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Peds

Pediatrics/GI/Burns RN EOP for NCLEX

TermDefinition
Sydenham chorea is a rare neurological disorder characterized by sudden onset chorea, usually in childhood. Chorea is defined as random-appearing, continuous (while awake), involuntary movements which can affect the entire body. This often includes the face and tongue.
Pyloric Stenosis Gastric outlet to sm intestine obstructed/thickened s/s Metabolic Alkalosis , projectile vomit, dehydration, growth failure tx pyloromyotomy
Rheumatic Fever Complication fm Scarlett fever or Strep throat immune attacks tissues/ heart valves tx NSAID, PCN, Rest
MCNS Minimal Change Nephrotic Syndrome Lg protein lost in urine s/s edema, albuminuria, cholesterolemia, eye edema 2-7 yr olds low sodium, albumin, corticoid
Hypoplastic L heart Cyanosis under development left side heart Cyanotic, HF, ↓ Cardiac Output, cardiovascular collapse tx LG ASD shunt or heart transplant
Cyanotic Heart Defects ↓ Pulm Blood Flow Tetralogy of Fallot Tricupsid Atresia Transposition Truncus Arteriosus Hypoplastic Left heart
Acyanotic Heart Defects ↑ Pulm Blood Flow ASD, VSD, PDA, AVC Coarctation Aorta Aortic Stenosis Pulm Stenosis
Transposition of Great Arteries no flow between systemic and pulm circulation tx prostaglandin e & arterial switch septotomy
Tricupsid Atresia tricupsid valve fails to develop prostaglandin e to keep PDA open tx arterial septotomy
Coartation of Aorta Narrowing of Aorta High bp, weak femoral, cool extremities, acyanotic
PDA Open ductus arteriosus after 2 days birth between aortic and pulm artery- acyanotic IV indomethacin and surgery
Acute Glomerulonephritis Triggered by SLE and Strep s/s facial edema, hematuria, pleurisy, htn, acites diet- low protein low salt low K, fluid restriction
Croup Barky cough, viral, acute phase at night tx moisture, steroids, bronchodialators
Bronchiolitis Inflammation of bronchioles from RSV fluids, albuterol treatments
RSV Respiratory Syncytial Virus hyperinflation, atelectasis, Elisa positive common in preemies
Epiglottis drooling, cyanotic, resp emergency
Kawasaki Disease inflammation of blood vessels, fever, rash, pink eye, strawberry tongue tx asprin, immunoglobulin
Sickle Cell RBCs obstruct blood flow causing pain fatigue blood transfusions common in black ppl
Thalassemia ↓ hemoglobin, auto-somal, mediteranians
Most common osteo sarcoma femur
Cystic Fibrosis Disease of exocrine glands abnormal mucous Parent carrier Sweat test s/s frothy fatty stools, lung infections tx CPT, vitamins, pancreatic enzymes
TB Myco-bacterium, droplet precaution INH, Rifampin, "myeins" 6-18 months
Imperforate Anus No anus at birth
APSGN Acute Post Step Glomerulonephritis kidney inflammation 2-3 weeks post strep
Wilms Tumor Kidney tumor, do not palpate abdominal, abdominal mass 3-4 yr olds
Diagnostic Respiratory Chest xray C & S ELISA Otoscopic Sweat Test CBC PFT
Laryngeal Cancer Common in smoking, chewing tobacco, alcohol
Cleft Palate Surgery 10-12 months old Special nipple, sm freq feedings, post op supine w/restraints
Tetralogy of fallot Cyanotic VSD, pulmonic stenosis, over riding aorta, RV hypertrophy Tet spells/squatting toddler
Polycythemia ↑ in red blood cells
Asthma Narrowing/Spasms bronchi Chronic non productive cough wheezing Triggers virus, allergans staus asthmaticus- epi pen/resp emergency
Hemophilia Clotting disorder- no sports-swelling in joints- clotting factor and plasma
Leukemia Blood cancer s/s Bone pain, swollen lymph, freq infections tx bone marrow, stem cell transplant, chemo
Hodgkins Cancer of lymphatic- swollen non painful nodes clavicle, fever, fatigue chemo & radiation
Peptic Ulcer Disease H-pylori, alcohol, smoking, nsaids tx Bactrim, Amox, PPI
TEF Tracheoesophageal Fistula s/s choking, salivating, infant water test complication: pneumonia, choking
Hirschsprung Disease No nerves in lg intenstines s/s no stool >48hrs newborn swollen belly, vomiting tx: Bowel resection
Esophageal Atresia esophagus doesn't connect to stomach tx gastrostomy for peg tube
Intussusception Intestines telescopes into another part of intestines s/s Jelly currant stools, abd pain, knee to chest, bile vomit tx ng, enema, sx
Appendicitis navel pain radiates to R lower abd , fever, n/v NPO, appendectomy, antibiotics rupture sudden pain relief
Object Permanence Peek a boo piajet, knowing an object is out of sight bt still exists
Most appropriate vaccine for adolescent Meningococcal Polysaccharide
Pre school Play Focuses on imitation of adults
Age child starts scribbling 18 mo
Preparing toddler for surgery Read books that explain hospitalization in age appropriate manner
School age child 6yr old Tonsils that touch Freckles Teeth start shedding
Babinksi reflex dissapears 1 year of age
Car seat rear facing until 1 year
4 year old perception of death its punishment same as going to sleep magical thinking
2 1/2 year old 20 teeth, birth weight quadrupled, pot bellied, bow legged
Obtain urine specimen of child who isnt potty trained pediatric urine collector
Communated Fx break or splinter 2 or more fragments shatters
Compound Fx Breaks skin
Complicated Fx organ or major vessel damage
Bryants traction Both legs suspended
Traction Care Assess for tightness, weakness, or contractures
Simple fx Doesn't break skin
Diverticulitis inflammation of intestinal pouch abd pain, diahrrea rest, low fiber diet clears, PCN
Chrons Auto immune attacks GI abd pain, bloody stools, anemia, low albumin and h & h immunosuppresants, corticoids, sx
Ulcerative colitis diet High Protein Low Protein Sulfasalazine Corticoids and nicotene
Rule of 9s Head 9% Arm 9% Leg 18% Trunk 36% Perineum 1% (if part half burned then divide in half for right percent)
Measles (Rubeola) MMR 8-12 days incubation, contagious 2 days after rash s/s rash face trunk extremities, Koplik spots, conjunctivitis, fever, coryza inflammation of nasal vit A decreases mortality
Osteoarthritis Wear and tear, eberton nodes, increased c reactive
Age appropriate toys infant- bright colors, large 2-3- push pull balls 3-4 imaginative play 4-5 real life play, puppets, imitate adults 5-10 structured games, group play 10+ crafts, videos, computer, sports
Adolescence theory Piaget- formal operations- abstract reasoning Erikson- identity vs role confusion Freud- genital Kohlberg- post conventional/principle social contract
School age theory Piaget- concrete operations- inductive reasoning and beginning logic 6-12 Erickson- industry vs inferiority Freud- Latency, good boy/girl, law and order Kohlberg- Conventional Level
Early childhood/preschool theory Piaget- preoperational thought, intuitive phase, 3-6 Erickson- initiative vs guilt Freud- phallic
Toddler Theory Piaget- preoperational thought, preconventional phase 1-3 Erickson- Autonomy vs shame/doubt
Infant theory Piaget- sensorimotor birth -2 1 year triples weight 5 month doubles erickson- trust vs mistrust
Prostate/testicular cancer Increased PSA, decrease urine flow, one testicle larger Self exam done in warm area, monthly prstectomy, orchectomy, bladder irrigation
TURP Trans-urethral Resection of Prostate for BPH tx anti-cholinergics, cont bladder irrigation, hyponatremia, hypovolemia
Glaucoma pressure within eye s/s slow vision loss, eye pain tx beta blocker, trabeculoplasty, eye drops
Seizures Both hemispheres- generalized Lose Consciousness aka Tonic Clonic or Grand Mal Epileptic- Unpredictable Phenytoin can't be taken with dairy
During/Post Seizure During: time and record, loosen clothing, remove glasses and hard objects, turn child to side, pillow under head, padded bed rails Post-ictal- time and record, breathing/airway, swallow test prior to diet, inspect for injuries-
Brain Stem injury Deep, rapid, irregular resp, fluctuations in bp/pulse, pupils dilated and fixed
Myleomeningocele s/s sac like meninges-spinal fluid, hydrocephalus, neurogenic bladder, latex allergy Sx within 24hr, nurse prone or side lying
Cerebral Palsy Hypertonicity, poor control posture/balance, wheel chair bound, short life span Tx Baclofen, intrathecal (admin via spinal canal), physical therapy
ICP/Hydrocephalus Bulging fontanel up to 1yr, change loc, seperated sutures, dilated scalp veins, diplopia, irratability Mannitol, ventriculoperitoneal shunt
Congenital Hip Dysplasia birth defect dislocation femur- gluteal folds and ortalani click test assoc w/club foot spika cast or pavlik harness
Varicella VZIG vaccine and acyclovir 14-21 day incubation, contagious 5 days before the rash, droplet until vesicles dried s/s fever, rash w/vesicles, malaise, toxic shock
Post Traumatic Meningitis in children Increasing drowsiness, fever, basilar skull fracture
Pancreatitis inflammation infection of the pancreas alcohol, gal stones upper abdominal pain, n/v NPO advance to low fat IV fluids, NG, pain mgt, ppi's, insulin regulation
Whooping Cough Pertussis Erythromyacin Contagious 1 week post exposure Most contagious during cough s/s runny nose, whooping cough, vomitting
DTAP DTAP injection Diptheria 2-7 day incubation, contagious 2-4 weeks s/s Rhinorea w/halitosis, stridor, bluish white lesions tonsils IV Anti-toxin & PCN
Roseola High persistent fever 3-4 days, then rash trunk-neck-face, cough, seizure tx no vaccine, antiviral medication ganciclovir
Erythremia infectiosum aka Fifth Disease HPV no vaccine for infants Rash - slapped face rash dissapears 1-4 days red maculopapular to trunk
Polio 7-10 days incubation, Vaccine Neurosystem mild to severe resp paralysis No cure
Lead poisoning >45g/dl chelation therapy
Fontanels Anterior closes 12-18 months Posterior closes 6-8 weeks
Scarlet Fever No Vaccine- PCN Strawberry tongue, toes and fingers peel, sore throat, high fever, rash Caused by GABHS
MS Immune system attacks healthy nerves s/s vision loss, pain, tremors, muscle spasms and contractures, muscle wasting Immunosuppressants, steroids, muscle relaxers
CO poisoning s/s headache, n/v, confusion, dizziness, sob tx pure Hyperbaric O2 therapy
Burn Degrees 1st- superficial partial thickness epidermis and part of dermis 2nd- Deep partial thickness epidermis and dermis 3rd- Full thickness epidermis, dermis, and subcutaneous fat tissue 4th- All tissues including muscle+
Assessment Parameters for Fluid Resuscitation Urine 30-50ml/hr Sytolic 90-100 Clear Lungs HR >100 Resp 16-20
Emergent Phase From burn injury can last 5 days hypovolemia, 3rd spacing Focus: Burn shock & Fluid replacement, ABCs, tetanus, antibiotic prophylaxis, avoid shock, dysrhythmias, airway obstruction, gangrene, ATN
Acute phase focus on skin care and infection prevention debriedment 2-3 times day skin grafts hydrotherapy and Antibiotic
Rehab phase Burn Wounds healed teaching, accomplish functions, body dysmorphic, joint contractures
Skin grafts Auto graft- patients own body Homograft or Allografts- cadaver Heterografts or xeno- animal
Curling's Ulcer acute gastric erosion fm severe burns tx enteral feedings, ppis/antacids
Diet for Burn Patients High Protein
Parkland Formula Lactated Ringers- 4ml/Kg/% burned Infusion rate: 1/2 first 8hrs 1/4 second 8hrs 1/4 3rd 8hrs
Created by: matthew0116
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