LPN NOTES 1-7-09
FUNDAMENTALS CH 14
Kidney failure results in a need for dialysis. Nephrons in the kidneys are the ones the filtrate the blood.
-Normal blood count of a person is 90-120. Dialysis patients have only about 60-90
-the kidneys are the master chemist in the body
-does the fluid and waste management of the body
-too much or too little electrolytes in the body may cause cardiac arrest. (Ex-potassium) (conducts the electrical impulses in the body, if the heart does not feel those impulses, it stops)
-too much or too little sodium may cause an increase or decrease of fluids in the body.
COPD-may lead to desaturation, the heart compensates by beating harder which makes it larger. Enlarged heart may lead to arythmias. May also lead to edema.
MOTELING-blood pools in the legs. When little signs that appear as stop signs connected together appear at the bottom of the ankles, then travel up to near the knee, that is when death is near. How fast it travels up the legs indicate how fast they will die most of the time.
CHEYNE STOKE BREATHING- deep searching of air intake. Sounds as gasping with periods of apnea in between. Happens before death.
-edema is checked at the sternum as that is the last place the elasticity will leave a body as the skin is very tight against the bone of the sternum.
-bedridden patients are checked for edema at the sacrum as the fluid follows the gravity downwards.
ACITIES- liver function does not work. Found commonly in alcoholics. Is verified by tapping on the side of the stomach cavity (is usually bloated) and a wave like motion goes across the stomach and comes back to the point of origination.
LACTALOSE-a honey thick liquid that is used for acities to reduce fluid accumulation.
-fluid volume deficit and Dehydration are different.
PEDS
-sleep patterns charts may not be individualized
BONE GROWTH-fetal connective tissues converts to cartilage then bone
-the epiphyseal plate has growth of long ones where fusion eventually occurs. Inferior fontanel closes by 11-13 months.
LENGTH- up to two years infants are layed down to get their length.
HEIGHT-is taken standing up.
BODY MASS INDEX (BMI)-body weight in kg divided by height in meters squared.BM= weight (kg)/height(m2)
-infants that are 80-95% on the BMI chart are at risk for obesity. Those less than 5% are at risk for underweight.
NUTRITIONAL HIGHTLIGHTS
Vegetarian diets- are usually high in fiber foods. May cause loss of calcium, zinc, magnesium and iron in the stool. It also fills up the stomach and provides fewer calories and nutrients.
Children are susceptible to nutritional defencesies and grow rapidly so that’s why they need extra calories and intake.
-Raw fruits, nuts, and seeds may not be appropriate choices to offer as they may cause chocking.
-the book mentions to combine calcium with citrus.
KNOW THE SIGNS OF A WELL NOURISHED CHILD-(BOOK)
REVIEW IMPORTANT INFO ON PAGE 376
ORAL CARE- first teeth to emerge in medical incision on lower gums at 6-7 months. Upper ones at 8-12 months.
Do’s and don’ts
-no sticky foods
-need fluoride at 6 months to 13 years
-don’t taste baby’s food
-know toothbrush replacement and care
-tooth trauma first aid
-oral care when platlet count is greater than 20,000. ( because of bleeding gums)
-don’t have bottle at night because it causes nursing caries. (saliva production is less at night which contributes to the sugar from the milk to remain in the mouth)
FLOURIDE PAGE 377
PLAY- the business of children. A must in the care plan when the child is in the hospital. May lead towards recovery faster therapeutically and physically.
DEVELOPMENT OF PLAY-
Infants-explore,imitate
1-2 years- parallel
3-5 yrs- cooperative, creative
5-8 yrs. Symbolic group play, secret clubs
8-10 yrs- competitive (terrible losers)
13-19 yrs. Fantasy, cliques
HIGHTLIGHTS IN CH 16
COLIC, IMMUNIZATIONS, NUTRITION, DEVELOPMENTAL MILESTONES, SAFETY, SIDS
THEORISTS:
PIAGET(cognitive)-0-2 yrs. Senserimotor-learns with senses, objective performance. Develops. Concern for safety appropriate toys/equipment etc. starts with reflexes that mature into actions as the nurological development matures. Are limited to actions they perform. Problems are solved without mental contribution.
OBJECT PERMANENCE- if its in sight its there, out of sight, out of mind. Object perm. starts to develop at 9 months, where the infant knows something exists even though its out of sight.
ERICKSON – trust vs. mistrust- 0-1 yrs. Learn trust based on consistency of care and caregiver. If successful, trust develops and security.
Not successful- inability to trust, insecurities, anxiety etc.
FREUD- oral stage- infants need to suck . Judicious use of a pacifier when not feeding. Pacifiers can be considered self comforting. Teething brings another dimension. When the hand actions develop and mature, pleasure may come from other sources.
COLIC PG 390. KNOW FOR TEST
Colic may be caused by cow’s milk, excessive gas, bowel distention, abnormal intestinal motility, GER gastroesaphageal reflex.
-treatments are mostly dietary changes, eliminate dairy, wheat
DISCLAIMER: THESE ARE STUDENT NOTES TAKEN OF LECTURE INFORMATION PRESENTED IN CLASS AND IS NOT AN OFFICIAL DOCUMENT FROM THE INSTRUCTORS OR THE FACULTY OF RTC. THE INFORMATION PRESENTED MAY NOT BE 100% COMPLETE OF WHAT WAS LECTURED IN CLASS AND SHOULD NOT BE USED AS AN ONLY SOURCE OF INFORMATION FOR ANY TESTS, QUIZ, OR FINAL EXAMS.