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VN 34 OB & Pedi > Test 10 > Flashcards

Test 10 Flashcards

1
Q
  1. Reye’s syndrome risk
A

 Causes by aspirin
- Affects liver and brain.
 Priority- prevent increase Intracranial Pressure (ICP)

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2
Q
  1. Cerebral Palsy manifestations
A

 Spastic-tense, contracted muscles (most common type of CP) on the toes
 Ataxic-poor since of balance, often causing falls and stumbles.
 Athetoid- constant, uncontrolled motion of limbs, head, and eyes
 Rigidity- tight muscles that resist effort to make them move.
 Tremor- uncontrollable shaking, Interfering with coordination.

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3
Q
  1. Cerebral Palsy: plan of care
A

 Teaching care to the parent with a child with special needs.

 Physical therapist
 Orthopedic
 Technologic aid
 Speech therapist
 Position to prevent contractures.
 Maintain skin integrity

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4
Q
  1. Seizures: assessment
A

 Oxygenation
 Vitals
 Time
 Aura
 Eye positioning and movement
 Bowel/ bladder incontinence

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5
Q
  1. Seizures: manifestations
A

Partial seizures: complex or simple
 Simple: Localized motor activity: shaking of leg or other body part. Now called focal seizures
 Complex: Non-purposeful movement/ lip smacking or rubbing of hands

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6
Q
  1. Seizures: carbamazepine
A

Use
 Generalized Tonic-clonic Focal.

Adverse effects:
Bone marrow suppressions and anorexia, Sleep disturbances

Nursing Implications:
 Administer low doses initially, then gradually increase dosage.
 Administer dose at bedtime and at the same time.
 There may be dizziness and downiness with intal dose. Avoid driving and other activities that require alertness at the beginning of treatment.
 This should subside within 3-4 days or weeks.
 Don’t stop abruptly, taper off.
 Toxicity: nystagmus, ataxia, vertigo, staggering gait

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7
Q
  1. Meningitis in infant: manifestations
A

 High-pitch cry
 Fever
 Bulging fontanel
 Irritability
 Headache
 Nuchal rigidity (stiff neck) that may progress to opisthotonos (arching of the back)
 Photophobia
 Delirium
 Projectile vomiting
 Generalized convulsion.

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8
Q
  1. Meningitis in infant: nursing care
A

 IV antibiotics
 Positioning, avoid straining, coughing, bright lights.
 Prevent with vaccines.
 Prophylactic antibiotic with close contact

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9
Q
  1. Otitis media: manifestations
A

 The child with acute otitis media is usually restless, shakes the head, and rubs or pulls at the ear.
 The child may also have fever, irritability, decreased activity, lack of appetite and hearing impairment.

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10
Q
  1. Otitis media: treatment
A

 Antibiotics or a myringotomy, incision of the eardrum with tiny tubes placed in the tympanic membrane, are used to treat otitis media. Or spontaneous rupture-usually relieves symptoms.
- 10 day course?

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11
Q
  1. Subjective data
A

 Information spoken by child or family is subjective data.
 Interviewing family and child allows collection of information which can be used to develop plan of care.
 Requires knowledge of growth and development and understanding of communication technique

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12
Q
  1. Chief Complaint
A

 Reason for visit
 Need to get the most complete explanation for the visit.

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13
Q
  1. Objective data
A

 Information observed directly.
 Includes height, weight, V/S and examination of body.

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14
Q

9a. Measuring temperature

A

 Oral: 97.6F to 99.3F (4-6 years)
 Rectal: usually 0.5F to 1F higher than oral
 Axillary: usually 0.5F to 1F lower than oral (infants)
 Tympanic: usually 0.5F to 1F lower than oral

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15
Q

9b. Apical pulse

A

 A family caregiver can hold the child on their lap for security for the full minute that the pulse is counted. Place the stethoscope between the child’s left nipple and sternum.

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16
Q

9c. Safety when assessing infant in outpatient settings:

A

 Never leave child unattended. Have hand within inch or 2 of child

17
Q

9d. Visual acuity:

A

 Visual acuity of children gradually increases from birth until about 7 years of age, when most children have 20/20 vision.
 2 months they can follow with their eyes.

18
Q

9e. Head and chest circumference:

A

 30-33cm of head circumference, chest should exceed head circumference by 2 to 3 inches.

19
Q

9f. Pain assessment of the child

A

 Grimacing, crying (wants to be alone), turn head to side to side frequently, pull on ears or rubs head, and turns or rolls constantly to get away from pain.

20
Q
  1. FEEBIE: For the administration of rectal medications, the child is placed in a side-lying position and the nurse must wear gloves or a finger cot. The suppository is lubricated, then inserted into the rectum, followed by a finger, which is inserted up to the first knuckle joint. The little finger should be used for insertion in infants. After the insertion of the suppository
A

the buttocks must be held tightly together for 1 to 2 minutes until the child’s urge to expel the suppository passes. The suppository would begin to soften making it difficult to insert if warmed prior to insertion.

21
Q
  1. IM injections for infants
A

 Vascular laterals

22
Q
  1. IM injections area that are contraindicated
A

 Avoid the Dorsal gluten.

23
Q
  1. Side note: when interviewing a child, the child can agree or disagree to have the parent present.
A

 Include preschool child and older child in interview.
 Use age-appropriate questions.
 Be honest answering child’s question.
 Use stories and book as appropriate.
 Listen attentively to child’s comments, make feel important.
 Admitting a child in a hospital but every child is different so always assess if they are ahead or late.

24
Q
  1. Vision Impairment
A

 Vision impairment includes myopia (nearsightedness), hyperopia (farsightedness), astigmatism, partial sight, or blindness.
 Adequate vision and normal development are more likely with early treatment.
 Specialized equipment helps prevent isolation.

25
Q
  1. Insertion of foreign bodies in the ear or nose
A

 Irrigation, forceps
 Risk of infection
 Should be evaluated by provider.

26
Q
  1. Manifestations of Increase ICP: infants
A

 Bulging Fontanels
 Separated sutures.
 High pitch cry
 Irritability, restlessness
 Lethargy, indifference
 Distended scalp veins
 Change in feeding.
 Inconsolability

27
Q
  1. Manifestations of Increase ICP: Children
A

 Change in LOC
 Headache
 Nausea/ vomiting
 Diplopia
 Lethargy or irritability
 Seizures
 Increased sleep
 Inability to follow commands.

28
Q
  1. Post op on child priority and nursing considerations: monitor
A

 Check vital signs.
 Check for hemorrhage.
 Check I & O, NPO before but after 6 hours they should have some output.

VN 34 OB & Pedi (17 decks)

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