Pediatrics Flashcards by Julie Hodgman

Anterior fontenel closes when?

Posterior?

Anterior: 12-18 months
Posterior: 2-3 months

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How to introduce foods to infants? Why?

One at a time because of allergies

Have an immature GI tract causing vomiting…. What caused the vomiting?

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Most common reason for failed potty training
How much milk should a 15mo drink/day?
When is the best friend stage
Major accident causes up to age 1?
Accidents between 6-12?

Not ready
2-3 cups - BALANCED diet and not just milk
9-10
Falls, poison, burns
MVA - biks, 4 wheelers, increased kidnapping risk

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How is the growth rate between 6-12?
Calories for a school-age kid?
How much sooner is girl puberty?

DEC - getting ready for a spurt
2400 calories
1-2 years

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Vitals/assessment

Start with what?
Best way to get VS?
Talk to who first?
What if you can't get them?
Order of VS?
How long to mx RR and HR
When we can't do rectal T?
When is rectal T recommended?
Who can we do axillary T? Temporal?
When to start oral T?
Do we add a degree ever?

Observation
Distraction
Parents
Record that you couldn't
RR, HR, BP, T
1 full minutes - bc of abnormalities 
When immunosuppressed
Recommended for kids younger than 2
All ages; All ages
Age 5-6; can be cooperative
NO!! always note where recorded

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Common site for O2?
How to record O2?
Make sure monitor matches what?

Fingers, toes
Record what is going on when recording
Monitor matches radial pulse

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Communication: NEWBORN

Age?
Primary mode of communication?
How do they express themselves?
What do they respond to?
What has a positive effect?
Encourage parents to what?

Birth - 1 month

Nonverbal
Express though crying
Respond to voice end presence
Touching = positive
encourage touching

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Communication: INFANT

Age?
Primary mode of communicant?
Being doing what?
How do they express themselves?
Do they comprehend words?
Respond to what?
Nursing strategies?

1 month - 12 months

Primarily nonverbal
Begin vocalizations
Express through crying, facial expressions
NO COMPREHENSION of words
Respond to patting, rocking, stroking

Nurse: high-pitch voice, cuddle, pat, rub to calm

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Communication: TODDLER

Age?
Evolving what?
What kind of language is greater?
How do they think?
What is their vocal like?
Primary question?
Attention span?
What is there memory like?

1-5 years

Evolving verbal skills
Greater receptive than expressive
CONCRETE thinkers
Vocal depends on development &amp; family use
WHY WHY WHY
Short attention span
Limited memory

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Toddler - Cognitive development

How to they like to express themselves?

How does play help development?

Egocentric
Magical thinkers
Animism

Through dramatic play and drawing

Play is the work of the child

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School - Age: Cognitive development

Age?
They can now use what?
They can understand what?

What is there vocab like?
Expressive vs/ receptive?
Do they misinterpret things?
Can they interpret nonverbal stuff?
How do they express themselves?

6-12
Use logic
Understand POV, cause/effect, body functions

Big vocab
Good balance of express/receptive
Commonly misinterpret things
Can interpret non-verbal stuff
Express through thoughts and feelings

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Adolescent

Age?
What kind of thinking?
Do they understand medical terminology?
Drive for what?
What are they building?
Need what?

Nursing strategies?

13-18
Abstract without full adult comprehension
Med is limited
Drive for independence 
Building trust and understanding
Need PRIVACY

Private area talking, straightforward, bye bye parents for part of interview

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How might a child with disability feel if they can’t communicate?

Nursing strategies

Helpless, fearful, anxious

Gestures, picture boards, writing tablets
System of head knows or eye blinks

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What is circumoral pallor?

Other S/S RR distress?

Blueness/pallor around the mouth
S/S RR distress

Accessory muscle use, nasal flare, sternal retractions, cap refill

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LTB (Laryngotracheobronchitis)

What is it?
Primarily affects who?
Caused from what? - Ex?

S/S

CROUP
Viral upper airway infection
Kids under 5
RSV, parainfluenza, adenovirus

SOB, barking cough, increased T

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Treatment of LTB (Croup)

Mild croup @ home?

More severe?
Meds?

Mild: steam, fresh air, cool temp therapy

Severe
Meds: Neb Epi; observe for relapse w/in 2 hr
CS to decrease airway inflammation

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Epiglotitis - DON’T CONFUSE W CROUP

Key differences? - S/S; sound vs look?

Severe and obstructive inflammation

No cough, dysphagia, RAPID progression to severe RR distress

Epiglotitis: Worse than they sound
LTB: Worse than they look

Also remember that asthma is not a virus and also leads to obstruction

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RSV

What is it?
Leading cause of what?

Risk Factors?
How to we PREVENT is?

Acute VIRAL infection affecting the bronchioles - includes RSV pneumonia, bronchiolitis, RSV

Leading cause of lower R illness in kids

RF: premie, congenital, smoke

Prevention: Palivizumab

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RSV

S/S
How fast does it progress?

How to treat? mild vs severe

S/S: UR infection, nasal discharge, fever, SOB, NP cough, ^RR, nasal flaring, retraction

Worse in 2-3 days!! CAN PROGRESS FAST!

Treatment
Mild: anti-paretics

Severe
Suction, O2 and possible MV
IV fluids
Albuterol, anti-paretics

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Pneumonia

Causes --
Viral
Bacterial
Mycotic
Aspiration

S/S

Inflammation of the lungs

Viral - RSV, Adenovirus
Bacterial - Strep, kids
Mycotic - walking, adolescent
Aspiration

S/S: RR distress symptoms

Tx: Depends on type
ABC, O2, fluids, antibiotics, hydrate, nebulizer

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Good pet for asthma?

Important to teach?

FISH

triggers

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CF
2 body systems affects?
What do they need with food?

Diet?
Vitamins?

RR and GI
Pancreatic enzymes within 30 min of eating - DONT crush/chew or will burn mouth

High fat, calories, protein (Don’t absorb fat well, malnourished)
Water-soluble bc don’t absorb fat well (ADEK)

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S/S CF

Taste?
Stool?
E imbalance?
1 sign in newborn?

How do you get the gene?

Tx?

Study These Flashcards

SALTY BABY; sweat chloride test dx
Steatorrhea 
Decreased Na
No meconium (bc thick and sticky poop)
Thick &amp; sticky secretions - clog lungs and pancreas; can't secrete enzymes

Must get gene from BOTH parents

Intense pulmonary tx to mobilize the secretions every day

Down syndrome

Prone to what infections? Why?
Frequent problems?
Importan to inform parents of what?

Study These Flashcards

RR infections d/t poor immune system
Heart defects
Genetic counseling for risks

HF is usually due to what in children? Early S/S? Tx? Meds?

Congenital defects ^ HR @ rest and with slight exertion ^ RR Scalp sweating Sudden weight gain (FLUID = HEART) Treatment Anything to decrease CO Cool humid O2 Uninterrupted sleep Meds Digoxin ACE I Furosemide

Digoxin Main S/S toxicity? Hold if HR is ____ ; infant vs kids Infant usual dose? When else to hold it? When to give it? Can we mix it? What if you miss a dose? What needs checked with another nurse?

Bradycardia and vomiting | Infant- HR

Nutrition for HF in children ``` What to do before meals? Size/frequency? Calories? Baby - feed how often? Max time to feed? Kind of nipple? What about breastfed babies? ``` What is different between kids and adults?

``` Rest before eating Small frequent meals Increased calories Baby - feed q3h (enough rest) Feed max 30 min Soft nipple; big hole BF baby may need more calories ``` Usually don't need Na or fluid restriction

What are hyper cyanotic spells? Often seen with what defect? ``` Treatment-- Position? O2? Meds? Clothes? Stimuli? what if they cry? Infections? ```

Tet spells, Tet of ballot Knee-chest; dec venous return , ^ preload 100% O2 Morphine for sedation Loose diapers/clothes DECREASE STIMULI - NO STRESS Respond to cries fast Treat infections fast - can't handle fever

What are the effects of chronic hypoxia?

Polycythemia - Increased RBC Body makes a lot of RBC but there isn't enough O2 for them to bind causing THICK blood --> Hydrate, no room for platelets Clubbing - late sigh Poor growth and development Squatting

Heart defects are classified by what?

Blood flow

Cleft palate/lip Top concern? What to correct first? Need to do what frequently? Best way to feed?

Nutrition Correct lip - palate not boney enough Burp - risk aspiration Long nipple/syringe to side of mouth

Cleft lip repair Position? Goal? Clean with what post? Restraint type?

Back or side lying, NEVER PRONE Protect suture line Saline Elbow - keep arm straight

Cleft palate repair Best time to do it? Avoid what? Diet? Are speech deficits common after?

Before speech develops; between 1-2 Hard things in mouth (straw, therm, cookie) Soft diet YEAH

What does GERD lead to? Feed what position? Sleep what position? Best way to feed?

Tissue damage to RR structures --> pneumonia and bronchospasm Feed upright Sleep: elevated prone - dec reflux, improves stomach emptying Small frequent meals with thickened formula (tbsp rice)

What essential is pyloric stenosis? Dx? Tx?

Enlarged pylori (opening of stomach to duodenum) - inc pressure causes projectile d/t tiny opening Dx: Pyloric US Tx: Hydrate, I/O, daily wight, monitor specific gravity

S/S intussusception Onset? **Stools? what might fix it?

Backward bowel causes obstruction Sudden onset Cramping, abd pain intermittent, inconsolable Drawing up knees CURRANT JELLY STOOLS Barium enema, then surgery if not

Celiac disease Tx Acronyms

Intolerance to gluten NO BROW - barley, rye, oats, wheat YES RCS - rice, corn, soy

Hirschsprungs What it is? S/S - stools? Tx

Ganglionic megacolic - bowel obstruction d/t piece of intestine w/o nerves and poop building up S/S Constipation, distention Ribbon-like stools w foul smell Tx Remove diseased part of bowel

UTI S/S Could lead to what untreated? Predisposing factors? 2 Dx Tx

FTT, feeding problems, vomiting/diarrhea Kidney failure RF 2 Frequency, dysuria, fever Flank pain Hematuria Dx: UA Tx: Antibiotics

Hematologic disorders What kind of isolation needed? High risk for what? Teaching?

Protective isolation Infection Hygiene; hand washing Sterile technique for central lines

Sickle cell disease Path S/S Tx

Dec blood flow > dec O2 > Pain S/S: PAIN, anorexia, exercise intolerance ``` Tx BEDREST AND HYDRATION Pain meds Antibiotics Blood Oxygen ```

How are these done FLACC - 5 parts Wong-Baker Age

FLACC - 0/10, Face, legs, activity, crying, consolability Age 2 mo - 7r Wong: FACES; Age 3+

Hydrocephalus Patho S/S Tx

Increased CSF; ^ICP ``` S/S Bulging anterior fontanel Dilated scale veins Depressed eyes Irritable, change in LOC High-Pitch cry Sun-setting eyes ``` Tx: VP shunt

Post of care of VP shunt Measure what? Assess what? Monitor what? Position?

Mx frontal occipital circumference Assess frontal and cranial suture line Monitor temp SUPINE

What to do when a baby is born with spend bifida?

PROTECT THE SACK - NS dressing | Prone

What can contribute to scoliosis? Tx: 3 Os

Heavy backpack Bags Carrying kids on hips Observation Orthosis (braces/support) Operation (spinal fusion; rods)

Pin worms Spread how? How to collect specimens? Who needs treated? S/S Tx Med? Hygiene?

Spread by hands to mouth (sandbox, dirt) Tape test to rectum early in am before BM WHOLE FAM - eggs can be everywhere S/S Bad butthole itch Irritable, restless, poor sleep, distracted Bed wetting Tx Mebedndazole Wash hands; clean fingernails

Relieve itch chicken pox

baking soda paste

Mono Virus name? Spread how? Tx

Epstein Barr Direct intimate contact Tx: rest, alagesics, fluid Enlarged spleen > no contact sports

Tonsillectomy - postop ``` Position Avoid what fluids? Indication of hemorrhage? Risk for hemorrhage how long? Common complaints? Breath? ```

``` HOB elevate; prone Red/brown fluids Frequent swallowing 10 days (scabs slough off) Sore throat, ear pain, low grade T Bad breath d/t old blood ``` LOT of ear pain = bad

Otitis media Patho usually follows what? S/S Tx what helps pain? Avoid what? Can they hear well?

Infection of the middle ear d/t blocked eustachian tubes Upper RR infection S/S Redness tympanic membrane Rupture is ok it'll grow back ``` Tx Heating pads Avoid chewing, smoke May need tubes to drain -ok if fall out Might have trouble hearing ```

How to prevent otitis media? tubes? Play what?

Baby it up for feeds No bottle propping No intense now blowing Avoid smoke tubes: wear ear plugs in water Play blowing games

Why are peanuts dangerous? Mentally challenged kids like what? IM in butt

Swell and crumble Attention - displease you Muscle not well developed - bad

What is Syrup of Ipecac?

Makes you vomit Poison Give more if not working Big bucket NG lavage if REALLY not working

Age of Eriksons ``` Trust vs Mistrust Autonomy vs Shame & doubt Initiative vs guilt Industry vs inferiority Identity vs Role confusion ```

``` birth - 18 months 2-3 3-5 6-11 12-18 ```

Pediatrics Flashcards

(55 cards)