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68WM6 Phs2 Test 11

68WM6 Phase 2 test 11 Care of Pediatric Patients

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