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ABSN > Peds Final - Review > Flashcards

Peds Final - Review Flashcards

(67 cards)

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1
Q

how to give meds to reluctant toddler / pre schooler

A

-give them a choice
-mix w/ food
-reward
-change method of delivery

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2
Q

Coarctation of the aorta

A

narrowing of aortic arch distal to the ductus so all the blood gets shunted up lower will have reduced blood flow, upper get high causing headaches, nose bleeds & bounding pulses
treated w/ prostaglandin E and surgery within first 2 years

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3
Q

kawasaki

A

body wide inflammation of veins, capillaries & coronary arteries treated with high dose aspirin for anti inflam & low dose for anti platelet and IVIG if fever is caught within 10 days

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4
Q

CHF

A

failure of the heart to supple enough blood to meet needs leading to sweating, tachy, decrease BF to kdineys, low urine output, cyanosis, SOB, edema, long cap refill

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5
Q

how to give digoxin

A

-1hr before or 2hr after eating
-check apical HR for 1 min prior
-do not mix with food or fluid
-put behind teeth then oral care

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6
Q

when to hold digoxin

A

if apical pulse is <90 in infants / young kids or <70 in older kids or low K+
if missed dose, can give within 4 hrs, but longer hold

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7
Q

signs of digoxin toxicity

A

-vomiting
-nausea
-bradycarida
-anorexia
-neurological & visional dysfunction

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8
Q

tetralogy of fallot

A

1) palmonic stenosis
2) overriding aortic arch
3) VSD
4) right ventricular hypertrophy

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9
Q

pre op care for cath lab

A

-npo for 4 to 6 hrs, clarify morning meds
-assessment including ht & wt
-assess skin can’t bring with a diaper rash or cystic ache
-mark pedal pulses

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10
Q

post op care for cath lab

A

observation of color, LOC, VS, res status, distal extremities, assess dressing for bleeding, fluids, blood sugar (esp hyper) & keep flat for 4-6hrs

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11
Q

bacterial endocarditis

A

infection of the valves and inner lining of the heart (usually occurs from a picc line or dental procedure) -> manifests w/ janeway spots, osler nodes, splinter hemorrhages under nails, petechia, anorexia, joint point & murmur

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12
Q

transposition of the great arteries

A

pulmonary artery arises from left ventricle and the aorta arises from the right ventricle -> treated w/ prostaglandin E until surgery

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13
Q

Hypospadias immediate post op care & teaching

A

urethral opening is on the ventral surface of the penis, surgical correction between 6-18mo no circ before surgery-> post opt care include assessing pressure dressing for drainage, cath care and teaching no tub baths, straddle toys, and baby cannot be carried on hip
more at risk for uti

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14
Q

key facts for GN

A

-caused by untreated strep, give abx
-S/s: headache d/t htn, coke colored urinne, facial edema
-urinalysis: hematuria, proteinuria & elevated SP w/ a negative culture
-diet: no salt, low pro
-bed rest, isolation
manual BP

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15
Q

key facts for acute renal failure

A

-caused by dehy (give fluids) or toxic meds (stop med then fluids)
-dx: low urine out, edema, classic dehy signs
-labs: bun & creatinine elevated, hypo Na, hyper K, hyper Phos
-meds: albumin then lasix

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16
Q

UTI teaching

A

wipe front to back, no tight clothes, hydrate, pee after sex, potty schedule, no bubble baths, change pads frequently
VCUG is reoccurring -> if reflux founds then abx or surgery in severe cases

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17
Q

key facts for NS

A

-S/s: massive proteinuria, rapid wt gain + generalized edema, decreased urine out, normal or slightly decreased BP, hypoalbuminemia
-bed rest & no salt, high pro if edema present + isolation
-meds: steroids & loop diuretics

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18
Q

key facts for HUS

A

-hx of GI bug + V/D, edema, oliguria, elevated BP, abdominal pain
-labs: low platelets & RBCs anemia
-Prevent: wash hands/fruits/vegs, cook & temp, avoid unpasteurized dairy & fruit juices

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19
Q

Downs S/s + treatment

A

-dx: depressed nose bridge & small nose, loose skin, large protruding tongue, wide space in between big toe, delayde sexual development, constipation
-tx: suction, antihis @6mo, blow nose, mist ; persistent feeding ; support neck & swaddle for thermal reg ; fluids & fiber

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20
Q

ADHD

A

-dx: 2 people say difficult concentrating, struggling in school and social settings
-tx: behavioral therapy 1st (front of class, low distraction, short written out task list) then meds (psychostim so clinic every couple months so assess growth & BP)
-med teaching: empty stomach, 7am and noon, no med holidays

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21
Q

DDH + harness

A

head of femur is not in hip socket so harness all the time besides baths prevent sink breakdown & avoid lotions/powders

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22
Q

MD

A

meets milestones then regression around 3-5 yrs
-brainstorm and work with family to keep them independent
-work w/ the therapies

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23
Q

SB

A

-paralyzed from waist down, incon of bowel and bladder (**high risk for uti d/t in&out cathing) + bowel training
-high risk for hydrocephalus after surgery

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24
Q

cast care

A

-neuro vascular checks + skin assessments 5 Ps
-do not stick anything into cast besides fingers
-ice for itching and swelling
-NSAIDs for pain No ibuprofen
-isometric exercises on affected side
kids are scared of removal -> ear plugs, demo on self, distraction

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25
CP
-dx by **missed milestones & persistent reflexes** -keep independent as long as possible -support use of muscle
26
asthma
-proper deliver of meds (control= steroids & long beta 2s, rescue= short beta 2s, bronchodi's & mag sulfact) -med teaching (sit up, shake, breath out, inhale & press, hold 10 sec or spacer) -PERF chart
27
croup
swelling or obstruction of airway creating horse, barky cough, stridor & res distress **viral = LTB, bacterial =epiglottis**
28
Juvenile arthritis meds
1) NSAIDs 2) DMARDs 3) humira or enbrel (biologic agents) 4) corticosteroids + pt and warm baths
29
RSV
airway infection resulting in inflammation -S/s: rhinorrhea, pharyngitis, intermit fever, cold symptoms -> wheezing, fever, feeding problems, increased secretions -> tachy, apneic spells, cyanosis -tx: ribavrin, bronchdilators, cortsteroids, hydration & treat symptoms **suction the child first** **vaccines only for high risk, <29wkers**
30
pertussis
**prevent! w/ Tdap** S/s: coughing so much that they cannot catch breath, decreased intake tx: erythromycin, humidified oxygen, <6mo might need to be vented
31
techniques to reduce reflux
-elevate head of bed -avoid caffeine, chocolate, mint, spicy food, high fat foods
32
tonsillectomy what to watch for post op
-excessive swallowing 8-10 after surgery bc that means bleeding, blood tinged sputum, discourage straws/coughing/laughing/crying -diet: soft, no red foods, no milk products **contraindication for cleft palate, acute infections, uncontrolled systemic disease or blood dyscrasias, <4 y/o**
33
Otitis medias
-how to prevent: limit exposure to cig smoke, no bottles in bed, breastfeed, no pacifier use beyond infancy -allergies increases -S/s: irritable, holds or pulls ears, may roll head, hearing loss if chronic -tx: abx, Tylenol/Ibuprofen, warm compress
34
gastroschisis tx before surgery
**no sac around organs** c section -> loosely cover organs w/ saline -> give fluids & abx -> bring to nicu -> multiple surgery (place organs inn silo in between)
35
gastroschisis nursing role
-sterile, careful handling -monitor for ileus -support family
36
cleft lip post surgery
z plasty in first weeks of life, after surgery place child on back or side **use restraints so they don't pick at sutures** and suction only if necessary
37
cleft palate post surgery
close palate w/ obturators between 12-18months, after surgery place on their bellies w/ restrains and suction only if necessary
38
how to feed baby with cleft lip/palate
caused by inheritance, teratogens during pregnancy, maternal smoking -> long nipple & stim suck reflex , upright, lots of burping, stop after 30-45min
39
calculate fluid needs
-1st ten kg (100 x kg) -2nd ten (50 x kg) -20+ (20 x kg) divide by 24 to get per hour
40
ways to prevent and reverse constipation
-child should have 5g of fiber + their age & fluids and potty schedule tx: water -> add fruit juice into water -> miralax **if intestines expanded, keep them cleared out for 6 mo**
41
how to care for a child w/ HIV
-aggressive antibiotics & prophylactic in the future -modify immunization schedule -very irritable so be calm and supportive -can go to school but if bodily fluids then gloves -increase kcals & protein
42
how to prevent HIV
-safe sex -do not share needles -take meds during pregnancy + c section
43
how to give iron
-acidic environment -use straw to push past teeth then oral care -increase fluids and fiber -do not mix with foods
44
what is the first sign of a sickle cell crisis
swelling & s/s of anemia **joints for vaso occlusive, spleen for splinic**
45
s/s of anemia
pale, bruise easily
46
what triggers a sickle cell crisis
-dehydration -hypoxia / increased O2 needs -infection -trauma -physical and emotional stress -high altitudes
47
effects of chemo
-immunosuppression -hair loss -N/V, decrease appetite & intake
48
DKA treatment
**BS >300, fruit breath, lethargy** 1)fluid replacement w/ 10mL/kg 0.9% NS IV priority- 1st hr 2)lyte replacement over 48hr (0.9% NS + 20 mEq/L KPhos + 20 mEq/L KCl) 2nd hr 3)insulin therapy 0.1u/kg/hr drip 2nd hr (do not give bolus) -**begin dextrose infusion when BG reaches 250-300** (D5 0.45% NS + 20 mEq/L KPhos + 20 mEq/L KCl) 4)careful monitoring, D/c fluids when pt tolerates oral fluids & then give SubQ insulin and stop the drip
49
DM key points
-aspart (novolog), lispro (humalog) are rapid acting, glargine & detemir are long -carb count, no restrictions besides high sugar -when sick stay on insulin routine, check urine ketones, stay hydrated, check BS often -biggest complication is DKA and then cerebral edema if we drop BG too fast
50
PKU diet
-no meat or dairy -limit fruits & vegetables -limit grains **most nutrition comes from pku formula** **can be breast fed**
51
cong hypothyroid med admin
oral thyroid hormone replacement -> start low and then slowly increase **will need to see dr and correct often d/t growth changes**
52
teaching for growth hormones
-administer at night subQ 5-7x/wk -can ice area before to decrease pain -squeeze fat **not making super tall, just to predicted height**
53
in a DKA pt, what do we flush the insulin line with
insulin
54
how do we know if the cancer has spread into the brain
**high risk in leukemia** headache, persistent nausea & vomiting, irritability, dizziness, seizures, behavioral changes, lateral eye movement
55
what does digoxin do
allows hard to contract harder
56
tet spell
**be calm & comforting** -knees to chest -100% oxygen by face mask -give morphine -IV fluid replacement -repeat morphine **do one at a time & do not advance in list unless needed)
57
bacterial endocarditis therapeutic mgt
-IV antibiotics for 2 to 8 wks -surgical removal of significant emboli and/or valve replacement
58
how to prevent bacterial endocarditis
prophylactic antibiotics 1hr before risky procedure for high risk kids
59
Kawasaki clinical manifestations
-fever that is unresponsive to meds -rash & dry lips -strawberry tongue -bilateral pink eye w/o junk -swollen palms **most dangerous when symptoms free in recovery phase bc embolism can form increasing risk for MI**
60
Autism
-dx: social+communication+behavior, abnormal eye contact, flaps, repeating phrases -tx: non verbal com, dim lights, limit ppl in room, calm, talk to caregivers, **what to do vs what not to do**
61
SB procedure immediately after birth
baby on belly -> apply non adherence sterile dressing over the sac -> NICU -> sedate & intubate -> surgery
62
reflexes time frame
-rooting & moro: 4mo -tonic & grasping: 6mo -babinski: 2yr
63
LTB
-slowly progressives and sounds worse than it is -home mgt as long as not inn distress -barky cough -high humidity, fluids, & racemic epinephrine -bed rest and continuous observation **avoid cough syrup/cold meds, bronchodilators & antibiotics**
64
epiglottitis
**life threatening d/t losing airway** -abrupt onset, open mouth, tongue out, drooling & agitated, looks sick & **wants to be upright** -tx: no tongue blades or looking at throat, portal x ray if needed, **sedate -> intubate -> abx - extubate**
65
long term consequences of cleft L/P
-altered speech, dentition and hearing -ear infections **teach good oral care, watch the ears and promote speech**
66
CF key facts
**always suction or pulmonary toilet or vest first** -lose extra salt, dehydration -dx: pilocarpine electrophoresis (salt chloride) >60 -tx: CFTR modulators, abx, hydration, pancreatic enzymes -diet: full fat, high kcal
67
hyperthyroid med : PTU
makes you immunocompromised so if pt gets a sore throat or infection, see medical professional immediately

ABSN (210 decks)

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