Help
Options
Didn't know it?
click below
click below
Knew it?
click below
click below
Don't Know
Remaining cards (0)
Know
retry
shuffle
restart
0:00
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
Peds Test #1
peds test 1
| Question | Answer |
|---|---|
| Well Child Checks-EPSDT | Early, Periodic/Prevention, Screening, Diagnosis, Treatment |
| BP | should be taken on >3yr, or younger if heart condition, newborn-6months 70/50, 1yr 75/55, 3-5yr 95/60, 10yr 100/65, 12yr 105/65, 14yr 110/70 |
| Weight | 3.5-50kg |
| Pulse | newborn 100-160, 6months 110-160, 1yr 90-150, 3yr 80-125, 5yr 70-115, 10-14yr 60-100 |
| Respirations | newborn 30-60, 6months 24-38, 1-3yr 22-30, 5yr 20-24, 10-12yr 16-22, 14yr 14-20 |
| If think heart murmur in infant | assess 4 extremity BP |
| Anterior Fontanel Closure | closes around 18 months |
| Posterior Fontanel Closure | closes btw 2-3 months |
| Ears | for <3yr pull pinna down/back, >3yr pull pinna up/back |
| Compensentory Mechanisims | nasal flaring, grunting, retractions |
| Denver Developmental Screening Test/DDST | birth-6yrs, not IQ test, screening-not diagnostic, not predictor of future abilities, compares performance on a variety of tasks to other children of same age, fours areas of functioning: personal/social, fine motor/adaptive, language, gross motor |
| NIPS/Neonatal Infant Pain Scale | assessment tool using behavior cues, six item 0-2pt scale w/ total score0-7, used for term neonates up to 2mo, use in combo w/ nursing judgment |
| FLACC/Face, Legs, Activity, Cry, Consolability | each of 5 categories scored from 0-2, total score 0-10 |
| Wong-Baker Faces | pain scale using 6 faces from smile to crying, corresponds w/ 0-10 pain scale |
| DTaP/Diptheria, Tetanus, Pertussis | IM, 2,4,6mo + 15-18mo + 4-6yr, contraindications: gelatin allergy, serious side effect w/ prior dose |
| Hep B | IM, birth + 2, 6mo, contraindications: pregnancy |
| MMR | SC, LIVE, 12-15mo + 4-6yr, contraindications: allergy to eggs, mycins, pregnancy, immunosuppressed, immunoglobulin w/in 3mo, together w/ VAR or separated by 28days |
| VAR | SC, LIVE, 12-18mo + >12yr two 4wks apart, contraindications: pregnancy, immunosuppression, allergy to mycins, recent blood transfusion, together w/ MMR or separated by 28days |
| Immunizations-SE/Adverse effects | location rxn @ site: pain, redness, swelling, low grade fever, mild irritability/fussiness, less common SE: noncontagious rash, mild joint pain, adv effects: anaphylaxis, anaphylactic shock, encephalopathy/encephalitis, brachial neuritis, paralysis, death |
| Dehydration | fluid loss>fluid intake, numerous causes, can be from prolonged vomiting/diarrhea, common in children, mild<5% loss, moderate 6-9% loss, severe>10% loss |
| Dehydration-Nursing Interventions | prevention, correct underlying cause, oral rehydration, IVF rehydration, monitor IVF infusion/ fluid choice/amount, freq monitoring/reassessment, teaching s/sx dehydration/ORT, pharmacologic tx, monitor for complications-fluid overload/hypovolemic shock |
| #1 Indicator of Dehydration | Serum CO2(same as arterial HCO3 22-28) |
| Dehydration-#1 improvement indicator | weight gain |
| Maintenance Fluid Requirements | <10kg:4ml/kg/hr, 11-20kg:40ml+(2ml/kg>10kg)/hr, >20kg:60ml+(1ml/kg>20kg)hr |
| Replacement fluid considerations | Goals: preserve CV, renal, neuro function, Bolus: one time infusion, Rehydration plans: make take >24hrs, monitor serum CO2 level, NO potassium added until adequate void(no pee-no K) |
| Vision Screening | should start by 5, most schools mandate |
| Hearing Screening | in NBN, assessed in all well-child visits |
| Otitis Media | inflammation & fluid in middle ear interfering w/ sound transmission, mostly bacterial, ^in winter months, may lead to deafness |
| Otitis Media-Children at Risk | chronic middle ear infections, meningitis, deafness in family, maternal rubella, prematurity, birth trauma w/ hypoxia, high fevers |
| Otitis Media-Presentation | accompanying URI, fever often >102, sharp constant ear pain, irritable, tugging at ears, bulging eardrum, decreased light reflex, drainage w/ rupture |
| Otitis Media-Nursing Interventions | teach parents to feed upright/no bottle propping, keep upright 30 min post feed, admin antibiotics-amoxicillin, symptomatic care-antipyretics for fever-mild pain mgmt., may require tubes if chronic |
| Otitis Media-Chronic | tube placement; allow to drain(polyeltholine pressure equalizing tubes), pre/post surg care, edu parents r/t care; earplugs for swimming, no diving/submerging, careful w/ water during shower |
| Otitis Media-Chronic-Complications | risk for hearing loss, chart in book |
| Effusion | fluid remains in ears after infection has cleared up-several episodes->hearing loss, maybe tubes |
| Tonsillitis | inflammation/enlargement of a tonsil(palantine); adenoids-pharyngeal tonsils, viral or bacterial organism, possible peritonsilar abscess-need antibiotics to decrease infection before surg |
| Tonsillitis-Presentation | sore throat, painful swallowing, ‘beefy’ red swollen tissue, mouth breathing, snoring/sleep apnea, halitosis, purulent exudate on tonsil, fever |
| Tonsillitis-Nursing Interventions | symptomatic care-antipyretics for fever-analgesics for pain, antibiotics if indicated |
| Tonsillectomy-PreOp | assess temp, stress ‘fixing’ throat in age appropriate terms, evaluate labs-WBC/Clotting time, check for loose teeth |
| Tonsillectomy-PostOp | monitor VS q2-4hr, obs freq swling/throat clring, fresh/red bleeding, posit head to side-awake, avoid suct/straw, avoid acidic liq/crunchy/spicy food, maint IV til PO adeq, cool non-irrit liq-NO dark/red-adv diet, pain meds, maint flu based on intake |
| Tonsilectomy-Main reasons for readmit | Dehydration & Hemorrhage->7-10days |
| Respiratory Problems-Acute | generally reversible, vary in severity; RSV, epiglottitis, pneumonia, foreign body aspiration, croup, smoke inhalation, blunt chest trauma |
| Respiratory Problems-Chronic | generally irreversible, characterized by exacerbations & remissions, obstructive sleep apnea, asthma, cystic fibrosis, bronchopulmonary dysplasia, tuberculosis |
| Epiglottitis | inflamed, acute medical emergency, drooling, breathing faster, guarding, do NOT look at throat, emergency trach at bedside, corticosteroid-IV, calm child, conformation-soft tissue film, Tylenol/Motrin for fever, improving-want to drink |
| RSV | infects epithelial cells, mucus-clogs, snorting, suck out w/ bulb syringe but fills back up, if respire 60+ STOP feeding, if 28 wk gestation or less-RSV candidate, Synagis IM inj 1x/month throughout flu season-Very expensive |
| Asthma | chronic inflam disorder of the airways mkd by recurrent atcks of dysp & wheezing due to spasmodic constrict bronchi, highly correlated w/ suscept to environ allergens: smoke, animal dander, dry air, exercise, stress, most common chronic dx of childhood |
| Asthma-Presentation | chest tightness, cough(harsh/nonproductive->secretions w/ ^mucus), wheezing on expiration/prolonged expiration, use of accessory muscles, thick mucus, decreased breath sounds as condition worsens, decreased O2 & ^CO2, decreased LOC if acute exacerbation |
| Asthma-Hallmark S/Sx | bronchoconstriction, inflammation/edema, mucus production |
| Asthma-What to assess | can child talk in complete sentences?, grunting, tripod, circum-oral cyanosis, initially-tachypnea, anxiety, wheezing on expiration->wheezing on inspiration |
| Asthma-Nursing Interventions-Hosp | humid O2(decr anx,WOB,rate),IVF hydrat, monit resp stat(rate/eff,WOB,acc musc, grunt,flar,retract),admin meds(Epi,ster, broncho),monitor(O2 sats,x-ray,PEFR-max flow rate out 1sec,PBV,PFT),CPAP/intub(if unable to sustain)long exp times on vent,edu(MDI use, |
| Asthma-Nursing Interventions-Home Care | coord care w/ parent/sch nurse(indiv health plan, edu about dis proc prn, support grps, log peak flow meter readings), admin quick relief meds prn & monitor resp, MDIs, assess for signs of exercise induced bronchospasm, avoid triggers |
| Muffled | deterioration in respire/ heart rate |
| Cystic Fibrosis | hered dis w/ widespread exocrine gland dysfunction; multisystem involvement w/ accum of excessively thick and tenacious mucus and secretions-respir problems everyday of life, eventually clogs glands(respiratory airways, GI enzyme secretion, repr ducts) |
| Cystic Fibrosis-Presentation | recur respir(drug resis)infect, dry nonprod cough; patches atelect-mucus plugs(x-rays), thick purulent sputum/mucus(clear/ grey-tinged;NOT yellow/green),wheez-air trap, cyanosis/club,steatorrhea;gallbla prob, malnutr;avitaminosis,grwth delays;infert prob |
| Cystic Fibrosis-Nursing Interventions-Hosp | report results sweat test, CPT and postural drainage, inhal Tx; O2 w/ caution, TCDB exer, humid environ, proph antibiotics, diet-panc enz w/meals/snacks; vit supp, high cal-high protein-low dairy,^fluids, home schooling,disc plan:family support services |
| Cystic Fibrosis-Nursing Interventions-Home Care | coord care w/ parents/school nurse & create schedules for: meds, Ts(CPT, resp tx), diet, exercise, Consider: change in body image, freq hospitalizations, discipline iss, financial concerns, gene implic(sib), Identify prim HCP(pedi) basic healthcare, imm |
| Cystic Fibrosis-Complications | Cardiomegaly, Cardio-Respiratory Failure, GI Obstructions |
| Pediatric Heart Conditions-Nursing Considerations | sm freq feeds, upright position, squatting/tripod, monitor daily wts, pulse, BP, admin meds, provide rest, do not allow crying, emotional support, foster app play, immunize/protect from infection, strict I&O |
| Pediatric Heart Conditions-PreOp | prepare for surg, monitor baseline CV status, assist collection of pre-op labs, edu/support parents |
| Pediatric Heart Conditions-PostOp | monitor CV status constantly for 1st 24h, hemorrhage, chest tube output, bleeding from other sites, fluid balance(50-75% maintenance 1st 24h), promote resp fxn(IS), monitor for infection-incision site; peri-operative antibiotics, instr parents-home care |
| Cardiac Cath-PreProcedure | NPO several hours except meds, oral sedative, VS,H&H, cap refill, pulses distal to expected cath insertion site, prepare child/parent |
| Cardiac Cath-PostProcedure | monitor for complic; arrhythmias, bleeding, hematoma, thrombus, infection, VS, perf of lower extrem, monitor pressure dressing q15 minx4 then q30minx1; will be in place 6hrs, BR x6hrs w/ leg straight, avoid elevating HOB-no flexion of hip, monitor I&O-con |
| Acyanotic | L to R shunt of blood, oxygenated blood mixed w/ unoxygenated blood, extra blood vol overloads pulmonary sx, pulmonary HTN: obstructive defects block blood flow from heart, VSD |
| Ventricular Septal Defect/VSD | heart malformation that allows blood to flow btw 2 ventricles, ^blood flow to lungs->CHF & pulm HTN, 50% close spontaneously |
| Ventricular Septal Defect/VSD-Presentation | loud harsh systolic murmur, dyspnea & freq respir infections, exercise intolerance/fatigue, freq squatting/syncope, X-ray reveals R ventricular hypertrophy, ECG shows R vent dysfunction, growth retardation |
| Ventricular Septal Defect/VSD-Nursing Interventions | Lanoxin; cardiotonic to treat CHF-check BP/P |
| Cyanotic | R to L shunt of blood, dilute oxygenated blood heads to body, chronic hypoxemia and cyanosis, Tetralogy of Fallot |
| Tetralogy of Fallot | congenital heart condition consisting of four defects(VSD, PS, ventricular hypertrophy, over-riding aorta), surgical correction |
| Tetralogy of Fallot-Presentation | hypoxia is primary prob since blood flow to lungs is restricted, cyanosis apparent after several months of age & becomes progressively worse, clubbing, abnormal heart sounds, murmur, ^rate/depth of respirations, hypoxic episodes/TET, freq squatting/syncop |
| Tetralogy of Fallot-Nursing Interventions | multiple surgeries, antibiotics-prevention of endocarditis, diuretics-promote diuresis & prevent fluid overload, digitalis-cardiotonic, give prostaglandin E to keep PDA open in preparation for surgery, child too young for corrective surgery may have palli |
| TET Spells | hypoxic episode where baby turns blue w/ crying or feeding, calm child(decrease anxiety/decreased WOB), positioning(knee-chest), O2 as needed, Medications: Morphine and/or Propanolol |
Created by:
neffielewis
Popular Nursing sets