Exam 2 Peds & IV therapy Flashcards Preview

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Flashcards in Exam 2 Peds & IV therapy Deck (144):
1

#1 IVstart site

AC space

2

5 purposes of IV therapy

provide maintenacne requirements for fluids & electrolytes
replace previous losses
replace concurrent losses
provide nutrition
administeration of meds/blood & blood components

3

how can you decrease the risk of infection with IV's

handwashing
use only once
approved antiseptic technique

4

name the 3 phases of intravenous therapy

pre-cannulation
cannulation (acessing the vein)
postcannulation (after its in)

5

what will anxiety cause in a pt that you are trying to start an IV

vasoconstriction

6

when choosing the best vein start where

distal to proximal

7

veins

dark red blood
slow blood return
have valves
blood flow is towards heart
superficial

8

where do you place the tourniquet

2-6 inches away from insertion site

9

if you pt is hairy do you cut or shave hair

cut hair

10

butterfly's are usually used for what

blood draws

11

cannula

hollow plastic tube, catheter

12

bevel

slanted edge on opening of the needle or cannula device

13

a 24 gauge catheter is used for what pt

infant

14

a 20 guage catheter is used for what pt

average adult pt

15

a 14 guage catheter is used for what pt

trauma pt

16

distal

farthest from heart

17

proximal

nearest to the heart

18

the bevel is always what?

up

19

what angle should your needle be at

15-30 degrees

20

when do you take off the tourniquet

after blood draw or right after IV stick if no blood draw needed

21

how many sticks are you allowed to have before you hve to get another nurse

2 sticks

22

if the IV fluid has stopped what should you check for

tube kink, vein valve occlusion, check all eqiopment

23

when do you need to get a MD order for IV sticks

foot access

24

when do IV sites have to be changed

Q96 hours or PRN
24 hours if started by Paramedic

25

When do you have to change the IV tubing

Q96 hours

26

when do you have to change the IV fluid

contains Rx: 24 hours
does not contain Rx: 48 hours

27

what do you lable the IVF bag with

time up & down, date time, inititals

28

when do you fluish a IV site

flush with 3mL of NS, Q8 hours, change the cap to a saline lock Q72 hours
Need to assess site Q4 hours

29

how often do you assess a PEDs IV site

Qhour

30

for pediatic patients what do you need to make sure is on IV line/pump

buretrol

31

what are comlications of the IO

osteomyletis, infiltration

32

when do you document a 3 mL flush

on pts with fluid restriction

33

what do you do if you remove a catheter and it is not intact

place tourniquet on PT immediately, Call MD

34

S/Sx of phlebtis

red warm, sore
DC IV then cool compress

35

S/Sx of thrombophelbitis

sore hard cord like vein, red line above site, edema, sluggish or stopped IV
DC IV, warm compress, assess

36

S/Sx of infection

red sore, edematous, drainage
DC IV site, culture of site and catheter tip, clean, dress site, observe pt for systemic s/sx

37

S/Sx of infiltration

edema, blanch at site, bumo at site, pain, redness, possible skin necrosis
assess, call MD, follow protocol for Rx

38

extravastation

keep IV site in place for possible antidote infusion

39

S/Sx of curculatory overload

dyspnea, cough, pitting edema with weight gain,
decrease IV rate, elevate head, dangle feet, VS, Breath sounds call MD

40

S/Sx of air embolism

chest, shoulder, lower back pain, hypotension, weak pulse, SOB decreased LOC
Tx: left side, MD, VS, O2, IV

41

S/Sx of body embolism

CP, shoulder lower back pain, SOB hypotension, weak pulse, decreased LOC
Tx: left side, tourniquet above IV site

42

S/Sx of septicemia

fever chills, tachy HA N/v, diarrhea
Tx: DC IV, cultures

43

IV push

only given by RN, takes 10-20 seconds for the Rx to reach the brain and heart, one minute to circulate throught the entire body

44

if your IV push is not compatible with the IV fluid what do you do

stop machine, flush with 10mL NS, push Rx, flush with 10 mL then start IVF again

45

when flushing after a IV push medication the first mL should be pushed at what rate

the same as the 1st mL of the medication

46

is potassium chloride used in IVP

NO!!!!!!

47

always do what before a PEDs procedure

prepare child/parents

48

a fetus can feel pain at what gestation

20 weeks

49

when can you use the faces pain scale

age 3

50

can you give a plavebo

no its unethical

51

EMLA

numbs area give one hour prior to procedure

52

when est. trust with a PEDs pt who is the first person you should est this trust with

the caregiver, then the pt

53

kids are weighed

daily

54

when assessing the PEDs patient what order should you do the VS

RR
HR
B/P
temperature

55

when doing a rectal temperature you insert how far

until the temperature starts to register

56

when do the fontanels start to close

12-18 months

57

when checking skin turgor on a PEDs where would you check

abdomen

58

a bald spot on the back of a childs head could indicate

lack of moving the child

59

at what age to infants get more control of thier head

4 months

60

at what age can PEDs floow an object

3-4 months

61

when taking a temperature how do you move the ear

down and back

62

belly breathing means what

respiratory distress, having to work harder

63

is a heart murmr normal

yes

64

if the mother has gestational DM what could that indicate for the unborn baby

BIG baby

65

Denver test

a developmental test, what kids should be doing at what age

66

infant CPR

30-2

67

pediatric doses should not exceed what

the minimum adult dose

68

when giving medications and feeding kids what should you give first

give Rx first

69

injection sites for PEDs

vastus lateralis perferred
dorsogluteal (only after child has been walking for one year)
ventrogluteal: child over 3
deltoid: 4-5 year olds

70

what size IVF bags are hung for PEDs

500 mL only! want to prevent fluid overload

71

S/sx of fluid over load

increase HR, BP

72

when do you want to avoid aphthalmic medications

when the child is crying

73

otic medication pull ear how

under 3 pull pina down and back
over 3 pull pina up and back

74

what do you feed children when sick

whatever they want and whenever they want it

75

normal temps for PEDs

98.6 oral
97.6 axillary
99.6 rectal
98.6 tympanic

76

when do childrens temps spike quickly

afterrnoon and night

77

at what temperature do you call the MD

100 degrees

78

possible causes of seizures in PEDs

tumor, trauma, hypoglycemia, hyponurtemia, neurological problms, hx of seizures

79

BP for PEDs

Systolic: for age 1-7 (age+90), for 8-18 (age+83)
diastolic: for age 1-5 (@56), age 6-18 (age + 52)

80

if using a mist tent what do you need to watch for

change in PTs temperature

81

if you have to weigh a diaper what is the weight = to?

1 gram is = 1 mL

82

BMI for PEDs

weight (lbs) x 703
--------------------------
height in inches

83

what is phototherapy used for

jaundice

84

transition period

newborn adjusts to extrauterine life

85

when using bulb to clear airway use where first

mouth then nose

86

Delee

deep suctioning of mouth, throat, nasal phyrnx and stomach

87

why do you place baby on moms chest

helps with temperature, HR, and RR

88

normal RR

30-60

89

normal HR

110-160

90

are apenic periods normal

yes! as long as they last no longer than 15 seconds

91

what is abnormal in the PEDs respiratory effort

nasal flarring, grunting, retractions

92

why do infants have heat loss

large surface area, limited subQ fat, superficial blood vessels

93

4 types of heat loss

convection
radation
evaporation
conduction

94

dont give kids ASA becasue

Reyes syndrome

95

when a baby is cold they use what to regain temperature

extra calories and oxygen

96

Apgar

asses cardiac pulmonary and neurosensory status

97

acrocyanosis

blueing discoloratio nof hands and feet
Its NORMAL

98

when checking umbilical cord what do you need to check

2 arteries and one vein
odor, drainage, bleeding, base for reddness

99

ompahlitis

inflammatio nof umbilical cord

100

when does the umbilical cord fall off

7-10 days

101

is Wartons jelly normal

yes

102

AGA

appropriate for gestational age
10th-90th percentile

103

SGA

small for gestational age
below 10th percentile

104

LGA

large for gestational age
above 90th percentile

105

normal range for height

18-22 inches

106

normal head measurement

12.5-14.5 inches

107

normal chest measurement

12-14 inches

108

why is vitamin K given to newborns

prevent hemorrhage

109

give vitamin K where

lateral aspect of thigh

110

when giving erythromycin when can it be removed

after one hour

111

what is abnormal for the fontanelles

firm, bulging, or depressed

112

vernix

protective white cheesy substance from sebaceous glands

113

erythematous

beefy red coloring @ 6-12 hours after birth & return to normal

114

milia

white papules

115

lanugo

fine hair

116

harlequin color

one side of the body pale while other side deep red
Tx: change postion

117

sclera

white/blue

118

strabismus

looking different directions

119

nystagmus

twitching

120

crackles are normal for a newborn for how long

first few hours

121

a temperature decrease is a sign of

infection & respiratory distress

122

jittering is a sign of what

hypoglycemia

123

temperature needs to be what before you give a bath

97.7

124

breast feeding is done when

8-12 times in a 24 hour period

125

newborns need how many calories/kg.day

110-120 cal/kg/day

126

hereditory metabolic disorder

newborn screening- PKU unable to metabolize and build ups and leads to perm brain damage

127

where do you do a heel stick on a PEDs

lateral aspect of foot

128

pulse ox for new born

right arm and left leg

129

circumcision

keep petroeum jelly on it to protect, clamping crushes nerve endings and blood vessels

130

is a high HR (180) & RR (90) normal for the first 30 minutes of life

yes

131

lanugo peak

28-30 weeks then decreases

132

inital period of newborn (first 30 minutes)

increase HR, RR, breif cyanosis, bowel sounds absent, good time for 1st feeding

133

sleep phase

begins at 30 minutes and lasts up to 4 hours
normal RR, HR, color pink, audible bowel sounds, good time for mom and baby to sleep

134

second period of reactivity

begins 4-6 hours after birth
RR & HR normal, color changes are rapid color changes because of vasomotor instability-mottling, bowel sounds are audible, good time for feeding

135

What are the meds newborns get first thing

Vitamin k
Erythromycin
Hep B

136

Mongolian spots

Flat bluish area on lower back or butt

137

Telangiectic nevi

Stork bite
On face or neck
Neck will stay forever

138

Candida

Yeast

139

Tinea

Ringworm

140

Tina pedis

Athletes foot

141

Tinea cruis

Jock itch

142

Impetigo

Contagious skin infection

143

Pediculosis

Lice

144

Verrucae

Warts