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PEDS > livin on a prayer and an old blueprint > Flashcards

livin on a prayer and an old blueprint Flashcards

1
Q

Hallmark symptoms of pyloric stenosis?

A

projectile vomiting,
moveable olive-shaped mass in
epigastrium

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2
Q

What is oral rehydration for diarrhea?

A

 Use Pedialyte (1/2 str Gatorade)
 Not clear liquids / no caffeine
 Not BRAT diet
 No juice – high osmolarity

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3
Q

What are symptoms measles?

A

High fever, conjunctivitis,
coryza, cough, anorexia,
malaise, Koplik spots, Rash
maculopapular from face to
trunk to extremities.

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4
Q

What are medications for asthma?

A
  • Bronchodilators
  • Anti-inflammatory agents (steroids)
  • IV fluids
  • Oxygen
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5
Q

How to determine deterioration in asthma?

A

Sudden cessation of wheezing and
decreased breath sounds indicates
worsening

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6
Q

Symptoms of asthma?

A

-Wheezing and dry cough, prolonged
expiration, restlessness, fatigue,
tachypnea, cyanosis, marked
respiratory distress
* Chronic use of accessory muscles for
respiration leads to barrel chest

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7
Q

Treatment of asthma?

A
  • Assess resp status, administer humidified
    oxygen prn, monitor pulse ox
  • Maintain IV access, avoid cold liquids to
    avoid bronchospasm
  • Position high-fowlers and cluster nursing
    care
  • Sudden cessation of wheezing and
    decreased breath sounds indicates
    worsening
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8
Q

Dx of asthma?

A
  • Chest x-ray and symptoms
  • Pulmonary Function Tests
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9
Q

ESRD diet?

A

 Low in protein, potassium, sodium, phosphorous
 High in carbohydrates
 Unrestricted amount of fat
 Limit fresh fruit and veggies
 High in calcium

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10
Q

what are symptoms of dehydration?

A

 Weight loss
 Increased heart rate
 Thirst, No tears
 Variable temperature
 Depressed fontanel in infant**
 Dry skin and mucous membranes
 Poor skin turgor and skin perfusion
 Fatigue, lethargy
 Diminished urinary output
 Altered level of consciousness

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11
Q

What is stage 1 of lyme?

A

Fever, HA, malaise, fatigue,
anorexia, conjunctivitis,
cough, stiff neck,
lymphadenopathy

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12
Q

What is stage 2 of lyme disease?

A

Neuro, cardiac,
Musculoskeletal systems

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13
Q

What is stage 3 of lyme disease?

A

Musculoskeletal pain,
arthritis

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14
Q

What is the treatment for lyme disease?

A

penicillin

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15
Q

What are risk factors for RSV?

A
  • older siblings
  • smoking
  • day care
  • sharing a cup
  • not using soap at the sink
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16
Q

Symptoms of RSV (bronchiolitis)?

A
  • Worsening of an upper respiratory
    tract infection with tachypnea,
    retractions, low-grade fever,
    anorexia, thick nasal secretions, and
    increasingly labored breathing
  • Older infants may have a frequent,
    dry cough
  • Lungs reveal wheezing or crackles
17
Q

Dx of RSV?

A

nasopharyngeal swab and chest x ray

17
Q

Treatment for RSV?

A
  • Complete respiratory assessment
  • Provide humidified oxygen
  • Pulse oximetry
  • Clear nasal passages with bulb
    syringe or deep nasal suctioning
  • Cluster nursing care
  • IV fluid, I & O, Weigh daily
  • Contact precautions
    -bronchodilators
    -steroids
    -IV fluids
18
Q

What is HUS triad?

A

anemia, renal failure, thrombocytopenia

19
Q

S & S of HUS?

A

vomiting, bloody diarrhea (loose stool/poop), stomach pain, fever, chills, and headache. As infection progresses, persons may experience fatigue, weakness, fainting, bruising, and paleness.

20
Q

Tx for HUS?

A

 Hemodialysis or peritoneal dialysis (for those anuric for 24
hrs, or oliguria w/uremia or HTN & seizures)
 FFP and plasmapheresis, fresh/washed packed cells
 Emergency support for family and child

21
Q

Symptoms of epiglottitis?

A

sudden onset of high fever, sore
throat, pain with swallowing
* Anxious, restless, looks ill,
insists on sitting upright
leaning on arms with chin
thrust out and mouth open
(tripod position)
* Dysphonia (muffled voice).
Dysphagia, drooling of saliva,
are classic signs

22
Q

Nursing care for epiglottitis?

A
  • NPO, IV fluids for hydration
  • Assess for resp distress
    continuously
  • Never leave child unattended
  • Keep intubation equipment
    available
23
Q

Meds for epiglottitis?

A
  • Antibiotics
  • Antipyretics
  • Corticosteroids
  • IV fluids
24
Q

What does cleft palate repair entail?

A

 Cleft palate: 6 - 18 months; before 2
years of age
 Position on side or back after surgery
 Cool mist tent
 Blended diet
 Elbow restraints: 4 - 6 weeks
 No straws, pacifiers, spoons, or fingers
in or around mouth for 7-10 days.
 No oral temps.

25
Q

S and Sx of CF?

A

cough, sputum, dyspnea, decreased
Sao2, crackles or wheezes in lungs,
cyanosis, digital clubbing, bulky, frothy,
foul-smelling stools (steatorrhea),
meconium ileus
* Assess: skin turgor, hydration status

26
Q

Tx of CF?

A
  • Provide high-calorie, high-protein foods
  • Administer pancreatic enzymes with all
    meals and snacks
  • Administer fat-soluble vitamins (A,E,D,K)
  • Avoid pulmonary treatments after meals to
    decrease the chance of vomiting
27
Q

Dx of CF?

A

-Sweat test
72 hours fecal fat
Chest x-ray
Prenatal DNA of amniotic fluid

28
Q

Symptoms of Hirschprung’s?

A

 No meconium with 1st 24-48 hours
 Distended abdomen & vomiting
 Signs of enterocolitis
 Chronic constipation
 Ribbon-like, foul-smelling stool

29
Q

Diagnosis of Hirschsprung’s?

A

rectal biopsy

30
Q

Treatment of Hirschsprung’s?

A

 Preop
 Depends on age & condition-enemas
 Postop
 NPO
 NG suction
 Abdominal assessment
 Ostomy-temporary
 Later: pull-through
 Ostomy revised: anal stricture & incontinence are
potential complications

31
Q

Symptoms of celiac?

A
  • Abdominal distention, vomiting
  • Anorexia, muscle wasting
  • Diarrhea with a foul odor
    Most intense pain at McBurney point
    Confirmed: CBC, UA (r/o UTI), WBC >10,000/mm, CRP (left shift – bands- indicating inflammation)
    CT > Abx > lap surgery
32
Q

What are good foods for celiac?

A
  • rice
  • corn
  • egg
  • quinoa
  • fruit
  • popsicles
  • water
  • chicken
  • beef
  • gluten free bread
33
Q

What are signs of water excess?

A
  1. Rales “wet” (difficulty breathing)
  2. Increased venous pressure
  3. Slow, bounding pulse
  4. Weight gain
  5. Lethargy
  6. Increased spinal pressure /seizure /coma
34
Q

Labs for water excess?

A
  • Low urine SG
  • Decreased HCT and serum electrolytes

Decreased Requirements
- CHF
- SIADH
- Increased ICP
- Oliguric renal failure

35
Q

Treatment for GER?

A

Depends on severity
Avoid foods that intensify reflux (citrus, caffeine, etc.)
Weight control
Small frequent meals
Thickened feeds
Elevate HOB for 1 hour after feed
PPI’s-omeprazole, H2 receptor inhibitors-ranitidine
Surgical management-nissen fundoplication

36
Q

How to help with pain of teething?

A

-firm & cold chewing objects, OTC analgesics, no aspirin
- Acetaminophen (10 - 15 mg/kg per dose-max. 5 doses/day

37
Q

What should be asked when sick infant arrives in ED?

A
  • when was the last time they ate and how much
  • when was the onset of symptoms
  • last time they went to the bathroom and how much was it
38
Q
A

PEDS (5 decks)

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