Final stuff Flashcards
1
Q
Once the umbilical cord is clamped and the infant takes the first breath…..what happens
A
the transition from intrauterine to extrauterine life begins.
2
Q
S/s of pregnancy dangers
A
severe, persistent vomiting Abdominal pain and vaginal bleeding Indicators of infection Preeclampsia Premature rupture of membranes Preterm labor Decreased fundal height Absence of fetal movement after quickening
3
Q
- Nursing Care for Pediatrics (Illness and Non-illness)
The best historian for pediatric people- are
A
PARENTS
4
Q
- Born with, slows everything down-tired, sluggish, poor feeding, cold extremities, constipation, loose WT due to not eating
s/s-Feeding problems, decreased activity, constipation, prolonged jaundice, skin mottling, umbilical hernia
A
Congenital Hypothyroidism
5
Q
- Skin Infections
- caused by B-hemolytic streptococci or staphylococci or both bacteria infection-spreads like WILF FIRE- contagious when crusty and weeping. Tx- bacterial cream
Diaper rash-candaditis
Yeast infection
———bacterial infection-gets under skin tissues, causes inflammation
———- red (slap baby face) a virus- get it from contact-drooling on toys/rattles
Fungal infection- tinea capitus- ring worm on head, tinea corpus-ring worm on the body
Tx of ring worm-
Eczema (Dermatitis)
Scabies
A
Impetigo
Cellulitis
Fifths disease
antifungals -Do not cover it up because heat makes it spread. Check animals if not in sports such as wrestling.
6
Q
- ERICKSONs Theory— KNOW what Stage of growth and development they are in. 16 year old in hospital- don’t chose what they like to do (such as video games, choose what supports their growth and development)
A
Yes
7
Q
- Growth and Development (Fine Motor/Gross motor)
FINE motor skills:
6 months of age- pincher grasp
6-12 months- able to pick up stuff
2 years of age- putting blocks in a bucket, using a spoon
5 years of age- cutting with a scissors
17 years old- playing instrument, detailed art, knitting, crocheting, beading
Girls develop fine motor skills before boys
GROSS motor skills:
6months- roll and sit
9-12 months- crawling, pulling self-up, maybe standing with hands on couch
9-15 months- trying to walk
ALL CHILDREN IS DIFFERENT
Boys develop gross motor skills before girls
A
H
8
Q
- Post-Surgical Care for Maternal and Pediatric Patients
PRIORITY care:
Pain Management
Obstetrics what is priority- Hemorrhage, uterine contractility whether its vaginal or cesarean
Infection- would find about 2 days after surgery. Fever not unusual postpartum- why? It’s the inflammatory response to a vaginal/cesarean delivery.
Pediatric patient post care- Airway first priority NO MATTER WHAT
A
H
9
Q
- Preterm Labor/Birth
Below 37 weeks is preterm labor
s/s of preterm labor- bright red bleeding, regular contractions that do not go away with hydration and rest
-if contracting- drink some water, lay down, wait an hour. Go in if not changing
32 weeks- plan of care:
Figure out exactly how far along they are, what meds we can give, IV and hydrate, if contracting give trebuterline-smooth muscle relaxant-stops labor by relaxing the muscles. Side effect to mom= adrenaline-heart rate goes up- many cant tolerate well. Know what cervical dilation is. Is not working can also give betamethasone IM to make sure baby is able to breath on its own, magnesium sulfate-helps with uterine contractility- good sign if contractions are stopping (most common reason it is used) Normal mag sulfate level= 1-3?
A
I
10
Q
- Preterm Newborn
What to give if baby comes out at 32 weeks- give surfactant- helps with movement in lungs (alveoli)- matures lungs
A
B
11
Q
- Maternal Diabetes
Gestational diabetes- shoulder dystocia, broken clavicle, hypoglycemia for the baby following delivery due to mom receiving insulin through out pregnancy. Babies pancreas is still producing insulin after birth from mom.
How to treat low BS in newborn? Breast food, give sucrose
Big baby-macrocosmic baby- if mom gives birth to one we are concerned about- potential lacerations, stretched uterus very large= possible post-partum hemorrhage
Diabetic moms may have polyhydramnios- too much amniotic fluid-common in diabetic moms.
A
Y
12
Q
- Triad of Newborn needs (Breathing, Nutrition, Warmth)
If a baby is born from a diabetic mom-what is it going to be working on? Concerned about blood sugar, be cold (using body heat), and going to struggle for oxygen. This is why we need to warm/ dry them, suction/clear airway, bread feed, or baby will use all of their sugar as well as struggle to breath.
A
H
13
Q
- Pain assessments in newborns, pediatrics, and women
FLACC or CRIES scale
Look at crying grimacing, facial expressions, flexed position, grunting, nasal flaring
Pediatrics- faces wonker scale, body, interaction, asking them, using language they use at home (ouwie)
17-year-old pain- numeric pain scale. Ask them how they feel. Ask Where, describe the pain to me.
A
N
14
Q
- Pregnancy Changes
First trimester 0-23 weeks expecting to occur? Nausea, breast tenderness, urination increase, mood swings
Normal urination? Ask does it hurt when you pee
Chadwiks sign, other signs?
2nd trimester 12-24- gains the most weight, all previous s/s should go away unless have hyperemesis, 20 weeks fundus is at belly button, GI slows-due to hormone relaxin, harder to breath because lungs are displaced due to diaphragm being pushed up. SOB is common in this stage, edema is normal in feet but NOT face. Carpel tunnel in the wrist is common due to increased pressure on the nerves. Blood pressure during pregnancy should stay about the same- look at history to see if it is normal for them.
3rd trimester 25-40 weeks- if gains a lot of weight what to be concerned about? HTN, preeclampsia, Polyhydramnios, (should not have large WT gain)
A
U
15
Q
- Mental Health Assessments maternal and pediatric
How to assess for behavioral issues in pediatrics- ask questions. How to know if physical abuse is occurring? May have bruising on areas such as wrists, chest, flank, face, burns, UTI, may be resistant to things. Emotional abuse- maybe withdrawn, others answering questions for them- may have emotional abuse or trauma
Types- mental, physical, emotional, sexual- UTI, neglect, financial, lynchalphybroxia?? Make your children sick, Premature infants/ females are at risk
A
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16
Q
- Hematologic Conditions
Ion deficiency anemia s/s- physical well-being-
Sickle cell anemia-cant carry all the oxygen due to being crescent shaped. Crisis means cells get jammed up in joints may have increased pain, decreased perfusion because oxygen is unable to diffuse to extremities. How to tx crisis- pain management, oxygenation, hydration. Warm pack to get blood flowing.
Hemophilia- unable to clot blood- bleeding precautions put in to place. Life expectancy- depends on state of condition and lifestyle they live.
Cold pack with inflammation
A
I
17
Q
- ICP- Intercranial pressure- can happen due to meningitis, brain tumor, stroke, abuse head trauma, brain injury. How to know they have it? Hyperactivity, increased restlessness, inability to stay awake, sunseeting eyes, bulging fontinales, fluid inside head with change VS and go into hypovolemic shock state (low BP..???) Inability to concentrate, HEADACHE, confusion. Tx of ICP- mannitol- (hypertonic solution)
Spinabifida- can have chronic ICP. Tx- includes shunt from brain to abdominal cavity and absorbed into circulatory system.
Shunt issues with ICP- should NOT have swelling such as buldging foltenals, infection, fever, ect.
A
I
18
Q
- Postpartum Assessments
What does it include after post-labor? BUBBLEHE
Breasts- day 1- colostrum, D2-3, milk come in, lactating moms education on engorgement- feed baby-put to breast, not breast feeding and engorgement teachings? Don’t touch, cabbage leaves, don’t stand under hot water-will lactate, empty both breasts (either by pumping or feeding)
Uterus- contract- firm, shrink-want little discharge, what is consider PPH post op- frequently soaked pad (every hour), over 1000 ML
B- Bladder- mom should be able to urinate- if she had an ISN, a narcotic, or epidural she may have delayed voiding abilities because of muscle tones.
Bowels- Constipation? Due to moms being afraid to have BM because of known or expected pain, laceration, episiotomy. Tx- increase water intake, fiber intake, stool softener, tux pads. May have hemmoroids.
Lochia- Types- Rubra- lasts 2-3 days, serosa-bloody mucusy discharge that should occur before they go home, Alba-discharge once mom ovulates again. Mucusy discharge.
Episiotomy- done for shoulder dystocia to be able to get in there and manipulate. Lacerations-infection, Hematoma- may be bulging shiny grey perineum, all blood in moving into cavity, hypovolemic shock state, BP down, pulse increase, s/o pain, may not be able to feel if epidural. Within first 24 hours
Homans- don’t do any more- Blood clot s/s- calf or thigh enlargement, warmth, pain, redness, decrease pulse to extremity, may go to lungs if dislodged- (pulmonary embolism)- s/s: SOB, dyspnea, anxiety.
A
I
19
Q
- KUBLER-ROSSs stages of Grief
Anger, denial, bargaining, acceptance
Abnormal condition dx- parents may be in denial
Drown, dead child, initial reaction to trauma** ???
A
H
20
Q
- Musculoskeletal Conditions in Pediatrics
Scoliosis- identified in school age population- most common- clubfoot tx- casting, 23 hours a day should be left on, 1 hour for ROM and rest hour, should be changed every? ** in 3 years????? Idk if you do not change cast size leg should stay the same size and cause major constriction to leg.
Most common after born??- hip dysplagia, cerebal palsy, CLAVICAL- broken bones is #1- assess for compartment syndrome- CMS- check circulation, motion and sensation. Include everytime a bones breaks-expeciialy in long bones. Compartment syndrome s/s- pallor skin, can loose extremity, cold….??
A
H
21
Q
- Neurological Conditions
Spina bifida-spinal defect when they are born
Cerebral palsy-
Meningitis- nuchal rigitidy, headache, photophobia. Viral and bacterial differences, bacterial can KILL
A
I
22
Q
- Pediatric Caner
Issues it creates for families- stress, fighting, family instability, care giver burn out,
A
J
