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Flashcards in TEST 1 Deck (36):

care and assessment of the newborn with an apnea monitor

can be used to prevent SIDS. machine will go off if there are no respirations for more than 15 seconds

- take monitor off when playing with baby
- monitor skin for breakdown
- keep a record of alarms to help determine when to discontinue monitoring
- ensure alarm can be heard through the house


care of the child with bronchiolitis

- provide humidified o2
- monitor oximetry
- encourage fluids
- suction nasopharynx
- nebulizer bronchodilator


appropriate toys and play for the toddler
1 - 3 years

solitary play turns into parallel play

- filling and emptying containers
- playing with blocks
- looking at books
- tossing balls
- finger paints
- large-piece puzzles
- thick crayons


side effects of medications used to treat asthma

- tremors
- tachycardia
- dry mouth
- decrease immune fx
- hyperglycemia
- black tarry stools
- fluid retention
- weight gain
- cold sore lesions


pediatric vital signs: findings to report

- 3mo to 6mo: 37.5 (99.5) axillary/rectal
- 1 year 37.7 (99.9) axillary/rectal
- 3 years 37.2 (99.0) axil/rectal/oral/tympanic
- 5 years 37.0 (98.6) axil/rectal/oral/tympanic
- 7 years 36.8 (98.2) axil/rectal/oral/tympanic
- 9 years 36.7 (98.1) axil/rectal/oral/tympanic
- 11 years 36.7 (98.1) axil/rectal/oral/tympanic
- 13 years 36.6 (97.9) axil/rectal/oral/tympanic

- Newborn 80-180
- 1 week to 3mo 80-220
- 3mo to 2years 70-150
- 2 to 10 years 60-110
- 10+ 50-90

- Newborn to 1year 30-35
- 1 to 2 years 25-30
- 2-6 years 21-25
- 6-12 years19-21
- 12+ 16-19

Blood Pressure:
1 year Girls 83-114/38-67 Boys 80-114/34-66
3 years Girls 86-117/47-76 Boys 86-120/44-75
6 years Girls 91-122/54-83 Boys 91-125/53-84
10 years Girls 98-129/59-88 Boys97-130/58-90
16 years Girls 108-38/64-93 Boys 111-145/63-94


erikson's theory: school age

6 - 12 years

Industry vs. Inferiority

Sense of industry is achieved through the development of skills.


care of the child with asthma

monitor airway!

check sounds

monitor vs and sa02

check CBC, chest X-ray

antibiotics are not used for asthma.

bronchodilators okay


care of the child with croup

medical emergency caused by Haemophilus influenzae. "bacterial epiglottis"

- child placed ini a mist tent, oxygen is given. pulse ox in place.
- chest X-ray ordered.
- semi fowlers position
- antipyretics
- oral fluids increased


infancy: foods to introduce during the first year of life

- breastfeeding provides complete diet for the first 6 months

- iron-fortified formula is acceptable alternative to breast milk

- recommended to start Vitamin D in the first few days of life

- after 6 months, 100% fruit juice is limited to 4-6oz a day

- Solids are introduced around 4-6 months

- iron-fortified cereal is typically introduced first

- new foods should be introduced one at a time, over 4-7 day period

- 6-8 months you can introduce veggies and fruits. then meats once both have been given.

- decrease breast milk when solid food increases

- table foods cooked, chopped, and unseasoned are appropriate at 9 months

- bedtime feedings are the last to be stopped


care of the child following a tonsillectomy

instruct parents to contact the provider if the chid experiences difficulty breathing, lack of oral intake, increase in pain, or indications of infection. ensure nothing sharp goes into the mouth.

administer ACETAMINOPHEN ONLY for pain comfort.

encourage fluid intake and diet advancement to a soft diet with no spices or hard pieces until recovery.

limit strenuous activity for 2 weeks as prescribed

full recovery is 14 days

- hemorrhage: watch for frequent swallowing.
- dehydration: encourage oral intake
- infection: seek attention if seeing signs.


evaluation of medications used to treat respiratory distress

- sao2 will be within expected range followed by absence of

- restlessness, apprehension, panic
- tachycardia, tachypnea
- stridor
- wheezing
- expiratory grunt
- retractions
- gasping and shallow breaths


the effect of hospitalization for: school age child

6 - 12 years

beginning awareness of body functioning. ability to describe pain. can understand cause and effect.

fear of loss of control. senses when not telling the truth. feels stress r/t separation from peers.


the effect of hospitalization for: toddler

1 year to 3 years

Limited ability to describe illness. Poorly developed sense of body image and boundaries. Limited ability to follow directions.

experiences separation anxiety. can exhibit an intense reaction to any type of procedure due to the intrusion of boundaries. behavior can regress.


erikson's theory: infant

1 month - 1 year

Trust vs. Mistrust

Trust is developed by meeting comfort, feeding, stimulation, and caring needs.

Mistrust is developed if needs are not met, or met before the infant has cried for it.


dietary concerns the child with cystic fibrosis

high protein
high calorie
3 large meals with snacks
encourage fluids
pancreatic enzymes with food
vitamins: A, D, E, K water soluble vitamins


the effect of hospitalization for: preschooler

3 - 6 years

limited understanding of the cause of illness but knows what it feels like. limited ability to describe manifestations. fears r/t magical thinking. concrete thinking.

separation anxiety. harbor feelings of bodily harm. can feel like hospital is a punishment


care of the child in a mist tent

#1 treatment for the CROUP patient

can cause fear in the child

the tent adds liquid and humidity to help with respiratory issues

place a bath blanket to absorb water

change linens often

document changes/complications


erikson's theory: preschooler

3 - 6 years

Initiative vs. Guilt

Preschoolers are energetic learners, despite not having all the abilities to be successful at everything. Guilt occurs when they believe they have misbehaved.


order of assessment for the infant

1 month - 1 year

1. respiratory rate
2. heart rate
3. weight
4. axillary temperature

least invasive to most invasive


discuss object permanence

Knowing that an object still exists when it is out of view. This occurs at approximately 9 months of age.


the effect of hospitalization for: adolescent

12 - 20 years

perceptions of illness change based on the degree of body image changes

develops body image disturbance. attempts to maintain composure but is embarrassed about losing control. feels isolation from peers. worries about outcomes.


caring of the child with epiglottitis

- protect airway!
- avoid throat culture/tongue blade
- prepare for intubation
- humidified oxygen
- continuous oximetry
- administer: epinephrine, corticosteroids, and IV fluids
- antibiotic therapy for 10 days


physical assessment of the infant: expected findings

- Color should be pink or acrocyanotic with no jaundice present on the first day

- Head circumference should be 2-3 cm larger than the chest circumference

- Cartilage should be firm and well formed.
- Nose should be midline, can also be flat and broad with lack of a bridge

- Lip movement should be symmetrical with strong suck reflex

- Epstein pearls are normal

- The neck should be short and thick, surrounded by skin folds and exhibit no webbing

- The neck should move freely from side to side and up and down

- The chest should be almost circular, barrel shaped

- Respirations are primarily diaphragmatic without retractions

- Umbilical cord should be odorless

- Bowel sounds should be present within minutes following birth

- Symmetrical gluteal folds, bowed legs and flat feet

- Two thirds of the soles of the feet should be well lined

- The nail beds should be pink

- Spine should be straight, flat, midline and easily flexed

- Vision- The newborn should be able to focus on objects 8-12 inches away from his face

- Weight- 2500 to 4000g

- Smell and taste- Newborns prefer sweets and can recognize the scent of their mother


risk factors for asthma

- family history of asthma and allergies
- allergies

triggered by:
- allergens
- exercise/activity
- cold air/changes in weather
- tobacco smoke
- infections/colds
- animal hair/dandar
- medications
- strong odors
- emotions
- gastroesophagela reflux
- food allergies


physical assessment of the infant: normal vs abnormal reflexes

Expected reflexes:
- Sucking and rooting reflex- Elicited by stroking an infant’s cheek or the edge of an infant’s mouth. The infant turns her head toward the side that is touched and starts to suck
- Palmar grasp- Elicited by placing an object in an infant’s palm. The infant grasps the object
- Plantar grasp- Elicited by touching the sole of an infant’s foot. The infant’s toes curl downward
- Moro reflex- The infant’s arms and legs symmetrically extend and then abduct while her fingers spread to form a C shape
- Startle reflex- Elicited by clapping hands or by a loud noise. The newborn will abduct arms at the elbows and the hands will remain clenched
- Tonic neck reflex- The infant extends the arm and leg on that side and flexes the arm and leg on the opposite side.
- Babinski reflex- Elicited by stroking the outer edge of the sole of an infant’s foot up toward the toes. The infant’s toes fan upward and out
- Stepping reflex- Elicited by holding and infant upright with his feet touching a flat surface. The infant makes stepping movements.


care of the child with cystic fibrosis

check lung sounds and respiratory status

vs and sao2

sputum culture

contact isolation


airway clearance

aerosol therapy, antibiotics

physical exercise

provide oxygen

tx for GERD


the effect of hospitalization for: infant

1 month to 1 year

the infant has an inability to decrease illness and follow directions. don't understand procedures.

stranger anxiety occurs between 6018 months. Will have discomfort and cry. sleep deprivation.


erikson's theory: toddler

1 - 3 years

Autonomy vs. Shame and Doubt

Independence is big for toddlers, who attempt to do everything for themselves.


assessment of the child presenting with asthma

- dyspnea
- cough
- audible lung sounds
- coarse lung sounds/wheezing w/crackles
- mucus production
- restlessness
- anxiety
- red ears, dark red lips
- sweating
- use of accessory muscles
- decreased sao2


erikson's theory: adolescent

12 - 20 years

Identify vs. Role Confusion

adolescents view themselves as individuals


normal growth and development of the infant/estimated weight gain for the infant

infants grow 5-7 oz per week the first 6 months.

birth weight doubled by 6 months.

tripled by 12 months.

grow about 1 inch in the first 6 months of life. increases by 50% by the age of 12 months


normal growth and development of the toddler

18 months: assume standing position. throws ball overhead. manages spoon without rotation. turns pages in a book, two or three at a time.

2 years: walks up and down stairs by placing both feet on the steps. builds tower of 6-7 blocks

2.5 years: jumps in one place with both feet. can stand on one shortly. draws circles. has good finger hand coordination


physical assessment of the toddler

anterior fontanel closes by 18 months.

30 months, rollers 4 times their weight

toddlers grow about 3 inches per year

15 months: walks without help. uses a cup well. built a tower of two blocks


chest physiotherapy

set of techniques that include percussion, vibration, and postural drainage. this looses secretions in the respiratory system.

pre: do 1-2 hours after eating or before bedtime. administer BRONCHODILATOR or NEBULIZER treatment prior

intra: position client right. apply manual percussion with cupped hands or a special device to clap rhythmically on the chest wall to break up secretions. stay in postural drainage position 10-15 minutes after to allow time drainage.

post: perform lung auscultation and check the amount, color, and character

- hypoxia


care of the child with tonsillitis

child is kept in a high humidity room

-provide symptomatic treatment for viral tonsillitis:
-cool fluids
-warm salt-water gargles

-administer antibiotic therapy for bacterial tonsillitis: finish the complete round of antibiotics


care of the child with RSV

- strict handwashing
- easily transmissible
- treatment based on symptoms
- suction secretions
- palivizumab may help but does not cure