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Pediatric Nursing > Exam 2 (Chapters 10-13, 19-21, 23) > Flashcards

Exam 2 (Chapters 10-13, 19-21, 23) Flashcards

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1
Q

Significant Stressors for Hospitalized Children

A

Separation from parents

Loss of self-control, autonomy, and privacy

Painful and/or invasive procedures

Fear of bodily injury and disfigurement

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2
Q

Infant Hospitalization Stressors

A

Separation anxiety (biggest one)

Stranger anxiety

Painful, invasive procedures

Immobilization

Sleep deprivation, sensory overload

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3
Q

Infant Responses to Hospitalization

A

Sleep-wake cycle is disrupted

Feeding routines disrupted

Displays excessive irritability

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4
Q

Toddler Hospitalization Stressors

A

Separation anxiety

Loss of self-control

Immobilization

Painful, invasive procedures

Bodily injury or mutilation

Fear of the dark

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5
Q

Toddler Responses to Hospitalization

A

Cries if the parent leaves the bedside

Frightened if forced to lay supine

Wonders why parents do not come to the rescue

Associates pain with punishment

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6
Q

Preschooler Hospitalization Stressors

A

Separation anxiety and fear of abandonment

Loss of self-control

Bodily injury or mutilation

Painful, invasive procedures

Fear of the dark and monsters

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7
Q

Preschooler Responses to Hospitalization

A

Displays difficulty separating reality from fantasy

Fears ghosts and monsters

Fears body parts will leak out when skin is not intact

Fears that tubes are permanent

Demonstrates withdrawal, projection, aggression, and regression

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8
Q

School-Age Child Hospitalization Stressors

A

Loss of control

Loss of privacy and control over bodily functions

Bodily injury

Separation from family and friends

Painful, invasive procedures

Fear of death

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9
Q

School-Age Child Responses to Hospitalization

A

Displays increased sensitivity to the environment

Demonstrates detailed recall of events to self and other patients

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10
Q

Adolescent Hospitalization Stressors

A

Loss of control

Fear of altered body image, disfigurement, disability, and death

Separation from peer group

Loss of privacy and identity

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11
Q

Adolescent Responses to Hospitalization

A

Displays denial, regression, withdrawal, intellectualization, projection, and displacement

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12
Q

Assisting Infant Through Procedure

A

Before: explain procedure, allow parents option of being there, let parents have contact

During: nursing staff should immobilize infant, perform procedure quickly, ask parents to have contact after procedure

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13
Q

Assisting Toddler Through Procedure

A

Before: give explanations of procedure and say toddler did nothing wrong

During: perform in treatment room, give short explanations and directions, immobilize toddler, allow child to cry

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14
Q

Assisting Preschooler Through Procedure

A

Before: give simple explanations, allow child to touch equipment

During: perform in treatment room, give short explanations, allow child to cry, encourage drawing afterwards

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15
Q

Assisting School-Age Child Through Procedure

A

Before: give clear explanations, teach stress reduction techniques

During: be ready to immobilize child, explanations throughout, facilitate stress control techniques, give praise

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16
Q

Assisting Adolescent Through Procedure

A

Before: give explanations, teach stress reduction, explore fear of certain procedures

During: assist in self-control, explain expected outcome

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17
Q

Conditions Dependent on Medications or Special Diet

A

Diabetes mellitus, asthma, seizures, PKU, organ transplantation, CF, celiac disease

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18
Q

Conditions Dependent on Medical Technology

A

Renal failure, bronchiopulmonary dysplasia

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19
Q

Conditions that Require Increased Use of Healthcare Services

A

Cancer, sickle cell disease, CF

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20
Q

Conditions that Cause Functional Limitations

A

Down syndrome, brain injury, autism, myelodysplasia, cerebral palsy

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21
Q

Brain Death Criteria

A

Child must be unresponsive in an irreversible coma from a known cause and have absence of brainstem reflexes

Apnea testing must reveal hypercarbia

Must be confirmed that child does not have hypothermia, conditions, or medications that could contribute to brain death findings

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22
Q

Infants and Death

A

Sensorimotor: senses emotions of caregivers and altered routines, senses separation

Resists cuddling and eats less, may have feeding problems, cries excessively, sleeps more than usual

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23
Q

Toddlers and Death

A

Preoperational: no understanding of death, aware someone is missing, unable to distinguish death from temporary separation

Regresses to younger stage of development, clingy, whiny, irritable, problems with eating and sleeping, fearfulness

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24
Q

Preschoolers and Death

A

Preoperational: believes death is temporary, experiences magical thinking, confuses death with being away, has beginning experience with death of animals

Regression to earlier developmental stage, bowel/bladder control issues, tantrums, withdrawal from activities, fear of sleep, asks a lot of questions, abdominal pain

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25
School-Aged Children and Death
Concrete Operations: understands what death is, knows it's permanent, may have guilt or assume blame for death Crying, moody, decreased concentration on schoolwork, psychosomatic complaints, may fear another loved one will die
26
Adolescents and Death
Formal Operations: understands death, sense of invincibility conflicts with fear of death, able to recognize effect of death on others May have severe depression, may seek comfort from friends, eating/sleeping problems, may act-out, may assume responsibility
27
Infectious Conjunctivitis
Viral or bacterial Viral: chlamydia, gonorrhea, herpes (can cause blindness) Bacterial: staphylococcus, haemophilus, streptococcus, moraxella
28
Periorbital Cellulitis
Bacterial infection of the eyelid and surrounding tissue caused by streptococcus or staphylococcus S/S: Swollen, tender, red/purple eyelids, restricted and painful movement of the eye, fever Tx: IV antibiotics
29
Hyperopia
Farsightedness All children have some degree until 9-10 years of age Blurring only occurs with excessive hyperopia Amblyopia can occur if treatment is not obtained
30
Myopia
Nearsightedness Most commonly develops at about 8 years of age Children may complain of headaches and squint to improve distance vision
31
Astigmatism
Child often holds pages very close to the face in order to obtain the best visual image
32
Strabismus
S/S include squinting and frowning when reading, closing one eye to see, having trouble picking up objects, dizziness, headache Corneal light reflex and cover-uncover tests to confirm Most common in children with cerebral palsy, hydrocephalus, Down syndrome, and seizure disorder
33
Amblyopia
Lazy eye Caused by untreated strabismus, congenital cataracts, or uncorrected refractive errors Tx: compensatory lenses, occlusion therapy, vision therapy, atropine drops
34
Retinopathy of Prematurity
Occurs when immature blood vessels of the retina constrict and become necrotic May occur in infants of low birth weight or of short gestation Associated with oxygen therapy
35
Otitis Media
Bulging tympanic membrane, air/fluid bubbles behind tympanic membrane, immobile/poorly mobile tympanic membrane, red tympanic membrane, reduced visibility
36
Otitis Media with Effusion
Tympanic membrane is retracted or neutral, immobile/partly mobile tympanic membrane Difficulty hearing or responding as expected to sounds
37
Nasopharyngitis
URI causes inflammation and infection of the nose and throat and is a common illness in infancy and childhood Red nasal mucosa with clear nasal discharge and an infected throat with enlarged tonsils
38
Sinusitis
Inflammation of one or more of the paranasal sinuses History of URIs is common, persistent cough from postnasal drip Malodorous breath, fever, mouth breathing, hyponasal speech, cervical lymphadenopathy
39
Pharyngitis
Infection that primarily affects the pharynx, including the tonsils Major complaint is a sore throat Minimal throat redness, exudate, mild lymphadenopathy, and low-grade fever are also common
40
Tonsillitis
Infection or inflammation of the palatine tonsils Frequent throat infections with breathing and swallowing difficulties, persistent redness of the anterior pillars, and enlargement of the cervical lymph nodes
41
Adenoiditis
Nasal stuffiness, discharge, postnasal drip
42
Initial Signs of Respiratory Failure
Restlessness, tachypnea, tachycardia, diaphoresis
43
Early Decompensation of Respiratory Failure
Nasal flaring, retractions, grunting, wheezing, anxiety, irritability, mood changes, headache, hypertension, confusion
44
Severe Hypoxia and Imminent Respiratory Arrest
Dyspnea, bradycardia, cyanosis, stupor, coma
45
Apnea
Cessation of respiration lasting longer than 20 seconds, or any pause in respiration associated with cyanosis, marked pallor, hypotonia, or bradycardia
46
Acute Spasmodic Laryngitis
Croup syndrome Least serious Abrupt nighttime onset, resolves over 24-48 hours Afebrile, mild respiratory distress, no signs of respiratory infection
47
Laryngotracheobronchitis
Caused by RSV virus Gradual onset as a URI, progressing to respiratory distress and potential airway obstruction over 24-48 hours Increased RR, stridor, normal expiration, no retractions, no apnea
48
Bacterial Tracheitis
Caused by staphylococcus, moraxella, haemophilus Progressive over 2-5 days, may present like LTB initially, but worsens High fever, URI, stridor, purulent secretions, toxic appearance, dysphagia
49
Epiglottitis
Caused by haemophilus, streptococcus, staphylococcus Progresses rapidly, may progress to complete airway obstruction Increased respiratory rate, stridor, normal expiration, positive retractions
50
Bronchitis
Classic symptom is a dry, hacking cough that increases in severity at night Rarely occurs as an isolated problem
51
Bronchiolitis
Air trapping condition common in premature infants, immunosuppressed children, children who attend daycare Caused by RSV Increased RR, normal inspiration, longer expiration, positive retractions, positive apnea
52
Pneumonia
Inflammation or infection of the bronchioles and alveolar spaces of the lungs
53
Bronchopulmonary Dysplasia
Also called chronic lung disease of prematurity Defined as the need for supplemental oxygen for at least 28 days after premature birth
54
Short Term Treatment for Asthma
Short acting rescue inhaler/bronchodilator
55
Long Term Treatment for Asthma
Corticosteroid or long acting bronchodilator
56
Upper Respiratory Symptoms of Cystic Fibrosis
Clogged sinuses Nasal polyps, chronic sinusitis, frontal headache, purulent nasal discharge, postnasal discharge
57
Lower Respiratory Symptoms of Cystic Fibrosis
Reduced ciliary clearance, obstructed airways, air trapping and hyperinflation, bacterial colonization, chronic fibrotic lung changes Moist cough, wheezing, coarse crackles, frequent infections, SOB, barrel chest
58
Pancreatic Symptoms of Cystic Fibrosis
Poorly digested food, vitamin deficiencies, poor weight gain or failure to thrive, delayed onset of puberty, CF-related diabetes mellitus
59
Gastrointestinal Symptoms of Cystic Fibrosis
Meconium ileus at birth, abdominal distention, steatorrhea, constipation or intestinal obstruction, rectal prolapse, liver cirrhosis
60
Characteristic Features of Heart Disease
Exercise intolerance Fatigue (during feeding the infant)
61
Post-Op Care for Heart Surgeries
Take heart rate for one whole minute apically Respiratory status Intake and output Pain control Watch for bleeding Blood pressure/pulses
62
Medications Used for Heart Disease
Lanoxin ACE Inhibitors Beta Blockers Diuretics Antiarrhythmics Antibiotics Aspirin
63
Bacterial Endocarditis Presents with...
Fever, pallor, petechiae, anorexia, fatigue, rheumatic fever
64
Risk Factors for Development of Congenital Heart Disease
Maternal rubella Maternal alcoholism Maternal age over 40 years Maternal Type I Diabetes Sibling/parent with a heart defect, chromosomal aberration, other congenital anomalies
65
Hemodynamics
High to low pressure, will take the path of least resistance
66
Pressure in the Heart
Pressure on the right side is lower than the left Resistance in pulmonary circulation is less than systemic circulation
67
Left to Right Shunt
No cyanosis Oxygenated blood is sent back to the lungs Fully oxygenated blood still going out to systemic circulation
68
Right to Left Shunt
Causes cyanosis Deoxygenated blood is being pushed to the left Deoxygenated blood goes out into systemic circulation
69
Increased Pulmonary Blood Flow
Shift: Left to Right No cyanosis S/S of CHF ASD, VSD, PDA
70
Decreased Pulmonary Blood Flow
Shift: Right to Left Cyanosis No CHF symptoms Tetralogy of Fallot, Tricuspid Atresia
71
Tetralogy of Fallot
Four abnormalities that result in insufficiently oxygenated blood being pumped to the body 1. Narrowing of the pulmonary valve 2. Thickening of the right ventricle 3. Displacement of aorta over ventricular septal defect 4. Ventricular septal defect
72
Obstruction to Blood Flow Out of the Heart
Shift: Left to Right No cyanosis CHF symptoms COA, AS, PS
73
Mixed Blood Flow
Shift: Right to Left and Left to Right Cyanosis: Yes and No CHF symptoms Transposition of the great vessels, truncus, hypoplastic left heart
74
Congestive Heart Failure
Inability of the heart to pump adequate amount of blood to systemic circulation at normal filling pressures to meet metabolic demands of the body Septal defects, cardiomyopathy, sepsis, anemia
75
Kawasaki Disease
Acute systemic vasculitis Etiology unknown Extensive inflammation of arterioles, venules, and capillaries
76
Acute Kawasaki Disease
Abrupt onset of high fever, unresponsive to antibiotics and antipyretics Child is very irritable
77
Subacute Kawasaki Disease
Begins with resolution of fever and lasts until all clinical signs have disappeared Greatest risk for coronary artery aneurysms
78
Convalescent Kawasaki Disease
6-8 weeks after onset
79
Therapeutic Management of Kawasaki Disease
High-dose IV gamma globulin Aspirin
80
Sickle Cell Anemia (HbSS)
Most common type of sickle cell disease RBCs are crescent-shaped Homozygous condition Child is subject to sickle cell crises Average lifespan is 45 years of age
81
Sickle C Disease (HbSC)
Child inherits one HbS gene and one HbC gene RBCs are C shaped Anemia is generally milder than sickle cell disease Painful crises occur about 50% as often as in HbSS disease Average lifespan is 64 years of age
82
Sickle Beta + Thalassemia Disease (Hb + SB) and Sickle Beta 0 Thalassemia Disease (Hb0 SB)
Combination of sickle cell trait and thalassemia trait In sickle cell beta +, there is a reduced amount of beta+, there is a reduced amount of hemoglobin A, and the lifespan is near normal In sickle cell beta 0, there is no hemoglobin A and the lifespan is mid-50s
83
Vaso-Occlusive Crisis
Most common type of crisis; caused by stasis of blood with clumping of cells in the microcirculation, ischemia, and infarction Precipitated by dehydration, temperature extremes, infection, localized hypoxemia, physical/emotional stress
84
Clinical Manifestations of Vaso-Occlusive Crisis
Extremely painful Fever, tissue engorgement, painful swelling of joints in hands and feet, priapism, severe abdominal pain
85
Severity of Vaso-Occlusive Crisis
Thrombosis and infarction of local tissue may occur if the crisis is not reversed Cerebral occlusion can result in stroke, manifested by paralysis and/or other CNS complications
86
Splenic Sequestration
Pooling of blood in the spleen
87
Clinical Manifestations of Splenic Sequestration
Profound anemia, hypovolemia, and shock
88
Severity of Splenic Sequestration
Life-threatening crisis Death can occur within hours
89
Aplastic Crisis
Triggered by infection with parvovirus B19 or depletion of folic acid
90
Clinical Manifestations of Aplastic Crisis
Diminished production and increased destruction of red blood cells Signs include profound anemia, pallor
91
Severity of Aplastic Crisis
Life-threatening
92
Thalassemias
Group of inherited blood disorders of hemoglobin synthesis characterized by anemia that can be mild or severe Pallor, jaundice, growth retardation, irritability, hepatomegaly, and splenomegaly are common
93
Hereditary Spherocytosis
Hemolytic disorder occurring in 1 in 5000 people of Northern European descent Clinical manifestations appear in the neonatal/early infancy stages; mild jaundice is usually evident Aplastic crises is the most serious complication
94
Disseminated Intravascular Coagulation
Life-threatening, acquired pathologic process in which the clotting system is abnormally activated, resulting in widespread clot formation in small vessels in the body Most common cause is sepsis Gingival bleeding, mucosal bleeding, hemoptysis, petechiae, purpura, bruising, oozing of blood after injection, hematuria, frank bleeding from incisions, tachycardia, and hypotension
95
Immune Thrombocytopenic Purpura
Bleeding disorder characterized by increased destruction of platelets in the spleen Multiple ecchymoses and petechiae and mucosal bleeding in the mouth or nose

Pediatric Nursing (7 decks)

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