Used in pts with stubborn arthritis not responded to NSAIDS SE potential for

Used in pts with stubborn arthritis not responded to

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Used in pts with stubborn arthritis, not responded to NSAIDSSE: potential for inc infection, malignancy risks, liver/lung toxicity, & birth defectsCyclophosphamidePotent immunosuppressive chemotherapy agent, used in combo with corticosteroidsNeed education session about benefits and risks- infertility and future malignancy Mycophenolate mofetilPurine inhibitor-For active lupus & lupus nephritisSE: Inc infection risk, liver toxicity, & birth defects--> sexually active females need to be on effective birth controlNursing care management**Minimize exacerbationsAvoid sun: sunscreen (SPF >30), hats, & protective clothing“Slip, slop, slap” rule= slip on a shirt, slop on sunscreen, & slap on a hatPromote normal growth and developmentDiet, exercise, and restBalanced diet that does not exceed calorie expenditureLow salt diet: If pt= nephrotic or hypertensive
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Low fat diet: If pt=dyslipidemiaDiet rich in calcium & vitamin D=prevent osteoporosisTherapy compliancePatient social and family supportDiscuss importance of infection control, diet, adolescent image (wt gain), SE of meds-nutritional counseling (2) Key points for a child with an allergic reaction-anaphylaxis.Anaphylaxis:Acute clinical syndrome resulting from interaction of an allergen in a hypersensitive patientPathophysiologyResult of an interaction between an allergen and a preexisting specific IgE=histamine release causes vasodilation and increased capillary permeability allowing fluid to leak into the interstitial space, vasospasm, bronchoconstriction. Get increase venous pooling, reduced arterial pressure and rapid fluid loss in interstitial spaces causing decrease venous returnClinical manifestationsOccurs seconds to minutes after exposure, feelings of uneasiness, impending doom; flushing, feeling warm, urticaria and angioedema. Sometimes loss of consciousnessTherapeutic managementVentilation (HOB elevated)Restoring adequate circulation Preventing further exposure-remove antigen, fluids, oxygen, beta-agonists, antihistamines and corticosteroids. Mild with antihistamines (Benadryl or cetirizine)Nursing care managementRecognize and intervene; IVF’s, I&O, vital signsIM epinephrine= 1st line of therapyPrevention is primary goalQuality patient outcomes: Early recognition, airway patency maintained, adequate circulation restored and maintained, further exposure to allergen preventedPractice Questions1.An 11-month-old male child has been admitted to the cardiac section of a pediatric hospital after having a high fever, peeling of his hands and feet, and a bright red “strawberry tongue” for the past 3 days. Kawasaki disease (KD) is suspected. Initial treatment with intravenous antibiotics has not decreased the fever. What therapy would the nurse expect to administer?
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