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Pediatric Nursing

Module 3 & 4 - Care of the Infant & Toddler

What compares the child's measurements (ht. & wt.) to others the same age and sex? Growth Charts
What deviations from an established growth pattern require further evaluation? Two or more percentile
The younger the patient, the higher the metabolic rate .... what is more unstable? Heat-regulating mechanisms
What are signs and symptoms of dehydration in an infant? Weight loss, irritable, dry mucous membranes, decrease in tears, sunken eyes, sunken fontanelles, decreased skin turgor, decreased urinary output
What must infants remain on for the first year of life? Breast milk or iron fortified formula
What does satiety mean? Hunger satisfaction
What is aspiration? Occurs when an infant inhales fluid or a foreign body into the lungs, often after vomiting
Who is at highest risk for aspiration? Pre-term infants; gag & cough reflexes are weak
Why are cleft lip/palate infants at risk for aspiration? Opening can increase the risk of liquid being introduced into the lungs
How do you care for a lethargic infant? Avoid bright lights, move & handle infant slowly & gently, talk in calm voice, sit the infant upright at intervals, and slowly dress & undress the infant
How do you cope with the irritable infant? Shield infant eyes from bright light, sit quietly w/ infant w/o talking or singing, eliminate excess noise, talk in soft voice, swaddle/cradle firmly, and provide non-nutritive sucking
How is colic characterized? Periods of unexplained irritability and crying in a healthy, well nourished infant
What is impetigo? Infectious disease of the skin caused by staphylococci or by group A beta-hemolytic streptococci
What does impetigo look like? Red papules, small vesicles/pustules, that break. Skin becomes raw and weeping, crust may form, and possible infection if scratching
Where is impetigo most found? Nose and mouth, moist areas of the body; anywhere on the body
What is the nursing care for impetigo? Educate parents how to care for lesions, prevent spread, and watch for s/s of infection
How is impetigo diagnosed? If indicated, may culture drainage for C & S
Who are more prone to middle ear infections? Infants
Why are infants more prone to middle ear infections? Their Eustachian tubes are shorter wider, and straighter than older children's or adults
What is the nursing care for otitis media? Assess for pain and fever and treat. Administer meds as ordered. Warm compress may be applied locally for comfort
How is otitis media diagnosed? Visualization of the tympanic membrane via otoscope reveals reddened and bulging membrane
How is otitis media treated? Analgesic's to relieve pain, antipyretics to reduce fever, antibiotics for infection
What is the patient teaching for otitis media? No water in the ears if tubes are present or tympanic membrane not intact. Do not insert cotton swabs into the ears
What is the most common deficiency in the US? Iron Deficiency
What are some symptoms of Iron Deficiency Anemia? Pallor, irritability, anorexia, and decrease in activity
What is the teaching regarding Iron Deficiency Anemia? Proper foods for infant, such as iron rich formula through out the first year. Give iron supplements with juice (Vitamin C aids in absorption)
What is Sickle Cell Disease? An inherited defect in the formation of hemoglobin
What are the chances that a child will get sickle cell if both parents are carriers? 1 in 4 chance (25%)
What is a vassooclusive crisis? An obstruction of blood flow by cells, infarctions, and some degree of vasospasm
What is infantile eczema? Inflammation of genetically hypersensitive skin, more common in the first 2 years (worse in winter), lesions become easily infected by bacterial or viral agents
What is used to treat infantile eczema? Topical steroids
What should be avoided if a child has infantile eczema? Wool and stuffed animals because of their allergy potential; use cotton fabrics, keep nails short, and child may need gloves or socks over hands to decrease scratching. Use mild soaps
When do maternal iron stores decrease? By age 6 months
What is Autism or ASD? Group of neurodevelopmental disorders characterized by difficulties in social interaction and communication, repetitive behaviors, and stereotyped interest and behaviors
What have studies failed to demonstrate a link between? Autism and immunizations
How often does autism occur? 1 in 88
What does treatment of autism involve? Providing well-structured home and school environments, behavior modification, and in some cases the use of specific drugs to deal with specific behavioral problems. Cluster care and routines
What should the nurse provide during the hospitalization of a child with autism? Highly structured environment with few distractions. A normal homelike routine should be maintained whenever possible, with safety as a priority
Who should the parents call immediately if a parent suspects their child has ingested medications, chemicals, or cleaning agents? Poison control
How many newborns are born with some type of hearing impairment? 1 in 1000
What is croup? General term applied to a number of conditions whose chief symptom is a "barking" croupy cough and varying degrees of inspiratory stridor
What is the nursing care for a patient that has croup? Position upright to improve breathing effort. Use a cool mist humidifier (must be cleaned & disinfected daily); also, monitor O2 saturations, vital signs, and I & O
What is pneumonia? Inflammation of the lungs; alveoli become filled with exudate and surfactant may be reduced
How is pneumonia diagnosed? CBC, CXR, nasal and/or throat cultures
What are pinworms (enterobiasis)? Most common variety of worm that infects humans, seen more often in toddlers, looks like a white thread about 1/3" long
How are pinworms diagnosed? Scotch tape test; eggs have to be viewed under a microscope
What medications are used to treat pinworms? Anthelmintics (Vermox) in children over 2 yrs of age. Soothing ointment may be applied to rectal area
How does a spiral fracture occur? Break in the bone caused by a forceful twisting motion; if the history of the injury does not match with the x-ray findings, child abuse should be suspected
What type of traction is used for a spiral fracture? Bryant's
What is Bryant's traction? Legs are suspended vertically, child's weight is counteraction; used for treating fractures of the femur in children under 2 years of age or under 20-30 pounds
What is the nursing care for a patient in Bryant's traction? Weights must be hanging freely, legs should be a right angles to the body, with the buttocks raised sufficiently to clear the bed. Elastic bandages should be neither too loose nor too tight.
What is a compound fracture? Wound in the skin that accompanies the broken bone, there is added danger of infection
What medications are used for a compound fracture? Analgesics for pain, and antibiotics to prevent infection
What is a greenstick fracture? Incomplete fracture in which one side of the bone is broken and the other is bent.
What are greenstick fractures common in children? Bones are soft, flexible, and more likely to splinter
What is the treatment for greenstick fracture? Casting to stabilize bone to heal
What is the nursing care for a greenstick fracture? Cast care
What medications are used for greenstick fracture? Analgesics for pain
What is the most common type of dislocation? Developmental Hip Dysplasia
What is developmental hip dysplasia? Head of the femur is partly or completely displaced as a result of shallow hip socket
How is developmental hip dysplasia diagnosed? Palpation of joint; x-ray
How is developmental hip dysplasia treated? Manipulated back in place; Pavlik harness or spica cast may be required (keeps hips in constant flexion & abduction for 4-8 weeks to keep head of the femur within the hip socket)
What is the nursing care for patient in Pavlik harness or spica cast? Good cast care; babies my use triple thick diapers
What is cerebral palsy? Term used to describe a group of motor disorders caused by dysfunction of various motor centers in the brain and often related to antenatal or developmental factors; NO CURE
What is the goal in nursing care for a patient with cerebral palsy? Assist in making most of assets and to guide them in becoming well-adjusted adults, performing at their maximum ability. Management of effects (difficulty feeding, braces on legs, etc.)
What is the major cause of death in children older than 1 year of age? Head injuries
What is a concussion? Temporary disturbance of the brain that is usually followed by a period of unconsciousness.
What is shaken baby syndrome? Injury that occurs when an infant is roughly shaken; infants can sustain injuries resulting in permanent disability or death
What is the nursing care for patients with head injuries? Neurologic assessment; V/S; feeding if needed; care of lacerations if present. Prevent accidents (side rails), monitor for increased ICP
What is one of the most common malignancies of early life and known to be associated with certain congenital anomalies, particularly of the genitourinary tract? Wilm's tumor (Nephroblastoma)
How is skeletal traction used? Applied directly to a bone; wires and surgical pins are inserted through the bone distal to the fracture site while the patient is under local or general anesthesia
What is assess for a patient that has skeletal traction? Assess and care for pin site; monitor for s/s of infection: inflammation, purulent drainage, and pain at pin site
How do you assess neurovascular status? Monitor peripheral pulse, quality, skin color, capillary refill, temperature of skin, movement and sensation
What is a contusion? Tearing of subcutaneous tissue resulting in hemorrhage, edema, and pain;
What is the most common soft tissue injury? Contusion
How do you manage soft tissue injuries? R.I.C.E. - Rest, Ice, Compression, Elevation
What helps limit movement that can worsen the injury? Rest
What is applied to the area that reduces swelling and helps stops bleeding? Ice
What is applying pressure to the area to help stop the bleeding? Compression
What is raising the injured area above the rest of the body as a way to reduce swelling? Elevation
What is a sprain? A ligament that is torn or stretched away from the bone at the point of trauma, there may be resulting damage to the blood vessels muscles, and nerves
What are the signs of a sprain? Disability and pain
What are the common sites of a sprain? Knee, ankle, and cervical spine (whiplash)
What is a strain? Microscopic tear to the muscle or tendon occurs over time and results in edema and pain
Where is the most common strain? Back
What is the treatment if the muscle is completely ruptured? Surgical repair
What is often prescribed if the strain is in the lumbarsacral region, and is aimed at strengthening the lower abdominal muscles? Exercise
What is RSV? Respiratory Syncytial Virus - single most important respiratory pathogen in infancy
What ages are affected by RSV? 2-7 months
How is RSV spread? Direct contact; pathogen survives more than 6 hours on countertops, tissues, and soap bars
What is the incubation period of RSV? 4 days
How is RSV diagnosed? Nasal swab
What is the nursing care/patient teaching for RSV? Monitor I & O, oxygen saturation, and lung sounds; teach good hand washing and supportive care
What is the leading cause of bronchiolitis? RSV
What is a syndrome caused by increased responsiveness of the tracheobronchial tree to various stimuli that results in reversible, paroxysmal (intermittent) constriction of the airways? Asthma
What is used to diagnose asthma? CBC, allergy skin testing, and pulmonary function test
What medications are used to treat asthma? Bronchodilators; anti-inflammatory, Leukotriene (Singular)
What is the nursing care/patient teaching for asthma? Assess lung sounds, monitor frequency and severity of attacks, monitor oxygen saturation. Placing patient in orthopneic position to assist with breathing. May hear expiratory wheezing on auscultation
What is a disorder manifested by a variety of symptom complexes. Characterized by recurrent paroxysmal attacks of unconsciousness that may be followed by alternate (tonic) contraction and (clonic) relaxation of the muscles or abnormal behavior? Epilepsy
What is a CNS disorder that the neurons discharge in an abnormal way? Epilepsy
How is Epilepsy diagnosed? CT, MRI, EEG, CBC, BUN, serum calcium, and X-ray of full skull
What medications are used to treat epilepsy? Anticonvulsants
What is the nursing care/patient teaching for epilepsy? Observe and record activity before seizure, type and length of seizure, behavior after seizure. Prevent injury during seizures; seizure precautions
What are the possible triggers to epilepsy? Increased physical activity, excessive stress, overwhelming fatigue, acute ETOH ingestion, exposure to flashing lights, specific substances such at ETOH, caffeine, cocaine, aerosols, and glue products
Created by: tandkhopkins