Busy. Please wait.

show password
Forgot Password?

Don't have an account?  Sign up 

Username is available taken
show password


Make sure to remember your password. If you forget it there is no way for StudyStack to send you a reset link. You would need to create a new account.
We do not share your email address with others. It is only used to allow you to reset your password. For details read our Privacy Policy and Terms of Service.

Already a StudyStack user? Log In

Reset Password
Enter the associated with your account, and we'll email you a link to reset your password.

Remove Ads
Don't know
remaining cards
To flip the current card, click it or press the Spacebar key.  To move the current card to one of the three colored boxes, click on the box.  You may also press the UP ARROW key to move the card to the "Know" box, the DOWN ARROW key to move the card to the "Don't know" box, or the RIGHT ARROW key to move the card to the Remaining box.  You may also click on the card displayed in any of the three boxes to bring that card back to the center.

Pass complete!

"Know" box contains:
Time elapsed:
restart all cards

Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.

  Normal Size     Small Size show me how

Infant Unit II

Unit 2

Increase pulmonary blood flow Atrial Septal Defect
Tetrology of Fallot PS, VSD, Overiding Aorta, R Ventricular Hypertrophy
Decrease pulmonary blood flow Tetrology of Fallot
Inability of heart to pump adequate blood to systemic circulation at normal filling pressures to meet metabolic needs CHF
Is a s/s of venous congestion from CHF Peripheral edema (esp. Periorbital)
Increase CO and decreases edema (Inc. Urinary output) Digoxin
Parameter for Digoxin 90-110 bpm
S/S of heart failure Decrease UOP, sweating, fatigue.
Hypotonic musculature, separation of sagital suture, oblique palpebral fissures, depressed nasal bridge, depressed nasal bridge, protruding tounge, short stature, transverse palmar crease, hyperflexibility Down Syndrome
High arched narrow palate, protruding tongue, stubby fingers, hypotonic muscles; Use cool mist Vaporizer for these guys. DS
Usually requires surgery to remove aganglionic portion of bowel Hirschprung Disease
Hirschprung Disease pre-op management Enemas, Low fiber, High calorie, High Protein diet
Pre-op cleft lip and palate Satisfy sucking needs
Asymmetry of gluteal and thigh folds with shortening of the thigh Galeazzi Sign
Limited hip abduction, as seen in flexion Ortolani Test
Apparent shortening of the femur, as indicated by the level of the knees in flexion Allis Sign
Pelvis tilts downward instead of upwards when weight is beared on affected hip Trandelenburg Sign
Hydrocephalus neonate s/s Bulging fontanel, dilated scalp veins, separated by sutures.
Occurs in conditions in which electrolyte and water deficits are present in approximately balanced proportions (Na 130-150 mEq/L) Isotonic Dehydration
Occurs when the electrolyte deficit exceeds the water deficit, (Na <130 mEq/L) Hypotonic Dehydration
Results from water loss in excess of electrolyte loss usually caused by a proportionately larger loss of water or a larger intake of electrolytes (Na >150 mEq/L) Hypertonic Dehydration (most dangerous)
What is the earliest detectable sign of dehydration? Tachycardia (Followed by dry skin & MM, Sunken fontanel)
The initial treatment for diarrhea ORT or ORS
The most frequent pathogen (viral) causing diarrhea in young children Rotavirus
Passage of normal stool brown stool indicates it has resolved, tell MD immediately so they stop treatment right away Intussusception
Avoids eye contact Non-Organic Failure to Thrive
Needs consistent Routine FTT
Ask only factual questions to parents like “what time did this happen?” SIDS
Check several times a day to be sure alarm is working Home Apnea Monitor
RN feeding FTT pt Remain Face-to-Face
Feeding a GERD baby Small frequent feedings
Contraindication for breastfeeding HIV
Before discharge of newborn, make sure they have a folow up appointment within 2-3days
These are signs of Digoxin Toxicity Vomiting, Nausea, Anorexia, Bradycardia , Dysrhythmias
Teach parents they must learn specific way to administer digoxin at home Check HR
May need increase in caloric density CHF
Child with hypoxia and cardiac defect, prevent dehydration Prevents CVA
Babies cannot ______ or ______ urine dilute; concentrate
Best place to check for skin turgor in infants Abdomen
Babies should urinate every ____ hrs 2
Best place for cap refill Fingers/toes or nose
Slight thirst, visible EJ, 3-5% W.L., >1.020; otherwise normal V/S Mild dehydration
Tachycardic, Tachypnea, Orthos ⁺, Irritable, Mod thirst, MM dry, ↓ tears, sunken fonatel, EJ not visible, 6-9% WL, ↓ turgor, ↑cap refill Moderate Dehydration
Tachycardic ↑, Hyperpnea, Shock, Hyperirritable-lethargy, ↑ thirst, MM parched, Absent tears/sunken eyes, Fontanels sunken, Anuria, >10% WL Severe Dehydration
Daily Maintenance Fluid Requirements 100, 50, 20ml/kg/day
Dont add K unless pt has good _____ function Renal
Normal Urine Specific Gravity 1.010-1.015
If they dont complete Rota vaccine by 6 mo They dont get it!
Is contagious (Contact), spread by fecal-oral route, can happen at any age; kills normal flora of gut (Give soy formula) Rotavirus
If going out of the country Use bottled water
Pediatric Indicators of Cardiac Dysfunction Poor Feed, Tachypnea, Tachycardia, FTT, Poor weight gain, A.I., DD, PPH, PFH.
The most common cause of death in the 1st year Heart Disease
Most common cardiac anomaly VSD
NPO on babies for ____ to ____ hours before cardiac cath 4; 6hrs
Ortolani and Barlow test best before 4wks (1mo)
The primary diagnostic tools to diagnose hydrocephalus in older infants and children CT or MRI
Posterior fontanel closed by this age 2mo
Anterior fontanel close by this age 18mo
Post-op care for VP shunt placement Place on unoperated side with HOB flat (or MD order)
Shrill, brief, high pitched cry, poor suck/feed, bossing, setting-sun, pupils sluggish Late s/s of ↑ ICP
What are some early s/s of hydrocephalus? Irritability, seizures, lethargy. (LOC change)
The most serous complication of VP shunt placement Infection (1-2mo after placement)
Any suspected drainage post VP shunt is inspected for this? Glucose
Are common post cardiac cath procedure during the first 24hrs? Dysrhythmias
Start feeding ASAP, keep in bed 24hrs with extremities straight, CMS, check site for bleeding or phlebitis Post Cardiac Cath
Closes as a result of ↑O₂ tension in arterial blood (Closes 10-15hrs after birth) PDA
Closes as a result of the loss of blood flow from the placenta Ductus Venosus
Increases Pulmonary blood flow Left to Right shunt
Decreases Pulmonary blood flow Right to Left shunt
What are 4 CHD that ↑ pulmonary blood flow PDA, VSD, ASD, Atrioventricular Canal
What are 3 Obstructive CHD? Coarctation of Aorta, PS, AS.
What are 2 CHD ↓ Pulmonary blood flow Tetrology of Fallot & Tricuspid Atresia
Transposition of the Great Arteries, Total Anomalous Pulmonary Venous Return, Truncus Arteriosus, Hypoplastic Left Heart Syndrome Mixed Blood Flow CHD
Machine type murmur, Widened pulse pressure, bounding HR, Tachycardia, Cardiomegaly PDA
Treatment can wait 1-2yr, Preemie Indomethacin, 6mo-1yr=Coils, 1-2yr=Clips PDA Treatment
PDA murmurs are very _____ Noisey
VSD best heard over Left Sternal border
Treatment for VSD Banding or Dacron patch for Lrg defects
If a VSD is small they may do this Wait, to close on its own
Is done based on the narrowness of the pulmonic valve. If it is too small the procedure will not be performed Ballon Angioplasty
RVH-Cardiomegaly, ↓ Pulmonary Blood flow, Dyspnea, Fatigue, Cyanosis Pulmonic Stenosis
↑ systemic blood pressure and bounding pulses in the arms, weak or absent femoral pulses, Cool lower extremities, Dizzy, HA, fainting, Epistaxis Coarctation of Aorta
Complications of Coarctation of Aorta HTN, ruptured Aorta, Aortic Aneurysm, and Stroke
Treatment for Coarctation of Aorta End-to-end Anastomosis, or Ballon Angioplasty
This is very important post-op Coarctation repair BP control w/ BB, ACE inhibitor and Diuretics
Complications of Tetrology of Fallot Polycythemia and CVD
More RBC production causes blood to ______. Thicken
During a Tet spell place baby in this position Knee-to-chest positio, supp O₂, Morphine
Clubbing is not seen in ______ only in _____ children. Infants; older
Is an increase in the with of the fingers due to chronic hypoxia in the area Clubbing
Is the 1st repair done in the Tet patients. Palliative Sunt
Complete repair of Tetrology of Fallot Performed in the 1st year of life
Is one of the most frequently used tests for detecting cardiac dysfunction in children Echocardiography
↓ Environmental stimuli, HOB up, Neutral thermal environment, Txt infections HF pts
Check this before giving ACE inhibitors BP
Administer PO meds to infants Via bottle nipple
Feeding schedule for HF pts Q 3hrs, for 30min/feed
Do not give _____ to a baby under 6mo water
Babies should dress with ____ layer more than you have 1
***Study: Does stenting help for Coarctation of Aorta Yes, safe and effective procedure before major Sxg.
***Study: KD ↑ risk of Coronary Abnormalities, ↑ risk of death, Harder to Diagnose, s/s not that Obvious <6mo
***Study: ↑ shunt malfunction, very costly to families and hospitals, economic burdens, need to find better ways to treat. Hydrocephalus
***Study: Intrauterine sxg repair improves outcomes and may decrease risk of neurogenic bladder although comes with risks. Spina Bifida repair
***Study: Mothers that strictly breast fed ↓ risk; Mothers that formula bottle fed ↑ risk x4 Pyloric Stenosis
***Study:Diagnostic w/ amniosynthesis in utero, 32wks gestation, ANP, ILAP, AFT, Biochemical link; ↑ preplanning to avoid feedings and immediate surgery; ↑amniotic fluid. TE Fistula Diagnosis in Utero
***Study: Air vs hydrostatic water; result Air is better. Intussusception Reduction
Tachycardia, Sweating (inappropriate), ↓UO, Fatigue, Weakness, Restlessness, Anorexia, Pale cool extremities, weak peripheral pulse, ↓BP, Gallop rhythm, Cardiomegaly Impaired Myocardial Function
Tachypnea, dyspnea, Retractions, Flaring nares*, Exercise intolerance, Orthopnea, cough, horseness, Cyanosis, wheezing, Grunting* Pulmonary Congestion
Weight gain, Hepatomegaly, Peripheral edema, Ascities, Neck vein distention Systemic Venous Congestion
Cause of acute systemic vasculitis (KD) Unknown
Sudden high fever, unresponsive to antipyretics and antibiotics Acute KD
End of fever through end of all KD signs Subacute KD
Clinical signs resolved, but laboratory values not returned to normal; completed with normal values Convalescent KD
Believed to be autoimmune disease- infection possible trigger Kawasaki’s Syndrome
Age range for KD <5y/o peaks @ 2
Fever for >5days, + Bilateral conjunctivitis, erythema of the lips, *strawberry tongue, peeling hand & feet (2nd-3rd wk), Polymorphous Rash, Cervical Lymphadenophathy >1.5cm Diagnosis for KD
Children diagnosed with KD are at risk for this? Myocardial Infarction
Abd. Pain, Vomiting, Restlessness, Inconsolable, Crying, Palor to shock. M.I. Kids
Large single dose over 10-12 hrs of IVIG or IVGG within 10 days of symptoms and ASA for fever KD treatment
Do not give this within 11 mo of receiving IVIG? Live Vaccines
Intervention for arthritic pain r/t KD Warm tub
90% of SIDS deaths occur by ___mo of age 6
↑ risk Male, Winter, African-american, Native American, Hispanic, Lower socioeconomic class, Pre-term infants, Low APGAR, First born and multiples SIDS epidemiology
Putting a baby to sleep with a ______ can help ↓ risk of SIDS Pacifier
Do not use soft bedding or fluffy pillows, stuffed animals, Do not sleep with infant, put babies of there BACK to sleep Teaching SIDS
Provide a false sense of security and go off too often Home Apnea Monitors
“_____” ok and babies should never be in between parents Co-sleeper
Allow ____ to spend unlimited time with their baby in a SIDS case. Parents
Denial, anger, hysteria, withdrawal, intense guilt, no visible response, mourning may take up to 1 year or more Common grief responses
A _____ study may be done before the leave the hospital to see if there are excessive periods of apnea. Sleep
RSV infection causes a prolonged ________ phase Expiratory
Age ranges for RSV 2-12mo rare >2yrs
Bronchioles become inflamed and swollen; lumina filled with exudates RSV infection
Diagnosing RSV ELISA & Nasal drainage
Infants with RSV Suction before feedings
Obstruction to the flow of CSF through the ventricular system Non-Communicating
Impaired absorption of CSF within the subarachnoid space, malfunction of the arachnoid villi Communicating Hydrocephalus
Needs to be measured at every healthy check-up Head circumference
This is a late sign of hydrocephalus High pitched cry
Due to failure of the neural tube to close during embryonic development Spina Bifida
Defect that is not visible externally Spina Bifida Occulta
Encases meninges and spinal fluid but no neural elements. Meningocele
Contains meninges, spinal fluid, and nerves. Myelominingocele
Meningocele or Myelomeningocele can be r/o with _____ testing Ultrasound
Possibility of bowel and bladder problems; ataxia; foot drop and might be subtle to very obvious; born by C-section. Spina Bifida later problems
Positioning for Spina Bifida Prone w/ knees bent;
Covering for Spina Bifida pre-op Moist sterile dressing, no clothing, no covers, assess for hydrocephalus
Feeding for Spina Bifida pre-op Prone with head turned to side.
Identified as a serious health hazard when a child w/ spina bifida experienced anaphylaxis due to this? Latex Allergy
Range from urticaria, wheezing, rash, to anaphylaxis. Allergic reactions to Latex
Banana, avocado, kiwi, chestnuts. Cross reactions Latex
Shallow acetabulum; delay in acetabular development; No dislocation or subluxation Preluxation
Incomplete dislocation; a disloactable hip; femur in contact w acetabulum; not displaced due to a stretch ligamentum teres and capsule Subluxation
Femoral head loses contact w acetabulum and is displaced posteriorly and superiorly Dislocation
Asymmetry best viewed in this position Prone
Loosens ligaments and muscles easier to treat dislocation Bryant’s Traction
Important consideration for a child in a cast? Skin care
Handling wet cast should be done with _____. Palms of hands
Eating with a hip spica is sometimes done _____ depending on age. Prone
Keep on except during bathing; Keeps hips abducted; triple diapers do the same thing; used for infants <6mo Pavlik Harness
With a Pavlik Harness always do these 4 things Undershirt, Check frequently, Gently massage, Diaper under straps.
Infants older than age ___ and in children, X-ray is used to confirm DDH 4mo
Treatment with Pavlik Harness typically lasts for 6-12wks
What is the Hallmark sign of Pyloric Stenosis Olive size mass
Projectile vomiting; non bilious, Baby is always hungry, signs of dehydration, BUN/Creat ↑, stools decrease, Visible Peristaltic waves Pyloric Stenosis
How is Pyloric stenosis diagnosed Ultrasound or upper GI
Pyloric stenosis is treated w this minor procedure; post-op vomiting common; Begin feeding 4-6hrs; 24hrs give formula; HOB ↑fowlers; Burp frequently Fredet-Ramstedt procedure
Nursing diagnosis for a pt w/ TE fistula Alteration in Nutrition Less body requirements.
Failed separation of the esophagus and trachea by the forth week of gestation. Tracheoesophageal Fistula
Clinical manifestations of TE fistula Excessive Salivation and Drooling
Three C’s of TE Fistula Coughing, Choking, Cyanosis
Common clinical manifestations of TE Fistula Apnea, ↑ respiratory distress after feeding, Abd. Distention
Immediately NPO; HOB up; suction frequently; begin abx; Keep g-tube unclamped Suspected TE Fistula
Respiratory conditions; G-tube feedings and Tracheomalasia (inspiratory stridor) Post-op TE Fistula repair
Absence of autonomic parasympathetic ganglion cells in one section of the colon Hirschsprung’s Disease
Accumulation of int. Contents and distention of the bowel ______ to the defect causes a large or megacolon. Proximal
HD is diagnosed with this Rectal Biopsy
Most common area for HD to occur? Rectosigmoid
What is the leading cause of death of HD in infants Enterocolitis (Fever may indicate this)
[Newborn]No meconium stool w/in 24-48hrs, ↓ PO intake, Bile stained vomit, Abd. Distention[INFANT], FTT, constipation, Diarrhea & Vomit(explosive watery) HD Clinical Manifestations
[Childhood] Chronic constipation, ribbon-like, foul smelling stool, Fecal mass, Visible peristalsis, poorly nourished & anemic HD Clinical Manifestations cont.
Done NB and preemie; insert cylinder w/ 3 ballons- test reflex response of sphincters; internal sphincters dont relax. Anorectal Mamometry
Remove aganglionic colon (2mo-1yr); at 20lbs they do sphincterotomy & pull down. 2 Stage repair for HD
_______ preparation for colostomy. Psychological
NPO; IV; abd. Dressings; perianal dsgs; may have NG tube; colostomy care. HD post-op
Cause unknown; ↑males; may be viral;↑ CF and Celiac disease; 50% <1y/o; most frequent cause of intestinal obstruction during infancy. Intussusception
How do you teach intussusception to parents. Glove with water
Most common area for intussusception Illeosecal valve
Bad complications of intussusception. Hemorrhage, Perforation, Peritonitis
Sudden acute pain w/ intervals where child is normal; vomiting; red-current jelly stools; abd. Tender and distended; Sausage RUQ; Dance’s sign Intussusception Clinical Manifestations
How do you diagnose Intussusception. Ultrasound
Is the passive transfer of gastric contents into the esophagus GE Reflux
What is the hallmark of GERD. Grimace and Cry; after feeding.
A ↓ in GERD will help ↓ ______ Asthma
PWG; anemia, irritability, gagging & chocking, apnea, recurrent pneumonia’s, heme-positive emesis or stools. GERD s/s
Hx of feedings; stool guaic; growth assessment; Esophageal pH monitoring, Endoscopy, Scintigraphy Diagnostic for GERD
Thicken formula w/ this for GERD pts. Rice cereal
Positioning for GERD pts after feedings Supine HOB 30 degrees or Prone HOB ↑ 30 for 30min while watching them.
Low dose Erythromicin for GERD does this. Speeds up motility
Tagament, Zantac, Pepsid (reduce acid in gastric contents) Antacids or H2 blockers
Reglan, Urecholine; may ↓ reflux. Prokinetic meds
Do not ______ nipple hole. Widen
Increase sucking helps clear food from esophagus; keep quiet after feeding. Give Pacifier GERD post feeding
Prognosis for GERD Good most cured by 18mo
In severe cases of GERD this Sxg is required. Nissen Fundoplication
How do you asses a Cleft palate? Gloved finger or visual inspection
This children have trouble sucking and seem to choke alot while feeding. Cleft Lip/Palate
Repair _____ first (2-3mo) and _____(6-12mo). Lip; Palate
Protect by logan bow or butterfly suture; Do NOT put on stomachs; Elbow Restraints. Cleft Lip/Palate Post-op
Best way to breast feed a kid with Cleft lip/palate. Football hold; keep head upright
Long-term problems of cleft lip/palate Speech impairment and OM
No tongue blades, No straws, No oral temps, No forks; WIDE BOWL SPOON; Soft Diet; Rinse mouth after feeding; may have breathing problems. Cleft Lip/Palate Repair Post-op
What is on the Left side of “My Plate” Vegetables and Fruits
What is on the Right side of “My Plate” Grains and Proteins (Dairy on side)
RBC and/or Hgb depletion Anemia
Wait ___ sec to clamp cord helps prevent anemia. 60
If infant is pale, cyanotic, not growing well; check this. CBC
Encourage _______ while breast feeding to help prevent anemia. Prenatal Vitamins
Caused by inadequate supply of dietary Iron. Iron Deficiency Anemia
Fetal iron stores good for ______ mo and preemies _____ mo. 5-6; 2-3
Teaching for Iron administration. Use syringe or straw(Age app), Brush teeth, Z-track if IM, Give with Vit C (O.J.); Acidic environment
Iron supplementation may cause dark stools and/or constipation DONT stop look at Diet
Refers to a state of inadequate growth from inability to obtain and/or use calories required for growth; Fall off the Growth Chart; <5th percentile; Symptom. FTT
Result from a physical cause (CHD, neuro prob, chronic UTI); accounts for 50%; r/o with H&P OFTT
Definable cause that is unrelated to disease; psycho social factors; poor parenting; lack of knowledge; disturbance of mother/child attachment. NFTT
Poverty, health beliefs, inadequate nutritional knowledge, family stress, feeding resistance, insufficient breast milk Factor ↑ NFTT
Unexplained, but usually accounted with NFTT Idiopathic or Mixed FTT
Diagnosis for FTT Plot on curve; Diet hx; H&P
This is characteristic behavior of caregiver w/ NFTT child. No Name Given to baby; negative comments; inadequate support; substance abuse.
Reversing malnutrition; Structuring environment for positive psychosocial interactions; multidisciplinary team to work w/ family. Goal for FTT pt
Extra chromosome 21 (92-95%); Translocation of chromosome 21(3-6%); Mosaicism (1-3%); Rinse mouth After feedings Trisomy 21 or Down Syndrome
↑ risk with maternal age >40y/o, although most infants w/ DS have mothers ____ <35y/o
Most kids with DS cannot play any contact sports because of this skeletal defect. Atlantoaxial Instability
Wide variation of DS; with __________ to low-average intelligence. Severely retarded
Better outcome for children with DS with these 2 things. Early intervention & promoting development.
↓ Birth weight ↑ risk of ____. CHD
↑Birth weight ↑ risk of _____. Heart Disease
First sign of compartment syndrome. Cyanosis
Use small, _____ ______ _____ to push food toward the back and side of mouth w/ kids with Down Syndrome Straight handled spoon
This prenatal supplement ↓ risk of NTD. Folic Acid
Iron should be administered in ______ meals in an acidic environment. Between
This is the best iron supplement for infants 4-6mo of age. Iron fortified Cereal
Wide base nipple for _____. Cleft lip (CL)
Best time to give PPI’s ____ before breakfast and/or dinner. 30min
RSV pt are under these 2 precautions. Contact and Droplet
Antiviral agent specific for RSV; Expensive; Teratogenic. Ribavirin
Helps PREVENT RSV infections; require monthly IM injections; must meet criteria Palivizumab (Synagis)
Best time to bulb suction a kid with RSV? Before feeding and before bedtime
What are 3 interventions that ↓risk of SIDS? Pacifier, Breast milk, & Immunizations
Alternating the position of an infants head prevents this. Plagiocephaly
Is the most important determinant in fluid loss. Daily Weight
Loss of ______ is one of the first BEHAVIORS observed in dehydration. Appetite
_______ is not a contraindication for ORT’s unless severe. Vomiting
_______ is not a contraindication to breastfeed. Mastitis
Whole cows milk before 1y/o l/t these possible problems. Intestinal bleeding & Anemia
Created by: BOjangles1006