Peds Flashcards
(32 cards)
Edu for the parents regarding nutrition for a 2 year old toddlers
give the toddler 2 choices for finger foods
What do we teach parents about sex education with preschoolers?
- will ask where do babies come from– ask where the child think they come from and what they already know
- only give info that is asked
- simple, direct, and honest answer
Education for parents on nightmares
parents should validate the child’s fear, rather than discouraging it
“Yes, I agree, monsters are scary; it’s a good thing they aren’t real”
What are some risk factors for suicide in adolescents? (9) select all that apply question
- Depression or mental illness
- History of suicide attempts
- Family history of suicide
- Poor school performance
- Substance Abuse
- Homosexuality
- Giving valued possessions away
- Incarceration
- Loner / No friends
Education on smoking in adolescence
- discuss short/long term effects, unintentional injuries/sexual encounters, school performance, dependency, society, healthy lifestyle, resisting peer pressure, confidence in one’s own judgement
- speak directly
- consider/ hear their input
- why are their reasons important
- collaborate to find a solution
- expect some noncompliance
When doing an assessment, what are two key concepts
- always background info prior to physical assessment
- less invasive first
What do you tell the parent when doing a examination on a child?
Newborn: Keep up running dialog with caregiver, explaining each step as you do it.
Infant: Explain each step; address child by name; perform most invasive parts last
Toddler: Introduce yourself to both child and caregiver; explain most steps to child, but all steps to adult; let child handle instruments; most invasive parts last.
Preschool: Speak to care giver before and after examination; let child decide order of examination; let them try instruments
School-age: Include child in all parts of examination with a Head-to-toe approach- genitals last. Speak to caregiver before and after
Teen: Explain confidentiality to both. Speak to them both together and separately. Head-to-toe. Genitals last.
nursing action in alternatives for pain management
- before pain/ nerves starts
- “take a deep breath in and blow bubbles out” with the child
- avoid “hurt” “pain” “this will be terrible”
- use descriptive words “pinching”
- offer praise, positive reinforcement, hugs, and support for using technique
s/s and hallmark sign of croup
- hallmark: barking/ seal sounding cough
- most likely developed at night suddenly and resolved in the morning (lasting 3-5 days)
- mild URI symptoms (mucus production blocking airway)
- inspiratory stridor
- suprasternal retraction
Postoperative care for Hirsprung disease, regarding ileostomy care
- Observe for fever, abdominal distention, diarrhea, explosive stools, rectal bleeding, straining.
- If any signs are noted above call MD ASAP. Admn. IV fluids and antibiotics to prevent shock and death. - Provide ostomy care to prevent skin breakdown.
- Measure stool and fluid volume
- Consult wound care RN for newly placed stoma
Signs and symptoms of adrenal crisis? (7)
- Persistent vomiting
- Dehydration
- Hyponatremia
- Hypotension
- Hyperkalemia
- Tachycardia
- Shock
post care for joint fluid aspiration
cold therapy to decrease swelling
pressure dressing to prevent hematoma formation or fluid re-collection
assess for infection (fever, joint pain, or edema)
post op/ discharge teaching for cardiac cath
- change dressing the day after
- keep dry for few days
- inspect site for redness, irritation, swelling, drainage, bleeding
- check temp for 3 days– report over 100.4 F
- resume usual diet
- avoid baths for 3 days (shower and ; sponge bath ok)
- avoid strenuous activities for 3 days
- admin Tylenol or Motrin for pain
What are the stages of Hodgkins disease
I- 1 group
II- 2+ groups on the same side of the diaphragm
III- groups of lymph nodes above and below the diaphragm
IV- metastasis to organ (liver, bone, lungs)
A- absence of systemic symptoms at dx
B- systemic symptoms present at dx (fever, night sweats, weight loss)
What is IBS?
abdominal pain relieved by defecation
onset of pain/discomfort associated with a change in frequency and/or form of stool
Inflammatory bowel disease: Crohn’s s/s and found in?
- s/s: abdominal pain, diarrhea, perianal disease, enteroenteric or enterocutaneous fistula, abscess, anorexia
- found in oropharynx, esophagus, stomach
Inflammatory bowel disease: ulcerative colitis s/s and found in?
- s/s: abdominal pain, bloody diarrhea, urgency, tenesmus
- found in colon (90%)
Ostomy care for a child: (5)
- Set up equipment (warm washcloth, pouch, etc)
- Take off pouch
- Observe skin and stoma- clean thoroughly
- Measure stoma, marking new backing of pouch, and cut to size.
- Apply new pouch
cleft palate guidelines in nutrition
- fed with special cleft lip nipple for bottle feeding
- if unrepaired, at risk for aspiration
- burp infant to expel excessive air taken in during diff sucking
- breast tissue may create good seal
- when suture line heals post op, ordinary feeding may return
- some surgeons allow breast feeding to return immediately
s/s of MILD dehydration
alert soft/ flat fontanels normal eyes pink/ moist mucosa elastic skin turgor normal vitals and skin may have slightly decreased output
s/s of SEVERE dehydration
alert-- comatose sunken fontanels deeply sunken orbits dry mucosa tenting skin turgor increased heart rate (may brady) normal BP (may hypo) cool, mottled, dusky extremities signif decreased output
dx labs/ values for pancreatitis
all levels elevated
- serum amylase and/or lipase
- liver profile
- blood work (leukocytosis, may be hyperglycemia and hypocalcemia)
- C-reactive protein
how do you prepare for an endoscopy?
- bowel cleansing prior to exam
- encourage fluids to prevent dehydration
- NPO
proper nutrition for celiac disease
- no gluten
- allowed: fresh fruit, veggies, milk, meat, fish, peanut butter, cold cuts, dried peas/ beans/ nuts, butter/margarine, sugar, honey, jelly/jam, plain chocolate, coconut, ground coffee, tea, soda, wine (from US)
- not allowed: wheat, oats, frozen yogurt, canned baked beans, french fries, fruit filled pies, dried fruit, commercial salad dressings, prepared soups, canned meats, creamed substances, alcohol distilled from cereals
