction dilates causing abdominal distention) Results in chronic constipation from lack of normal peristalsis |
| Hirschsprung’s disease (Aganglionic Megacolon): Manifestations | Ribbon-like stools, constipation, abdominal distention, anorexia, vomiting, failure to thrive May lead to intestinal obstruction and signs of shock Diagnosed by barium enema, rectal biopsy, and anorectal manometry |
| Hirschsprung’s disease (Aganglionic Megacolon): Treatment and nursing care | Surgical removal of the affected colon with anastomosis Temporary colostomy may be necessary During hospitalization, daily abdominal girth is recorded I&O is recorded Bowel sounds are regularly assessed |
| Intussusception: Description | Is the telescoping of one part of the intestine into another part just below it Is common at the ileocecal valve between the small and large intestine Peristalsis may cause strangulation and cause bursting and peritonitis Occurs most frequently in boys |
| Intussusception: Manifestations | Sudden onset of abdominal pain, loud cries, straining efforts, vomiting of green- yellow emesis If untreated, can have movements of blood and mucus that contain no feces (currant jelly stools) Abdomen is rigid |
| Intussusception: Treatment | Barium enema is the treatment of choice with surgery if reduction is not achieved Surgery involves making an incision into the abd and milking the intestine back into place If unable to reduce the bowel, resection with anastomosis is done |
| Gastroenteritis: Description | Inflammation of the stomach and the intestines Noninfectious causes – food intolerance, overfeeding, improper formula preparation, Ingestion of high amounts of sorbitol Priority problem – fluid and electrolyte imbalance from diarrhea |
| Gastroenteritis: Treatment and nursing care | Identify and eradicate the cause Teach parents proper feeding techniques and diet that are age appropriate Rehydration – Pedialyte in small, frequent feedings Maintain I&O Weigh diapers Use and teach good hand washing techniques Use enteric precautions |
| Gastroesophageal reflux: Description | Occurs when the lower esophageal sphincter does not prevent backflow of stomach contents into the esophagus Etiology is unknown but is associated with neuromuscular delay, as in pre-term birth or patients with Down syndrome or cerebral palsy |
| Gastroesophageal reflux: Manifestations | Vomiting (may be forceful), weight loss, bleeding, respiratory problems Baby will be fussy and hungry Aspiration is a risk May be accompanied by anemia or failure to thrive |
| Gastroesophageal reflux: Treatment and nursing care | Diagnosis - barium swallow or esophagoscopy, pH monitoring of the esophagus Burping without overfeeding Positioning on right side with HOB elevated after feedings Meds - metoclopramide (Reglan) or bethanecol chloride (Urecholine) |
| Vomiting: Description | Results from sudden contractions of the diaphragm and stomach muscles Persistent vomiting can cause metabolic alkalosis from continuous loss of hydrochloric acid and sodium chloride |
| Manifestations - vomiting - Causes - | improper feeding techniques, introduction of foods with different consistencies, self-gagging during play, infections of ear/nose/throat, communicable diseases, Reye syndrome, PUD, IICP, strangulated hernia, bowel obstructions, contaminated food |
| Vomiting: Treatment and nursing care | Burp frequently during feedings place child on right side following feedings Keep accurate I&O NPO status until vomiting decreases then begin CL diet and progress as tolerated Meds - trimethobenzamide (Tigan) IM or rectally |
| Failure to thrive: Description | In absence of cause, infants fail to gain and often lose weight Development is delayed and may present with “ragdoll limpness” May be stiff and unresponsive to cuddling May be wary of caretaker Common among autistic and institutionalized retarded children |
| Failure to thrive: Prevention | parenting classes, early recognition and support of families at risk Plan interventions that enhance parent-infant bonding Important to support the mother Listen actively, correct misinformation, |
| The most common worm infestation of the GI tract Appears as a white thread about 1/3 inch long Spreads from person-to-person by inhaling eggs or handling contaminated toys, toilet seats, doorknobs, food, soiled linen | |
| Enterobiasis (pinworms):Manifestations | Anal itching, irritability, restlessness, weight loss, anorexia, visible worms on stool or anus Diagnosed by tape on anus in early morning before stooling or bathing |
| Enterobiasis (pinworms):Meds & Teaching | mebendazole (Vermox) is single-dose chewable tablet Teach good hand washing and keep fingernails trimmed short Treat all symptomatic family members (Vermox is contraindicated in pregnancy) Disinfect all toilet seats daily Launder linens in hot water |
| Acute glomerulonephritis: Description - formerly called "Bright's Disease" - | Possibly results from allergic reaction to an infection in the body Antibodies that attack the infection also attack the glomerulus Usually caused by beta-hemolytic streptococcus infection of the throat |
| Acute glomerulonephritis: Manifestations | Symptoms range from mild to severe from 1 to 3 weeks after strep infection has occurred Smoky-brown or bloody urine, periorbital swelling, fever, headache, diarrhea, vomiting, oliguria, hypertension |
| Acute glomerulonephritis: Treatment and nursing care | Bedrest until hematuria subsides and physical rest is facilitated Penicillin is the antibiotic of choice Frequently monitor vital signs and immediately report blood pressure changes |
| Wilm’s tumor | is an adenocarcinoma malignancy of the urinary tract Believed to have genetic basis ⅔ of cases occur before age 3 Is usually diagnosed by mass in the abdomen during regular physical exam Diagnosis by IVP, ultrasound, CXR, CT, bone surveys, and liver scan |
| Surgery to remove the tumor is performed as soon as possible Radiation is done before and after the surgery Children with localized tumors (Stages I or II) have a 90% chance of cure Avoid handling of the abdomen before surgery to prevent mets | |
| Results when skin is irritated by prolonged contact with urine, feces, retained diaper soaps, and friction | |
| Diaper dermatitis (Diaper rash) Treatment and nursing care | Prevention is easier than cure Frequent diaper changes limits exposure to moisture Wash perineal area with soap and water with each diaper change Avoid plastic pants Topical petrolatum, A&D ointment or zinc oxide can be beneficial |
| Acne vulgaris: Description | Inflammation of sebaceous glands and hair follicles Principal lesions include comedones, papules, and nodulocystic growths Caused by hormonal influencing sebaceous glands to secrete increased amounts of sebum |
| Vitamin A acid (Retin-A) aids in the elimination of keratinous plugs Isotretinoin (Accutane) is given to patients with severe pustulocystic acne contraindicated in pregnancy and is not prescribed when at risk for pregnancy | |
| Description - fungi that invade the skin, nails, and hair Tinea capitis - ringworm of the scalp Tinea corporis - ringworm of the skin Tinea pedis - ringworm of the foot (Athlete's foot) Tinea cruris - ringworm of the groin (Jock itch) | |
| Burns: Description | Leading cause of death in the home among those aged 1 - 4 Incidence is higher among boys May be a result of child abuse and neglect Most common in early morning hours before parents awaken and after school |
| Types of burns | Thermal – due to fire or a scalding vapor or liquid Chemical – due to a corrosive powder or liquid Electrical – due to electrical current passing through the body Radiation – due to x-rays or radioactive substances |
| Burns:Extent is described as: | Moderate Partial thickness involving 15 - 30% of body surface Full thickness involving less than 10% of body surface Major Partial thickness of 30% or more of body surface Full thickness of 10% or more of body surface |
| Stop the burning process Turn off electricity before touching electrocuted child Cover with a clean cloth to minimize contact with air, reduce pain, minimize hypothermia, and prevent contamination Do not give PO fluids Start IV is possible | |
| Wound care: Burns | Immediate care includes cleansing, debridement, and dressing Strict asepsis is maintained Whirlpool baths, hose baths, or Betadine baths may be ordered to soften necrotic tissues No two burn surfaces should touch |
| Temporary grafts may be used in acute stage of recovery to protect wound from infection and reduce fluid loss | Homografts from cadavers free from disease Xenografts (heterografts) from different species Porcine (pigskin) grafts are commonly used Are available fresh or frozen |
| Permanent grafts are performed during rehab to improve appearance and function | Autografts are taken from the patient’s own body Isografts are taken from an identical twin donor |
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