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Peds 23-24 CCC 105

Peds Ch 23-24 CCC PN105

What is retinoblastoma? Malignant tumor of the retina; yellowish white reflex in pupil; loss of vision, strabismus, hyphema, pain
Shaken Baby Syndrome causes brain to strike inside skull, results in retinal, subarachnoid, and subdural hematomas as well as cerviccal spine injuries and permanent disability or death
Milwaukee Brace instructions worn 23 hours per day over a t-shirt to protect skin
Assess for scoliosis check shoulder height bilaterally, check ribs for one side hump, check for asymmetry on back when leaning forward, prominent scapula
Why is osteomyelitis so painful? affected vessels are compressed anc cause edema
treatment for osteomyelitis IV antibiotics, pus drainage, analgesics for pain, bed rest
Serious complications of Bryant's traction gravitational vascular drainage causing anoxia of muscles and vasospasms leading to contractures and paralysis; Volkman's ischemia (obstructed circulation)
How does the Russell traction work? sling placed under knee suspending distal thigh over bed pulling vertically from sling and longitudally from foot plate
Decerebrate posture all limbs are extended and hands are pronated (brainstem injury)
Decorticate posture arms, wrists, and fingers are flexed to center of body, plantar flexion of feet (brain cortex injury)
long term effects of Legg-Calve's Perthes marked distortion of femur head, leads to imperfect joint or degenerative arthritis
S/S of Duchenne;s muscular dystrophy history of delayed motor development, calf muscles hypertrophied, progressive weakness, ankle contractures, Gower's maneuveres (rising from floor)
Concussion symptoms headache, drowsiness, blurred vision, vomiting, dyspnea, unconsciousness, loss of memory before-during-after incident, skull fracture, bleeding
Meningitis common symptom stiff neck and severe headache, delirium, irritability, restlessness, fever, vomiting (use transmission based droplet precautions)
How to diagnosis meningitis spinal tap to check for pus on spinal column
teaching prevention of Reye's syndrome avoid use of salicylate medications (aspirin) during viral infections like flu or chicken pox, get varicella vaccine
Febrile seizures seizure response to rapid rise in temperature (above 102) - transient condition from 6mon-5yr of age; self limiting - teach parents correct use of antipyretics and colling measures
Safety nursing intervention of child having generalized tonic-clonic seizure check for identification; protect from nearby hazards; observe and record all stage manifestations; maintain airway; afterwards, turn on side and loosed clothes; call for ambulance if over 5 min, pregnant, injured, or diabetic
Post-op care of tympanostomy with insertion of tubes analgesics for pain, avoid water in ears, report excess draining or blood, followup to make sure condition is resolved and to check hearing
Treatment of ear infections irrigations, topical antibiotics, analgesics for pain
How to instill ear drops in infants pull pinna back and down
How to instill ear drops in children pull pinna back and up
Signs of hearing impairment no verbal attempts by 18mos, lack of response to sounds, behavior problems, poor academic progress, aggressive with other children
Why are infants prone to ear infections? eustacian tube is wider, shorter, and straighter
What is the cardinal sign or hyphema? bright or dark red spot in front of lower part of iris
Absence seizure (petit mal) symptoms blank stare; temporary loss of awareness resulting in lack of continuity of thought process
After a generalized tonic-clonic (grand mal) seizure, the nurse would expect what action of the child? postictal lethargy (short period of sleep)
tonic seizure stiffening of muscles
clonic seizure alternating stiffening and relaxing of muscles
3 stages of grand mal seizure aura (sudden cry); seizure; postictal lethargy (short period of sleep)
S/S of Reye's syndrome sudden onset of effortless vomiting and lethargy, combativeness and altered consciousness; in infant, diarrhea, hypoglycemia, tachypnea, anemia, seizures
Musculoskeletal assessment of child assess gait, muscle tone, neurological exam, and diagnostic tests (bone scan, CT, MRI, ultrasound)
Difference in child's skeletal system compared to adult bone not completely ossified, epiphyses present, periosteum thicker and produces callus more rapidly, lower mineral content and greater porosity make stronger
4 neurological checks level of consciousness; pupil/eye movement; vital signs, motor activity
Juvenile RA goals reduce joint pain and swelling; promote mobility and preserve joint function; promote growth and development; promote independence; help child and family adjust and alleviate stress
Juvenile RA interventions physical and occupational therapy; supportive flat mattress with resting splints; moist heat and exercise; whirlpool baths; therapeutic play
What is amblyopia? "lazy eye;" reduction or loss of vision occurring in children who strongly favor one eye
Amblyopia treatments Early detection gives better results; eyeglasses for refractive errors (far/near sightedness) and patching (occlusion therapy) to force use of affected eye
S/S child abuse observation of parent/newborn interaction; repeated hospitalization; multiple fractures; presistent feeding problesm; failure to thrive; chronic school absenteeism; child overly upset about hospital discharge; runaways
Assessing child abuse divide body in 4 planes - injury in >1 is suspicious; too many clothes; retinal hemorrhage; failure to thrive; irritation of genitals; dirty clothes; skin rashes; location/color of bruises/scars/wounds; wound imprints/outlines on skin
Reporting obligations of child abuse must report suspisicion of child abuse
Bruising, 1-2 days bruise is swollen and tender
Bruising, 0-5 days bruise is red or purple
Bruising, 5-7 days bruise is green
Bruising, 7-10 days bruise is yellow
Bruising, 10-14 days bruise is brown
Bruising, 14-28 days bruise is clear
Created by: cmp12345
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