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Level 3 > Families exam 4 - psychosocial and integumentary > Flashcards

Families exam 4 - psychosocial and integumentary Flashcards

1
Q

How should new situations be introduced to a patient with autism?

A

slowly

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2
Q

What should you monitor for in a patient with autism?

A

behavioral changes

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3
Q

How should you communicate with a patient with autism?

A
  • age-appropriate
  • brief
  • concrete
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4
Q

What should be promoted/encouraged for a patient with autism?

A
  • positive reinforcement
  • increasing social awareness
  • verbal communication
  • setting realistic goals
  • opportunities for small successes
  • setting clear rules
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5
Q

What are expected findings of ADHD?

A
  • inattention
  • hyperactivity
  • impulsivity
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6
Q

What type of approach should be used for a patient with ADHD?

A
  • calm
  • firm
  • respectful
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7
Q

What should be modeled for a patient with ADHD?

A

acceptable behavior

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8
Q

What should you have before giving a child with ADHD directions?

A

their attention

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9
Q

What kind of explanations should be given to a patient with ADHD?

A

short and clear

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10
Q

What should you set/provide for a patient with ADHD?

A
  • set clear limits
  • provide consistency
  • provide positive feedback and rewards for good behavior
  • provide a safe environment
  • assist with developing coping mechanisms
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11
Q

How should the environment be modified for a patient with ADHD?

A
  • structured
  • decrease stimuli
  • use organizational charts
  • have a consistent study area
  • use steps when assigning chores
  • use pastel colors
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12
Q

What medications are used for ADHD?

A
  • methylphenidate, dextroamphetamine (psychostimulants)
  • atomoxetine (SNRI)
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13
Q

What are parental characteristics of child abuse?

A
  • young parents
  • single parents with a partner unrelated to the child
  • low income
  • low self-esteem
  • lack of knowledge
  • substance use disorder
  • history of abuse
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14
Q

What are child characteristics of child abuse?

A
  • < 1 year old
  • unwanted
  • hyperactive
  • physical/mental disabilities
  • premature infant
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15
Q

What can injuries in various stages of healing mean?

A

child abuse

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16
Q

What are behavioral characteristics of a child experiencing child abuse?

A
  • fear of parents
  • lack of emotional response/reaction
  • withdrawn
  • aggression
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17
Q

What is the most important thing to assess with a child who has depression?

A

actual/potential risk to self
- suicide plan
- lethality of the plan
- means to carry out the plan

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18
Q

Where can candidiasis be found?

A

moist areas
- mouth
- belly
- skin
- vagina

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19
Q

What is used to treat candidiasis?

A

topical antifungal ointment (miconazole/fluconazole, nystatin)

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20
Q

What color is crust that forms with impetigo?

A

honey-colored

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21
Q

Where does impetigo usually happen?

A

on the face around the mouth and nose

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22
Q

What medication is used for less severe cases of impetigo? How long must you use this before you are no longer contagious?

A
  • topical bactericidal or triple antibiotic ointment
  • not contagious are 48 hours
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23
Q

What medication is used for more severe cases of impetigo? How long must you use this before you are no longer contagious?

A
  • oral antibiotics
  • not contagious after 24 hours
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24
Q

What should be done before applying ointment to impetigo?

A

remove crusts with warm water and antibacterial soap

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25
Q

Can you share items (towels, hate, combs, brushes, towels) with impetigo?

A

NO

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26
Q

What is the ost important thing for the nurse and family to do for impetigo?

A

hand hygiene!!!

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27
Q

What type of shampoo is used for lice?

A

1% permethrin shampoo

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28
Q

What should not be shared if a child has lice?

A
  • combs/brushes
  • hair ties/clips
  • hats
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29
Q

How should nits be removed?

A

with a fine-tooth nit comb

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30
Q

How long should items that cannot be washed be bagged up if a child has lice?

A

14 days

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31
Q

How should items be washed if a patient has lice?

A

in hot water with detergent and in a hot dryer for 20 mins

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32
Q

How should items be washed is a patient has impetigo?

A

on hot with bleach

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33
Q

What does a diaper rash look like?

A
  • bright red
  • scaly
  • pimples, blisters, ulcers, large bumps, pus-filled sores
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34
Q

What should be used to clean the perineal area with a diaper rash? How should it dry?

A

non irritating cleanser, let air dry

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35
Q

What type of diapers should be used for diaper rash?

A

superabsorbent disposable diapers

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36
Q

What skin barriers can be used for diaper rash?

A
  • zinc oxide
  • petroleum ointement
  • aluminum acetate solution
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37
Q

Should you wash off the skin barrier with each diaper change?

A

NO

38
Q

What can diaper rash be a sign of?

A

neglect

39
Q

What type of ointments cannot be used for diaper rash?

A

corticosteroid ointments

40
Q

What is considered open acne? What is considered closed acne?

A
  • open: blackheads
  • closed: whiteheads
41
Q

Where is acne most common?

A
  • face
  • back
  • neck
  • chest
42
Q

What type of compress is used for acne?

A

warm

43
Q

What must be determined before starting isotretinoin?

A

if the pt is sexually active

44
Q

What should you monitor for with isotretinoin?

A

behavioral changes
- s/sx of depression
- suicidal ideation
- violent behavior
- feelings of isolation

45
Q

What should be encouraged to help with acne?

A
  • balanced/healthy diet
  • sleep/rest
  • daily exercise
  • frequent shampooing
  • washing affected areas 1-2x/day
46
Q

What should be avoided with acne?

A
  • scrubbing
  • abrasive cleansers
  • tanning beds
47
Q

What are adverse effects of taking isotretinoin?

A
  • dry skin/eyes/mucous membranes
  • decreased night vision
  • HA
  • photosensitivity
48
Q

What happens to cholesterol levels when taking isotretinoin?

A

increased cholesterol and triglycerides

49
Q

Why is isotretinoin contraindicated in women of childbearing age who are not taking oral BC?

A

it is TERATOGENIC!!!

50
Q

If sexually active, what actions have to be taken with isotretinoin?

A

must use 2 forms of contraception for 1 month before, during, and 1 month after tx

51
Q

When does stage 1 of lyme disease occur?

A

3-30 days after the bite

52
Q

When does stage 2 of lyme disease occur?

A

3-10 weeks after the bite

53
Q

When does stage 3 of lyme disease occur?

A

2-12 months after the bite

54
Q

What is the “bull’s eye” rash, and when does it occur?

A
  • erythema migrans at the site of the tick bite
  • stage 1 of lyme disease
55
Q

What other s/sx occur in stage 1 of lyme disease?

A
  • HA
  • muscle weakness/myalgias/stiff neck
  • chills/fever/fatigue
  • itching
56
Q

When does systemic involvement begin with lyme disease?

A

stage 2

57
Q

What neurologic symptoms occur in stage 2 of lyme disease?

A
  • cranial nerve palsies (Bell’s)
  • meningitis
58
Q

What musculoskeletal symptoms occur in stage 2 of lyme disease?

A
  • facial weakness/paralysis
  • muscle pain
  • swelling in large joints (knees)
59
Q

What cardiovascular symptoms occur in stage 2 of lyme disease?

A
  • myocarditis
  • AV block
60
Q

When does splenomegaly occur with lyme disease?

A

stage 2

61
Q

When does arthritis occur with lyme disease?

A

stage 3

62
Q

What symptoms occur with stage 3 of lyme disease?

A
  • numbness and tingling (neuropathy)
  • arthritis
  • encephalopathy
  • deafness
  • speech problems
63
Q

What antibiotics are given for stage 1 of lyme disease?

A
  • doxycycline (children 8+)
  • amoxicillin (children >8)
  • cefuroxime (children >8)
64
Q

What antibiotic can be given within 72 hours of the tick bite as a single dose?

A

doxycycline

65
Q

What antibiotic os given for stage 2-3 lyme disease?

A

ceftriaxone

66
Q

How can tick bites be prevented?

A
  • avoid tall grass
  • use insect repellant
  • avoid contact with insects
  • avoid woodpiles
  • inspect and treat pets, carpet, furniture
  • avoid flowery prints and bright clothing
  • avoid perfumes and colgnes
67
Q

What are the priorities for burns?

A
  • stop the burn
  • prevent infection
  • fluid replacement
  • manage pain
  • maintain homeostasis and body temp
68
Q

What does a third-degree/full-thickness burn damage/destroy?

A
  • entire epidermis
  • dermis
  • possible damage to SQ tissue
  • nerve endings
  • hair follicles
  • sweat glands
69
Q

What color are third-degree burns?

A

red to tan, black, brown, or waxy white

70
Q

What do third degree burns feel like?

A

dry and leathery

71
Q

What happens as a third-degree burn heals?

A
  • might not be painful at first
  • as burn heals pain returns and the severity increases
72
Q

How long does it take for a third-degree or fourth-degree burn to heal?

A

weeks to months

73
Q

Do third-degree burns require grafting?

A

yes

74
Q

What is damaged by fourth-degree/deep-full thickness burns?

A

all layers of the skin extending to the muscle, fascia, and bones

75
Q

What does a fourth-degree burn feel/look like?

A
  • dull and dry
  • color variable
  • possible visible ligaments, bones, or tendons
76
Q

Is pain present with fourth-degree burns?

A

no

77
Q

What is the tx for fourth-degree burns?

A
  • autografting
  • possible amputation
78
Q

What causes a thermal burn?

A
  • flames
  • hot surfaces/liquids
79
Q

What gets damaged with a thermal burn?

A
  • face/lips
  • tracheobronchial tree
80
Q

What s/sx occur with thermal burns?

A
  • wheezing
  • increased secretions
  • hoarseness
  • wet rales
  • singed nasal hairs
  • laryngeal edema
  • carbonaceous secretions
81
Q

What should you avoid putting on the burn?

A
  • ice
  • greasy lotion/butter
82
Q

How should a burn be cleansed?

A
  • cool/tepid water
  • mild soap
83
Q

What should be put on the burn after it is cleaned?

A
  • antimicrobial ointment
  • dressing
84
Q

What immunization might be needed for a burn?

A

tetanus

85
Q

What is the priority for major burns?

A
  • maintaining the airway and ventilation
  • humidified O2 at 100%
86
Q

When should dressing changes be done for major burns?

A
  • with scheduled analgesia
87
Q

How can infection be prevented with major burns?

A

reverse isolation: protect them from what we might have

88
Q

What nutrition should be increased with major burns?

A
  • protein and calories
  • vitamin A, C, zinc
89
Q

What s/sx of septic shock should be reported for burns?

A
  • confusion
  • increased cap refill
  • spiking fever
  • tachycardia
  • tachypnea
  • decreased urine output
  • mottled/cool extremities
  • decreased bowel sounds
90
Q

What s/sx of infection should be reported for burns?

A
  • discoloration
  • edema
  • odor
  • drainage
91
Q

What is the parkland formula?

A

volume of LR solution = 4 mL x BSA% x weight (kg)
- give half of the solution for the first 8 hours
- give the other half of the solution for the next 16 hours

Level 3 (29 decks)

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