Ati Peds 3i605p
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Chapter 25
...
13.
2.
What is an inguinal hernia
Protrusion of abdominal organs through the inguinal canal into the scrotum
With bladder exstrophy how should you cover the exposed bladder
With sterile, nonadherent dressing and prepare for immediate surgery
14.
How do you care for phimosis
Retract foreskin and perform a cleansing, if prescribed, for mild cases
15.
What is a medication that may be useful in treating bladder spasms
Oxybutynin
16.
After surgery to correct structural defect how long should a patient wait for a tub bath
At least one week or as prescribed
17.
What kind of therapy can be used for toddlers and preschoolers for emotional after surgery
Play therapy
18.
What are clinical manifestations of epispadias
Bladder exstrophy, widened pubic symphysis, broad/spade like penis
19.
A nurse is caring for an infant who has ambiguous genitalia. Which of the following are appropriate actions for the nurse to take?
Prepare for surgery, obtain a detailed family history, refer to genetic counseling, explain the need for a chromosomal analysis
20.
What are clinical manifestations of obstructive uropathy
Increased urine flow Urinary tract infection Metabolic acidosis Inability to concentrate urine Hydronephrosis
21.
Chapter 26
...
22.
What is acute glomerulonephritis
The glomeruli are inflamed, which impacts the kidneys to filter the urine properly
23.
What is acute poststreptococcal glomerulonephritis
An anti-body - antigen disease that occurs as a result of certain strains of group A strep and is most commonly seen in children between the ages of two and seven
24.
What are signs/symptoms of acute glomerulonephritis
Decreased urine output Irritability Periorbital edema Hypertension Anorexia Cloudy, tea colored urine
3.
What is Chordee?
Ventral curvature of the penis
4.
What is bladder exstrophy
Eversion of the posterior bladder through the anterior bladder wall and lower abdominal wall
5.
6.
What is hypospadia's
What is epispadias
Urethral opening located behind the glands of the penis or on the ventral surface of the penile shaft Meatal opening located on the dorsal surface of the penis
7.
What is phimosis
Narrowing of the preputial opening of the foreskin
8.
What is cryptorchidism
Undescended testes
9.
What is Hydrocele
Fluid in the scrotum
10.
What is varicocele
Elongation, dilatation and tortuosity of the veins superior to the testicle
11.
What is testicular torsion
Testicle hangs free from the vascular structures
12.
Children become aware of and are very interested in the genital area, normality of genital function and gender differences between three and six years of age. Due to this, repair of structural defects ideally should be done between what ages
6 to 15 months of age, but before three years, to minimize impact on body image and to promote healthy development
25.
What are laboratory test results for acute glomerulonephritis
Proteinuria Hematuria Elevated bun/creatinine Chest x-ray (to identify pulmonary edema, cardiac enlargement or pleural effusion)
38.
You should include the parent or caregiver in rating the pain of a
Young child or infant
39.
What does FLACC stand for and what ages is this pain scale used for
Face, legs, activity, cry, consolability, two months to seven years
26.
During periods of oliguria what should you restrict the patient from eating
Foods high in potassium (throughout therapy sodium and fluid may be restricted)
27.
What is medication therapy for acute glomerulonephritis
Diuretics and antihypertensives to remove accumulative fluid and manage hypertension
40.
What ages is the faces pain scale used for
Three years and older
28.
What is nephrotic syndrome
Alterations in the glomerular membrane allow proteins, especially albumin, to into the urine, resulting in decreased serum osmotic pressure
41.
What ages is the oucher pain scale used for
3 to 13 years
42.
What ages is the numeric pain scale used for
Ages five and older
43.
How long do you observe behavior for noncommunicating children's pain checklist ages 3 to 18 years
10 minutes
44.
What are some atraumatic and pharmacologic measures
45.
What kind of injections are not recommended for pain control in children
IM
46.
Intranasal medications are not recommended for children younger than
18
47.
Fentanyl patch can be used for children over the age of
12
48.
Chapter 11
...
What are signs/symptoms of nephrotic syndrome
Weight gain Periorbital edema Ascites Decreased frothy urine Proteinuria 2+ Few RBCs in the urine
How would the bloodwork look in a patient that has nephrotic syndrome
Hypoalbuminemia Hyperlipidemia Hemoconcentration Hyponatremia Hi GFR
31.
When is a kidney biopsy indicated
Only if nephrotic syndrome is unresponsive to steroid therapy
32.
How do you treat nephrotic syndrome
With steroid therapy, diuretics and possibly albumin
33.
If a patient cannot tolerate prednisone or has repeated relapses of MCNS what should you ister
Cyclophosphamide
What are common infections seen in children with nephrotic syndrome due to steroid therapy
Pneumonia Peritonitis Cellulitis
35.
Chapter 9
...
36.
What are some expressions of pain in an infant
Eyes tightly closed, mouth open in a squarish shape and eyebrows lowered in drawn together
Self-report for pain is used for children over the age of
Four
29.
30.
34.
37.
49.
50.
Current stage of development as it relates to death chart
Chapter 2
52.
Expected temperatures for children chart
54.
Examples of expected ranges of blood pressure by age and gender chart
56.
Erect head posture is expected in infants after blank months of age
Four
57.
Lymph nodes should be nonpalpable but if they are palpable what should they be like
Small, nontender and mobile
58.
When does the posterior fontanelle usually close
6 to 8 weeks of age
59.
When does the anterior fontanelle you some close
12 to 18 months
60.
What tests are used to check visual acuity of children who are unable to read letters or numbers
E or HOTV test
61.
Palpebral is pink and bulbar is blank
Transparent
62.
How many teeth should infant have by age one
6 to 8
63.
When children are younger than seven what kind of breathing is seen
More abdominal movement is seen during respirations
64.
Where is S1 and S2 best heard
S1 is heard best at the apex and S2 at the base
What are physical manifestations of death
51.
53.
55.
...
Expected pulse rates and respirations for children
What should the blood pressure of an infant be
65-80/40-50
65.
Infant reflexes expected findings and age chart
66.
Chapter 13
67.
What are things you should do during a seizure
78.
What is an apparent life threatening event
Sudden event where the infant exhibits apnea, changing color, change in muscle tone and choking
79.
What are risk factors for ALTE
Respiratory infections Urinary tract infections Gastroesophageal reflux Seizure
80.
What are diagnostic procedures for an ALTE
PH study ECG EEG MRI Sleep study
81.
What are risk factors for sudden infant death syndrome
82.
What are things that patients can do to reduce the risk of SIDS
83.
What are the stages of acetaminophen poisoning
84.
What are the stages of supplemental iron poisoning
...
68.
What is a hemispherectomy
Removal of one hemisphere of the brain
69.
What is a corpus callosotomy
Separation of the two hemispheres in the brain
70.
What is diphtheria
A respiratory illness causing difficulty breathing
71.
Chapter 42
...
72.
How is apnea defined in pediatrics
This cessation of respirations for more than 20 seconds
73.
If an infant has an obstructed airway what should you do
Use a combination of back blows and chest thrusts
74.
If children and adolescents have an obstructed airway what should you do
Use abdominal thrusts
75.
How should you place a child recovering from an airway obstruction
Side lying position with legs bent at the knees for stability
76.
What is a submersion injury
A near drowning incident in which the child has survived for 24 hours after
77.
What would be a good laboratory test for a drowning patient
ABGs
85.
What are manifestations of lead poisoning
86.
What is the intervention used for acetaminophen
87.
What is the interventions used for aspirin
88.
N-acetylcysteine (Mucomyst) given orally
Interventions for other specific substances chart
89.
What is early signs of respiratory distress
Tachypnea, tachycardia, diaphoresis, dyspnea, restlessness, retractions
90.
Chapter 27
...
91.
What are some risk factors for fractures other than normal playing
Obesity and poor nutrition
92.
What are some of the different types of fractures
93.
What is emergency nursing care at the time of injury
94.
How long should you elevate the cast above the heart to prevent swelling
During the first 24 to 48 hours
95.
How does a cast feel when it is first applied
Warm
96.
What should you instruct the patient to do after it cast has been removed
Soak the extremity in warm water and then apply lotion
97.
Skin traction uses a pulling force that is applied by weights. Using tape and straps applied to the skin along with boots and/or cuffs, weights are attached by a rope to the extremity. What are examples of skin traction
Buck, Russell, Byrant traction
Skeletal traction uses a continuous pulling force that is applied directly to the skeletal structure and/or specific bone. A pin or rod is inserted through or into the bone. What does skeletal traction allow a patient to do without interfering with the pull of the traction and it decreases complications associated with immobility and traction
Change positions
99.
What does balanced suspension traction do
Suspends the leg in a flexed position with the hip and hamstring muscles relaxed
100.
What should you have attached to the vest with a halo traction just in case R is necessary
A wrench
101.
How should you make the bed for a patient that has a traction
From head to toe
102.
What are clinical manifestations of compartment syndrome
98.
103.
What are clinical manifestations of osteomyelitis
104.
What kind of traction has the patients butt raised off the bed
Bryant
105.
Chapter 23
...
106.
When is repair of a cleft lip usually done
Typically done between 2 to 3 months. Infant should be at least 10 weeks old, weigh 10 pounds and hemoglobin 10
107.
When is repair of a cleft palate usually done
6 to 12 months
108.
For isolated cleft lip you should encourage breast-feeding, use a wide-based nipple for bottlefeeding and squeeze
The infants cheeks together during feeding to decrease the gap
109.
For or CL/ you should position the infant upright while cradling the head during feeding, use a specialized bottle with a one-way valve and a specially cut nipple, burp the infant frequently and
Syringe feeding it may be necessary for the infant who is unsuccessful with other methods
110.
What are things you should avoid giving an infant after a CL/ repair
Nipple or pacifier and hard toys
111.
How should you position the patient immediately after a cleft lip repair
Upright, car seat position, on their back or on their side in the immediate postoperative period to maintain the integrity of the repair. Also apply elbow restraints to keep the infant from injuring the repair site
112.
How should you position the patient immediately after a cleft palate repair
Change the infants position frequently to facilitate breathing. The infant may be placed on the abdomen in the immediate post operative period
What should you avoid placing in an infants mouth after cleft palate repair
Tongue depressor or pacifier. Really anything. Also elbow restraints may be needed for 4 to 6 weeks after
114.
What are three complications of CL/
Ear infections, speech problems, dental problems
115.
Risk factors for GER include prematurity, bronchopulmonary dysplasia, neurological impairments, asthma, cystic fibrosis, cerebral palsy, scoliosis. Risk factors for GERD include
Neurological impairments, hiatal hernia, esophageal atresia, morbid obesity
116.
What are complications of GER and GERD
Recurrent pneumonia, weight loss and failure to thrive
117.
What is hypertrophic pyloric stenosis
Thickening of the pyloric sphincter which creates an obstruction and usually occurs within the first five weeks of life
118.
What are signs/symptoms of hypertrophic pyloric stenosis
113.
119.
What is nursing care following surgery for hypertrophic pyloric stenosis
120.
What is Hirschsprung disease
A structural anomaly of the G.I. tract that results in decreased motility and mechanical obstruction
121.
What are signs/symptoms of Hirschsprung disease in a newborn
Failure to meconium within 24 to 48 hours after birth Episodes of vomiting bile Refusal to eat Abdominal distention
122.
What are signs/symptoms of Hirschsprung disease in an infant and older child
123.
What should the diet be in a patient that has Hirschsprung disease
High-protein, high calorie, low fiber diet
124.
What are three complications of Hirschsprung disease
Enterocolitis Anal stricture Incontinence
125.
What is intussusception
One part of the intestine telescopes into another part. Most common in children between three months and three years
126.
What is a risk factor for intussusception
Cystic fibrosis
127.
What is treatment for intussusception
Air enema or surgery in reoccurring cases
128.
When a patient has appendicitis what are two things you should avoid
Heat to the abdomen and enemas/laxatives
129.
What is the most common complication of appendicitis
Peritonitis
130.
Chapter 28
...
131.
How is club foot treated
Through a series of casting starting shortly after birth and continuing until correction is accomplished
What are two disorders that clubfoot can occur with
Cerebral palsy and spina bifida
132.
133.
What are symptoms an infant has developmental dysplasia of the hip
Limited hip abduction Asymmetry of gluteal and thigh folds Positive ortolani and Barlow test Shortening of the femur
141.
What are symptoms that a child has developmental hip dysplasia
Positive Trendelenburg sign One leg shorter than the other Walking on toes on 1 foot Walk with a limp
142.
Treatment for newborn to six months for dysplasia of the hip is the Pavlik harness. What should you know about this harness?
Maintain harness placement for 12 weeks Check straps every 1 to 2 weeks for adjustment (teach family not to do this) Perform neurovascular and skin integrity checks
143.
When adduction contracture is present a bryant traction may be used what angle should the hips be flexed at and where should the Butt be
90°, butt raised off the bed
144.
How should you handle spica cast
With palm of the hand until dry
145.
What is osteogenesis imperfecta
Heterogeneous, autosomal dominant disorder of the bones resulting in fractures and deformity
146.
What are signs/symptoms of osteogenesis imperfecta
147.
Treatment for osteogenesis imperfecta is ive. Medications such as blank may be istered to increase bone density
What are the different types of clubfoot
134.
What are three surgical interventions for clubfoot
Osteotomy-removing part of the bone Fusion-fusing two bones together Tendon lengthening or shortening
135.
What is leg calve perthes disease
Aseptic necrosis of the femoral head which can be unilateral or bilateral
136.
LD can occur from trauma or coagulation defects. Signs and symptoms can include intermittent painless limp, hip stiffness, Limited ROM and
Thigh pain Shortening of the affected leg Muscle wasting
137.
What is treatment for LD
NSAIDs, rest and nonweightbearing treatments such as traction or abduction brace, in some cases surgery may be needed
138.
What kind of diagnostic test is used for LD
Radiographs
What is subluxation
Incomplete dislocation of the hip
139.
140.
Pamidronate
148.
Complications of osteogenesis imperfecta include hearing loss, permit deformities and disuse osteoporosis. How can you prevent disuse osteoporosis
Limit time in casts and encourage activity
155.
Fungal infection/causative agent clinical manifestations chart
149.
The Cobb technique is used to determine the degree of curvature with a patient that has scoliosis. What does the Risser scale do
Determine the skeletal maturity
156.
Treatment of bacterial infections chart
150.
When is surgical intervention used for scoliosis
When there's a curvature greater than 45° 157.
151.
After a patient has surgery for scoliosis what kind of rolling will they be doing
Log
Treatment of viral infections chart
152.
Chapter 30
...
153.
Bacterial infection/causative agent's clinical manifestations chart
158.
Treatment of fungal infections chart
159.
Read pages 350 to 351
...
160.
What is scabies
Mites that spread by direct with an infected person. Eggs mature in 21 days
161.
What is pediculosis capitis
Head lice (lifespan of an adult is one month and they can live up to 48 hours without a host)
162.
What is pediculosis corporis
Body lice (they can live in clothing for one month and die at room temperature in 5 to 7 days)
154.
Viral infection/causative agents clinical manifestations chart
163.
Clinical manifestations of lice chart
164.
Treatment of scabies and lice chart
165.
When teaching a parent about lice what should you teach them?
166.
Read through chapter 36
...
167.
Chapter 40
...
168.
Leukemia causes an increase in the production of immature WBCs which leads to
Infiltration of organs and tissues
169.
Leukemia is the most common cancer of children. It is more common in boys and Caucasians. The peak onset is between the ages of
Two and five years of age
170.
Early manifestations of leukemia include lowgrade fever, pallor, increased bruising and petechia, liftlessness, enlarged liver/lymph nodes/ts and
171.
What are late manifestations and laboratory test for leukemia
172.
Bone marrow aspiration or biopsy is the most definitive diagnostic procedure for leukemia. If present, the specimen will show prolific quantities of immature he make blast cells and protein markers indicating a specific type of leukemia. What are the nursing actions for a bone marrow aspiration
173.
Cerebrospinal fluid analysis may also be used to assess CNS involvement with leukemia. What are the nursing actions for this procedure?
Abdominal/leg/t pain Constipation Headache Vomiting and anorexia Unsteady gait
174.
175.
176.
Chemotherapy side effects and nursing interventions chart
Chemotherapy side effects and nursing interventions chart 2
If a patient were to have elevated blood pressure in the arms with bounding pulses in the upper extremities but decreased blood pressure and pulses in the lower extremities what would you suspect the patient has?
Coarctation of the aorta
182.
What is tricuspid atresia
Complete closure of the tricuspid valve that results in mixed blood flow
183.
What are three manifestations of tetralogy of fallot (four defects that result in mixed blood flow)?
Cyanosis at birth that progresses over the first year of life Systolic murmur Episodes of acute cyanosis and hypoxia (Blue spells)
184.
What is truncus arteriosus
Failure of septum formation, resulting in a single vessel that comes off of the ventricles
185.
How long should a patient remain NPO before cardiac catheterization
4 to 6 hours prior to the procedure
186.
How long should the affected extremity be placed in the straight position to prevent bleeding after cardiac catheterization
4 to 8 hours
187.
When should digoxin be withheld
When the infants pulse is less than 90 and a child's pulse is less than 70
188.
What can ace inhibitors cause
Hyperkalemia
189.
What a clinical manifestations of endocarditis
Low-grade fever Malaise Decreased appetite with weight loss
190.
What do you ister IV to a patient that has Kawasaki's disease
IV gamma globulin
Therapeutic procedures for leukemia
When a child is at risk for infection from chemotherapy what should you monitor
ANC
178.
What are some complications of myelosuppression
Hemorrhage or thrombocytopenia, anemia
179.
How should you treat a nosebleed
With cold and pressure
180.
Chapter 20
...
177.
181.
What are three things that you should teach a patient at discharge for Kawasaki's disease
Encourage ive ROM exercises in the 204. bathtub Avoid live immunizations for 11 months Notify the provider of any fever
Children that have surgery at an early age are at a high risk for developing what
Latex allergies
205.
192.
Chapter 36
...
193.
How is Epstein bar virus/mononucleosis transmitted
Saliva
What is a common complication of down syndrome
Respiratory infections (so you should rinse the child's mouth with water after feeding)
206.
194.
How is erythema infectiosum (fifth disease)/parvovirus B 19 transmitted
Droplet/blood
What is nursing care for a patient has juvenile idiopathic arthritis
195.
How is mumps transmitted
Direct , droplet and contaminated surfaces
196.
How is pertussis and rubella transmitted
Direct and droplet
197.
How is rubeola transmitted
Direct , droplet and can survive two hours on surfaces
198.
How is varicella transmitted
Direct , droplet, from a person with shingles (airborne precautions)
199.
What might swollen salivary gland indicate
Mumps
200.
What might swollen lymph glands and splenomegaly indicate
Mononucleosis
201.
Chapter 29
...
202.
Differences between spastic, dyskinetic, and ataxic cerebral palsy
191.
203.
What you do preoperatively for a patient that has myelomeningcele
207.
What should you encourage the patient with juvenile idiopathic arthritis to get on a regular basis
208.
The different types of muscular dystrophy
209.
A nurse is caring for a child who has cerebral palsy. What two medications with the nurse istered to treat painful muscle spasms?
Baclofen and diazepam
Chapter 12
...
What are some symptoms of meningitis
Photophobia Nausea Irritability Headache Nuchal rigidity (unless it is a newborn)
1. Place infant any warmer, without clothing 2. Apply a sterile, moist, nonadherent 210. dressing with NS on the sack changing it every two hours 211. 3. Place infant in the prone position with hips flexed, legs abducted 4. ister IV antibiotics as prescribed
Regular eye exams
What would the CSF analysis of bacterial meningitis look like
Cloudy color Elevated WBC Elevated protein Decreased glucose Positive Gram stain
213.
What would the CSF analysis of viral meningitis look like
Clear color Slightly elevated WBC Normal or slightly elevated protein Normal glucose Negative Gram stain
214.
What is the definitive diagnostic test for meningitis
Lumbar puncture
212.
215.
What is not indicated for viral meningitis
Antibiotics and corticosteroids
217.
When should children receive the Hib and PCV vaccines
Two, four and six months of age, then again between 12 and 15 months
What is three ways to diagnose r syndrome
Laboratory tests, liver biopsy and lumbar puncture (to rule out meningitis)
Reye syndrome primarily affects the liver and brain causing
Liver dysfunction and cerebral edema
220.
Chapter 3
...
221.
When does an infants posterior and anterior fontanelle close
Posterior: 6 to 8 weeks Anterior: 12 to 18 months
222.
What is the minimum age in infant should be to use ibuprofen
Six months
223.
When does separation anxiety begin
Around 4 to 8 months
219.
When does stranger fear become evident
225.
What is the immunization schedule for children one year and younger
226.
At what temperature should the hot water thermostat be set at for infants
49°C or below (120°F)
227.
How long should infants and toddlers remain in a rear facing car seat
Until the age of two or the height recommended by the manufacturer
228.
What is a medication you would not want to give to an infant that has botulism
Gentamicin
229.
What is normal peak expiratory flow rate
80 to 100%
230.
How long is the incubation period for measles
10 to 20 days
231.
What is the longest you should suction a child tracheostomy prevent hypoxia
No more than five seconds
232.
What helps to prevent recurrences of rheumatic fever
Monthly injections of penicillin
Nursing care for the patient that has meningitis
216.
218.
224.
Between six and eight months of age
Chapter 25
...
13.
2.
What is an inguinal hernia
Protrusion of abdominal organs through the inguinal canal into the scrotum
With bladder exstrophy how should you cover the exposed bladder
With sterile, nonadherent dressing and prepare for immediate surgery
14.
How do you care for phimosis
Retract foreskin and perform a cleansing, if prescribed, for mild cases
15.
What is a medication that may be useful in treating bladder spasms
Oxybutynin
16.
After surgery to correct structural defect how long should a patient wait for a tub bath
At least one week or as prescribed
17.
What kind of therapy can be used for toddlers and preschoolers for emotional after surgery
Play therapy
18.
What are clinical manifestations of epispadias
Bladder exstrophy, widened pubic symphysis, broad/spade like penis
19.
A nurse is caring for an infant who has ambiguous genitalia. Which of the following are appropriate actions for the nurse to take?
Prepare for surgery, obtain a detailed family history, refer to genetic counseling, explain the need for a chromosomal analysis
20.
What are clinical manifestations of obstructive uropathy
Increased urine flow Urinary tract infection Metabolic acidosis Inability to concentrate urine Hydronephrosis
21.
Chapter 26
...
22.
What is acute glomerulonephritis
The glomeruli are inflamed, which impacts the kidneys to filter the urine properly
23.
What is acute poststreptococcal glomerulonephritis
An anti-body - antigen disease that occurs as a result of certain strains of group A strep and is most commonly seen in children between the ages of two and seven
24.
What are signs/symptoms of acute glomerulonephritis
Decreased urine output Irritability Periorbital edema Hypertension Anorexia Cloudy, tea colored urine
3.
What is Chordee?
Ventral curvature of the penis
4.
What is bladder exstrophy
Eversion of the posterior bladder through the anterior bladder wall and lower abdominal wall
5.
6.
What is hypospadia's
What is epispadias
Urethral opening located behind the glands of the penis or on the ventral surface of the penile shaft Meatal opening located on the dorsal surface of the penis
7.
What is phimosis
Narrowing of the preputial opening of the foreskin
8.
What is cryptorchidism
Undescended testes
9.
What is Hydrocele
Fluid in the scrotum
10.
What is varicocele
Elongation, dilatation and tortuosity of the veins superior to the testicle
11.
What is testicular torsion
Testicle hangs free from the vascular structures
12.
Children become aware of and are very interested in the genital area, normality of genital function and gender differences between three and six years of age. Due to this, repair of structural defects ideally should be done between what ages
6 to 15 months of age, but before three years, to minimize impact on body image and to promote healthy development
25.
What are laboratory test results for acute glomerulonephritis
Proteinuria Hematuria Elevated bun/creatinine Chest x-ray (to identify pulmonary edema, cardiac enlargement or pleural effusion)
38.
You should include the parent or caregiver in rating the pain of a
Young child or infant
39.
What does FLACC stand for and what ages is this pain scale used for
Face, legs, activity, cry, consolability, two months to seven years
26.
During periods of oliguria what should you restrict the patient from eating
Foods high in potassium (throughout therapy sodium and fluid may be restricted)
27.
What is medication therapy for acute glomerulonephritis
Diuretics and antihypertensives to remove accumulative fluid and manage hypertension
40.
What ages is the faces pain scale used for
Three years and older
28.
What is nephrotic syndrome
Alterations in the glomerular membrane allow proteins, especially albumin, to into the urine, resulting in decreased serum osmotic pressure
41.
What ages is the oucher pain scale used for
3 to 13 years
42.
What ages is the numeric pain scale used for
Ages five and older
43.
How long do you observe behavior for noncommunicating children's pain checklist ages 3 to 18 years
10 minutes
44.
What are some atraumatic and pharmacologic measures
45.
What kind of injections are not recommended for pain control in children
IM
46.
Intranasal medications are not recommended for children younger than
18
47.
Fentanyl patch can be used for children over the age of
12
48.
Chapter 11
...
What are signs/symptoms of nephrotic syndrome
Weight gain Periorbital edema Ascites Decreased frothy urine Proteinuria 2+ Few RBCs in the urine
How would the bloodwork look in a patient that has nephrotic syndrome
Hypoalbuminemia Hyperlipidemia Hemoconcentration Hyponatremia Hi GFR
31.
When is a kidney biopsy indicated
Only if nephrotic syndrome is unresponsive to steroid therapy
32.
How do you treat nephrotic syndrome
With steroid therapy, diuretics and possibly albumin
33.
If a patient cannot tolerate prednisone or has repeated relapses of MCNS what should you ister
Cyclophosphamide
What are common infections seen in children with nephrotic syndrome due to steroid therapy
Pneumonia Peritonitis Cellulitis
35.
Chapter 9
...
36.
What are some expressions of pain in an infant
Eyes tightly closed, mouth open in a squarish shape and eyebrows lowered in drawn together
Self-report for pain is used for children over the age of
Four
29.
30.
34.
37.
49.
50.
Current stage of development as it relates to death chart
Chapter 2
52.
Expected temperatures for children chart
54.
Examples of expected ranges of blood pressure by age and gender chart
56.
Erect head posture is expected in infants after blank months of age
Four
57.
Lymph nodes should be nonpalpable but if they are palpable what should they be like
Small, nontender and mobile
58.
When does the posterior fontanelle usually close
6 to 8 weeks of age
59.
When does the anterior fontanelle you some close
12 to 18 months
60.
What tests are used to check visual acuity of children who are unable to read letters or numbers
E or HOTV test
61.
Palpebral is pink and bulbar is blank
Transparent
62.
How many teeth should infant have by age one
6 to 8
63.
When children are younger than seven what kind of breathing is seen
More abdominal movement is seen during respirations
64.
Where is S1 and S2 best heard
S1 is heard best at the apex and S2 at the base
What are physical manifestations of death
51.
53.
55.
...
Expected pulse rates and respirations for children
What should the blood pressure of an infant be
65-80/40-50
65.
Infant reflexes expected findings and age chart
66.
Chapter 13
67.
What are things you should do during a seizure
78.
What is an apparent life threatening event
Sudden event where the infant exhibits apnea, changing color, change in muscle tone and choking
79.
What are risk factors for ALTE
Respiratory infections Urinary tract infections Gastroesophageal reflux Seizure
80.
What are diagnostic procedures for an ALTE
PH study ECG EEG MRI Sleep study
81.
What are risk factors for sudden infant death syndrome
82.
What are things that patients can do to reduce the risk of SIDS
83.
What are the stages of acetaminophen poisoning
84.
What are the stages of supplemental iron poisoning
...
68.
What is a hemispherectomy
Removal of one hemisphere of the brain
69.
What is a corpus callosotomy
Separation of the two hemispheres in the brain
70.
What is diphtheria
A respiratory illness causing difficulty breathing
71.
Chapter 42
...
72.
How is apnea defined in pediatrics
This cessation of respirations for more than 20 seconds
73.
If an infant has an obstructed airway what should you do
Use a combination of back blows and chest thrusts
74.
If children and adolescents have an obstructed airway what should you do
Use abdominal thrusts
75.
How should you place a child recovering from an airway obstruction
Side lying position with legs bent at the knees for stability
76.
What is a submersion injury
A near drowning incident in which the child has survived for 24 hours after
77.
What would be a good laboratory test for a drowning patient
ABGs
85.
What are manifestations of lead poisoning
86.
What is the intervention used for acetaminophen
87.
What is the interventions used for aspirin
88.
N-acetylcysteine (Mucomyst) given orally
Interventions for other specific substances chart
89.
What is early signs of respiratory distress
Tachypnea, tachycardia, diaphoresis, dyspnea, restlessness, retractions
90.
Chapter 27
...
91.
What are some risk factors for fractures other than normal playing
Obesity and poor nutrition
92.
What are some of the different types of fractures
93.
What is emergency nursing care at the time of injury
94.
How long should you elevate the cast above the heart to prevent swelling
During the first 24 to 48 hours
95.
How does a cast feel when it is first applied
Warm
96.
What should you instruct the patient to do after it cast has been removed
Soak the extremity in warm water and then apply lotion
97.
Skin traction uses a pulling force that is applied by weights. Using tape and straps applied to the skin along with boots and/or cuffs, weights are attached by a rope to the extremity. What are examples of skin traction
Buck, Russell, Byrant traction
Skeletal traction uses a continuous pulling force that is applied directly to the skeletal structure and/or specific bone. A pin or rod is inserted through or into the bone. What does skeletal traction allow a patient to do without interfering with the pull of the traction and it decreases complications associated with immobility and traction
Change positions
99.
What does balanced suspension traction do
Suspends the leg in a flexed position with the hip and hamstring muscles relaxed
100.
What should you have attached to the vest with a halo traction just in case R is necessary
A wrench
101.
How should you make the bed for a patient that has a traction
From head to toe
102.
What are clinical manifestations of compartment syndrome
98.
103.
What are clinical manifestations of osteomyelitis
104.
What kind of traction has the patients butt raised off the bed
Bryant
105.
Chapter 23
...
106.
When is repair of a cleft lip usually done
Typically done between 2 to 3 months. Infant should be at least 10 weeks old, weigh 10 pounds and hemoglobin 10
107.
When is repair of a cleft palate usually done
6 to 12 months
108.
For isolated cleft lip you should encourage breast-feeding, use a wide-based nipple for bottlefeeding and squeeze
The infants cheeks together during feeding to decrease the gap
109.
For or CL/ you should position the infant upright while cradling the head during feeding, use a specialized bottle with a one-way valve and a specially cut nipple, burp the infant frequently and
Syringe feeding it may be necessary for the infant who is unsuccessful with other methods
110.
What are things you should avoid giving an infant after a CL/ repair
Nipple or pacifier and hard toys
111.
How should you position the patient immediately after a cleft lip repair
Upright, car seat position, on their back or on their side in the immediate postoperative period to maintain the integrity of the repair. Also apply elbow restraints to keep the infant from injuring the repair site
112.
How should you position the patient immediately after a cleft palate repair
Change the infants position frequently to facilitate breathing. The infant may be placed on the abdomen in the immediate post operative period
What should you avoid placing in an infants mouth after cleft palate repair
Tongue depressor or pacifier. Really anything. Also elbow restraints may be needed for 4 to 6 weeks after
114.
What are three complications of CL/
Ear infections, speech problems, dental problems
115.
Risk factors for GER include prematurity, bronchopulmonary dysplasia, neurological impairments, asthma, cystic fibrosis, cerebral palsy, scoliosis. Risk factors for GERD include
Neurological impairments, hiatal hernia, esophageal atresia, morbid obesity
116.
What are complications of GER and GERD
Recurrent pneumonia, weight loss and failure to thrive
117.
What is hypertrophic pyloric stenosis
Thickening of the pyloric sphincter which creates an obstruction and usually occurs within the first five weeks of life
118.
What are signs/symptoms of hypertrophic pyloric stenosis
113.
119.
What is nursing care following surgery for hypertrophic pyloric stenosis
120.
What is Hirschsprung disease
A structural anomaly of the G.I. tract that results in decreased motility and mechanical obstruction
121.
What are signs/symptoms of Hirschsprung disease in a newborn
Failure to meconium within 24 to 48 hours after birth Episodes of vomiting bile Refusal to eat Abdominal distention
122.
What are signs/symptoms of Hirschsprung disease in an infant and older child
123.
What should the diet be in a patient that has Hirschsprung disease
High-protein, high calorie, low fiber diet
124.
What are three complications of Hirschsprung disease
Enterocolitis Anal stricture Incontinence
125.
What is intussusception
One part of the intestine telescopes into another part. Most common in children between three months and three years
126.
What is a risk factor for intussusception
Cystic fibrosis
127.
What is treatment for intussusception
Air enema or surgery in reoccurring cases
128.
When a patient has appendicitis what are two things you should avoid
Heat to the abdomen and enemas/laxatives
129.
What is the most common complication of appendicitis
Peritonitis
130.
Chapter 28
...
131.
How is club foot treated
Through a series of casting starting shortly after birth and continuing until correction is accomplished
What are two disorders that clubfoot can occur with
Cerebral palsy and spina bifida
132.
133.
What are symptoms an infant has developmental dysplasia of the hip
Limited hip abduction Asymmetry of gluteal and thigh folds Positive ortolani and Barlow test Shortening of the femur
141.
What are symptoms that a child has developmental hip dysplasia
Positive Trendelenburg sign One leg shorter than the other Walking on toes on 1 foot Walk with a limp
142.
Treatment for newborn to six months for dysplasia of the hip is the Pavlik harness. What should you know about this harness?
Maintain harness placement for 12 weeks Check straps every 1 to 2 weeks for adjustment (teach family not to do this) Perform neurovascular and skin integrity checks
143.
When adduction contracture is present a bryant traction may be used what angle should the hips be flexed at and where should the Butt be
90°, butt raised off the bed
144.
How should you handle spica cast
With palm of the hand until dry
145.
What is osteogenesis imperfecta
Heterogeneous, autosomal dominant disorder of the bones resulting in fractures and deformity
146.
What are signs/symptoms of osteogenesis imperfecta
147.
Treatment for osteogenesis imperfecta is ive. Medications such as blank may be istered to increase bone density
What are the different types of clubfoot
134.
What are three surgical interventions for clubfoot
Osteotomy-removing part of the bone Fusion-fusing two bones together Tendon lengthening or shortening
135.
What is leg calve perthes disease
Aseptic necrosis of the femoral head which can be unilateral or bilateral
136.
LD can occur from trauma or coagulation defects. Signs and symptoms can include intermittent painless limp, hip stiffness, Limited ROM and
Thigh pain Shortening of the affected leg Muscle wasting
137.
What is treatment for LD
NSAIDs, rest and nonweightbearing treatments such as traction or abduction brace, in some cases surgery may be needed
138.
What kind of diagnostic test is used for LD
Radiographs
What is subluxation
Incomplete dislocation of the hip
139.
140.
Pamidronate
148.
Complications of osteogenesis imperfecta include hearing loss, permit deformities and disuse osteoporosis. How can you prevent disuse osteoporosis
Limit time in casts and encourage activity
155.
Fungal infection/causative agent clinical manifestations chart
149.
The Cobb technique is used to determine the degree of curvature with a patient that has scoliosis. What does the Risser scale do
Determine the skeletal maturity
156.
Treatment of bacterial infections chart
150.
When is surgical intervention used for scoliosis
When there's a curvature greater than 45° 157.
151.
After a patient has surgery for scoliosis what kind of rolling will they be doing
Log
Treatment of viral infections chart
152.
Chapter 30
...
153.
Bacterial infection/causative agent's clinical manifestations chart
158.
Treatment of fungal infections chart
159.
Read pages 350 to 351
...
160.
What is scabies
Mites that spread by direct with an infected person. Eggs mature in 21 days
161.
What is pediculosis capitis
Head lice (lifespan of an adult is one month and they can live up to 48 hours without a host)
162.
What is pediculosis corporis
Body lice (they can live in clothing for one month and die at room temperature in 5 to 7 days)
154.
Viral infection/causative agents clinical manifestations chart
163.
Clinical manifestations of lice chart
164.
Treatment of scabies and lice chart
165.
When teaching a parent about lice what should you teach them?
166.
Read through chapter 36
...
167.
Chapter 40
...
168.
Leukemia causes an increase in the production of immature WBCs which leads to
Infiltration of organs and tissues
169.
Leukemia is the most common cancer of children. It is more common in boys and Caucasians. The peak onset is between the ages of
Two and five years of age
170.
Early manifestations of leukemia include lowgrade fever, pallor, increased bruising and petechia, liftlessness, enlarged liver/lymph nodes/ts and
171.
What are late manifestations and laboratory test for leukemia
172.
Bone marrow aspiration or biopsy is the most definitive diagnostic procedure for leukemia. If present, the specimen will show prolific quantities of immature he make blast cells and protein markers indicating a specific type of leukemia. What are the nursing actions for a bone marrow aspiration
173.
Cerebrospinal fluid analysis may also be used to assess CNS involvement with leukemia. What are the nursing actions for this procedure?
Abdominal/leg/t pain Constipation Headache Vomiting and anorexia Unsteady gait
174.
175.
176.
Chemotherapy side effects and nursing interventions chart
Chemotherapy side effects and nursing interventions chart 2
If a patient were to have elevated blood pressure in the arms with bounding pulses in the upper extremities but decreased blood pressure and pulses in the lower extremities what would you suspect the patient has?
Coarctation of the aorta
182.
What is tricuspid atresia
Complete closure of the tricuspid valve that results in mixed blood flow
183.
What are three manifestations of tetralogy of fallot (four defects that result in mixed blood flow)?
Cyanosis at birth that progresses over the first year of life Systolic murmur Episodes of acute cyanosis and hypoxia (Blue spells)
184.
What is truncus arteriosus
Failure of septum formation, resulting in a single vessel that comes off of the ventricles
185.
How long should a patient remain NPO before cardiac catheterization
4 to 6 hours prior to the procedure
186.
How long should the affected extremity be placed in the straight position to prevent bleeding after cardiac catheterization
4 to 8 hours
187.
When should digoxin be withheld
When the infants pulse is less than 90 and a child's pulse is less than 70
188.
What can ace inhibitors cause
Hyperkalemia
189.
What a clinical manifestations of endocarditis
Low-grade fever Malaise Decreased appetite with weight loss
190.
What do you ister IV to a patient that has Kawasaki's disease
IV gamma globulin
Therapeutic procedures for leukemia
When a child is at risk for infection from chemotherapy what should you monitor
ANC
178.
What are some complications of myelosuppression
Hemorrhage or thrombocytopenia, anemia
179.
How should you treat a nosebleed
With cold and pressure
180.
Chapter 20
...
177.
181.
What are three things that you should teach a patient at discharge for Kawasaki's disease
Encourage ive ROM exercises in the 204. bathtub Avoid live immunizations for 11 months Notify the provider of any fever
Children that have surgery at an early age are at a high risk for developing what
Latex allergies
205.
192.
Chapter 36
...
193.
How is Epstein bar virus/mononucleosis transmitted
Saliva
What is a common complication of down syndrome
Respiratory infections (so you should rinse the child's mouth with water after feeding)
206.
194.
How is erythema infectiosum (fifth disease)/parvovirus B 19 transmitted
Droplet/blood
What is nursing care for a patient has juvenile idiopathic arthritis
195.
How is mumps transmitted
Direct , droplet and contaminated surfaces
196.
How is pertussis and rubella transmitted
Direct and droplet
197.
How is rubeola transmitted
Direct , droplet and can survive two hours on surfaces
198.
How is varicella transmitted
Direct , droplet, from a person with shingles (airborne precautions)
199.
What might swollen salivary gland indicate
Mumps
200.
What might swollen lymph glands and splenomegaly indicate
Mononucleosis
201.
Chapter 29
...
202.
Differences between spastic, dyskinetic, and ataxic cerebral palsy
191.
203.
What you do preoperatively for a patient that has myelomeningcele
207.
What should you encourage the patient with juvenile idiopathic arthritis to get on a regular basis
208.
The different types of muscular dystrophy
209.
A nurse is caring for a child who has cerebral palsy. What two medications with the nurse istered to treat painful muscle spasms?
Baclofen and diazepam
Chapter 12
...
What are some symptoms of meningitis
Photophobia Nausea Irritability Headache Nuchal rigidity (unless it is a newborn)
1. Place infant any warmer, without clothing 2. Apply a sterile, moist, nonadherent 210. dressing with NS on the sack changing it every two hours 211. 3. Place infant in the prone position with hips flexed, legs abducted 4. ister IV antibiotics as prescribed
Regular eye exams
What would the CSF analysis of bacterial meningitis look like
Cloudy color Elevated WBC Elevated protein Decreased glucose Positive Gram stain
213.
What would the CSF analysis of viral meningitis look like
Clear color Slightly elevated WBC Normal or slightly elevated protein Normal glucose Negative Gram stain
214.
What is the definitive diagnostic test for meningitis
Lumbar puncture
212.
215.
What is not indicated for viral meningitis
Antibiotics and corticosteroids
217.
When should children receive the Hib and PCV vaccines
Two, four and six months of age, then again between 12 and 15 months
What is three ways to diagnose r syndrome
Laboratory tests, liver biopsy and lumbar puncture (to rule out meningitis)
Reye syndrome primarily affects the liver and brain causing
Liver dysfunction and cerebral edema
220.
Chapter 3
...
221.
When does an infants posterior and anterior fontanelle close
Posterior: 6 to 8 weeks Anterior: 12 to 18 months
222.
What is the minimum age in infant should be to use ibuprofen
Six months
223.
When does separation anxiety begin
Around 4 to 8 months
219.
When does stranger fear become evident
225.
What is the immunization schedule for children one year and younger
226.
At what temperature should the hot water thermostat be set at for infants
49°C or below (120°F)
227.
How long should infants and toddlers remain in a rear facing car seat
Until the age of two or the height recommended by the manufacturer
228.
What is a medication you would not want to give to an infant that has botulism
Gentamicin
229.
What is normal peak expiratory flow rate
80 to 100%
230.
How long is the incubation period for measles
10 to 20 days
231.
What is the longest you should suction a child tracheostomy prevent hypoxia
No more than five seconds
232.
What helps to prevent recurrences of rheumatic fever
Monthly injections of penicillin
Nursing care for the patient that has meningitis
216.
218.
224.
Between six and eight months of age
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