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Pediatric Nursing
Module 3 & 4 - Care of the Infant & Toddler
| Question | Answer |
|---|---|
| What compares the child's measurements (ht. & wt.) to others the same age and sex? | Growth Charts |
| What deviations from an established growth pattern require further evaluation? | Two or more percentile |
| The younger the patient, the higher the metabolic rate .... what is more unstable? | Heat-regulating mechanisms |
| What are signs and symptoms of dehydration in an infant? | Weight loss, irritable, dry mucous membranes, decrease in tears, sunken eyes, sunken fontanelles, decreased skin turgor, decreased urinary output |
| What must infants remain on for the first year of life? | Breast milk or iron fortified formula |
| What does satiety mean? | Hunger satisfaction |
| What is aspiration? | Occurs when an infant inhales fluid or a foreign body into the lungs, often after vomiting |
| Who is at highest risk for aspiration? | Pre-term infants; gag & cough reflexes are weak |
| Why are cleft lip/palate infants at risk for aspiration? | Opening can increase the risk of liquid being introduced into the lungs |
| How do you care for a lethargic infant? | Avoid bright lights, move & handle infant slowly & gently, talk in calm voice, sit the infant upright at intervals, and slowly dress & undress the infant |
| How do you cope with the irritable infant? | Shield infant eyes from bright light, sit quietly w/ infant w/o talking or singing, eliminate excess noise, talk in soft voice, swaddle/cradle firmly, and provide non-nutritive sucking |
| How is colic characterized? | Periods of unexplained irritability and crying in a healthy, well nourished infant |
| What is impetigo? | Infectious disease of the skin caused by staphylococci or by group A beta-hemolytic streptococci |
| What does impetigo look like? | Red papules, small vesicles/pustules, that break. Skin becomes raw and weeping, crust may form, and possible infection if scratching |
| Where is impetigo most found? | Nose and mouth, moist areas of the body; anywhere on the body |
| What is the nursing care for impetigo? | Educate parents how to care for lesions, prevent spread, and watch for s/s of infection |
| How is impetigo diagnosed? | If indicated, may culture drainage for C & S |
| Who are more prone to middle ear infections? | Infants |
| Why are infants more prone to middle ear infections? | Their Eustachian tubes are shorter wider, and straighter than older children's or adults |
| What is the nursing care for otitis media? | Assess for pain and fever and treat. Administer meds as ordered. Warm compress may be applied locally for comfort |
| How is otitis media diagnosed? | Visualization of the tympanic membrane via otoscope reveals reddened and bulging membrane |
| How is otitis media treated? | Analgesic's to relieve pain, antipyretics to reduce fever, antibiotics for infection |
| What is the patient teaching for otitis media? | No water in the ears if tubes are present or tympanic membrane not intact. Do not insert cotton swabs into the ears |
| What is the most common deficiency in the US? | Iron Deficiency |
| What are some symptoms of Iron Deficiency Anemia? | Pallor, irritability, anorexia, and decrease in activity |
| What is the teaching regarding Iron Deficiency Anemia? | Proper foods for infant, such as iron rich formula through out the first year. Give iron supplements with juice (Vitamin C aids in absorption) |
| What is Sickle Cell Disease? | An inherited defect in the formation of hemoglobin |
| What are the chances that a child will get sickle cell if both parents are carriers? | 1 in 4 chance (25%) |
| What is a vassooclusive crisis? | An obstruction of blood flow by cells, infarctions, and some degree of vasospasm |
| What is infantile eczema? | Inflammation of genetically hypersensitive skin, more common in the first 2 years (worse in winter), lesions become easily infected by bacterial or viral agents |
| What is used to treat infantile eczema? | Topical steroids |
| What should be avoided if a child has infantile eczema? | Wool and stuffed animals because of their allergy potential; use cotton fabrics, keep nails short, and child may need gloves or socks over hands to decrease scratching. Use mild soaps |
| When do maternal iron stores decrease? | By age 6 months |
| What is Autism or ASD? | Group of neurodevelopmental disorders characterized by difficulties in social interaction and communication, repetitive behaviors, and stereotyped interest and behaviors |
| What have studies failed to demonstrate a link between? | Autism and immunizations |
| How often does autism occur? | 1 in 88 |
| What does treatment of autism involve? | Providing well-structured home and school environments, behavior modification, and in some cases the use of specific drugs to deal with specific behavioral problems. Cluster care and routines |
| What should the nurse provide during the hospitalization of a child with autism? | Highly structured environment with few distractions. A normal homelike routine should be maintained whenever possible, with safety as a priority |
| Who should the parents call immediately if a parent suspects their child has ingested medications, chemicals, or cleaning agents? | Poison control |
| How many newborns are born with some type of hearing impairment? | 1 in 1000 |
| What is croup? | General term applied to a number of conditions whose chief symptom is a "barking" croupy cough and varying degrees of inspiratory stridor |
| What is the nursing care for a patient that has croup? | Position upright to improve breathing effort. Use a cool mist humidifier (must be cleaned & disinfected daily); also, monitor O2 saturations, vital signs, and I & O |
| What is pneumonia? | Inflammation of the lungs; alveoli become filled with exudate and surfactant may be reduced |
| How is pneumonia diagnosed? | CBC, CXR, nasal and/or throat cultures |
| What are pinworms (enterobiasis)? | Most common variety of worm that infects humans, seen more often in toddlers, looks like a white thread about 1/3" long |
| How are pinworms diagnosed? | Scotch tape test; eggs have to be viewed under a microscope |
| What medications are used to treat pinworms? | Anthelmintics (Vermox) in children over 2 yrs of age. Soothing ointment may be applied to rectal area |
| How does a spiral fracture occur? | Break in the bone caused by a forceful twisting motion; if the history of the injury does not match with the x-ray findings, child abuse should be suspected |
| What type of traction is used for a spiral fracture? | Bryant's |
| What is Bryant's traction? | Legs are suspended vertically, child's weight is counteraction; used for treating fractures of the femur in children under 2 years of age or under 20-30 pounds |
| What is the nursing care for a patient in Bryant's traction? | Weights must be hanging freely, legs should be a right angles to the body, with the buttocks raised sufficiently to clear the bed. Elastic bandages should be neither too loose nor too tight. |
| What is a compound fracture? | Wound in the skin that accompanies the broken bone, there is added danger of infection |
| What medications are used for a compound fracture? | Analgesics for pain, and antibiotics to prevent infection |
| What is a greenstick fracture? | Incomplete fracture in which one side of the bone is broken and the other is bent. |
| What are greenstick fractures common in children? | Bones are soft, flexible, and more likely to splinter |
| What is the treatment for greenstick fracture? | Casting to stabilize bone to heal |
| What is the nursing care for a greenstick fracture? | Cast care |
| What medications are used for greenstick fracture? | Analgesics for pain |
| What is the most common type of dislocation? | Developmental Hip Dysplasia |
| What is developmental hip dysplasia? | Head of the femur is partly or completely displaced as a result of shallow hip socket |
| How is developmental hip dysplasia diagnosed? | Palpation of joint; x-ray |
| How is developmental hip dysplasia treated? | Manipulated back in place; Pavlik harness or spica cast may be required (keeps hips in constant flexion & abduction for 4-8 weeks to keep head of the femur within the hip socket) |
| What is the nursing care for patient in Pavlik harness or spica cast? | Good cast care; babies my use triple thick diapers |
| What is cerebral palsy? | Term used to describe a group of motor disorders caused by dysfunction of various motor centers in the brain and often related to antenatal or developmental factors; NO CURE |
| What is the goal in nursing care for a patient with cerebral palsy? | Assist in making most of assets and to guide them in becoming well-adjusted adults, performing at their maximum ability. Management of effects (difficulty feeding, braces on legs, etc.) |
| What is the major cause of death in children older than 1 year of age? | Head injuries |
| What is a concussion? | Temporary disturbance of the brain that is usually followed by a period of unconsciousness. |
| What is shaken baby syndrome? | Injury that occurs when an infant is roughly shaken; infants can sustain injuries resulting in permanent disability or death |
| What is the nursing care for patients with head injuries? | Neurologic assessment; V/S; feeding if needed; care of lacerations if present. Prevent accidents (side rails), monitor for increased ICP |
| What is one of the most common malignancies of early life and known to be associated with certain congenital anomalies, particularly of the genitourinary tract? | Wilm's tumor (Nephroblastoma) |
| How is skeletal traction used? | Applied directly to a bone; wires and surgical pins are inserted through the bone distal to the fracture site while the patient is under local or general anesthesia |
| What is assess for a patient that has skeletal traction? | Assess and care for pin site; monitor for s/s of infection: inflammation, purulent drainage, and pain at pin site |
| How do you assess neurovascular status? | Monitor peripheral pulse, quality, skin color, capillary refill, temperature of skin, movement and sensation |
| What is a contusion? | Tearing of subcutaneous tissue resulting in hemorrhage, edema, and pain; |
| What is the most common soft tissue injury? | Contusion |
| How do you manage soft tissue injuries? | R.I.C.E. - Rest, Ice, Compression, Elevation |
| What helps limit movement that can worsen the injury? | Rest |
| What is applied to the area that reduces swelling and helps stops bleeding? | Ice |
| What is applying pressure to the area to help stop the bleeding? | Compression |
| What is raising the injured area above the rest of the body as a way to reduce swelling? | Elevation |
| What is a sprain? | A ligament that is torn or stretched away from the bone at the point of trauma, there may be resulting damage to the blood vessels muscles, and nerves |
| What are the signs of a sprain? | Disability and pain |
| What are the common sites of a sprain? | Knee, ankle, and cervical spine (whiplash) |
| What is a strain? | Microscopic tear to the muscle or tendon occurs over time and results in edema and pain |
| Where is the most common strain? | Back |
| What is the treatment if the muscle is completely ruptured? | Surgical repair |
| What is often prescribed if the strain is in the lumbarsacral region, and is aimed at strengthening the lower abdominal muscles? | Exercise |
| What is RSV? | Respiratory Syncytial Virus - single most important respiratory pathogen in infancy |
| What ages are affected by RSV? | 2-7 months |
| How is RSV spread? | Direct contact; pathogen survives more than 6 hours on countertops, tissues, and soap bars |
| What is the incubation period of RSV? | 4 days |
| How is RSV diagnosed? | Nasal swab |
| What is the nursing care/patient teaching for RSV? | Monitor I & O, oxygen saturation, and lung sounds; teach good hand washing and supportive care |
| What is the leading cause of bronchiolitis? | RSV |
| What is a syndrome caused by increased responsiveness of the tracheobronchial tree to various stimuli that results in reversible, paroxysmal (intermittent) constriction of the airways? | Asthma |
| What is used to diagnose asthma? | CBC, allergy skin testing, and pulmonary function test |
| What medications are used to treat asthma? | Bronchodilators; anti-inflammatory, Leukotriene (Singular) |
| What is the nursing care/patient teaching for asthma? | Assess lung sounds, monitor frequency and severity of attacks, monitor oxygen saturation. Placing patient in orthopneic position to assist with breathing. May hear expiratory wheezing on auscultation |
| What is a disorder manifested by a variety of symptom complexes. Characterized by recurrent paroxysmal attacks of unconsciousness that may be followed by alternate (tonic) contraction and (clonic) relaxation of the muscles or abnormal behavior? | Epilepsy |
| What is a CNS disorder that the neurons discharge in an abnormal way? | Epilepsy |
| How is Epilepsy diagnosed? | CT, MRI, EEG, CBC, BUN, serum calcium, and X-ray of full skull |
| What medications are used to treat epilepsy? | Anticonvulsants |
| What is the nursing care/patient teaching for epilepsy? | Observe and record activity before seizure, type and length of seizure, behavior after seizure. Prevent injury during seizures; seizure precautions |
| What are the possible triggers to epilepsy? | Increased physical activity, excessive stress, overwhelming fatigue, acute ETOH ingestion, exposure to flashing lights, specific substances such at ETOH, caffeine, cocaine, aerosols, and glue products |
Created by:
tandkhopkins
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