DISEASE ASSESMENT FINDINGS MEDICATIONS NSG.

CONSIDERATIONS
Impetigo - Vesicles or pustules - Antibiotic ointments - Use contact precautions
- Highly contagious bacterial surrounded by edema and - Apply warm water
infection of the skin redness compresses to the lesions
caused by beta-hemolytic - Lesions weeping cloudy 2 or 3 times daily, followed
streptococci, serous fluid by mild soap-and-water
staphylococcus aureus, or - Honey-colored crusts rinse to soften crusts for
both. - Pruritus and burning removal and promote
- Most common sites: healing
mouth, hands, neck, - Teach the parents to apple
extremities. antibiotic ointments and
explain that the infection is
communicable for 48
hours after antibiotic
ointment treatments Is
begun
- Separate use of towels,
linens, and dishes
- Linens and clothing should
be washed separately with
detergent in hot water

PEDIATRIC DISORDERS
I. INTEGUMENTARY

DISEASE ASSESMENT FINDINGS MEDICATIONS NSG. CONSIDERATIONS

Pediculosis Capitis (Head Lice)
- Transmitted by way of
direct and indirect contact.
- Most common site:
occipital area; less
frequently, the eyebrows
and eyelashes are affected
DISEASE
- Intense pruritus
- Small, gray specks that
may crawl fast
- Nits, visible as tiny silver or
gray specks resembling
dandruff
ASSESMENT FINDINGS
- Pediculicide shampoo - Remove nits by back-
combing the child’s hair
with a fine-tooth comb
after loosening nits with a
mixture of half vinegar and
half water 1 hour before
back combing.
- Teach the child not to
share clothing, headwear,
or brushes and combs.
MEDICATIONS NSG. CONSIDERATIONS
Scabies
- Caused by infestation with
Sarcoptes scabiei, the itch
mite.
- Transmitted by way of
close personal contact
with an infected person.
DISEASE
- Intense pruritus, especially
at night
- Pustules
- Burrows, which appear as
fine grayish-red lines on
the skin
ASSESMENT FINDINGS
- Scabicide is applied - Importance of
topically. handwashing.
- Seal non-washable toys
and other items in plastic
bags for at least 4 days.
NSG. CONSIDERATIONS/ TREATMENT
Nephroblastoma (Wilms Tumor)
- This tumor of the kidney
may present unilaterally
and localized or bilaterally,
sometimes with metastasis
to other organs.
- Treatment: is a
combination of surgery
(partial to total
nephrectomy) and
chemotherapy with or
without radiation.
II. ONCOLOGICAL
DISEASE
- Abdominal swelling or
mass (firm, nontender,
confined to one side, and
deep within the flank)
- Abdominal pain
- Urine retention
- Hematuria
- Hypertension
- Signs & symptoms of lung
involvement if metastasis
has occurred
ASSESMENT FINDINGS
Before Surgery:
- Monitor VS, particularly blood pressure.
- Avoid palpitation of abdomen, which could disrupt the tumor
capsule, resulting in seeding elsewhere in the body.
- Measure the client’s abdominal girth daily each morning.
After Surgery:
- Monitor temperature for signs and symptoms of infection;
monitor the blood pressure for any changes.
- Monitor for hemorrhage.
- Monitor intake and output closely, particularly urine production.
- Monitory gastrointestinal activity, bowel sounds, stool
production, and abdominal distention.
- Avoid contact sports.
NSG. CONSIDERATIONS/ TREATMENT
Neuroblastoma - Abdominal swelling or Before Surgery:
- An embryonal tumor mass (firm, nontender, - Monitor signs and symptoms related to the location of the
found in children, arises confined to one side, and tumor.
from the neural chest. deep within the flank) After Surgery:
- The abdomen is usually - Abdominal pain - Watch for complications related to the location of the surgery.
the primary site because - Urine retention
the tumor cells arise from - Hematuria
the adrenal gland or - Hypertension
retroperitoneal
sympathetic chain.
- Most presenting signs and
symptoms are caused by
tumor compression of
adjacent normal tissue and
organs.
- Surgery is performed to
remove the tumor as
possible and to obtain
biopsy specimens.

DISEASE ASSESMENT FINDINGS NSG. CONSIDERATIONS/ TREATMENT

Osteogenic Sarcoma
(Osteosarcoma)
- Found in metaphysis of
long bones, especially the
legs; most cases occur in
the femur.
DISEASE
Retinoblastoma
- Malignant tumor of the
embryonic neural retina.
- This tumor of the eye is
found only in children.
- reflected off the retina.
- Signs and symptoms in the - May include surgical resection with limb salvage to remove
earliest stage are almost affected tissue or amputation.
always attributed to - Chemotherapy may be administered both before and after
extremity injury or normal surgery.
growing pains. - If amputation is performed, tell the child about phantom limb
- Localized pain at the site pain (burning aching, or cramping pain in the missing limb)
that may be attributed to - Prosthetic fitting
trauma or the vague
complaint of “growing
pains”; often relieved with
a flexed position.
- Palpable mass
- Limping
- Progressively limited range
of motion with curtailment
of physical activity
- Pathological fractures at
the tumor site
ASSESMENT FINDINGS NSG. CONSIDERATIONS/ TREATMENTS
- A white reflection - Postoperative are of the enucleated orbit entails careful
(leukocoria) is seen in one observations for signs & symptoms of infection, hemorrhage,
of the child’s eyes instead and edema.
of the normal red color - The child will wear a patch over the socket for approximately 1
when a camera flash is week postoperatively.
 DISEASE
Ewing Sarcoma
- The bone tumor is more
often located in the
midshaft of a long bone,
especially the femur, ribs,
and pelvic bones, or in the
vertebrae.
III. METABOLIC & ENDOCRINE
DISEASE
ASSESMENT FINDINGS NSG. CONSIDERATIONS/ TREATMENTS
- Pain - Nursing care is similar to osteosarcoma.
- Swelling of soft tissue
around the affected bone
- Fever
- Anorexia malaise, fatigue,
and weight loss if
metastasis has occurred
- Neurological signs and
symptoms if a vertebral
tumor is present
- Respiratory signs &
symptoms if a rib tumor is
present
ASSESMENT FINDINGS NSG. CONSIDERATIONS/ TREATMENTS
Fever
- Abnormally high body
temperature
DISEASE
Dehydration
- Infants and children are
more vulnerable to fluid-
volume deficit that adults.
- Causes: decreased fluid
intake, diaphoresis,
vomiting, diarrhea,
diabetic ketoacidosis, and
extensive burns.
- Temperature of 38.0 C or - Monitor child’s temperature
higher - Administer antipyretics (acetaminophen, ibuprofen) as
- Flushed skin prescribed.
- Diaphoresis - Do not administer aspirin unless prescribed, because it may
- Chills precipitate the development of Reye’s syndrome.
- Restlessness or lethargy - Provide adequate fluid intake.
- Monitor the child for dehydration and fluid and electrolyte
imbalances.
ASSESMENT FINDINGS NSG. CONSIDERATIONS/ TREATMENTS
- Dry skin and mucous
membranes
- Loss of skin elasticity and
turgor
- Tachycardia
- Sunken eyeballs ad
fontanels
- Weight loss
- Decreased urine output
and increased urine
specific gravity
- Thirst
- Absence of tears
- Changes in level of
consciousness