Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Peds Final > Pediatrics Final > Flashcards

Pediatrics Final Flashcards

(119 cards)

Start Studying
1
Q

If a pt comes into triage and you are worried about hyperglycemia what findings would make you now worry that it is actually DKA?

A

1) If pt has fruity breath (sometimes smells like rotten apples)
2) Kussmaul respirations (deep & rapid respirations)
3) Confusion → neurological changes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

When do you administer glucagon?

A

When there is concern for low blood sugar → when they are hypoglycemic, but they cannot swallow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

If a pt is hypoglycemic but can swallow, what do they need? what can we give them? (5)

A

they need 10-15 g simple carbs, can be:
1) 1 tbsp sugar
2) 4 oz juice (ppt says 3-6oz)
3) 8 oz whole milk
4) graham crackers
5) 6 oz regular soft drink

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

If a hypoglycemic pt has severe confusion why would we administer glucagon as opposed to carbs?

A

they are not coordinated → so we are worried that they are going to aspirate or not be able to swallow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Are children with diabetes ever told to restrict fluids?

A

NO! There is NEVER a time where they should restrict fluids → bc dehydration is a huge risk for them

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

If diabetes pts have the stomach virus, why must they always be evaluated?

A

they are at such high risk for becoming dehydrated and that just complicates their insulin requirements!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

List the Sx of hypoglycemia (first 6 are from test review, but there are 17 total)

A

1) Confused, seems out of it
2) Lack of coordination
3) Slurred speech
4) Hunger
5) Sweating
6) Tachycardia
7) Pallor
8) Trouble with concentration
9) Headache
10) Shakiness
11) Lightheadedness
12) Palpitations
13) Shallow/normal respirations
14) Unusual feedings
15) Blurred vision
16) changes in emotional behavior
17) seizure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

how do we confirm hypoglycemia?

A

check glucose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What can happen if a hypoglycemic pt has a seizure?

A

they go into a coma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what blood glucose value confirms hypoglycemia?

A

< 70

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

let’s say that you saw an adolescent at the playground and he is walking around confused and seems out of it, how would you know they are hypoglycemic?

A

If you happen to have a glucose monitor on you while you are at the park, you would check that

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

List the sx of hyperglycemia (first 8 are from test review but there are 15 total)

A

1) Polyuria → increased urination
2) Polydipsia → increased thirst
3) Polyphagia → increased hunger
4) Nausea
5) Vomiting
6) Dry mucous membranes
7) Poor skin turgor
8) Confusion
9) Abdominal pain
10) Skin → warm, dry, flushed
11) Diminished reflexes
12) Weakness/lethargy
13) Weak pulses
14) Recurrent vaginal yeast
15) Oliguria (late)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the difference btwn sx of polyuria & oliguria in hyperglycemic pts?

A

Polyuria is an early sign
Oliguria is a late sign

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

If your pt has hyperglycemia but you are not worried about DKA, what would you do?

A

just monitor glucose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What 8 hr fasting glucose level confirms hyperglycemia?

A

126 mg/dL or MORE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what random blood glucose level confirms hyperglycemia?

A

200 mg/dL or MORE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what oral glucose tolerance test level confirms hyperglycemia?

A

200 mg/dL or more in the 2-hr sample

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What glucose level indicates DKA?

A

hyperglycemia that is > 300 mg/dL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is the first priority when a pt presents with the classic sx of DKA?

A

check ketones (if they have fruity breath odor, confusion or kussmaul)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

If a pt with suspected DKA comes into the doctors office, what do we do?

A

need to send them to the ER! they cannot go home or stay in the office

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

if a pt comes in with deep & rapid respirations and fruity breath odor, you would choose on the test to check for ketones over checking glucose. why?

A

because you are suspicious of DKA, and checking for ketones is the priority for DKA.

if you do not check for ketones, you do not know if it is DKA.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

what are other nursing actions for DKA? (4)

A

1) Cardiac monitor
2) Venous access
3) IV fluids & electrolytes
4) Insulin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What must a school nurse know/do for a child with diabetes? (2)

A

1) know the insulin they are taking
2) need to check glucose before gym class/physical activity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

why does glucose need to be checked before physical activity?

A

If it is too low, they need to eat!!

If their glucose is high, we do not worry as much. But if it is low, they cannot exercise without eating first

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
does early diagnosis of diabetes lead to more desirable outcomes?
Yes, it can prevent them from going into DKA
26
If you have a pt come into the office with unexplained weight loss and some sx of increased hunger & thirst, what do we want to do?
get them checked for diabetes
27
what can cause T1DM?
autoimmune, genetic, & unfortunately sometimes can be triggered after viruses
28
when is GHD common diagnosed?
typically early childhood like age 5
29
is GHD typically genetic? (think of the 4 risk factors)
it can be but not always risk factors: 1) hereditary disorders 2) structural factors 3) other pituitary deficiencies 4) idiopathic
30
What is GHD linked to?
low self esteem
31
what a very important nursing action for a pt with short stature or a pt you think has GHD?
monitor for low self esteem
32
low self esteem in GHD is a lot of times part of what?
the decision making in growth hormone replacement
33
How long do children on growth hormone replacement stay on it?
they do not stay on it their entire life They stop it when the endocrinologist determines that they have terminated their growth but oftentimes when they have reached their predicted adult height
34
predicted adult height in pts with GHD is based on what?
their parental heights
35
does every short person have GHD?
No
36
Can you mix insulin glargine with other insulin?
NO! Do not mix with other insulin due to incompatibility
37
what nursing actions should be done regarding insulin administration? (3)
1) Observe guardian and child drawing up and administering insulin​ 2) Observe guardian and child using the insulin pump ​3) Client education
38
What must be taught to pts regarding insulin administration? (2)
1) rotate injection sites 2) inject at 90 degree angle
39
when mixing a rapid or short acting insulin with a longer acting insulin, what should be drawn first? why?
draw up shorter-acting insulin first and then the longer-acting insulin​ this reduces the risk of introducing the longer-acting insulin into the vial of the shorter-acting insulin
40
What does a nurse educator need to do to successfully teach family about glucose mgmt. in newly diagnoses diabetic? (2)
1) teach back method 2) make sure they understand nutrition
41
A big component to understanding diabetes is not just insulin, but also what?
nutrition
42
why is it important to understand nutrition in pts newly diagnosed with diabetes?
when they are first diagnosed they will not have tools like continuous glucose monitoring & insulin pumps they need to understand nutrition before switching to those tools
43
what do adolescents need to understand about exercise expenditure?
it can change their glucose needs!!
44
what is the most common tx for DDH for newborns to 6 m/o?
pavlik harness
45
how should a pavlik harness be worn? why?
Put the harness over the clothes → want to have something cotton in between the skin & the harness so there is less skin breakdown!
46
what must the family know if their child has to wear pavlik harness?
how to assess for skin breakdown → redness, skin peeling, any type of blistering
47
how long does the child wear the pavlik harness?
23/24 hrs a day → only take off to shower/bathe
48
what kind of soaps & lotions must be used when a pt is wearing pavlik harness?
mild soaps and lotions!! Want to use lotions that are more like ointments → Vaseline & Aquaphor are ok!
49
what kind of lotions do we NOT want to use when a child is wearing pavlik harness?
Lotions should not have fragrance & should not cause stickiness to the actual harness bc we do not want it to be rubbing against the skin
50
what do parents need to make sure of when their child is wearing a pavlik harness?
Make sure there is no soiling bc it is around their pelvis → skin MUST be cleaned if they throwup or have a blowout
51
What would be a positive finding on physical exam that suggests possible DDH?
Positive Ortolani and/or Barlow exams → when we suspect DDH If there is a question that says negative Ortolani & Barlow that is NOT DDH
52
When adolescents with scoliosis have to wear braces, the main thing we are going to work with them on is what?
self-esteem
53
how long are scoliosis braces worn?
23/24 hrs a day *ONLY taken off for showering *They sleep in it
54
what must adolescents with scoliosis understand? why?
the importance of wearing brace we are trying to avoid surgery which itself is very complicated & uncomfortable
55
how does the scoliosis brace need to be worn?
on top of clothing
56
main thing with adolescents & scoliosis is....(2)
assessing self-image/mental status & convincing them that they need to wear the brace
57
what is the nurses biggest job when a pt is casted?
neurovascular checks
58
what should be done during neurovascular checks on a casted pt?
1) Capillary refill checks 2) Check that there is no hotspots against the skin 3) Make sure you can slip fingers between skin & cast → it should NOT be completely tight 4) They should have some sensation → tell you they feel cast against skin
59
how do we instruct pts to help reduce swelling?
ice & elevation
60
how long can ice sit on skin?
only 10-15 mins at a time
61
would we put ice over cast?
Would not put ice over the cast, only injury sites & areas surrounding
62
what is a big thing we do for swelling for pts with a cast?
elevation
63
what do we use to reduce swelling for pts with sprained ankle?
rest, ice, compression, elevation
64
for pts with a fracture that has a cast, when should families know to return?
if it is swollen or they lost sensation
65
if there are hard spots on the cast from the plaster, what do we do?
moleskin around the edge of the cast so it doesn’t breakdown skin
66
what is important to know regarding bathing & having a cast?
Cannot get it wet → make sure families understand how they can bathe with cast since they cannot take it off
67
nurses are mandatory reporters. what does this mean?
Must report any type of suspected child abuse → do not investigate, just report red flags
68
What age group having a fracture would be the most concerning for maltreatment?
Infants that are not mobile yet
69
If a 3 month old supposedly rolled off the bed and broke their arm what is the first nursing action?
report suspected abuse to children youth services bc this injury is unlikely for that age group
70
what is VAERS?
vaccine adverse event reporting system
71
who can report to VAERS?
Anyone can report → concerned citizen, teacher, whoever
72
what does the pneumococcal vaccine protect against?
**BIGGEST thing is meningitis** Also pneumococcus
73
what does DTaP vaccine protect against?
Diphtheria, tetanus & pertussis
74
how do DTap and Tdap differ?
Tdap → same thing, the components are just different The bigger letters are the biggest components: - Tdap is for adolescents because they need more tetanus - DTaP is for babies because they need more diphtheria & pertussis
75
what does Hib vaccine protect against?
Haemophilus influenzae type B
76
what does HepB vaccine protect against?
hepatitis B
77
what % efficacy does MMR vaccine have?
98% efficacy → get 90-95% after the first dose & 98% after 2nd dose.
78
MMR is one of our best vaccines but it gets the worst rep out there. why?
people believe MMR vaccine is linked to autism which has been proven wrong
79
what should the nurse do when telling families about MMR vaccine? (3)
1) Let them know it is one of the best vaccines out there 2) Tell them that even if they only did one dose they are going to achieve a decent amount of immunity 3) Tell them that there is truly no link between MMR and autism
80
How can we explain the risk vs benefits of vaccine to families?
Vaccines are NOT proven to have no risk → but they are proven to have more benefit than risk as nurses we must be truthful with our patients & inform them of this and that benefits outweigh the risks
81
what are potential reactions to vaccines?
1) They can have fever after vaccine → very very small risk for febrile seizure 2) Can have reaction at the skin level → redness, bruising, uncomfortable, hot & itchy
82
how can skin reactions to vaccines be tx?
Can tx with topical benadryl or hydrocortisone cream
83
what risk comes with measles?
can lead to long term respiratory complication, hearing loss, & death
84
how can you best explain herd immunity?
The more people that get the vaccine, the less people it can be spread to **About 85% of population (community) needs to get the vaccine to achieve herd immunity*
85
If you have a question where the child is getting ready to go through a painful procedure your first nursing action is to do what?
Speak to the child and make sure they understand the procedure & make sure their questions are answered
86
What is assent?
making sure the pt truly understands what they are about to go through
87
where are most childhood cancers found?
tissues
88
What infection precautions should be taught to families with immunocompromised patients? (4)
1) Hand hygiene!! 2) Abx prophylactic → if prescribed make sure they know the instructions on how to take 3) Stay away from sick people!! 4) Stay away from large groups of people **Think about infectious control**
89
When considering nursing dx for children starting chemo or radiation what needs to be considered first when a child is facing a poor prognosis?
Ask open ended question to assess where they are in accepting their diagnosis
90
When a child undergoing treatment for pediatric cancer how can we help them when they feel powerless? (2)
1) Ask an open ended question → “what does it mean to feel powerless?” 2) Then try to give them areas where they can regain power → help by supporting them and helping giving them a choice
91
what are examples of ways to assist the child in regaining power?
letting them choose what food they eat, what arm their IV is going in, etc.
92
What skin care needs to be taught to patient/parents for radiation exposure? (5)
1) Cannot go in the sun 2) Cannot put Vaseline on their skin 3) Not supposed to wash their skin with soap → sometimes they are prescribed gentle soaps but they are not supposed to 4) Be careful with clothes rubbing against skin 5) Cannot wipe off the marks of the radiation tattoos → need to know where the target area is
93
What are nutritional considerations that should be given to children undergoing chemo?
1) They need high calorie and high fat foods!! 2) Ask what favorite foods are → think how to add proteins & fats to it (maybe protein shakes & puddings)
94
What makes it harder for kids to eat when they are on chemo? what could end up happening?
they are at higher risk for ulcerations could end up on feeding tubes
95
what is the classic appearance of impetigo?
yellow, honey crusted pimples → they ooze & that is why they crust
96
what causes impetigo?
bacteria, so it is infectious
97
what are the tx options for impetigo?
Topical abx → mild impetigo Oral abx → severe impetigo
98
What precautions would be necessary if a child w impetigo was hospitalized?
contact
99
what is scabies?
a mite that grows under the skin → break out to waist and burrows
100
what is the clinical appearance of scabies?
**Pencil like lines rash will break out** → creases in fingers & toes, underneath breasts folds & arm folds, armpits, groin folds
101
If the question says the pt has asthma but has pencil like marks on the skin, what do you have to do?
tx for scabies
102
What precautions are necessary if child w scabies is hospitalized?
contact
103
how is scabies spread?
Direct contact! All family members must be Tx If adolescent is sexually active → partners must be treated as well
104
what is the clinical appearance of tinea corporis?
**Ringworm → round clear ring in the center with crusty edges “crusty donut”**
105
how should cream be applied to tinea corporis and why?
**Biggest thing → cream must be applied at least 0.5 to 1.0 inch outside the ringworm rask** Bc the spores are often in the skin before it is visible, so the rash can actually be in the process of expanding
106
how is tinea corporis spread?
Direct contact (can be indirect if it is on the mat) - Through pet dander - An infected mat → wrestlers or gymnasts - Direct contact with someone else that has it
107
does a child w tinea corporis need to avoid sports?
YES → they cannot participate in sports until they have had tx for at least 72 hours
108
list the characteristics of 1st degree burns
red non-blistering (like basic sunburn on face)
109
list the characteristics of 2nd degree burns
blisters some thickening little bit of lifting
110
list the characteristic of 3rd degree burns
charred center
111
if you have a pt who was in a house fire, aside from skin burns you also have to check for what?
inhalation injury
112
for any type of smoke exposure why do we have to check for inhalation injury?
they could be acting fine & still have inhalation injury
113
list the common sx of ADHD (5)
1) Difficulty concentrating 2) Poor test score (sometimes not always) 3) Poor organization 4) Forgetfulness 5) Misplace/lose things
114
what is the nursing priority for pts w ADHD?
pt education is not easy for someone with ADHD (also not easy for the child’s parent) so find something to entertain the child in order to be able to give education
115
list common sx for ASD (3)
1) altered communication 2) cannot always express how they are feeling 3) altered sleep patterns
116
What is the priority for nurses to do for pts w ASD who have altered communication?
help them to find other ways to communicate
117
What is the nursing Dx for ASD? why is this important?
disturbed sleep pattern not safe to have child wandering house when parents are sleeping
118
what are nursing actions for health sleep habits? (6)
1) good sleep hygiene (no screens before bed i.e. iPad) 2) calming corners 3) low dim lights 4) low noise (white noise or brown noise) 5) calm environment (basically decrease environmental stimulation) 6) safety principles → making sure there are locks high on the doors so they’re not going to become a flight risk, sleeping tent to keep them in one confined area, depends on age too
119
what is the last resort tx for ASD?
medications

Peds Final (1 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions