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68wm6 peds II
| Question | Answer |
|---|---|
| Things that should be included in a physical assessment of cardiac function. | Nutrition, color, deformities, unusual pulses, respiratory, clubbing, percussion, rate & additional sounds. |
| The most important nursing responsibilities after a child returns from a cardiac catheterization. | Observe for complications, Apply pressure 1 inch above for bleeding, bed rest 4-6 hours. |
| Something you should do immediately if you notice bleeding from a cath site. | Apply pressure 1 inch about site. |
| What do you need to do prior to administering digoxin. | Measure apical pusle for 1 full minute. |
| Things you can do for a patient experiencing a blue spell. | Rest, reposition, O2. |
| Three congenital defects that increase pulmonary blood flow. | CHF, ASD, VSD |
| A temporary way to treat VSD. | Pulmonary. banding |
| Patent Ductus Arteriosus. | Failure of fetal ductus arteriosus to completely close after the first few weeks. |
| Typically the first sign of a PDA. | Continuous machine-like murmur heard over the left second intercostal space. |
| Tetralogy of Fallot. | VSD, Pulmonic stenosis, Overiding aorta, Right ventricle hypertrophy. |
| Categories of heart failure. | Left sided and right sided. |
| Hypoplastic left heart syndrome. | Underdevelopment of the left side of the heart, resulting in an absent or nonfunctional ventricle and hypoplasia of the ascending aorta. |
| Signs and symptoms of Digitalis toxcicity. | Nausea, vomiting, blurred vision, change in color of vision, dizziness, delirium. |
| When bacterial endocarditis is most likely to occur. | After dental work, UTI, Cardiac surgery, directly. |
| Chorea. | Uncontrolled movements in the body. |
| AAP guidelines for treating kids with high cholesterol. | Restrict fat and cholesterol intake. |
| The cause of essential hypertension. | Structural anomalies. |
| Clinical manifestations of Kawasaki's disease. | Sustained fever, Bilateral conjunctivitis, Oral mucosa changes, change in extremities, polymorphous rash. |
| Things you can do for a patient with a polymorphous rash to relieve itching and burning. | Cool cloths, unscented lotion, loose clothes. |
| Two times of cardiac disorders in children. | Congenital and aquired. |
| Things to look for during a physical assesment of a cardiac patient. | Nutritional state, color, chest deformities, unusual pulses, respiratory status, clubbing of fingers and toes, Heart rate, rhythm and additional sounds, percussion. |
| Most invasive cardiac diagnostic tool. | Cardiac catheterization. |
| Cardiac Catheterization. | A radiopaque catheter passed through the femoral artery directly into the heart and large vessels. |
| The principal cause of death during the first year of life. | Congenital heart disease. |
| Ostium primium (ASD 1) | Opening at lower end of septum, may be associated with mitral valve defects. |
| Ostium secundum (ASD 2) | Opening near center of septum. |
| Sinus venosus defect. | Opening near junction of superior venacava and right atrium. |
| Coarctation of the Aorta. | Constriction or narrowing of the aortic arch or descending aorta |
| Three groups of CHF. | Impaired myocardium functioning, pulmonary congestion, systemic venous congestion. |
| Most common cause of bacterial endocarditis. | Streptococcus viridans. |
| Preventative measure used for bacterial endocarditis. | antibiotic prophylaxis 1 week prior to a procedure. |
| Rheumatic fever. | An inflammatory disease that occurs after infection with group A beta hemolytic streptococcal pharyngitis. It involves the joints, skin, brain, serous surfaces, and heart. |
| 3 categories of cardiomyopathy. | dilated cardiomyopathy, hypertrophic, and restrictive. |
| Secondary hypertension | Caused by renal disease, congenital, vascular and endocrine disorders. |
| Acute systemic vasculitis. | Kawasaki disease. |
| 5 signs children exhibit with kawasaki disease. | Strawberry tongue, sustained fever, bilateral conjunctivitis, peripheral edema, polymorphous rash. |
| Anemia. | reduction in the number of RBCs or HGb, Most common hematologic disorder in infancy and childhood. |
| Iron deficiency anemia | Most prevalent nutritional disorder. |
| Highest risk for Iron deficiency anemia. | 12 - 36 months |
| Method you use to administer Iron via IM. | Z track method, DO NOT MASSAGE! |
| Things to teach parents about iron administration. | Give as prescribed, take with OJ, turns stool tarry, NVD, may stain teeth use dropper. |
| When a child has predominantly HbS they will have this. | Sickle cell anemia. |
| Types of sickle cell crisis. | Vaso-occlusive, Splenic sequestration, aplastic, hyperhemolytic. |
| S&S of acute chest syndrome. | Chest pain, fever, cough, tachypnea, wheezing, hypoxia. |
| Prevention of Sickle cell crises. | Maintaining hemodilution. |
| Beta-thalassemia | deficiency in rate of production of specific globin chains in HGb. |
| Thalassemia Major. | also known as cooley anemia, very severe can lead to cardiac failure and death if left untreated. |
| Aplastic anemia. | Bone marrow failure condition in which formed elements of blood are simultaneously depressed. |
| Factors that can cause Aplastic Anemia. | Infection, irradiation, drugs, exposure to household or industrial chemicals, idiopathic. |
| Hemophilia. | disorder where blood does not clot normally and even the slightest injury can cause severe bleeding. |
| Factor VIII is needed for forming this. | Thromboplastin. |
| Bleeding control for hemophilia. | RICE |
| Thrombocytopenia | excessive destruction of platelets. |
| Purpura | discoloration caused by petechiae |
| Leukemia. | malignant diease of blood forming organs of the body that results in an uncontrolled growth of immature WBCs. |
| Hodgkin's disease | malignancy of lymph system |
| Hodgkin's manifestations. | painless lump, low grade fever, night sweats, anorexia, weight loss, malaise, rash, pruritis. |
| How much saliva do infants produce during the first few months. | Very little amounts. |
| Chronic diarrhea | lasts longer than 14 days. |
| The most common cause of serious gastroenteritis. | Rotavirus. |
| The best intervention for diarrhea. | Prevention |
| Constipation with fecal soiling. | encopresis |
| alteration in frequency,consistency or ease of passing stool. | Constipation |
| Long intervals between passing stools | Obstipation. |
| When is the first meconium stool passed. | 24-36 hours. |
| What is hirschsprungs disease. | Lack of innervation and normal peristalsis of intestines |
| The manifestations of Apendicitis. | RLQ abdominal pain, rebound tenderness, NVD. |
| 3 post-op goals of apendectomy. | Pain management, prevent infection, early ambulation. |
| What is Meckel's diverticulum? | A small blind pouch neat the ileocecal valve that fails to dissapear completely and may be connected to the umbilicus by a cord. |
| What is the most common congenital malformation of the GI tract? | Meckel's diverticulum. |
| Crohn's disease. | Cronic inflammation of all layers of the bowel wall. |
| What kind of diet is used to treat a patient with Crohn's disease? | Well balanced, high protein, high calorie diet. |
| What is a duodenal ulcer? | An ulcer involving the pylorus or duodenum. |
| Who are primary ulcers most common in? | children over 6 years old without predisposing factors. |
| Who are secondary ulcers most common in? | Infants less than 6 months old. |
| Esophageal atresia and tracheoesophageal fistula. | tissues of the GI tract fail to separate properly from the respiratory tract in utero. |
| what is VATER | Vertebral, anorectal, tracheoesophageal, renal |
| What is VACTERL | Vertebral, anorectal, cardiovascular, tracheoesophageal, renal, limb. |
| The surgery to correct a hernia is known as what? | Herniorrhaphy. |
| What is pyloric stenosis? | Narrowing of the lower end of the stomach that occurs in relation to hypertrophy of the circular muscles of the pylorus or by spasms of the sphincter. |
| What are the manifestations of pyloric stenosis? | projectile vomiting, constant hunger, dehydration, olive shaped mass in RUQ. |
| What is a pylorotomy? | A surgical procedure in which pyloric muscle is incised to enlarge the opening to allow food to pass. |
| Intussusception. | Slipping of one part of the intestine into another portion of the intestine below it (telescoping) |
| What are currant jelly stools? | bowel movements of blood and mucus with no feces. (intussusception) |
| What is the leading malabsorption disorder in children? | Celiac disease. |
| Manifestations of celiac disease. | Failure to thrive. Large, bulky & frothy stools. Abdominal distension with atrophy of buttocks. |
| What must be restricted in a patient's diet, with celiac disease. | Gluten. |
| True or false. Meckel's diverticulum is most common in boys. | True. |
| What are the clinical manifestation's of crohn's disease | Abdominal pain, fever, weight loss, anorexia, recal bleeding, anal fistulas. |
| What are the 3 C's of TEF | Coughing, choking, cyanosis. |
| When does a strangulated hernia occur. | before 6 months of life. |
| What can happen if intussusception is left untreated? | The bowel can rupture and cause peritonitis. |
| What is the prefered route of medication administration in children. | Oral/PO |
| Why would you not add medication to an infant's formula? | Incase they don't finish all of the formula. |
| What are some things you can do to make it easier to administer meds to a toddler? | Mix them with juice or fruit, use simple terms, be firm, use distractions, offer stickers or rewards. |
| Considerations when offering meds to a school-age child. | concrete explanations, give choices, interact when possible, medical play. |
| Nursing considerations when administering meds to adolescent. | more abstract explaination for meds, include in decision making. drink through straw to minimize distaste. |
| Prefered site for IM injection in infants and smaller children. | Vastus lateralus. |
| What injection site do you want to avoid in children under 5 years of age and why? | Dorsogluteal, this area is usually underdeveloped. |
| What is the appropriate needle gauge for a SQ injection | 23-26 |
| What is the appropriate needle gauge for a ID injection. | 25-27 |
| Prefered IV site for an infant younger than 9 months of age | Scalp vein. |
| How do you administer ear drops in a child <3 years of age? | Pull ear down and back before. |
| How do you administer ear drops in a child >3 years of age? | Pull ear up and back before. |
| Where do you apply eye drops? | In the conjunctival sac that is formed when lower lid is pulled down. |
| What illnesses are antibiotics commonly given for in children? | Acne, Bacterial meningitis, cystic fibrosis, sepsis, otitis media. |
| What is the drug of choice in treating thrush? | Nystatin (mycostatin) |
| What are the medications used to treat Tuberculosis? | Isoniazid, rifampin, pyrazinamide |
| What drug is used to treat influenza? | amantadine hydrochloride. |
| What is the drug used to treat herpes and chicken pox? | acyclovir (Zorivax) |
| Drugs that are used to treat juvenile rheumatoid arthritis. | Methotrexate(amethopterin, Folex, rheumatrex, trexal) cytarabine (Cytosar, depocst) Corticosteroids are also used. |
| Antiarrythmic used in children with cardio problems. | Digoxin |
| What is an ACE inhibitor | an antihypertensive. |
| What is digoxin contraindicated in? | Uncontrolled ventricular arrythmias, AV block, idiopathic hypertropic subaortic stenosis, constrictive pericarditis. |
| What heart rates in infants and children would make you withold Digoxin? | <70 child, <90 infant |
| Therapeutic Serum Digoxin levels | 0.5-2 ng/mL |
Created by:
wlthompson49
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