Editing Pediatric Nursing (section)

=== Other frequently tested conditions ===

* '''Sickle cell disease:''' vaso-occlusive crisis is managed with hydration, oxygen, warmth, and scheduled analgesia including opioids. '''Cold, dehydration, infection, stress, and high altitude precipitate crises.''' Never apply cold to a painful area. Splenic sequestration presents with a rapidly enlarging spleen and shock and is an emergency.
* '''Cystic fibrosis:''' thick secretions affect lungs, pancreas, and reproductive tract. Findings include meconium ileus in the newborn, steatorrhea, failure to thrive despite a large appetite, and a positive '''sweat chloride''' test. Give '''pancreatic enzymes with every meal and snack''', a high-calorie, high-protein diet, and airway clearance therapy.
* '''Type 1 diabetes mellitus:''' teach carbohydrate counting, rotation of injection sites, sick-day rules, and hypoglycemia treatment with 15 grams of fast-acting carbohydrate. Adolescents may omit insulin for weight control or peer reasons; assess for this.
* '''Nephrotic syndrome''' presents with '''massive proteinuria, hypoalbuminemia, and generalized edema with periorbital swelling worst in the morning'''; corticosteroids are the mainstay. '''Acute post-streptococcal glomerulonephritis''' presents 1 to 3 weeks after a streptococcal infection with '''tea-colored or smoky urine, hypertension, mild edema, and only modest proteinuria'''.
* '''Reye syndrome:''' acute encephalopathy with fatty liver change linked to salicylate use during viral illness. Therefore '''aspirin is avoided in children with viral illness such as influenza or varicella''' unless specifically indicated as in Kawasaki disease.
* '''Congenital heart disease:''' signs of heart failure in infants include '''poor feeding, diaphoresis while feeding, tachypnea, tachycardia, and poor weight gain'''. In tetralogy of Fallot, a hypercyanotic "tet" spell is managed by placing the infant in the '''knee-chest position''' and giving oxygen while calming the child.