TEST 1 Flashcards
(36 cards)
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
- CPT
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
- PUSH-PULL TOYS
- 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
Temperature:
- 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
Pulse:
- Newborn 80-180
- 1 week to 3mo 80-220
- 3mo to 2years 70-150
- 2 to 10 years 60-110
- 10+ 50-90
Respirations:
- 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
COMPLICATIONS:
- 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
- respiratory rate
- heart rate
- weight
- 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
