Pediatric Flashcards
(177 cards)
1
Q
Explain the difference between growth and development
A
Growth is increase in physical size
Development is increase in function
2
Q
Does development follow chronological age
A
No
3
Q
What is cephalocaudal development
A
It’s development that moves from head downward through the body toward feet
4
Q
What is Proximodistal development
A
Development from center of the body to outward extremity
5
Q
What kind of grasp reflex does a newborn have
A
Involuntary
6
Q
Which fontanel closes first
A
Posterior
7
Q
Around what month do the anterior fontanel close
A
12-18 months
8
Q
Around what month do the posterior fontanel close
A
2-3 months
9
Q
How do you position an earlobe to view the auditory canal in a child
A
down and back
10
Q
How many cups should a 15 month toddler consume daily
A
2-3 cups
11
Q
What age is the best friend stage
A
9-10
12
Q
What are the major causes of accidents in children up to 1 year of age
A
Falls
Poisoning
Burns
13
Q
What is the major cause of accidents in a 6-12 years
A
MVA
14
Q
Does the growth rate of a 6-12 year of age increase or decrease
A
decreases
15
Q
A school age child requires how many calories
A
2400 calories
16
Q
Who develops earlier, girls or boys and about how many year difference
A
girls and 1-2 years
17
Q
What is the order to obtain vital signs
A
- Respiration
- Heartbeats
- BP
- Temperature
18
Q
With temperature when should you do a rectal temperature and when should you not
A
Children younger than 2
contraindicated for immunocomppresed or no rectum
19
Q
With temperature when should you do an axillary
A
All ages if oral is not possible
20
Q
With temperature when should you do an oral temp
A
start at 5-6 years
21
Q
With temperature when should you do a tympanic temp
A
All ages
22
Q
What age group uses non-verbal as their primary mode of communication
A
Newborn(birth-1month) and infants (1month -12 months)
23
Q
What age group uses crying as a way to express themselves
A
Newborn(birth-1month) and infants (1month -12 months)
24
Q
What age group responds to human voice and presence
A
Newborn(birth-1month) and infants (1month -12 months)
25
What age group allows the nurse to speak in high-pitched voice and cuddle and pat and rub to calm them
infants (1month -12 months)
26
What age group is mroe receptive to language than expressive
Toddler and preschooler (1-5 years)
27
What age group uses concrete thinking and may misinterpret phrases
Toddler and preschooler (1-5 years)
28
What age group may ask a lot of questions, has a short attention spam, limited memory
Toddler and preschooler (1-5 years)
29
What age group uses egocentric, magical thinkers animism and expresess themselves with playing and drawing
Toddler and preschooler (1-5 years)
30
What age group uses logic, understands points of view, understands cause and effect and body functioning
School age (6-12 years)
31
What age group uses big vocal, has both receptive and expressive language and still has misinterpretation of phases
School age (6-12 years)
32
What age group can interpret nonverbal messages, express thoughts and feelings
School age (6-12 years)
33
What age group uses abstract thinking, has limited interpretation of medical terminology,longs for independence, needs privacy
Adolescent 13-18 years
34
What nursing strategy must be used for adolescents 13-18 years
Straightforward approach, talk in private
| Conduct some interview without parent presence
35
What are some signs of respiratory dysfunction
- Accessory muscle use
- Nasal flaring
- Circumoral Pallor
- Sternal retractions
- Capillary refill>3 seconds
36
Laryngotracheobronchitis, an upper respiratory disease, common type is? who does it primarily affect and what is it caused by
Croup and affects children under 5 years. caused from viral infection
37
What are the S/S of Croup
Slight to severe dyspnea
Barking or brassy cough
Increased Temp
38
Treatment for Laryngotracheobronchitis(LTB)
- Manage mild Croup at home: Steam, hot showers, car rides cool wind, cool temps.
- Hospitalization: Nebulized Epinephrine (constrict edematous vessels)
- Corticosteroids to decrease inflammation
39
What is the difference between epiglottitis and croup
Epiglottitis is serous obstructive inflammation
Absent of cough
Presence of Dysphagia and rapid progression to severe respiratory distress
40
What is RSV
RSV is respiratory syncytial Virus that is an acute viral infection that affects the bronchioles, which includes RSV bronchiolitis or RSV pneumonia
41
Who is at more danger for RSV
the very young, leading cause of illness in children less than 2 years
42
What are some risk factors related to RSV
- Prematurity
- Congenital disorders
- Smoke
43
What can we do to prevent RSV
Immunize Palivizumab (Synagis) and RespiGam
44
If a person has
- URI
- Nasal discharge
- mild fever
- dyspnea
- Nonproductive cough
- tachypnea with flaring nares
- Retraction and possible wheeze what are these s/s common for
RSV
45
When can you notice worsening of symptoms of RSV if not treated
Days 2 or 3
46
How do we treat Mild RSV
Supportive Care: antipyretics
47
How do we treat Severe RSV
```
Suction
Oxygen (may need mechanical vent)
IV fluids
Albuterol (Proventil)
Antipyretics
```
48
What is pneumonia and how is it caused
Inflammation of lung
- viral- RSV, parainfluenza, Adenovirus
- Bacterial, Strep
- Mycotic (walking pneumonia)
- Aspiration pneumonia
49
What are some s/s of pneumonia
- Fine crackles or rhonchi, productive or non-productive cough
- Decreased or absent breath sounds
- Abdominal distention
- Back Pain
- Fever high
- Chest pain
50
How do we treat pneumonia
Depending on type
1) ABC
2) Oxygen
3) Fluids
4) Abx
5) Supportive care: hydration, antipyretics and nebs
51
What is Asthma
Inflammation and constriction of airways resulting in obstruction
52
What are some s/s of asthma
- cough
- SOB
- Audible wheeze
- prolonged expiratory wheeze
- restlessness and cyanosis
53
What is important thing to note with asthma education
avoid triggers
| Pets, food, environmental condition and emotions
54
What two body systems are affected with cystic fibrosis
Resp and Gi
55
What type of enzymes can be given to help improve digestion and what is important to mention
Pancreatic enzymes, do not crush or chew the enzymes
56
What kind of diet do you want a person with cystic fibrosis to be on
Well balance
low fat
high calories
high protein
57
What kind of vitamins does a person with cystic fibrosis need
Water soluble, including A, D, E and K
58
What kind of stool does a person with Cystic fibrosis have
Steahorrhea, fatty frothy stool
59
What test is used to dx cystic fibrosis
Sweat Chloride
60
What electrolyte imbalance does a child with Cystic fibrosis have
Hyponatremia
61
What is the earliest sign of cystic fibrosis in achild
Meconium ileus
62
What are the mucous secretions in a person with cystic fibrosis
thick and sticky
63
Is cystic fibrosis an inherited disease from only one parent
No from both
| AUTOSOMAL RECESSIVE
64
What type of infection are Down Syndrome children most prone to develop
Respiratory, because of poor immune system
65
What is the most common defect in a person with down syndrome
Heart
66
What is the main reason for heart failure in children
Congenital heart defects
67
What are some early s/s of heart failure
- increased pulse at rest and with slight exertion
- increased resp rate
- scalp sweating
- fatigue
- sudden weight gain
68
What do you think of with fluid retention
Heart problem
69
What treatments should you be doing for a child with heart failure
- ongoing assessment
- listen to lungs
- control room temp
- sit them up
- rest
- decrease stimuli
- cool humidified oxygen
- uninterrupted sleep
- medications
70
What are some medications used to treat heart failure
- Digoxin
- Aceinhibitors
- furosemides
71
What should we worry about in terms of weight in children
more than 1lb or more a day
72
What is the main sign of dig toxicity
Bradycardia and vomitting
73
When should you hold digoxin for infants
When pulse is less than 110
74
When should you hold digoxin for children
When pulse is less than 70
75
What is the normal dig level
0.8-2.0 ng/mL
76
When is it safe to give digoxin
Either 1 hour before feeds or 2 hours after feedings
77
Should you give digoxin with food, or give more if baby throws up, or if it's past due it's scheduled time, or more than 1 ml
NO
78
Giving digoxin to children you should always check what?
Check the dose with another nurse
79
What do you watch for with Ace Inhibitors
1) Decreased Bp
2) Kidney Problems
3) Dry Cough
80
How does Ace inhibitors work
They block aldosterone and can cause hyperkalemia
81
Why give furosemide with heart failures
To decrease volume
82
What is a good scheduling for meals for a HF ped patient
every 3 hours, they should be well rested prior to eating and small frequent feeds
83
What can you do to help the ped patient receive adequate nutrition when facing HF
Increase calories
Don't prolong feeds longer than 30 mins
Use soft nipple with large opening so baby wont work so hard to get meals
84
Do breastfeeding babies require more or less supplements for calories
More and do not restrict sodium/fluids
85
What is a hypercyanotic spell
It's a blue spells or "tet" spells and seen in infants with Tetralogy of Fallot
86
Why would you give lavage feedings
If the patient is having respiratory distress
87
What is tetralogy of fallot
4 defects
1) Ventricular Septal Defect
2) Stenosis of Pulmonary Artery
3) Overriding Aorta
4) Right Ventricular hypertrophy
88
What's the treatment for a hypercyanotic spell
- put patient in knee chest position
- give them 100% oxygen
- Morphine for Sedation
- Loose Clothes
- Quiet play
- No stress
- Respond to crying quickly
- Infections must be treated promptly
89
Why put a patient in knee chest position
This position decreases venous return and increases systemic resistance
90
What are some effects of Chronic Hypoxia
- Polycthemia (increased RBC)
- Clubbing (late sign of chronic hypoxia)
- Poor growth and development
- Squatting
91
What is a congenital heart defect
It's a structural or functional defect of the heart or greater vessel and is present at birth
92
In children what are cardiac defects classified as
Blood flow patterns
- increased pulmonary blood flow
- obstructive defect
- defect with decreased pulmonary blood flow
93
For someone with a cleft palate or cleft lip what are we concerned about
nutrition
94
Which do you correct first, cleft palate or cleft lip
Cleft lip
95
What should you do frequently with a client that has a cleft palate and or lip
burp them
96
After a cleft lip repair what position do you put the client and what do you place on the patient
Put them on their back, or side lying and use elbow restraints
97
What do you clean the suture line post-op a cleft lip
Saline
98
When is the best time to repair a cleft palate
Before speech develops around ages 1-2 years
99
What should you avoid with a cleft palate repair
Avoid putting anything in the mouth
100
What kind of diet do you have a patient that has a cleft palate repair
Soft diet
101
Are speech defects common after a cleft palate repair
yes
102
What is the difference between Gastroesophageal reflux and gastroesophageal reflux disease
GERD is the chronic form of GER
and its passage of gastric contents into esophagus
GERD tissue damage of resp structures and is worse
103
A patient with GERD what position do you put them in for feeding and at night
upright position
104
What position do you put a GERD patient in if you want to decrease reflux and improve emptying and decrease chance of aspiration
Elevated Prone position (30 degrees)
105
What are some s/s of pyloric stenosis
projectile vomitting after feeds and they are always hungry after vomitting
olive shaped mass in epigastric region near umbilicus
106
what is the dx for pyloric stenosis
Pyloric u/s
107
What are the tx for pyloric stenosis
Hydration
I/O
Daily weights
Monitor specific gravity
108
What is intussusception (interceptive bowel)
It is when a piece of bowel goes backward inside itself forming an obstruction
109
When someone has a sudden onset, cramps, abdomnial pain intermittent, inconsolability, drawing up of knees, currant jelly stool (blood and mucous)
what are these s/s related to
Interceptive Bowel
110
What should you be monitoring a client with interceptive bowel
The stool to see if it fixed itself
111
What could tx an interceptive bowel
-enema
-surgery
and after resolved they keep patient in hospital for 3 days to make sure it doesn't return
112
What is celiac disease
It is a genetic malabsorption disorder where there is a permanent intestinal intolerance to gluten
113
What is the treatment for celiac disease
No food with glutten
They cannot have BROW
Can have RCs
114
What is BROW that celiac patients cannot have
Barley
Rye
Oats
Wheat
115
What is RCS that the celiac patient can have
Rice
| Corn and Soy
116
What is Hirschsprung's disease
It is a congenital anomaly aka aganglionic (part of the intestine not having any nerves) megacolon that results in mechanical obstruction, usually afffects sigmoid colon
117
The s/s of a hirschsprung's disease
Constipation
abodminal distention
ribbon like stool with foul smells
118
The tx for hirschusprung's disease
Remove portion of bowel that is diseased
| May require 2 surgeries to give healing time
119
What is a common infection in children more so young females affecting most commonly 2-24 months
UTI
120
if a child has failure to thrive, feeding problems, has vomitting and diarrhea what could this show
UTI
121
if UTI is untreated what could happen
Tissue could be destroyed and scarring occurs and this could lead to kidney failure
122
What is important to teach families regarding UTI
That it could re-occur and hygeine
| S/s anything fishy
123
What are some pre-disposing factors related to UTI
- Renal anomalies
- Constipation
- Displaced bladder
- Poor hygeine
- Pin worms
- Sexual activity
124
When are classic signs of UTI's seen and what are they
Children greater than 2 years and
- frequency
- dysuria
- Fever
- Flank pain
- Hematuria
125
After 24 months do UTI's incline or decline in males
Decline
126
What is used to dx uti
urine samle through catherization is most accurate
127
What are tx for UTI
Antibiotic therapy: PO or IV
128
What do you include in a client with hematological disorders
Protective Isolation in their plan of care
129
What is high risk for a patient with hematologic issues and what should be encouraged
Infection, good hand hygeine sterile technique
130
What is sickle cell disease
Hereditary disorder in which hemoglobin is partly or completely replaced with a sickle cell hemoglobin
131
What can occur with sickle cell crisis
decreased blood flow and decreased oxygen leads to pain
132
What are some s/s related to sickle cell disease
Pain in areas of involvement (all sickle cell shaped floating and get tangled and form clot and impede blood flow causing pain)
Anorexia
Exercise intolerance
133
What are some treatment options for someone with sickle cell disease
```
Bed rest
hydration
analgesics
antibiotics
blood transfusion
oxygen
```
134
What pain scale do you use for infants 2 months to 7 years of age
FLACC Scale
| face, legs, activity, crying consolability
135
What do you sue for children 3 years and older
Wong-Baker Pain rating scale (faces scale)
136
What scale do you use for children 5 years and older
Numeric scale
137
What is hydrocephalus
Disturbance of ventricular circulation of cerebral fluid in brain and causes increase cranial pressure
138
What are the s/s of hydrocephalus
- Bulding with palpatation of anterior fontanel
- dilated scalp vein
- depressed eyes
- irritability and change in loc
- high-pitched cry
- setting sun sign
139
What is the treatment for hydrocephalus
Insertion of VP (ventriculoperitoneal shunt)
140
After inserting a VP shunt what kind of care do you provide
- measure frontal occipital circumference
- fontanel and cranial suture assessment
- monitor temp
- put them in supine position
141
What is hydrocephalus associated with
Myelomeningocele which is a sac on the back that the baby born with spina bifida has
142
What do you do with a patient that has a sac on the back (myelomeningocele)
Put the patient in prone position
| cover sac with moist sterile normal saline dressing so it wont dry out
143
What is scoliosis and when is it apparent
It is the lateral curvature and rotation of spine and is apparent before age 10 and can be genetic
144
What contributes to scoliosis
heavy back pack
bags
carrying children on hips
145
What is the treatment for scoliosis think 3 o's
Observation
Orthosis (supports and braces)
Operation
146
What is a common symptom related to lice and how can it be spread
itching through personal contact
147
How are pin worms spread
Hand to mouth
148
How do you collect a specimen to diagnose pin worm
Tape to rectum early in the morning
149
Should the whole family be treated for pin worms
yes
150
What are some s/s of pin worm
- itching
- general irritability
- restlessness
- poor sleep
- bed wetting
- distractibility
- short attention spam
151
What is mebendazole used to treat
Pin worms, also good hygeine and keeping fingernails short is good
152
What causes chicken pox
Varicella zoster virus
153
What are some home remedies that help with chicken pox
oatmeal baths
| baking soda paste
154
What does the varicella zoster cause in adults
Shingles
155
What is the name of the virus that causes mononucleosis
Epstein Barr
156
How is it spread
Through direct intimate contact (kissing disease)
157
How should Mono be treated
Rest, analgesics and fluid
158
What organ can be enlarged with Mono
Spleen therefore no contact sports
159
After a tonsillectomy how should a client be positioned
Place on side and elevate HOB or Prone to prevent aspiration
160
Do we give brown or red fluids post op a tonsillectomy
No
161
What can indicate to the nurse of a hemorrhage after a tonsillectomy
Constant swallowing
162
How many days post op is a client at risk for hemorrhage
up to 10 days
163
What are some common complaints post op tonsillectomy
Sore throat and slight ear pain
| Low grade temp and bad breath
164
What part of the ear is affected with otitis media and what is blocked
middle and the eustachian tube is blocked
165
What does an otitis media follow from
Upper respiratory infection
166
What are some s/s related to otitis media
Tympanic membrane bulgy and bright red
167
What are some treatments for Otitis media
- heating pad
- lie on affected side
- avoid smoke
- tympanostomy tube
168
Should a client who has otitis media be chewing
No give soft foods
169
What is a tympanostomy tube
It's a tube used to drain fluid from middle ear
170
Is it ok if tubes fall out, PE tubes or grommet tubes
Yes it's ok
171
How can we prevent otitis media
- sit up baby for feeds
- no bottle propping
- No hard nose blowing
- play blowing games
- avoid smoke
172
What should you do if tubes are in and you need to bath baby
wear ear plugs
173
Why are peanuts dangerous when aspirated
They swell and crumble
174
Why does a mentally challenged child often deliberately do things to displease
for attention
175
Why don't you give IM medications to the ventrogluteal muscle for children who have not been walking for at least a year
Because that muscle hasn't developed yet
176
After a perineal surgery what position do you put your client in post-op
Never PRONE
| On the other side to decrease stress on suture line
177
What do you give an infant if you want to make them vomit because it irritates their stomach
Syrup of Ipecac
