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68WM6 Phs2 Test 11
68WM6 Phase 2 test 11 Care of Pediatric Patients
| Question | Answer |
|---|---|
| growth is viewed as | quantitative change |
| development is viewed as | qualitative change |
| what type of pattern do developmental stages follow? | cephalocaudal pattern (head to foot) |
| what are the 5 developmental age periods? | prenatal, infancy, early childhood, milddle childhood, late childhood/adolescence |
| describe the prenatal age period | conception to birth; rapid growth rate, total dependency, most crucial period |
| describe infancy age period | birth to 12 months; rapid motor and social development, trust developed, foundation for future interpersonal relationship is laid |
| describe early childhood period | 1-6 years; intense activity, marked physical and personality development, Learn role standards, gain self control and acquire language and wider social relationships |
| describe middle childhood age period | 6-12 yrs; Developing away from the family group and centered on the world of peer relationships, Developing skill competencies and social cooperation and early moral development take on more importance |
| describe later childhood age period | 12-19 yrs; Tumultuous period of rapid maturation and change is known as adolescence, Considered to be a transitional period that begins at the onset of puberty and extends to the point of entry into the adult world |
| typical vital signs for an infant | temp: 96.5-99.5 HR: 120bpm RR:30 BP:90/60 |
| typical vital signs of toddler | Temp: 98-99 HR:90-120bpm RR:20-30 BP:80-100/64 |
| typical vital signs of school age children | Temp: 98-99 HR:55-90bpm RR:22-24 BP: 110/65 |
| typical vital signs of adolescence | Temp: 98-99 HR: 70bpm RR:20 BP:120/70 |
| a baby cries..."feed me" and you respond and meet those needs. what type of psychosocial development is this? | Trust vs mistrust birth-1 yr |
| the child wants to feed themselves, walk by themselves, start "talking", they want to do things for themselves...all of these are examples of what psychosocial development stage? | autonomy vs shame (1-3 yrs) |
| if a parent helps with the construction a box fort and provides support instead of telling the child to go play in their room because they have enough toys which stage of psychosocial development is this? | initiative vs guilt (3-6 yrs) |
| Children learn to compete and cooperate with others and learn the rules and consequences | Industry vs Inferiority (6-12 years) |
| Adolescents become overly preoccupied with the way they appear in the eyes of their peers | Identity vs Role Confusion (12-18 years): |
| concepts and attitudes one has towards their body | body image |
| when do kids become most aware of the physical self? | adolescence |
| value one places upon self and the overall evaluation of oneself | self esteem |
| A personal, subjective judgment of one’s worthiness derived from and influenced by social groups in the immediate environment and the individual’s perception of how they are valued by others | self esteem |
| Factors that influence the formation of a child’s self esteem include | Temperament and personality. Ability to accomplish age appropriate tasks. Significant others. Social roles and expectations |
| What factors influence parental expectations related to child development? | Media, role models, and lack of parenting knowledge |
| what are 3 stressors r/t hospitalization? | separation anxiety, loss of control, fear of pain |
| what are the three phases of separation anxiety? | protest, despair, denial or detachment |
| what part of separation anxiety is where a child denies food/drink, and does not play actively? | Despair |
| at what stage is separation anxiety the greatest stressor? | infants and toddlers |
| at what stage do children protest by asking questions and could possibly become aggressive and hit others? | preschooler |
| what development group is better able to cope, react to separation from peers, have feelings of lonliness, boredom, isolation, or may reject siblings/parents | school age children |
| what group welcome parent separation, fear loss of acceptance, and may reject parents | adolescence |
| Uses transductive reasoning and deduct from particular to particular, rather than from the specific to the general | preschoolers |
| Respond well as long as they have a measure of control. Problems will arise from boredom and activity limitations | school age children |
| Egocentric, magical thinking. Fantasize reasons for hospitalization/illness | preschoolers |
| They respond with depression, hostility or frustration | school age children |
| React with rejection, uncooperativeness or withdrawal, anger or frustration | Adolescents |
| Struggles are for independence, self-assertion and liberation. Threats to identity results in loss of control | Adolescents |
| give some examples of what the nurse can do to help w/separation anxiety | allow parents to "room in", maintain daily routine, allow items from home(toys,blanket), promote giving them choices, let them know expectations |
| how do parents respond to child's illness/hospitalization? | disbelief, anger/guilt, fear/anxiety, frustration, depression |
| what can you as the nurse do to help lessen the stress w/ parents? | inform parents on what to expect, be involved, remain objective, encourage "room in", take breaks-rest, establish trust, arrange for religious visit, listen to verbal/nonverbal |
| lessen sibling stress by: | encourage them to visit, encourage parents to spend time with healthy child |
| why is pain undertreated in children? | nurse's misconception of pain, complexities of pain assessment, lack of info r/t available pain reduction techniques |
| what are some things you can do to reduce pain nonpharmacologically? | distraction, relaxation, guided imagery, positive self-talk, thought stopping, cutaneous stimulation |
| r/t peds, dosages are calculated by? | weight |
| what is ELMA cream? | Local anesthetic applied at least ONE HOUR prior to procedures such as IV insertions and blood draws |
| the right route for a ped pt is: | most effective, least traumatic |
| what is the most common side effect for meds r/t peds? | constipation |
| what is the most serious side effect of meds r/t peds? | resp depression |
| children learn through _____, which is also their job. | play |
| what are some classifications of play? | social-affective, skill, unoccupied behavior, dramatic, games |
| social-affecive play | Where infants take in pleasure in relationships with people. Infants learn to provoke emotions and responses with behaviors such as cooing, smiling or crying |
| skill play | after the infants have developed the ability to grasp and manipulate, they demonstrate their abilities through skill play, repeating the same actions over and over again |
| unoccupied behavior | Children daydream, fiddle with clothes or other objects, or walk aimlessly |
| dramatic / pretend play | By acting out events of daily life, children learn and practice the roles and identities modeled by the members of their family and society |
| true or false: children who have long hospital stays are at risk for developmental delays and regression | true |
| what type of toys do small children enjoy | small colorful toys, large playhouses |
| what type of toys do school-age children like | puzzles, legos, books, and games |
| computers and video games-toys for who? | adolescents |
| what are three examples of nondirective play? | bean bag toss, wagon rides, play dough |
| what are some cultural factors to keep in mind? | heredity, physical characteristics, customs/folkways, foods, relationship w/provider |
| what is the shape of a newborn's spine? | c-shape |
| an infant who does not pull to a standing position by ______ months old should be evaluated | 11-12 |
| typically what age do infants walk? | 18 months |
| what is the highest / lowest APGAR score | 10 / 0 |
| what are the 5 areas that are assessed in the APGAR | skin color, pulse rate, reflex irritability, muscle tone, breathing |
| APGAR-what does each letter stand for? | Appearance, Pulse, Grimace, Activity, Respirations |
| "toddling" is seen at what age? | 12-13 months |
| at what age would you expect to see a toddler going up and down stairs and walking on their tiptoes, jump, stand on one foot for a sec or two? | 2-2.5 yrs old |
| at what age would you see a toddler riding a tricycle, standing on one foot, and doing broad jumps | 3 yrs old |
| at what age do toddlers hop on one foot, skip, catch a ball, and swing arms while walking? | 4 yrs old |
| at what age would you expect toddlers to be steadier on their feet and movements be symmetrical and graceful | 6 yrs old |
| at what age would you expect a child to possible skate, swim, or jump rope? | 5 yrs old |
| what are three things you are observing for r/t muscle tone? | symmetry, strength and contour, neurological exam |
| what can the effects of immobility or the lack of have on a toddler? | speech/language skills affected, decreased communication skills, sluggish psychomotor skills, increased fantasizing & possible hallucinations/disorientation |
| what type of diet would you expect r/t immobility of a toddler? | high-protein, high-calorie foods |
| contusion | Tearing of subcutaneous tissue resulting in hemorrhage, edema and pain |
| The force of stress on a ligament is so great as to displace the normal position of the opposing bone ends | Dislocation |
| Ligament is partially or completely torn or stretched away from the bone causing damage to blood vessels, muscles and nerves | sprain |
| Microscopic tear to muscle or tendon over time resulting in edema and pain | strain |
| what immediate tx can you do to limit damage from edema and bleeding? | RICE |
| Occurs when the resistance of bone against the stress being exerted yields to the stress force | fracture |
| transverse fracture | crosswise right angle to the long bone |
| oblique fracture | slanting but straight |
| spiral fracture | slanting and circular, twisting around the bone (usually suspect child abuse) |
| s/s of fractures in children | swelling, pain/tenderness, decreased use, bruising, muscular rigidity, crepitus |
| r/t fractures, what are the 5 P's? | Pain/point of tenderness, Pulse-distal, Pallor, Paresthesia-distal, Paralysis-distal |
| if a pt with a new cast complains of a burning sensation, what do you tell them? | Casts put off heat at first, it's normal and will go away. |
| Tell your pt with a new cast to report what? | unrelieved pain, swelling w/discoloration, decreased pulses, inability to move distal exposed parts |
| what would you teach parents if their child is in a hip spica cast? | feed child with head elevated or prone, small bedpans may be necessary for using bathroom |
| what are some of the types of traction covered? | simple traction, Hamilton Russell traction, Gallows traction, balanced skeletal traction, Bryant traction, overhead traction, Dunlop traction, Bucks traction |
| what are some nursing considerations for a pt w/ traction? | pain meds, skin observation, weights hang free, pressure reduction device on bed, |
| the checklist for traction device includes: | weights hanging freely, ropes on pulleys, knots not resting on pulleys, linens not on traction ropes, counter traction in place, apparatus not touching foot of bed |
| the checklist for the pt on traction: | proper alignment, HOB 20 degrees or less, heels elevated, ROM unaffected parts, antiembolism stockings, skin integrity, pain relief, prevent constipation, encourage trapeze |
| risk factors for DDH | gender, birth order, family hx, intrauterine position, delivery type, joint laxity, postnatal position |
| what are the three degrees of DDH? | acetabular dysphasia, sublaxation, dislocation |
| sublaxation | incomplete dislocation of hip |
| dislocation | femoral head looses contact with acetabulum and is displaced posteriorly and superiorly over the rim |
| mildest form of DDH in which there is a delay in the development of the acetabulum | acetabular dysphasia |
| what two types of therapuetic measures are used for DDH r/t newborns to 6 months? | Pavlik harness and hip spica |
| what two types of therapuetic management are typically used for children 6-18 months? | gradual reduction of traction, open or closed reduction |
| clubfoot is | complex deformity of the ankle and foot where there is an inversion and the foot is pointed downward and inward in varying degrees of severity |
| what are the three classifications of clubfoot? | Positional. Syndromic or teratologic. Congenital or idiopathic |
| describe positional clubfoot | believed to occur primarily from intrauterine crowding and responds to simple stretching and casting |
| associated with congenital anomalies such as myelomeningocele and is a more severe form of clubfoot that is often resistant to treatment | Syndromic or teratologic clubfoot |
| Congenital clubfoot | often called idiopathic and may occur in an otherwise normal child and has a range of rigidity and prognosis |
| what is the goal for clubfoot tx? | painless, plantigrade and stable foot |
| what are the three stages of clubfoot tx? | correction, maintenance, and follow up observation |
| characterized by excessive fractures and bone deformity | Osteogenesis Imperfecta |
| what are some clinical features of Osteogenesis Imperfecta? | bone fragility/deformity/fractures, blue sclerae, hearing loss, Dentinogenesis imperfecta(genetic disorder of tooth development) |
| what are the goals of tx for Osteogenesis Imperfecta? | prevent deformities, contractures, muscle weakness, osteoporosis, malalignment of lower extremities |
| what are some nursing considerations for a child with Osteogenesis Imperfecta? | careful handling, educate parents on limitations, support groups |
| osteochondroses disorders. A self-limiting juvenile idiopathic vascular necrosis of the femoral head | Legg-Calve’-Perthes Disease |
| what are the goals of tx r/t Legg-Calve’-Perthes Disease? | keep head of femur in hip pocket, avoid weight bearing, bed rest, traction |
| complex spinal deformity in three plans, usually involving lateral curvature, spinal rotation causing rib asymmetry, and thoracic hypokyphosis | Scoliosis |
| which type of scoliosis is caused by poor posture and is easily corrected? | Functional |
| due to changes in the shape of the vertebrae or thorax | structural scoliosis |
| what are signs of scoliosis? | one shoulder higher than the other, C-shaped spine, one hip more prominent, back pain, illfitting clothing |
| names of two braces used to tx scoliosis | boston brace, milwaukee brace |
| infection of the bone | osteomyelitis |
| infectious emboli may travel to small arteries of the bone and local destruction and abscesses can set up | osteomyelitis |
| manifestations of osteomyelitis | pain, decreased movement & limited ROM, signs of inflammation, limp |
| ways to diagnose osteomyelitis | increased WBC & ESR, bone scan, hx, blood culture, urine for bacterial antigens, tissue biopsy |
| what tx would you expect for a pt with osteomyelitis? | IV antibiotics x 4-6 wks, bed rest, immobilization, surgical drainage |
| primary malignant tumor of the long bones. | Osteosarcoma |
| who are the highest at risk for osteosarcoma? | children who have had radiation therapy or retinoblastoma |
| what are some manifestations of osteosarcoma? | pain & swelling, lowered pain r/t flexed position, pathologic fracture may occur |
| how do you diagnose osteosarcoma? | CT Scan, bone scan, bone biopsy, complete physical |
| what are tx options for osteosarcoma? | Radical resection or amputation. Internal prostheses. Long term survival with early diagnosis & treatment |
| what is basic cancer care r/t osteosarcoma? | support pt & family, anticipate grief, stump dressing, body image change, positioning, phantom limb pain, rehab |
| malignant growth that occurs from the marrow, usually of long bones but can develop in the skull or flat bones of the trunk. | Ewing’s Sarcoma |
| what would you expect tx to be for a pt with Ewing's sarcoma? | chemotherapy/radiation, surgical removal |
| what would you teach your pt and family about Ewing's sarcoma? | warn against vigorous weight-bearing, prepare for effects of tx, support family & pt |
| autoimmune inflammatory disease causing inflammation of joints and other tissue | Juvenile Idiopathic Arthritis |
| what are three forms of Juvenile Idiopathic Arthritis? | systemic, polyarticular, pauciarticular |
| high fevers, transient rast, elevated sed rate, enlarged liver and spleen are signs of which kind of Juvenile Idiopathic Arthritis | systemic |
| this type of Juvenile Idiopathic Arthritis usually affect 4 or more joints - age range | polyarticular - 1-3 y/o to -10 y/o |
| this type of Juvenile Idiopathic Arthritis is usually in large joints and affects 4 or less joints-age range | pauciarticular - <16 y/o |
| s/s of Iridocyclitis | redness, pain, photophobia, decreased visual acuity, non-reactive pupils |
| goals for tx of Juvenile Idiopathic Arthritis | reduce pain, swelling. Promote: mobility, growth, development, independence. preserve joint function |
| medications for Juvenile Idiopathic Arthritis include | NSAIDS, methotrexate, immunoseppressant, gold, Slow-acting anti-rheumatic drugs |
| what other types of therapy & tx could be used for Juvenile Idiopathic Arthritis | ROM exercises. Pool exercises. Avoid traumatizing inflamed joints. Warm bath and moist hot packs. Resting splints. Using a very low pillow or no pillow. Maintain proper body alignment |
| examples you could teach a family to help w/ Juvenile Idiopathic Arthritis at home | Use a firm mattress. Age appropriate activities. Modify daily living: Elevate toilet seats. Install handrails. Velcro fasteners |
| what is included in the upper resp tract? | oronasopharynx, pharynx, larynx, upper part of trachea |
| lower resp tract parts | lower trachea, mainstem bronchi, segmental bronchi, subsegmental bronchioles, terminal bronchioles, alveoli |
| what are some influences on childhood resp problems? | age, season, living conditions, preexisting medical conditions |
| infants less than ____ months have a lower infection rate | 3 |
| what are some anatomic differences of airway structures in peds? | smaller diameter of airways, distance between structures are shorter, short open eustachian tubes increase susceptibility |
| ability to resist infection can depend on: | immune system deficiencies, malnutrition, anemia, fatigue, allergies, asthma, cardiac anomalies, cystic fibrosis |
| most resp infections occur when | winter and spring |
| what are some common nursing diagnoses r/t resp infections | ineffective breathing pattern, fear/anxiety, ineffective airway clearance, risk for infection, activity intolerance, altered family processes, pain |
| what are some nursing considerations r/t resp infection? | promote rest/comfort, handwashing, decrease fever, hydrate, nutrition, support & encourage family and child |
| at what age is it safe to give a child gatorade? | > 1 year |
| what is the most common infection of the resp tract? | common cold a.k.a. > Nasopharyngitis |
| how do you spread nasopharyngitis? | sneezing, coughing, direct contact |
| if you have a pt with persistent nasopharyngitis, what might you expect? | inhaled cocaine use, other drug abuse |
| fever up to _____ is not uncommon in children < 3 years old | 104 F |
| what antibiotic would you give to a pt with nasopharyngitis? | None - antibiotics ineffective |
| how can you tx nasopharyngitis? | bed rest, keep airways clear, maintain fluid intake, take Tylenol & Motrin and moist air |
| inflammation of the structures of the throat | acute pharyngitis |
| acute pharyngitis can progress to ______ ___________ ____________ or ____. | acute rheumatic fever (ARF), glomerulonephritis |
| manifestations of acute pharyngitis | Fever, malaise, difficulty swallowing and anorexia, |
| what are manifestations of viral pharyngitis? | conjunctivitis, rhinitis, cough, hoarseness |
| signs of strep in children >2 y/o | high fever (104), difficulty swallowing, may last longer than a week |
| tx for pharyngitis may include? | antimicrobial therapy orally for 10 days; may also advise salt water gargles |
| a persistent infection may indicate that a child is a carrier for what? | group A beta-hemolytic strep |
| when is a child no longer contagious r/t acute pharyngitis? | antibiotics are started and fever has reduced |
| what tx is very painful and not the 1st choice for children? | IM benzathine penicillin G |
| what tx measures would you expect for a pt with tonsillitis | cool mist vaporizor, salt water gargles, throat lozenges, cool liquid diet, Tylenol for comfort |
| post op for tonsilectomy, what would you assess for? | increased pulse, resp, restlessness, frequent swallowing, vomiting bright red blood |
| what would you do for / teach a post op tonsilectomy pt | ice collar, small clear liquids, keep quiet, avoid coughing, clearing throat, & blowing nose |
| Various conditions in which the primary symptom is a "barking" cough and some degree of inspiratory stridor | croup syndrome |
| Acute laryngotracheobronchitis | most common type of croupe |
| manifestations for bacterial tracheitis | 1 month to 6 y/o, croupy cough mostly at night, usually preceeded by a URI, my have inspiratory stridor, fever, thick purulent tracheal secretions |
| tx for bacterial tracheitis | humidified o2, antipyretics, antibiotics, may require intubation with frequent suctioning, early detection is the key |
| children usually between 1-3 y/o, occurs at night suddenly and lasts a few hours | spasmodic croup |
| what are some causes of acute spasmodic laryngitis? | virus, allergy, psychosocial, Gastroesophageal reflux is often the cause |
| symptoms of acute spasmodic laryngitis | barking, brassy cough, resp distress, anxious child, dyspnea, child appears well the next day |
| how would you treat spasmodic laryngitis? | cool mist humidifier, warm mist from steam, racemic epinephrine, Corticosteroids |
| which croup can progress into a medical emergency? | Laryngotracheobronchitis |
| what is the most common method of RSV spreading? | Direct contact with respiratory secretions, usually via contaminated hands |
| how long can RSV live on a countertop? | 6 hours |
| Usually preceded by a mild upper respiratory infection and has characteristics of barking or brassy cough, stridor and respiratory distress | Laryngotracheobronchitis |
| Mist tent, Blow by, Intravenous fluids, increase humidity are things you would do for: | Laryngotracheobronchitis |
| what medications would you use for Laryngotracheobronchitis? | nebulized epinephrine, o2 therapy, corticosteriods |
| RSV | Respiratory Syncytial Virus |
| what is the priority nursing diagnosis r/t RSV? | ineffective breathing pattern |
| what is something you should report r/t RSV? | Wheezing, rales or rhonchi, or sudden "quiet chest" which puts child at risk for respiratory arrest |
| r/t RSV, what is your goal for SPO2 levels? | 90-95% |
| what two things can you give to a child to reduce risk for dehydration? | Pedialyte, Ricelyte |
| what is the antiviral medication identified useful against RSV? | Ribavirin (Virazole) |
| what would you expect the medication order be for Ribavirin? | mist 18-24 hrs p/day for minimum for 3 days. |
| Inflammation of the lungs in which the alveoli become filled with exudate | Pneumonia |
| what are 4 things that can cause ICP? | Tumors or other lesions. Accumulation of fluid. Bleeding. Cerebral edema |
| how would you determine the state of consciousness in a child? | determined by how the child resonds to the environment |
| inability to respond to sensory stimuli | unconsciousness |
| the pt cannot be aroused despite painful stimuli | coma |
| on the Glascow Coma Scale, the _____ the score, the deeper the coma. | lower |
| elevated body temp = | intracranial bleeding |
| what are some things that can elevate your body temp? | alcohol, barbituates, salicylates |
| changes in blood pressure and pulse are _____ ______ signs. | very late |
| what are some things you are looking for when you assess the skin during a neurologic exam? | injury, needle marks, petechia bites, ticks |
| decorticate | arms adducted, bent at elbows, and fisted hands and cerebral cortex affected (FLEXED Position) |
| decerebrate | arms straight, hands flexed out, legs apart, brainstem affected (EXTENDED position)sign of dysfunction at the midbrain characterized by rigid extension and pronation of the arms and legs |
| this is when you rotate the head quickly to one side and the eyes should go the other way during a neurologic test | Dolls eyes |
| negative response during "dolls eyes" test is r/t what? | damage to brainstem or oculomotor nerve |
| what is oculovestibular response? | using a syringe, put ice cold water into the ear. Eyes should move toward that ear |
| what type of diagnostic measures would you expect to diagnose neurologic problems? | Labs:glucose, BUN, CBC, MRI, CT scan |
| what is the priority measures in an unconscious child? | patent airway, tx of shock, reduce ICP |
| in an unconscious child, what is #1 priority during assessment? | RESPIRATORY management |
| what measures would you take r/t ICP and positioning the pt | prop onto one side, use alternating pressure mattress, elevate HOB, maintain head in midline postion |
| indications for ICP monitoring | GCS of 8, GCS of <8 w/resp issues, gut feeling |
| what drug category would be used to cerebral overload | osmotic diuretic |
| cerebral dysfunction is related to hypothermia or hyperthermia? | HYPERthermia |
| what sense is the first to go and the first to come back? | hearing |
| what is the #1 leading cause of death for children > 1 year old? | head injuries |
| what are three major causes of death r/t brain injury? | falls, motor vehicles, bicycle injuries |
| what are two hallmarks for a concussion? | amnesia & confusion |
| what are types of skull fractures? | linear, depressed, comminuted, basilar, open, diastatic |
| blood between the dura and the skull | epidural hemorrhage |
| blood between dura and the cerebrum | subdural hemorrhage |
| What are the potential complications of head injuries? | Hemorrhage, infection, cerebral edema and brain herniation |
| What nursing intervention is most appropriate for a child with a head injury who is very restless and irritable? | Provide analgesic as ordered |
| a near drowning is | Survival for at least 24 hours after submersion in a fluid medium |
| Name three of the problems caused by near-drownings | Hypoxia, asphyxiation and hypothermia |
| where do the majority of childhood brain tumors occur? | posterior third of brain |
| What are the most common signs and symptoms of a child with a brain tumor? | headache, especially on awakening and vomiting that is not related to feeding |
| defect that causes one or more sutures on a baby's head to close earlier than normal | craniosynostosis |
| Caused by an imbalance in production and absorption of CSF | Hydrocephalus |
| at what age do cranial sutures close? | 12 |
| what post-op position would you place a child in r/t a shunt placement for ICP? | FLAT, or as ordered |
| What are the signs and symptoms of infection in a child that is 24 hours postoperative shunt revision? | elevated vital signs, poor feeding, vomiting, decreased responsiveness, and seizures |
| what are three main types of meningitis? | viral, bacterial, tuberculosis |
| s/s of meningitis? | fever, headache, vomiting, stiff neck, light adversion, drowsiness, joint pain, seizures, high pitch cry in infants |
| involuntary arching of the back due to muscle contractions | Opisthotonos |
| what would the CSF look like in a pt with meningitis? clear or cloudy? | more cloudy as infection gets worse |
| what types of medical tx would you expect r/t a pt with meningitis? | IV fluids, IV antibiotics, Resp Isolation, sedative, anticonvulsant |
| What is the most common causative agent of bacterial meningitis in children? | Streptococcus pneumoniae and Neisseria meningitidis |
| name causes of encephalitis | Togaviruses and herpes virus type 1 and 2. Following URI. Rubella or rubeola. Lead poisoning. Bacteria, spirochetes and fungi |
| an acute non-inflammatory encephalopathy and hepatopathy, with no reasonable explanation for the cerebral and hepatic abnormalities | Reye's Syndrome |
| what is the definitive test for Reye's syndrome? | Liver biopsy |
| Obtunded. Coma. Hyperventilation. Decorticate rigidity are s/s of what stage of Reye's syndrome | III |
| Vomiting. Lethargy. Drowsiness. Liver dysfunction. Follows commands. Brisk papillary reaction are s/s of what stage of Reye's syndrome? | I |
| stage II s/s of Reye's syndrome | Disorientation. Combative. Delirium. Hyperventilation. Hyperactive reflexes. Appropriate response to pain. Liver dysfunction. Sluggish pupillary response |
| Stage IV s/s of Reye's syndrome | Deepening coma. Decerebrate rigidity. Loss of oculo-cephalic reflexes. Large and fixed pupils. Minimal liver dysfunction |
| Stage V s/s of Reye's syndrome | Seizures. Loss of deep tendon reflexes. Respiratory arrest. Flaccidity. No evidence of liver dysfunction |
| what are the goals of tx r/t Reye's Syndrome? | reduce ICP, PATENT AIRWAY, maintain cerebral o2 and fluid and electrolyte balance |
| SIRS | systemic inflammatory response syndrome |
| what are some diagnostic tests for sepsis? | positive blood culture, urine culture, CSF culture, anemia, immature WBC's and neutropenia |
| Caused by malfunctions of the brain’s electrical system | seizures |
| fever greater than _____ with rapid elevation is a s/s of seizures. | 101.8 |
| what are the two types of partial seizures? | simple partial, complex partial |
| diet low in carbs, adequate protein, and high in fat is a _____________ diet | ketogenic |
| what kind of diagnostic tests would be run r/t a seizure pt | CT, MRI, EEG, CBC, LP, neuro exam |
| what are three primary drugs used for partial seizures and/or tonic clonic seizures | Carbamazepine (Tegretol). Phenytoin (Dilantin). Valproic Acid (Depakote) |
| Ethosuzimide (Zarontin). Valproic Acid (Depakote | Primary drugs for absence seizures |
| Once the child is free for __ years with a normal EEG, the therapy and medications are gradually discontinued | 2 |
| Continuous seizure that lasts more than 30 minutes | status epilepticus |
| What are some possible causes of seizures? | Birth injury, Epilepsy, infection, fever, dehydration, hypoglycemia, anesthetics, drugs and poisons. |
| a person whose hearing disability precludes processing verbal information | deaf |
| results from interference of transmission of sound to the middle ear | Conductive or middle-ear hearing loss |
| Perceptive or Nerve Deafness | damage to the inner ear structures or the auditory nerve |
| Central Auditory Imperception | hearing losses that does not demonstrate defects in the conductive or sensorineural structures |
| Functional hearing loss | hearing loss occur without lesions or another explanation for central hearing loss |
| what are 2 medications you expect for Otitis Media? | Amoxicillin, Ceftriaxone |
| surgical procedure in which a tiny incision is created in the eardrum, so as to relieve pressure caused by the excessive build-up of fluid | Myringotomy |
| what are 2 medications you expect for Otitis Media? | Amoxicillin, Ceftriaxone |
| surgical procedure in which a tiny incision is created in the eardrum, so as to relieve pressure caused by the excessive build-up of fluid | Myringotomy |
| farsightedness | Hyperopia |
| Myopia | nearsightedness |
| eye muscles do not coordinate - two images get to brain instead of one | strabismus |
| vision is lost in one eye simply because the child favors the dominant eye | "lazy eye" / amblyopia |
| the most common types of visual disorders in children. | refractive errors - glasses are tx |
| Most common congenital malignant intraocular tumor | Retinoblastoma |
| Enucleation | surgical removal of eye |
| s/s of autism | failure to make eye contact, limited functional play, significant GI problems(consitpation) some degree of mental retardation |
| s/s of retinoblastoma | cat's eye reflex, strasbismus, red painful eye, blindness is late sign |
| s/s of strabismus | squinting, closing one eye, tilting head, difficulty focusing |
| legal blindness | 20/200 or less and visual field of 20 degrees or less |
| 3 components of cognitive impairment | iq of 70 or <, impairment of at least 2 skills, younger than 18 y/o |
| several phyical problems are associated w/ down syndrome, name 3 | congenital heart malformations, resp infection, thyroid dysfunction |
| what can parents do to lessen resp infections in a child w/ down syndrome? | use a buld syringe, rinse mouth after feeding, increasing fluid intake, use a cool-mist vaporizer |
| what are s/s of fragile x? | long faces, large ears, large testes, speech delay, short attn span, may be agressive, autisitc-like behavior, hyper taste sound and touch senses |
| pneumonia due to inhaled substances | aspiration pnuemonia |
| an oil substance inhaled into the airways | lipoid pneumonia |
| pneumonia caused by poor circulation into the lungs | hypostatic pneumonia |
| chronic inflammatory disorder of the airways | asthma |
| symptoms of asthma occur less than 2 x a wk | mild intermittent asthma |
| symptoms of asthma occur less than once a day but > than 1 x p/wk | mild persistent asthma |
| symptoms of asthma occur daily | moderate persistent asthma |
| severe persistent asthma | symptoms occur continually |
| in asthma resp difficulty is more pronounced in _______ | expiration |
| what are common nursing diagnosis for asthma? | risk for suffication, ineffective airway clearance, activity intolerance, interrupted family processes, risk for fluid volume deficit, risk for injury |
| What are the classic signs of asthma? | Dyspnea, wheezing, coughing |
| What are the goals of asthma therapy? | Maintain normal activity, pulmonary function, prevent chronic symptoms, exacerbations, drug therapy, normal and happy child |
| What is cystic fibrosis? | is a genetic disorder that affects mostly the lungs but also the pancreas, liver, kidneys and intestine. Long-term issues include difficulty breathing and coughing up sputum as a result of frequent lung infections |
| what are some symptoms of cystic fibrosis | symptoms include sinus infections, poor growth, fatty stool, clubbing of the finger and toes, and infertility in males among others. |
| Clinical manifestations of cystic fibrosis? | Meconium ileus, GI issues, pulmonary issues, clubbing of the fingers |
| Complications of cystic fibrosis? | Prolapsed rectum, intestinal obstruction, bronchiectasis, atelectasis, hyperinflation, pneumonia, reproductive system issues. |
| Goals of therapeutic management of cystic fibrosis? | Prevent and control infections in your lungs, Loosen and remove the thick, sticky mucus from your lungs,Prevent blockages in intestines |
| Treatment for Cystic Fibrosis? | Antibiotics for infections of the airways ,Chest physical therapy, Exercise, Oxygen |
| What are the two main problems related to the GI system as seen in Cystic Fibrosis? | intestinal obstruction and prolapsed rectum |
| What exercises can the parents be taught to do at home to help move secretions up and out? | : Postural drainage and chest physical therapy. |
Created by:
jrstrader
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