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6TH SEMESTER > PEDI--EXAM 2--TEST BANKS > Flashcards

PEDI--EXAM 2--TEST BANKS Flashcards

1
Q

chain of infection

A 
pathogenic agent
reservoir
portal of exit
transmission
portal of entry
host susceptibility
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2
Q

illness passed by direct or indirect contact

A

communicable disease

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3
Q

risk factors for communicable disease

A
  • Immature immune system
  • Limited prior exposure to communicable diseases
  • Poor hygiene behaviors
  • Poor health and immunodeficiency increase risk
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4
Q

Prevention of the Spread of Infectious Disease

A

Hand washing

Standard precautions

Avoid exposure to infected individuals

Promote immunizations

Decrease/eliminate pathogens

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5
Q

in some cultures, infectious diseases are seen as?

A

punishmentor the result of curses or evil spirits.

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6
Q

monitoring patterns of disease occurrence

A

disease surveillance

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7
Q

Outcomes of disease surveillance

A

Development of public health programs

Scientific advances

Reduction or elimination of many infectious and communicable diseases

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8
Q

Antibody production stimulated by vaccine antigens without causing clinical disease

A

active immunity

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9
Q

Antibodies produced in another host (human or animal) given when child needs antibodies faster than the body can make them

Includes immune globulins

Note—does not confer lasting immunity; child will need vaccine in future

A

passive immunity

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10
Q

Contraindications to vaccine administration

A

History of anaphylactic reaction to the vaccine or one of its components

Moderate to severe acute illness

For specific vaccines, pregnancy or allergy to some components

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11
Q

Agencies involved in development of immunizations

A

FDA

CDC

ACIP

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12
Q

Barriers to

Immunization Compliance

A

Economic factors

Limited access to health care

Lack of convenient primary care

Parental knowledge deficit

Religious/cultural prohibitions

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13
Q

can be administered when children have a mild illness

A

vaccines

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14
Q

give combinations of _____ at the same visit

A

vaccines

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15
Q

must be obtained before immunization administration

A

informed consent

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16
Q

Required documentation for immunizations

A

Date of administration

Vaccine given

Manufacturer

Lot number and expiration date of vaccine

Site and route of administration

Name, title, and address of person administering vaccine

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17
Q

A ____ of the administration should be given to the client’s parent.

A

record

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18
Q

how to minimize pain during administration

A

Provide local anesthetic

Give child as much control as possible

Be honest with the child

Provide sucrose drink and pacifier if appropriate

Use age-appropriate distraction techniques

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19
Q

exposure to different temperatures may result in damage to vaccine ______.

A

potency

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20
Q

sx of communicable disease

A

Nonspecific symptoms

Fever (most common)

Fatigue

Malaise

Weakness

Aches

Decreased appetite

Nausea /vomiting/ diarrhea

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21
Q

cultures can test for?

A

bacterial
viral
fungal

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22
Q

clinical therapy of communicable diseases

A

antipyretics
antibiotics
antiviral medications

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23
Q

Vector-Borne Illnesses are transmitted by

A

biting insects or animals

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24
Q

Microorganisms spread and multiply, initiating inflammatory response

A

Vector-Borne Illnesses

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25
Q

prevent growth or destroy microorganisms of Vector-Borne Illnesses

A

antimicrobials

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26
Q

Assess for and treat general symptoms of vector-borne illnesses

A

Pain

Fever

Altered nutritional status

Dehydration

Toxic appearance

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27
Q

how to Limit the spread of infection of vector-borne diseases

A

Isolate from other children

Clean shared items

Maintain a high level of suspicion when numerous individuals with similar signs and symptoms are seen

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28
Q

what to educate parents on about vector-borne illnesses

A

symptom management

limiting spread of infection

when to consult the healthcare provider

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29
Q

fever management of vector borne illnesses

A

Administering antipyretics

Removing unnecessary clothing

Monitoring temperature

Encouraging extra fluids

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30
Q

how much acetaminophen

A

10-15 mg/kg/dose every 4-6 hours

not to exceed 5 doses in 24 hours

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31
Q

how much ibuprophen

A

4-10 mg/kg/dose every 6-8 hours

not to exceed 40 mg/kg daily

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32
Q

Systemic inflammatory response syndrome in the presence of infection

A

sepsis

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33
Q

who is at a high risk for sepsis?

A

infants (perinatal through first year)

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34
Q

what else increases infants risk for sepsis

A

low birth weight

multiple invasive procedures

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35
Q

sepsis risk for older infants and children increases in presence of:

A 
Chronic conditions
Burns
Invasive catheters
Compromised immune system
Long-term antibiotic use
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36
Q

Common causative microorganisms of sepsis

A

Group B streptococcus

E. coli

Haemophilus influenza

Staphylococcus

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37
Q

Pathophysiology of sepsis leads to:

A

impeded blood flow

leaking capillaries

vasodilation and constriction

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38
Q

impeded blood flow leads to?

A

reduced delivery of oxygen & nutrients

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39
Q

leaking capillaries leads to?

A

peripheral edema & fluid accumulation in lungs

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40
Q

vasodilation and contraction results in?

A

hypoxia & organ dysfunction

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41
Q

Early signs of sepsis in children

A

Fever or hypothermia

Tachycardia, tachypnea

Bounding pulses

Warm extremities

Altered responsiveness

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42
Q

late signs of sepsis in children

A

Hypotension

Prolonged capillary refill time

Mottled cool extremities

Weak pulses

Progressive mental changes

Decreasing urine output

Fever or hypothermia

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43
Q

Clinical therapy of sepsis focuses on

A

organ preservation

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44
Q

how do they focus on organ preservation

A

Oxygen

Aggressive fluid resuscitation

Vasopressor medications

Antibiotics

Cardiovascular monitoring

Temperature regulation

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45
Q

newborn skin

A

thin

little subQ fat

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46
Q

infants skin

A

more water

loosely attached cells

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47
Q

adolescent’s skin

A

thickens

cells tightly bound

eccrine and apocrine glands mature

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48
Q

ex of dermatitis

A

atopic
contact
diaper
seborrheic

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49
Q

bacterial infections

A

impetigo

cellulitis

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50
Q

fungal infections

A

tinea infections

thrush

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51
Q

an acute inflammation of the dermis and underlying connective tissue characterized by red or lilac, tender, warm, edematous skin

A

cellulitis

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52
Q

etiology of cellulitis

A

trauma,
impetigo,
folliculitis,
or recent otitis media

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53
Q

Viral infections

A

Molluscum contagiosum

Warts

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54
Q

Infestations

A

Pediculosis capitis

Scabies

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55
Q

Initial response to injury

A

inflammation

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56
Q

inflammation lasts

A

3-5 days

57
Q

Swelling, blood clotting

Wound sealing to prevent bacterial invasion

A

inflammation

58
Q

Chronic, relapsing, superficial inflammatory skin disorder

A

Atopic eczema

59
Q

Nursing management

of Atopic eczema

A

Hydrate and lubricate skin

Reduce pruritus

Minimize inflammatory changes

Determine triggers

Apply topical corticosteroids

Provide emotional support

60
Q

Chronic, pruritic, papulosquamous skin condition

A

psoriasis

61
Q

Nursing management of psoriasis

A

Application of topical steroids and vitamin D

Tar shampoo

Ultraviolet B phototherapy

Systemic drug therapy

Provide emotional support

62
Q

• Correct way to determine daily weight of infant in diapers:

A

o Same scale, same clothes, same time q day

63
Q

education to parents about oral rehydration of child

A

dilute colas/juice
no diet colas
give in frequent small amts.
continue giving if child vomits

64
Q

safety measures for child with IV?

A

o Don’t put in arm that child sucks thumb of/ school age writes with; if starting to walk don’t put it in feet.

o Use smallest bag of solution (500mL instead of 1,000mL)

o Use a pump

o Microdrip tubing

o Make sure tubing doesn’t wrap around them

o If IV is in a joint, may need to splint that joint to prevent problems don’t wrap too tight

o Try not to cover up actual site so you can assess

65
Q

• Mother dilutes formula. Nurse educates mother that this can cause

A

hyponatremia

66
Q

• Child you are caring for has fluid restrictions. What are some methods nurse can use?

A

o When giving oral fluids, use cold fluids in an insulated cup (looks like theres more in it)

o Have child swish before swallowing (to relieve thirst)

o Let child choose fluids

o Before walking in with food tray, remove excess fluids

67
Q

• which of the following are causes of hypernatremia?

A

o Inability to communicate thirst (developmentally delayed)
o Not diluting formula enough
o Inadequate amount of breast milk
o Tube feeding w/o water intake
o Not replacing fluids adequately when vomiting/diarrhea/sweating

68
Q

• Child with hypokalemia should eat:

A

pizza & fruits

69
Q

• Who is at most risk for hypocalcemia:

A

adolescent girl worried about her weight, diets (teens often avoid dairy products)

70
Q

• Best way to administer Ca?

A

o 10% Calcium Gluconate IV (DO NOT GIVE IM B/C CAN CAUSE MUSCLE NECROSIS)

71
Q

• Hyperventilation can cause?

A

o Respiratory alkalosis

72
Q

• If the pH is decreased and the PCO2 is increased, what is going on?

A

o Respiratory acidosis

73
Q

• Diabetic child is going into ketoacidosis. Also going into…

A

metabolic acidosis

74
Q

• Metabolic alkalosis caused by:

A

o Prolonged vomiting
o NG tube suction
o O.D. on sodium bicarbonate tums.

75
Q

• Child comes in for 12m shots. Presents with mild ear infections and a fever that is 101F.

A

o Can still get shots (over 102F cannot)

76
Q

• What would contraindicate that a child receive their hep B shot?

A

o Allergic rxn to baker’s yeast.

77
Q

• Which is the only immunization that can be given SQ or IM?

A

o Polio (IPV)

78
Q

• Only oral vaccine?

A

rotavirus

79
Q

• Mother of child with chicken pox is inquiring about when her child will not be contagious anymore.

A

o Contagious until all lesions are crusted over (most contagious 1-2 days before rash)

80
Q

CHICKEN POX CAN ONLY GIVE

A

• ORAL OR TOPICAL ANTIHISTAMINES

o DO NOT GIVE BOTH FORMS OF BENADRYL!!!!

81
Q

• Child 12m old presents with bluish white spots on buccal mucosa. Diagnosed with measles.
What are these spots called?

A

o Koplik spots

82
Q

• WBC count w/ differential of child with allergic rxn would show an increase in?

A

eosinophils

83
Q

• A nurse is trying to get a small child to do deep breathing exercises. What are some things she could have them do?

A

o Blow a pinwheel
o Cotton ball race blowing through straws
o Blow bubbles

84
Q

• Child has HIV, daycare workers should follow what precautions when changing diapers?

A

standard

85
Q

• Child has congenital immunodeficiency. Which immunization should you avoid?

A

varicella (live vaccine)

86
Q

• Which of the following is a sign that teen is coping with dx of SLE

A

tells friends about it

87
Q

• The nurse can help the child with Juvenile Idiopathic Arthritis manage pain and inflammation by :

A

o Applying warm wet rag to painful joints

88
Q

• Child presents to the ED having an anaphylactic reaction. Priority nursing action is to:

A

o Get epinephrine!

89
Q

• Child comes in with latex, wheat, and ____ allergy. Nurses first action should be to:

A

a) Assess room for latex products what I put
b) Talk to dietician
c) Put sign on door what I think was right.
d) Don’t remember…

90
Q

• Child has exudative honey colored crusted lesions. Indicative of

A

o Impetigo very contagious.

91
Q

• Burn severity is determined by:

A

o Depth
o Percentage of BSA affected
o Body parts involved

92
Q

• Child presents with mild burn.

A

o Apply antibiotic ointment and cover. DO NOT APPLY ICE

93
Q

Which child is most as risk for f&e imbalances ?

A

18 month old with fever

94
Q

Which child is most as risk for dehydration?

A

• Child that has pulmonary congestion and is tachypnea

95
Q

which fluids to give?

A

o – Lactated Ringers

96
Q

♣ start out normal with mild dehydration, sunken appearance as dehydration progresses

A

fontanels

97
Q

• Measuring output for children in diapers:

A

o Weigh dry diaper THEN weigh each subsequent wet diaper without wipes

98
Q

Daily weight

A

♣ weigh children with same scale, clothes, & at same time every day. If they lost a kg, they lost 1L of fluid

99
Q

• Calculating percent of weight loss

A

original weight - new weight.

take that answer and divide it by the original weight to get % of body weight loss

100
Q

if parent is giving child sprite…what do you teach them

A

dilute it half and half with water

101
Q

how much fluid to start with?

A

1-3 tsp of fluid every 10-15 minutes

102
Q

gradually ___ fluids as child stops vomiting

A

increase

103
Q

if child has diarrhea–

A

continue with age appropriate diet

104
Q

usually start with what IV fluid to replenish sodium?

A

isotonic (ringers lactate or NS)

TQ was LR @ 20 ml

105
Q

(small infants may not have much of a neck to be able to tell ___ ___ ____.

A

JVD

106
Q

nursing care for hyponatremia

A

check iv fluids type & rate

check pump

educate parents on fluid replacement when child is V&D

107
Q

hypokalemia manifestations

A

constipation

108
Q

hyperkalemia…monitor?????

A

urine output

109
Q

Parent came and saw all salt gone and the child was very lethargic, which level was affected?

A

potassium too high

110
Q

♣ Educate them on K rich foods that we do NOT want them to eat such as

A

• Apricots, bananas, cantaloupe, cherries, dates, figs, molasses, orange juice, peaches, potatoes, prunes, raisins, strawberries, tomato juice

111
Q

if you have hyperkalemia avoid

A

salt substitutes

112
Q

how to encourage deep breathing with preschooler in respiratory acidosis

A

blow bubbles

113
Q

causes of respiratory alkalosis

A

hyperventillation & anxiety

114
Q

causes of metabolic acidosis

A

ingestion of aspirin or antifreeze

115
Q

if ingested antifreeze assess what first?

A

respiratory and airway

116
Q

A four-year-old child is admitted to the hospital secondary to dehydration. Lab tests indicate a high hemoglobin and hematocrit, and the serum sodium is below normal levels. This fluid loss is indicative of which condition?

A

hypotonic dehydration

117
Q

A nurse is taking care of four different pediatric clients. Which of the following children is at greatest risk for dehydration?

A

18 month old with fever or 7 year old with tachypnea

118
Q

In the morning, a nurse receives a report on four pediatric clients, each of whom has some form of fluid-volume excess. Which of the children should the nurse see first?

A
  1. The child with tachypnea and pulmonary congestion
119
Q

A nurse is planning care for a child with hyponatremia. The nurse, delegating care of this child to a licensed vocational nurse (LVN), cautions the LVN to watch for which clinical manifestation?

A
  1. Seizures
120
Q

A child with croup has an increased pCO2, a decreased pH, and a normal HCO3 blood gas value. The nurse interprets this as uncompensated:

A

respiratory acidosis

121
Q

The nurse is expecting the admission of a child with severe isotonic dehydration. Which intravenous fluid should the nurse anticipate the doctor to order initially to replace fluids?

A

LR

122
Q

A six-year-old child is hypokalemic. The nurse is helping the child complete the menu. The nurse would encourage this child to select which menu items?

A
  1. Pizza with a fruit plate
123
Q

A child is admitted to the hospital for hypercalcemia and is placed on diuretic therapy. Which diuretic would the nurse expect to give?

A
  1. Furosemide (Lasix)
124
Q

The nurse is evaluating an infant for dehydration. Which assessment provides the most accurate information on dehydration?

A

weight loss

125
Q

check what first with Neumocystic Jyro pneumonia

A

respiratory

126
Q

cure for HIV

A

none

127
Q

– What is not okay for hospital d/t latex allergies

A

– goggles

128
Q

toddlers with pneumonia can’t

A

blow balloons

129
Q

avoid what drugs for lupus?

A

sulfa drugs

130
Q

o Increases susceptibility to infection

A

methotrexate

131
Q

how to avoid triggers of SLE?

A

cover body with long sleeves and hats

132
Q

joint deformities and pain all the time

A

juvenile idiopathic arthritis

133
Q

was what should the nurse teach when child has no complaints on their meds with juvenile idiopathic arthritis?

A

regular exercise (swimming)

134
Q

♣ Encourage adequate nutrition with juvenile idiopathic arthritis such as

A

adequate fiber & liquids

135
Q

what to teach for allergic reactions

A

teach to put a plastic cover over the mattress

136
Q

tx of anaphylaxis

A

give epinephrine

137
Q

if hypotensive how to treat anaphylaix

A

epinephrine, respiratory, fluids, supine

138
Q

educate parents on what contains latex such as

A

goggles

6TH SEMESTER (22 decks)

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