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Flashcards in PEDI--EXAM 2--TEST BANKS Deck (138):
1

chain of infection

pathogenic agent
reservoir
portal of exit
transmission
portal of entry
host susceptibility

2

illness passed by direct or indirect contact

communicable disease

3

risk factors for communicable disease

-Immature immune system

-Limited prior exposure to communicable diseases

-Poor hygiene behaviors

-Poor health and immunodeficiency increase risk

4

Prevention of the Spread of Infectious Disease

Hand washing

Standard precautions

Avoid exposure to infected individuals

Promote immunizations

Decrease/eliminate pathogens

5

in some cultures, infectious diseases are seen as?

punishmentor the result of curses or evil spirits.

6

monitoring patterns of disease occurrence

disease surveillance

7

Outcomes of disease surveillance

Development of public health programs

Scientific advances

Reduction or elimination of many infectious and communicable diseases

8

Antibody production stimulated by vaccine antigens without causing clinical disease

active immunity

9

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

passive immunity

10

Contraindications to vaccine administration

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

11

Agencies involved in development of immunizations

FDA

CDC

ACIP

12

Barriers to
Immunization Compliance

Economic factors

Limited access to health care

Lack of convenient primary care

Parental knowledge deficit

Religious/cultural prohibitions

13

can be administered when children have a mild illness

vaccines

14

give combinations of _____ at the same visit

vaccines

15

must be obtained before immunization administration

informed consent

16

Required documentation for immunizations

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

17

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

record

18

how to minimize pain during administration

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

19

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

potency

20

sx of communicable disease

Nonspecific symptoms

Fever (most common)

Fatigue

Malaise

Weakness

Aches

Decreased appetite

Nausea /vomiting/ diarrhea

21

cultures can test for?

bacterial
viral
fungal

22

clinical therapy of communicable diseases

antipyretics
antibiotics
antiviral medications

23

Vector-Borne Illnesses are transmitted by

biting insects or animals

24

Microorganisms spread and multiply, initiating inflammatory response

Vector-Borne Illnesses

25

prevent growth or destroy microorganisms of Vector-Borne Illnesses

antimicrobials

26

Assess for and treat general symptoms of vector-borne illnesses

Pain

Fever

Altered nutritional status

Dehydration

Toxic appearance

27

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

Isolate from other children

Clean shared items

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

28

what to educate parents on about vector-borne illnesses

symptom management

limiting spread of infection

when to consult the healthcare provider

29

fever management of vector borne illnesses

Administering antipyretics

Removing unnecessary clothing

Monitoring temperature

Encouraging extra fluids

30

how much acetaminophen

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

not to exceed 5 doses in 24 hours

31

how much ibuprophen

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

not to exceed 40 mg/kg daily

32

Systemic inflammatory response syndrome in the presence of infection

sepsis

33

who is at a high risk for sepsis?

infants (perinatal through first year)

34

what else increases infants risk for sepsis

low birth weight

multiple invasive procedures

35

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

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

36

Common causative microorganisms of sepsis

Group B streptococcus

E. coli

Haemophilus influenza

Staphylococcus

37

Pathophysiology of sepsis leads to:

impeded blood flow

leaking capillaries

vasodilation and constriction

38

impeded blood flow leads to?

reduced delivery of oxygen & nutrients

39

leaking capillaries leads to?

peripheral edema & fluid accumulation in lungs

40

vasodilation and contraction results in?

hypoxia & organ dysfunction

41

Early signs of sepsis in children

Fever or hypothermia

Tachycardia, tachypnea

Bounding pulses

Warm extremities

Altered responsiveness

42

late signs of sepsis in children

Hypotension

Prolonged capillary refill time

Mottled cool extremities

Weak pulses

Progressive mental changes

Decreasing urine output

Fever or hypothermia

43

Clinical therapy of sepsis focuses on

organ preservation

44

how do they focus on organ preservation

Oxygen

Aggressive fluid resuscitation

Vasopressor medications

Antibiotics

Cardiovascular monitoring

Temperature regulation

45

newborn skin

thin
little subQ fat

46

infants skin

more water
loosely attached cells

47

adolescent's skin

thickens

cells tightly bound

eccrine and apocrine glands mature

48

ex of dermatitis

atopic
contact
diaper
seborrheic

49

bacterial infections

impetigo

cellulitis

50

fungal infections

tinea infections

thrush

51

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

cellulitis

52

etiology of cellulitis

trauma,
impetigo,
folliculitis,
or recent otitis media

53

Viral infections

Molluscum contagiosum

Warts

54

Infestations

Pediculosis capitis

Scabies

55

Initial response to injury

inflammation

56

inflammation lasts

3-5 days

57

Swelling, blood clotting

Wound sealing to prevent bacterial invasion

inflammation

58

Chronic, relapsing, superficial inflammatory skin disorder

Atopic eczema

59

Nursing management
of Atopic eczema

Hydrate and lubricate skin

Reduce pruritus

Minimize inflammatory changes

Determine triggers

Apply topical corticosteroids

Provide emotional support

60

Chronic, pruritic, papulosquamous skin condition

psoriasis

61

Nursing management of psoriasis

Application of topical steroids and vitamin D

Tar shampoo

Ultraviolet B phototherapy

Systemic drug therapy

Provide emotional support

62

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

o Same scale, same clothes, same time q day

63

education to parents about oral rehydration of child

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

64

safety measures for child with IV?

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

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

hyponatremia

66

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

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

• which of the following are causes of hypernatremia?

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

• Child with hypokalemia should eat:

pizza & fruits

69

• Who is at most risk for hypocalcemia:

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

70

• Best way to administer Ca?

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

71

• Hyperventilation can cause?

o Respiratory alkalosis

72

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

o Respiratory acidosis

73

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

metabolic acidosis

74

• Metabolic alkalosis caused by:

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

75

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

o Can still get shots (over 102F cannot)

76

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

o Allergic rxn to baker’s yeast.

77

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

o Polio (IPV)

78

• Only oral vaccine?

rotavirus

79

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

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

80

CHICKEN POX CAN ONLY GIVE

• ORAL OR TOPICAL ANTIHISTAMINES



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

81

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

o Koplik spots

82

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

eosinophils

83

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

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

84

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

standard

85

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

varicella (live vaccine)

86

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

tells friends about it

87

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

o Applying warm wet rag to painful joints

88

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

o Get epinephrine!

89

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

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

• Child has exudative honey colored crusted lesions. Indicative of

o Impetigo very contagious.

91

• Burn severity is determined by:

o Depth
o Percentage of BSA affected
o Body parts involved

92

• Child presents with mild burn.

o Apply antibiotic ointment and cover. DO NOT APPLY ICE

93

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

18 month old with fever

94

Which child is most as risk for dehydration?

• Child that has pulmonary congestion and is tachypnea

95

which fluids to give?

o – Lactated Ringers

96

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

fontanels

97

• Measuring output for children in diapers:

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

98

Daily weight

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

99

• Calculating percent of weight loss

original weight - new weight.

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

100

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

dilute it half and half with water

101

how much fluid to start with?

1-3 tsp of fluid every 10-15 minutes

102

gradually ___ fluids as child stops vomiting

increase

103

if child has diarrhea--

continue with age appropriate diet

104

usually start with what IV fluid to replenish sodium?

isotonic (ringers lactate or NS)

TQ was LR @ 20 ml

105

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

JVD

106

nursing care for hyponatremia

check iv fluids type & rate

check pump

educate parents on fluid replacement when child is V&D

107

hypokalemia manifestations

constipation

108

hyperkalemia...monitor?????

urine output

109

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

potassium too high

110

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

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

111

if you have hyperkalemia avoid

salt substitutes

112

how to encourage deep breathing with preschooler in respiratory acidosis

blow bubbles

113

causes of respiratory alkalosis

hyperventillation & anxiety

114

causes of metabolic acidosis

ingestion of aspirin or antifreeze

115

if ingested antifreeze assess what first?

respiratory and airway

116

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?

hypotonic dehydration

117

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

18 month old with fever or 7 year old with tachypnea

118

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?

1. The child with tachypnea and pulmonary congestion

119

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?

1. Seizures

120

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

respiratory acidosis

121

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?

LR

122

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?

1. Pizza with a fruit plate

123

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

1. Furosemide (Lasix)

124

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

weight loss

125

check what first with Neumocystic Jyro pneumonia

respiratory

126

cure for HIV

none

127

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

– goggles

128

toddlers with pneumonia can't

blow balloons

129

avoid what drugs for lupus?

sulfa drugs

130

o Increases susceptibility to infection

methotrexate

131

how to avoid triggers of SLE?

cover body with long sleeves and hats

132

joint deformities and pain all the time

juvenile idiopathic arthritis

133

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

regular exercise (swimming)

134

♣ Encourage adequate nutrition with juvenile idiopathic arthritis such as

adequate fiber & liquids

135

what to teach for allergic reactions

teach to put a plastic cover over the mattress

136

tx of anaphylaxis

give epinephrine

137

if hypotensive how to treat anaphylaix

epinephrine, respiratory, fluids, supine

138

educate parents on what contains latex such as

goggles