Peds Final Flashcards
(38 cards)
Erikson’s Stages
- Trust vs. Mistrust (Birth-18 months)
- Autonomy vs. shame + doubt (18 months-3 years)
- Initiative vs. guilt (3-5 years)
- Industry vs. inferiority (5-12 years)
- Identity vs. Role confusion (12-18 years)
Isotonic dehydration
- Lose electrolytes and water equally
- Primary form in kids!!!
- Sodium levels are normal
- Biggest concern is shock!!
Hypotonic dehydration
- Lose more electrolytes than water
- Sodium levels are low (<135)
Hypertonic Dehydration
- More water is lost than electrolytes
- Most dangerous type of dehydration!!
- Sodium levels are high (>150)
- Seizures are more likely
- Tachycardia is earliest sign of dehydration
- For each 1% weight loss = 10mL/kg fluid resuscitation
Mild dehydration
- Fluid loss less than 50mL/kg
- Capillary refill less than 2 seconds
Moderate dehydration
- Fluid loss 50-90mL/kg
- Capillary refill 2-3 seconds
Severe dehydration
- Fluid loss greater than or equal to 100mL/kg
- Capillary refill greater than 3 seconds
Calculation of fluid requirements
Child who weighs 1-10kg = 100mL/kg
Child who weighs 11-20kg =
1000mL + 50mL/kg for each kg over 10 kg
Child who weighs more than 20 kg =
1500mL +20mL/kg for each kg over 20kg
Renal Diet
- Low protein
- Low phosphorus
- Low sodium
- Low potassium
- HIGH carbs
- HIGH calcium
LIMIT FRESH FRUITS + VEGGIES
Celiac diet
No gluten!!
(no wheat, rye, barely, or oats)
Signs/Symptoms of increased ICP
Early:
- Headaches, diplopia (blurry vision), N/V, vertigo, seizures
Late:
- Bradycardia, decreased LOC, decreased motor response, diminished response to pain, cushing’s triad (bradycardia, HTN, irregular respirations)
Infant:
- Wide sutures, tense/bulging fontanels, high-pitched cry, setting-sun sign
What diet for seizure prevention?
ketogenic diet:
(high fat, low carb, adequate protein)
Wilm’s tumor Nursing care
- Surgery ASAP to remove tumor, affected kidney, and adjacent adrenal gland
- DO NOT PALPATE!!!
What is wilm’s tumor and what are signs and symptoms
AKA nephroblastoma
- most common malignant renal and intra-abdominal tumor in childhood
- More common in asian and black children
Pyloric stenosis
hallmark signs
- projectile vomiting
- moveable olive-shaped mass in epigastrum
Pertussis
(aka whooping cough)
symptoms:
- runny nose
- cough that becomes more severe and spasms
- flushing or cyanosis
- vomiting
treatment:
- antibiotics
- steroids
Asthma symptoms
- wheezing and dry cough
- prolonged expiration
- restlessness + fatigue
- tachypnea
- cyanosis
- chronic use of accessory muscles for respiration can lead to barrel chest
nursing care for asthma
- assess resp. status and monitor pulse ox
- admin. humidified oxygen prn
- position high-fowlers and avoid cold liquids to avoid bronchospasm
- sudden cessation of wheezing + decreased breath sounds = worsening
- maintain IV access
Cystic fibrosis patho
- increased viscosity of secretions
- lungs atelectasis
- clogged pancreatic ducts
- absence of pancreatic enzymes in small intestines - unable to absorb fats/protein
Cystic fibrosis symptoms
- cough and sputum
- dyspnea and decreased SaO2
- crackles or wheezes
- cyanosis
- digital clubbing
- bulky, frothy, foul-smelling stools (steatorrhea)
- meconium ileus (bowel obstruction)
Nursing care and meds for cystic fibrosis
- fat soluble vitamins (A,E,D,K)
- administer pancreatic enzymes w/ meals and snacks
- avoid exposure to resp. infections
- chest percussion and postural drainage
- activity and exercise will loosen secretions
What is the main diagnostic cystic fibrosis?
if before birth:
- prenatal DNA of amniotic fluid
if after birth:
- sweat test
Vaso-occlusive crisis symptoms
- pain
- priapism
- acute chest syndrome
- stroke
Hemophilia treatment
- factor VIII
- no heat therapy
- No IM injections
- no aspirin/NSAIDS
