ABSTRACT
TCAs are an extremely toxic source of poisoning in young children. Overdoses of TCAs can cause coma, seizures, hypotension, cardiac arrhythmias, and cardiac arrest. Treatment is directed at rapid assessment, monitoring, support of vital functions, halting drug absorption, and treating CNS and cardiac toxic effects. All children should be monitored for a minimum of 6 hours, and many require admission to a critical care unit. The mainstay of therapy is alkalinization. Intravenous administration of sodium bicarbonate is the preferred treatment for hypotension, shock, and arrhythmias. Blood pH should be monitored and should be maintained between 7.45 and 7.55. More specific drug therapy, cardioversion, or artificial pacing may be required for refractory arrhythmias. Before the child is discharged from the hospital, strategies to reduce the risk of future poisonings should be discussed with the child's family.
Subject(s)
Antidepressive Agents, Tricyclic/poisoning , Critical Care/methods , Family , Adolescent , Age Distribution , Aged , Child , Child, Preschool , Drug Overdose , Drug Prescriptions , Electrocardiography , Humans , Monitoring, Physiologic/methods , Monitoring, Physiologic/nursing , Nursing Assessment/methods , Poisoning/diagnosis , Poisoning/epidemiology , Poisoning/etiology , Poisoning/therapyABSTRACT
OBJECTIVES: To determine the rate of occurrence of Gardnerella vaginalis in the genital tract and rectum of the asymptomatic prepubertal boy and to examine the effect of circumcision on the rate of recovery. DESIGN: A prospective survey design was used. Cultures for G vaginalis were obtained from the urethral meatus, surrounding glans, and rectum of prepubertal boys. Boys who had a history of sexual abuse, current urogenital symptoms, or who had taken antibiotics in the preceding 2 weeks were excluded from this study. SETTING: The study was conducted in ambulatory clinical settings at a children's hospital within a major medical center that serves as a statewide referral center. PARTICIPANTS: A group of 99 circumcised and uncircumcised prepubertal boys participated in the study. The participants ranged in age from 1 month to 7 years 4 months. MAIN OUTCOME MEASURE: Results of cultures for G vaginalis. RESULTS: No cultures were positive for G vaginalis from the urethra, glans, or rectum in any of the participants in this study. CONCLUSIONS: The findings of this study provide preliminary evidence that G vaginalis is not an organism that commonly colonizes the urogenital or gastrointestinal tract in asymptomatic prepubertal boys. Based on these findings, it does not seem prudent to apply the concept of asymptomatic colonization to prepubertal boys unless further studies refute these findings.
Subject(s)
Gardnerella vaginalis/isolation & purification , Genitalia, Male/microbiology , Rectum/microbiology , Case-Control Studies , Child , Child Abuse, Sexual , Child, Preschool , Circumcision, Male , Humans , Infant , Male , Prospective Studies , Sexually Transmitted Diseases, Bacterial/microbiology , Toilet TrainingABSTRACT
Intervertebral disk calcification in children can result in a syndrome of neck pain, muscle spasm, and torticollis. Usually the clinical course is benign with spontaneous recovery; however, occasionally nerve root or spinal cord compression can be seen. We report a seven-year-old patient with symptomatic cervical disk calcification and briefly discuss the salient clinical and radiographic features.
Subject(s)
Calcinosis/complications , Cervical Vertebrae , Intervertebral Disc , Spinal Diseases/complications , Torticollis/etiology , Calcinosis/diagnostic imaging , Cervical Vertebrae/diagnostic imaging , Child , Humans , Intervertebral Disc/diagnostic imaging , Male , Radiography , Spinal Diseases/diagnostic imaging , Torticollis/therapyABSTRACT
The purpose of this study was to examine content validity of two nursing diagnoses in the home health setting: impaired skin integrity and altered urinary elimination: total incontinence. Eighty-two home health nurses rated the importance of each of the defining characteristics for the two nursing diagnoses. Diagnostic content validity scores (DCV) were calculated for each defining characteristic for both diagnoses using the method described by Fehring (1986). Four characteristics for each diagnosis had DCV scores greater than .75, indicating characteristics were critical indicators for the diagnosis. Erythema, denuded skin, disruptions of dermal and epidermal tissue, and lesions were critical indicators for impaired skin integrity. Lack of awareness of incontinence, constant flow of urine, lack of awareness of bladder cues to void, and incontinence refractory to other treatments were critical indicators for alteration in urinary elimination: total incontinence.
Subject(s)
Community Health Nursing , Home Care Services , Nursing Diagnosis/standards , Skin Diseases/nursing , Urinary Incontinence/nursing , Adult , Aged , Attitude of Health Personnel , Humans , Middle Aged , Nursing Evaluation Research , Nursing Staff/psychology , Reproducibility of ResultsABSTRACT
The purpose of this study was to examine the relationship among selected demographic and psychosocial family characteristics and family functioning and to identify which combination of variables best predicts family functioning when a child has attention deficit disorder. Seventy-six mothers and 47 fathers from 79 families participated in the study. The target child had been previously diagnosed with attention deficit disorder either with or without hyperactivity and aggressive symptoms. A significant correlation between family functioning and age of the hyperactive child was supported. Families of older children reported poorer functioning, and parenting competence was negatively related to parental perception of the child's behavior. Older age of the child in combination with higher levels of impulsivity/hyperactivity were significant in predicting family functioning.
