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NCTC pedi unit 4
| Question | Answer |
|---|---|
| hypothyroidism s/s | sluggish, sleeps alot, enlarged tongue causing noisy respirations, dry skin, no perspiration, cold hands and feet, infant feels floppy |
| hypothyroidism TX | admin of the synthetic hormone synthroid or levothroid, levels monitored regularly, |
| hypothyroidism teaching | meds taken same time qday, do not interchange brands, child may experience reversible hair loss, insomnia, aggressiveness, life long med therapy req. |
| tay-sachs disease info | jewish population, infant normal until 5-6 mo. of agecarriers can be identified by screening, most die before 5 yrs. |
| tay-sachs s/s, Tx | head lag or inability to sit, blindness, mental retardation, TX- no treatment, hospitalization for complications such as pneumonia, care given in the home |
| diabetes insipidus s/s | polydipsia, polyuria are initial signs, prefers water over milk formula, excessive thirst and the search for water overshadow playing, eating, learning, wt loss, growth failure, dehydration occur rapidly |
| diabetes insipidus TX | hormone replacement in the form of desmopressin by sub q injection or DDAVP (desmopressin acetate) nasal spray. |
| diabetes insipidus water intoxication s/s | edema, lethargy, nausea, cns signs- INFO- if unable to express thirst child is at great risk |
| diabetes insipidus teaching | teach signs of OD, address school access to bathrooms, and water fountains, if restricted could be life threatening |
| HIV s/s | failure to thrive, lymphadenopathy, chronic sinusitis, and nonresponse to tx of infections, sx of HIV develop more rapidly in children due to immature immune system |
| opportunistic infections | oral thrush, pneumonia, cytomegalovirus take advantage of the body's depressed immune system |
| HIV tx teaching | supportive, no cure, psychological support, referrals for financial, supportive help, teach long term compliance c meds, inspect mouth for lesions, monitor resp. status, immunizations |
| HIV is transmitted by | birth from infected mother, sexual contact c infected person, needle sharing |
| droplet precautions are used for | pertussis, influenza, droplets from cough or sneeze contaminate |
| airborne precautions for | TB, varicella, rubeola (measles), small airborne particles float in air can be inhaled any place in room |
| contact precautions are | skin to skin, RSV, hep A, impetigo, wound infections |
| expanded precautions (protective isolation) | for immunocompromised pt's safety |
| STD's - prevention | abstinence, condom use , early detection, education, awareness |
| chickenpox - vaccine given at 12-18 mo | incubation period is 2-3 wks, contagious up to 6 days after appearance of rash, mild fever, macules, pustules, papules, vesicles, all present at same time |
| rubella (german measles)vaccine given at 12-15 mo. MMR | avoid exposure to pregnant women in early months, causes fetal anomalies |
| fifth disease | slapped cheek appearance, incubation period is 4-14 days, contagious during incubation period |
| mumps - vaccine given after 15 mo. of age | fever, HA, glands near ear and toward jawline ache, painful swelling, contagious until swelling subsides |
| whooping cough (pertussis)DPT- vaccine given at 2,4,6 mo. | fever, cold, cough, noisy gasp for air that creates whoop |
| lyme disease | tick bite, may burn, fever, arthralgia, wear protective clothing in wooded areas, |
| hep B vaccine series given at birth, during newborn period | fever, anorexia, HA, abdominal pain, dark urine, chalk like stool, jaundice, -prevent contact c blood, blood products, identify high risk mothers and newborns, educate concerning need for vaccine |
| questions to ask before giving vaccines | allergic to gelatin or eggs? ever had reaction to vaccine before? ever run high fever after vaccine? monitor child for 29 min. after being vaccinated |
| do not give live virus vaccines to | immunocompromised , pregnancy, bacteremia or meningitis, immunocompromised caregiver in the the home, corticosteroid therapy, hx of high fever (105')after previous vac. |
| use what in case of allergic response to vaccine | epinepherin |
| autism s/s | failure to make eye contact, poor attention, behavior, poor orientation to one's name, usually seen by age 1 |
| autism NI | provide highly structured environment c few distractions, maintain routine, meds- haloperidol calms, amphetamines decrease hyperactivity |
| autism goals | reduce behavioral symptoms that interfere c cognitive development and family interaction |
| OCD s/s | repetitive, ritualistic behaviors that interfere c normal life |
| OCD nurses role | monitor med response, assess normal growth, development, ritualistic behavior by 3 yo normally replaced by hobbies by 8 yo., behavior therapy combined c med= best results, clomipramineto control behavior |
| depression s/s | loss of appetite, sleep problems, lethargy, social W/D, sudden drop in grades, hesd banging, lying, stealing |
| depression tx, NI | outpatient basis, prescribed drugs, NI- recognition, initiating appropriate and prompt referral |
| suicide s/s | flat effect, school performance deteriorates, isolation, changes in appearance, giving away of valued possessions, talk of death |
| nurse must | take every threat of suicide seriously, and identify at-risk adolescents |
| completed suicides are more common in | boys than girls, but girls make more attempts |
| suicide prevention | listen, do not contradict, indicate understanding, encourage expression of feelings |
| ADHD s/s | inattention- easily distracted, fails to complete work. impulsiveness- can't wait turn, disruptive c other kids. hyperactive- can't stay seated, climbs furniture. learning disabilities, dyslexia |
| ADHD tx | education, counceling, meds, support groups, positive interactions, behavioral management, strenghts rather than weaknesses, meds- ritalin, aderol, dexadrine |
| anorexia s/s | primary symptom is severe wt loss, self starvation, intense fear of gaining wt, amenorrhea, dry skin, lanugo hair, cold intolerance, low BP, abdom. pain, constipation |
| anorexia tx | complex, hospitalization, psychotherapy, behavior therapy, antidepressant meds, |
| bulimia s/s | binge-purge thought to be coping mech. for dealing c guilt, depression, low self esteem, persistent vomiting can cause erosion of tooth enamel, laxatives and vomiting can cause electrolyte imbalance |
| bulimia NI | educate, identify, prevent, refer |
| cam therapy is | complimentary and alternative medicine therapies |
| massage is used for | kids c asthma, arthritis, eating disorders. effleurage is form used during pregnancy, |
| massage is contraindicated in kids c | cancer, osteoporosis, localized infection, cardiac and circulatory disorders, down syndrome, |
| acupressure is used for | pregnancy to prevent n/v, stimulating area around ankle bone can affect uterus and pelvic organs and relieve pain during labor |
| acupoints to avoid during pregnancy | bottom of foot, inner lower leg, base of thumb, most areas over abdomen, may result in premature labor |
| herbal tx's | not often supported by scientific studies, focus on improving cognition, producing sedation, alleviating anxiety |
| peppermint used in newborns for | colic, flatulence, nausea, indigestion |
| black cohosh is used for | reducing hot flashes, joint pain, other menopausal discomforts |
| guided imagery is | belief that mind can influence body, most often combined c breathing and relaxation for discomforts of labor, focus on specific image |
| essential oils contraindicated during pregnancy | anise, juniper, thyme, wintergreen, nutmeg, pennyroyal, mugwort |
| essential oils useful during pregnancy under supervision | jasmine, citrus, clary sage, lavender, peppermint, relieve anxietuy, reduce nausea, improve general feeling of well being |
| essential oils for kids c chronic pain | lavender, chamomile, sandalwood |
| coin rubbing can be mistaken as | child abuse |
| hypoglycemia s/s, tx, cause | fatigue, hunger, pale, clammy, tremors, HA, lethargy - TX- ADMIN GLUCAGON, OJ, CARBS ORALLY-- cause-- excess exercise, too little food, insulin overdose |
| hyperglycemia s/s, tx, cause | polyuria, polydipsia, polyphagia, fruity odor to breath, deep rapid respirations(kussmaul's)-TX REGULAR INSULIN--cause-- insulin underdose, food overdose |
| ketoacidosis s/s | diabetic coma, hypoglycemia s/s,including hypertonic dehydration |
| kussmaul's breathing is | deep rapid respirations |
| type 1 dm | onset- abrupt. body size- normal/ thin. glucose level- fluctuates widely c exercise and infection. ketoacidosis- common. insulin required- almost all. insulin dosage- increases until stable |
| type 2 dm | onset- insidious; often found by screening test. body size- often obese. blood glucose - fluctuations are less. ketoacidosis- infrequent. insulin required- less than 25%. insulin dosage- may remain stable |
| immediate acting insulins | lispro (humalog)- onset is 15 min. peak is 30-90 min. aspart (novolog)- |
| rapid acting insulin | regular insulin- onset- 30-60 min. peak- 2-4h. duration- 4-6h |
| intermediate acting insulin | lente( humulin L, novolin L) onset- 1-2.5h. peak- 6-8h. duration- 12-16h. |
| long acting insulin | ultralente insulin (humulin U) onset- 4-8h. peak- 10-30h. duration- 20-36h |
| long acting insulin | lantis-do not mix c other insulins! onset- 1h. peak- 5h. duration- 24+ hrs. |
| insulin shock is | hypoglycemia |
Created by:
echilders
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