The nurse is caring for Troy, a. 6-year-old boy who has juvenile idiopathic arthritis( JIA) and is being treated with methotrexate daily to control his pain. He was diagnosed with a strep infection four days ago. He now has a low-grade fever, tea colored urine, and some swelling around his eyes. He is admitted for acute glomerulonephritis( AGN). He weight 48 pounds.

1) identify the therapeutic and nursing management that would be included in Troy's plan of care given his diagnoses.

2) define the complications of both his chronic and acute illnesses that are priorities for nursing management and the corresponding interventions.

3) describe how the therapeutic drug management for his JIA may have contributed to Troy's recent strep infection and any nursing interventions that can be suggested

4) Troy is order 40mg/kg/day of amoxicillin BID. The suspension comes in a concentration of 400mg/5ml

calculate the daily dose of amoxicillin Martin will receive in mg.

how many mg will the nurse administer at each dose?

how many milliters will the nurse administer at each dose?

1. Steven, a 4-year-old boy, is seen in the pediatric office for a well-child exam. He is a healthy, active boy who attends extended-day preschool as his mother works long hours. His mother states she has some questions about Steven. She says she is concerned about Steven’s growth, his language skills, and disciplining him. Steven’s mother tells you that “he seems heavier than my other children did at his age.” Upon measuring Steven you note his height to be 38.5 inches (98 cm) and his weight to be 46 pounds (20.9 kg). His calculated BMI of 21.76 plots well above the 95^th percentile for age. After further discussion with Steven’s mother, you determine that he has an excessive daily intake of fruit juice and whole milk, and eats numerous fast-food meals weekly.

1. Describe teaching about diet and activity that you will do with Steven’s mother.

Steven’s mother asks if there is something wrong with Steven because he stutters and says “um” a lot.

2. What type of education or support will you give Steven’s mother?
3. When questioned about the type of discipline used in the home, Steven’s mother states that she feels bad when she spanks him, because he becomes so withdrawn afterwards and that it doesn’t really seem to work anyway. She states she just doesn’t know what else to do. What kind of anticipatory guidance can you provide?

2. Gina has come into the primary care center with her mother Kris for an 11-year-old wellness examination. As the nurse prepares Gina for her examination, Kris asks to speak to the nurse outside the examination room. Kris shares with the nurse her concerns about recent changes she has noticed in Gina. She explains that Gina’s body is beginning to change and she has made a number of comments about her body image. Kris is concerned about Gina’s self-esteem and emotional development.

a. What are some of the prepubescent changes school-age children experience that the nurse can share with Kris?

b. What are some of the issues regarding body image that the nurse can teach Kris about?

c. What can the nurse teach Kris regarding self-esteem in school-age children to address her concerns?

A 10-year-old boy presented to a new pulmonary physician for evaluation. His mother stated that his primary condition was asthma. He had developed respiratory symptoms at 2 months of age, had been seen by many specialists, and had been on multiple medications since that time. The pregnancy was uneventful. When he was 2 months old, he developed a recurrent cough. He was started on albuterol and then, at 6 years of age, switched to levalbuterol hydrochloride. At various times he has also been treated with cromolyn sodium, fluticasone proprionate and salmeterol, and montelukast as well as with a short course of prednisolone for exacerbations. His last course of oral steroids was 9 months ago. The hallmark of his illness was that a cold would always trigger his asthma. He had approximately one emergency department visit per year, but he had never been hospitalized. His asthma symptoms would typically worsen with the weather changes in the spring and fall; the cold winter months were often particularly difficult. In addition to his asthma, his medical history was remarkable for several events of otitis media, seasonal mold allergies, occasional headaches, and croup. One or more of the events occurred about three times a year, lasting approximately 3 days for each episode. His current medications include 1 inhalation of com- bination fluticasone proprionate and salmeterol in the 250/50 strength twice daily and 2 to 4 inhalations of levalbuterol as needed. This visit was scheduled in the hopes of decreasing this child’s episodes of illness, assessing the current medication regimen, and discussing new treatment opportunities.

1. What role does fluticasone proprionate and salmeterol serve in controlling this child’s asthma symptoms?

Daniel: Susan and Joe had a wonderful little boy named Daniel, but he had been having an awful lot of bacterial infections and he was barely a year old. It seemed that the antibiotics cleared up one bacterial respiratory infection only to have another follow shortly. The scary thing was that Daniel had just fought off a case of pneumonia caused by Pneumocystis carnii, a fungal infection that was usually found in people with HIV. Waiting for the test results of an HIV test for their little boy was one of the worst experiences ever. Thank goodness it came back negative. However, it seemed that their troubles were just beginning. After this last lung infection, the fungal one, and a negative HIV test, their doctor had ordered a number of other blood tests, including a genetic test that Susan didn’t fully understand. Apparently the doctor was worried about Daniel’s immune system functions. Susan had also met with a genetic counselor who collected a family history of any immune disorders. The details were vague, but Susan’s mother, Helen, knew that one of her three brothers had died young from an unexplained lung infection. Unfortunately, Grandma Ruth had passed away a few years ago, leaving them with numerous unanswered questions. Susan and Joe had an appointment with their doctor that afternoon to go over the results. When they arrived Dr. Dresdner led them into an office where Ms. Henchey, the genetic counselor, waited. This can’t be good, thought Susan. The doctor began by explaining that they had analyzed Daniel’s blood and found that while he had normal levels of B cells and T cells, his antibody levels were anything but normal. The levels of IgG, IgA, and IgE were very low, almost undetectable, and Daniel had abnormally high levels of IgM and IgD. It appears that his immune system failed to undergo immunoglobulin isotype switching due to a CD40 ligand mutation in Daniel's DNA. Diagram an antibody response graph for a normal 1st and 2nd exposure with the antibodies correctly labeled for each exposure. Then diagram what Daniel's graph would look like, based on his situation. Diagram and/or explain why IgG is low and what CD40's role is? Why is a mutation in that gene a problem? (There is no specific diagram I am looking for here, either diagram it or explain it, depending on which you prefer.)

Charlie is an 8-year-old boy who is having difficulty making friends and sitting still in class. When he goes to school, his teacher complains that he can't sit still. He will sit for 3 minutes but soon after he starts bouncing his leg, and then he begins tapping his pencil. Shortly thereafter, he starts rapping lyrics under his breath. He is performing well in school, but his behavior is distracting others.

Charlie isn't hyperactive like this at home, but his mother is concerned. His mother wants you to prescribe him Xanax for anxiety and Adderall for ADHD. After you do an extensive interview with Charlie, you realize that he is just bored in his U.S History class and would rather be playing basketball in P.E.

However, Charlie's mother insists that you write a few prescriptions. Research suggests that medical professionals (Doctors, Nurse Practitioners, Physician Assistant's, etc.) are often pressured to write prescriptions even when they don't believe that it is the best thing to do for the patient.

Your investigation has led you to believe that Charlie just needs more physical exercise. But his mother continues to insist that Charlie needs medication. How would you explain to his mother what you plan to do?

Use your investigation skills and present your facts to her. Be sure to incorporate at least 1 developmental theory covered in this week's readings to support your argument.

Charlie is an 8-year-old boy who is having difficulty making friends and sitting still in class. When he goes to school, his teacher complains that he can't sit still. He will sit for 3 minutes but soon after he starts bouncing his leg, and then he begins tapping his pencil. Shortly thereafter, he starts rapping lyrics under his breath. He is performing well in school, but his behavior is distracting others. Charlie isn't hyperactive like this at home, but his mother is concerned. His mother wants you to prescribe him Xanax for anxiety and Adderall for ADHD. After you do an extensive interview with Charlie, you realize that he is just bored in his U.S History class and would rather be playing basketball in P.E. However, Charlie's mother insists that you write a few prescriptions. Research suggests that medical professionals (Doctors, Nurse Practitioners, Physician Assistant's, etc.) are often pressured to write prescriptions even when they don't believe that it is the best thing to do for the patient. Your investigation has led you to believe that Charlie just needs more physical exercise. But his mother continues to insist that Charlieneeds medication. How would you explain to his mother what you plan to do? Use your investigation skills and present your facts to her. Be sure to incorporate at least 1 developmental theory to support your argument.

Charlie is an 8-year-old boy who is having difficulty making friends and sitting still in class. When he goes to school, his teacher complains that he can't sit still. He will sit for 3 minutes but soon after he starts bouncing his leg, and then he begins tapping his pencil. Shortly thereafter, he starts rapping lyrics under his breath. He is performing well in school, but his behavior is distracting others.

Charlie isn't hyperactive like this at home, but his mother is concerned. His mother wants you to prescribe him Xanax for anxiety and Adderall for ADHD. After you do an extensive interview with Charlie, you realize that he is just bored in his U.S History class and would rather be playing basketball in P.E.

However, Charlie's mother insists that you write a few prescriptions. Research suggests that medical professionals (Doctors, Nurse Practitioners, Physician Assistant's, etc.) are often pressured to write prescriptions even when they don't believe that it is the best thing to do for the patient.

Your investigation has led you to believe that Charlie just needs more physical exercise. But his mother continues to insist that Charlie needs medication. How would you explain to his mother what you plan to do?

Use your investigation skills and present your facts to her. Be sure to incorporate at least 1 developmental theory covered in this week's readings to support your argument.

Multiple choice questions

1. Tetrad of foetal defect is due to viral infection. Its not characterized by
A. Cataract
B. Heart effect
C. Mental retardation
D. Cleft feet

2. Maternal diabetes can result in
A. Malformation
B. Cleft lip
c. congenital dislocation of hip
D. Organomegaly

3.A man is therapist at Radiotherapy Department at KBTH. Which of the following findings would you consider most relevant in a man’s past history to indicate a risk factor for a neoplasm he’s developed which no family member is suffering from
A. Chronic alcoholism
B. Radiation exposure in childhood
C. Ataxia telangiectasia
D. Occupational exposure

4.   Hyaline droplet degeneration is
a. Accumulation of bad protein inside a cell
b. Accumulation of good protein inside a cell
c. Accumulation of glycogen inside a cell
d. Accumulation of good protein outside a cell

5. Intracellular deposition of calcium is an indication of

a. Good cardiac output
b. Ischaemia
c.Cell death
d. Infarction

6. Hypoxic injury is characterized by
a. Loss of oxidative phosphorylation and b. ATP generation by mitochondria
c Karyohexis
d. Abundant glycogen
e. Increased ATP

7 The most critical factor in determining whether the skin will regenerate following burn injury is the presence of
a. Good cardiac output
b. Skin appendages
c. Minimal oedema
d. Granulation tissue

8. Events that happen at the site of acute inflammation are the following except
a. Change in vascular caliber and flow
b. Increased vascular permeability
c. Fluid and cellular exudation
d. Endogenous enzymes digestion