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PEDS HESI Review

TermDefinition
Erickson's Theory: Infant (Birth to 1 year) Trust vs. Mistrust
Erickson's Theory: Toddler (1 to 3 years) Autonomy vs. Doubt and Shame
Erickson's Theory: Preschool (3 to 6 years) Initiative vs. Guilt
Erickson's Theory: School Aged (6 to 12 years) Industry vs. Inferiority
Erickson's Theory: Adolescent (12 to 19 years) Identity vs. Role Confusion
Milestones: Infant (Birth to 1 year) 2mos- Posterior fontanel closes; 4mos-Moro reflex disappears and head control is achieved; 5-6mos-Rolls from abdomen to back; 7mos-Transfers objects from hand to hand; 7-9mos- develops stranger anxiety; 8mos- sits unsupported; 10 months- crawls
Milestones: Toddler (1 to 3 years) 12-18 mos- anterior fontanel closes; 2y- feeds self with spoon and cup 7 achieves 50% of adult height & can start toilet training; 2-3 word sentences spoken by 2 years; 3-4 word sentences spoken by 3 years; temper tantrums common
Milestones: Preschool (3 to 6 years) Each year child gains 5lbs and 2.5-3 inches; child uses scissors at 4 years; child ties shoelaces at 5 years; thinking is egocentric and concrete; sentences of 5-8 words; sexual identity begins
Milestones: School Aged (6 to 12 years) Each year child gains 4-6lbs and about 2 inches in height; egocentric thinking replaced by social awareness of others; child learns to tell time and understands past, present, and future; socialization with peers becomes important
Milestones: Adolescent (12 to 19 years) Girls growth spurts begin earlier than boys (10-15 years on avg); Boys (14-17 on avg); secondary sex characteristics develop; adult-like thinking and problem solving develop
Pain scales Faces and Poker Chip Scale- can be used by children 3 years and older; Numeric Pain Scale- can be used by children 9 years and older; FLACC (facial movement, leg movement, activity, cry, and consolability)- assess nonverbal child
Burns kids under 2 have greater surface area in head and trunk, greater fluid volume proportionate to body size, and less effective CV responses to fluid shifts; can't use rule of 9s; maintenance and replacement fluids, measure ur. output (1-2ml/kg/hr)
Poisoning identify poisonous agent quickly, advise parents to bring any emesis, stool, etc. to ED; Use of syrup of ipecac no longer recommended as it may cause more damage; may require gastric lavage, activated charcoal, or Narcan; poison-proof home
Lead poisoning Can be inhaled, ingested, or transmitted through placenta. Most common source is lead based paint on older homes(built before 1950);BLL (Blood Lead Level) test is used for screening and diagnosis; Administer prescribed Chelating agents to reduce high BLL
Signs of respiratory distress in children Reslessness; increased resp rate; inc. pulse rate; diaphoresis; flaring nostrils; retractions; grunting; adventitious/absent breath sounds; use of accessory muscles; cyanosis and pallor; dec. PO2, inc. PCO2
Asthma & s/s def: inflammatory reactive airway disease; airways become edematous and congested with mucus; smooth muscles of bronchi and bronchioles constrict; air trapping occurs in alveoli; expiratory wheezing; rales; crackles
Asthma treatment Administer rapid-acting bronchodilators and steroids for acute attacks; Beta-adrenergic agonists such as albuterol, cromolyn sodium, levalbuterol, and budesonide are most commonly used meds; monitor peak expiratory flow rate at home
Cystic Fibrosis def: autosomal recessive disease that causes dysfunction of the endocrine glands; overabundant mucus production obstructs vital structures; causes lung insufficiency; pancreatic insufficiency; inc. loss of sodium and chloride in sweat
Cystic fibrosis s/s meconium ileus at birth; recurrent respiratory infection; pulmonary congestion; steatorrhea; foul-smelling bulky stools; delayed growth and poor weight gain; salty skin
Cystic fibrosis treatment monitor respiratory status; administer antibiotics as prescribed; administer pancreatic enzymes; administer fat soluble vitamins in water soluble form; administer O2 and nebulizer treatments (DNase) as prescribed
Cystic fibrosis diet high calorie; high protein; moderate to high fat; and moderate to low carbs (to avoid an increase in CO2 drive); a child needs 150% usual calorie intake for normal growth and development
Epiglottits def: severe life-threatening infection of the epiglottis; condition progresses rapidly and may cause acute airway obstruction; H. influenzae usually responsible organism
Epiglottitis s/s restlessness; high fever; sore throat, dysphagia; drooling; muffled voice; tripod position
Epiglottitis treatment Encourage prevention with Hib vaccine; maintain child in upright position; prepare for intubation or tracheostomy; administed IV antibiotics as prescribed; prep for hospitalization in ICU; NEVER EXAMINE THROAT OR PLACE ANYTHING IN MOUTH- may obstruct!
Bronchiolitis def: viral infection of the bronchioles that is characterized by thick secretions; usually caused by RSV and can be easily transmitted by close contact with family, hospital personnel; others
Bronchiolitis s/s hx of upper respiratory symptoms; irritable, distressed infant; paroxysmal coughing; nasal congestion; nasal flaring; prolonged expiratory phase; wheezing, rales
Bronchiolitis treatment ISOLATE CHILD!! Assign nurse that has no other patients to prevent transmission; Clear airway of secretions with bulb syringe; maintain hydration; Admin. palivizumab to provide passive immunity in high-risk children
Otitis media def: inflammatory disorder of middle ear; anatomic structure of the ear predisposes young children to ear infections (straight passageway); risk for hearing loss if left untreated or hx of many infections
Otitis media s/s fever; pain; infant may pull at ear; enlarged lymph nodes; discharge from ear; vomiting diarrhea
Otitis media treatment admin. antibiotics if prescribed; REDUCE BODY TEMP; position child on affected side; prevent smoking around child and propping bottle to feed infant
Tonsillitis Inflammation of the tonsils; may be related to infection of strep species; IF IT IS RELATED TO STREP, TREATMENT IS VERY IMPORTANT because of risk of developing glomerulonephritis or rheumatic heart disease
Tonsillitis s/s sore throat; fever; enlarged tonsils
Tonsillitis treatment Throat cultures to determine viral or bacterial origin; warm saline rinses; ice chips; treat fever with acetaminophen; surgical care if indicated
Surgical care of tonsillitis Prior to tonsillectomy nurse should be sure PT and PTT have been determined; hx of excessive or prolonged bleeding; POSTOP- monitor for signs of excessive bleeding; ice collar helps with pain and vasoconstriction
Signs of bleeding after tonsillectomy frequent swallowing; vomiting fresh blood; and clearing throat
Congenital Heart Disorders Heart anomalies that develop in utero and manifest at birth or shortly thereafter; may be categorized as increased pulmonary blood flow; decreased pulmonary blood flow; obstructive defects; mixed defects
Acyonotic heart disorder Left to right shunt; increased pulmonary blood flow
Cyanotic Right to left shunt; decreased pulmonary blood flow
VSD Ventricular Septal Defect; there is a hole between the ventricles;INC PULM BF; oxygenated blood from left ventricle is shunted into the right ventricle and recirculated into the lungs; small defects may close spontaneously; large defects may cause CHF
ASD Atrial Septal Defect; there is a hole between the atria; INC PULM BF; surgical closure recommended to prevent CHF, dysrhythmias
PDA Patent Ductus Arteriosus; abnormal opening between the aorta and pulmonary artery; Inc Pulm BF; Usually closes within 72hrs after birth; may cause pulmonary HTN; may req med intervention with indomethacin (Indocin)
Coarctation of the Aorta Obstructive narrowing of the aorta; common finding is hypertension in the upper extremities and weak or absent pulses in the lower extremities; may require surgical correction
Aortic Stenosis
Created by: artabbey28