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Flashcards in PEDS test 1 Deck (101)
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Trust vs mistrust

birth to 1 year

Infants need consistent, loving care by a motherinf person.

mistrust results when their is deficient or lacking of trust in the infants life, or their basic needs are not met.


Autonomy vs shame and doubt

1 to 3 years

autonomy - the child is able to control their new physical abilites as well as mental abilities

shame and doubt happens when they are made to feel small, are forced to be dependent in areas they capable of being in control.


initiative vs guilt

3 to 6 years

initative, children are able to have their own mind and control their actions with being aware of threats.

If they are bad to feel their actions are bad, they will start to feel a sense of guilt


industry vs inferiority

ages 6 to 12

industry- feel the need to work, want to carry activites that they can finish or complete. start to compete and cooperate with others and learn rules.

if too much is expected of them or they feel they cannot measure up they have feelings of inferiority and inadequacy.


identity vs role confusion

ages 12 to 18 

start to become very concerned with their appearances and discovering their role in life. 

if they have trouble discovering their role they end up in role confusion.


Vaccines with live viruses


influenza (intranasal) - live attenuated


Vaccines given IM (vastus lateralis until 18 months or older, then can be given deltoid as well)

DTap, Tdap, hep A, hep B, Hib, IPV, PCV, influenza, MCV4, HPV


c Vaccines given SQ

MMR, MMRV, MPSV4, Varicella


when will you know  that varicella (chicken pox) is not contagious?

When the vesicles have all crusted.


Pertussis ( whooping cough)

Resp symptoms seen first

cough until they vomit, usually.

direct or droplet spread, or contact with contaminated objects



nursing care for pertusiss

obtain nasopharyngeal culture for diagnosis

encourage oral fluids, offer small amounts frequently/

during paroxysms ensure adequate O2 (put infant on side to decrease risk of aspiration if vomit)

provide humidified O2, suction PRN

observe signs of airways obstruction (increased restlessness, apprehension, retractions, cyanosis)

encourage compliance with AntiBX for household contacts

encourage booster in adolescents

use standard precautions and a mask.


Rota vaccine


first does should be age 6-12wks, shouldnt be given first does after 12wks, should be done with doses at 32 wks, no dose later than 32 wks.


DTap vaccine

Diphtheria and tetanus toxoids and acellular pertussis 

min age: 6 wks

final does between 4-6 yrs


Hib vaccine

haemophilus influenzae type b 

min age: 6 wks



pneumococcal vaccine

min age: 6 wks



pneumococcal polysaccharide vaccine

min age: 2 yrs



measles, mumps, rubella vaccine

min age: 12 months

2nd dose usually between 4-6 yrs



meningcoccal vaccine

min age: 2 years


Nasopharyngitis (common cold) 

caused by many different viruses (RSV, influenza, rhinovirus)

more severe in infants and young children

fever is common in younger children


nasopharyngitis care

rest, fluid, stay home

motrin and tylenol, decongestant if over 6 months, buld syringe

avoid milke products = increase secretions

wash hands !

elevate HOB - helps breathing

premi with underlying cardiac issue or decompensate with RSV- admit to hosp


Acute epigoltitis (type of croup)

EMERGENCY - swollen epiglottis cannot rise and allow airway to open

obstructive inflammation (occlusion of trachea) 

happens between 2-8 

common cause - Hib - get child vaccinated 


Acute epiglotitis care

DO NOT INSPECT THROAT or do with GREAT caution, complete obstruction can occur, should only be done if intubation can be performed immediately if necessary.

Airway management:

watch for obstruction of epiglottis

have intubation or trach equipment ready

drugs- antibiotics can be used-usually see decrease swelling after 24 hrs, steriods and IV fluids are also used.


Acute laryngotracheobronchitis (LTB)

most commone of croup syndromes

usually caused by viral infection

ages 6 mnt - 8 yrs

inflammation of the mucosa lining the larynx and trachea cuase narrowing of airway



LTB s/s

s/s usally at night and go away in cold

inspirator stridor and retractions, barking or seal-like couch, tachypnea, hypoxia if unable to inhale enough air, resp acidosis may occur if unable to exhale CO2, may have fever


LTB care

montior resp status - rate, retractions, listen to breath sounds before and after and tx

try to keep child calm

supplement O2, maintain cool mist


parents can run shower and allow child to breathe warm, moist air

high humidity with cool mist can provide relief

maybe ne nebulized tx

corticosteriods can be used to decreased inflammation


Cystic fibrosis

Autosomal recessive trait - one gene from both parents

most common diease to affect white children

disorder of Resp, GI and exocrine glans


most of kids with cystic fibrosis had what as a newborn

meconium ileus


most common pathogens responsible form pulmonary infections with cystic fibrosis..

staph and pseudomonas


GI problems with CF:

need to replace pancreatic enzymes with all food - sprinkle on food before eating

need a well balanced, high protein, high calorie diet

give fat soluble vitamins in the water miscible form


Assessment with cystic fibrosis

lung sounds, couch, clubbing, frequency and nature of stools, abdmoinal distention, failure to thrive