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68wm6 peds II

Things that should be included in a physical assessment of cardiac function. Nutrition, color, deformities, unusual pulses, respiratory, clubbing, percussion, rate & additional sounds.
The most important nursing responsibilities after a child returns from a cardiac catheterization. Observe for complications, Apply pressure 1 inch above for bleeding, bed rest 4-6 hours.
Something you should do immediately if you notice bleeding from a cath site. Apply pressure 1 inch about site.
What do you need to do prior to administering digoxin. Measure apical pusle for 1 full minute.
Things you can do for a patient experiencing a blue spell. Rest, reposition, O2.
Three congenital defects that increase pulmonary blood flow. CHF, ASD, VSD
A temporary way to treat VSD. Pulmonary. banding
Patent Ductus Arteriosus. Failure of fetal ductus arteriosus to completely close after the first few weeks.
Typically the first sign of a PDA. Continuous machine-like murmur heard over the left second intercostal space.
Tetralogy of Fallot. VSD, Pulmonic stenosis, Overiding aorta, Right ventricle hypertrophy.
Categories of heart failure. Left sided and right sided.
Hypoplastic left heart syndrome. Underdevelopment of the left side of the heart, resulting in an absent or nonfunctional ventricle and hypoplasia of the ascending aorta.
Signs and symptoms of Digitalis toxcicity. Nausea, vomiting, blurred vision, change in color of vision, dizziness, delirium.
When bacterial endocarditis is most likely to occur. After dental work, UTI, Cardiac surgery, directly.
Chorea. Uncontrolled movements in the body.
AAP guidelines for treating kids with high cholesterol. Restrict fat and cholesterol intake.
The cause of essential hypertension. Structural anomalies.
Clinical manifestations of Kawasaki's disease. Sustained fever, Bilateral conjunctivitis, Oral mucosa changes, change in extremities, polymorphous rash.
Things you can do for a patient with a polymorphous rash to relieve itching and burning. Cool cloths, unscented lotion, loose clothes.
Two times of cardiac disorders in children. Congenital and aquired.
Things to look for during a physical assesment of a cardiac patient. Nutritional state, color, chest deformities, unusual pulses, respiratory status, clubbing of fingers and toes, Heart rate, rhythm and additional sounds, percussion.
Most invasive cardiac diagnostic tool. Cardiac catheterization.
Cardiac Catheterization. A radiopaque catheter passed through the femoral artery directly into the heart and large vessels.
The principal cause of death during the first year of life. Congenital heart disease.
Ostium primium (ASD 1) Opening at lower end of septum, may be associated with mitral valve defects.
Ostium secundum (ASD 2) Opening near center of septum.
Sinus venosus defect. Opening near junction of superior venacava and right atrium.
Coarctation of the Aorta. Constriction or narrowing of the aortic arch or descending aorta
Three groups of CHF. Impaired myocardium functioning, pulmonary congestion, systemic venous congestion.
Most common cause of bacterial endocarditis. Streptococcus viridans.
Preventative measure used for bacterial endocarditis. antibiotic prophylaxis 1 week prior to a procedure.
Rheumatic fever. An inflammatory disease that occurs after infection with group A beta hemolytic streptococcal pharyngitis. It involves the joints, skin, brain, serous surfaces, and heart.
3 categories of cardiomyopathy. dilated cardiomyopathy, hypertrophic, and restrictive.
Secondary hypertension Caused by renal disease, congenital, vascular and endocrine disorders.
Acute systemic vasculitis. Kawasaki disease.
5 signs children exhibit with kawasaki disease. Strawberry tongue, sustained fever, bilateral conjunctivitis, peripheral edema, polymorphous rash.
Anemia. reduction in the number of RBCs or HGb, Most common hematologic disorder in infancy and childhood.
Iron deficiency anemia Most prevalent nutritional disorder.
Highest risk for Iron deficiency anemia. 12 - 36 months
Method you use to administer Iron via IM. Z track method, DO NOT MASSAGE!
Things to teach parents about iron administration. Give as prescribed, take with OJ, turns stool tarry, NVD, may stain teeth use dropper.
When a child has predominantly HbS they will have this. Sickle cell anemia.
Types of sickle cell crisis. Vaso-occlusive, Splenic sequestration, aplastic, hyperhemolytic.
S&S of acute chest syndrome. Chest pain, fever, cough, tachypnea, wheezing, hypoxia.
Prevention of Sickle cell crises. Maintaining hemodilution.
Beta-thalassemia deficiency in rate of production of specific globin chains in HGb.
Thalassemia Major. also known as cooley anemia, very severe can lead to cardiac failure and death if left untreated.
Aplastic anemia. Bone marrow failure condition in which formed elements of blood are simultaneously depressed.
Factors that can cause Aplastic Anemia. Infection, irradiation, drugs, exposure to household or industrial chemicals, idiopathic.
Hemophilia. disorder where blood does not clot normally and even the slightest injury can cause severe bleeding.
Factor VIII is needed for forming this. Thromboplastin.
Bleeding control for hemophilia. RICE
Thrombocytopenia excessive destruction of platelets.
Purpura discoloration caused by petechiae
Leukemia. malignant diease of blood forming organs of the body that results in an uncontrolled growth of immature WBCs.
Hodgkin's disease malignancy of lymph system
Hodgkin's manifestations. painless lump, low grade fever, night sweats, anorexia, weight loss, malaise, rash, pruritis.
How much saliva do infants produce during the first few months. Very little amounts.
Chronic diarrhea lasts longer than 14 days.
The most common cause of serious gastroenteritis. Rotavirus.
The best intervention for diarrhea. Prevention
Constipation with fecal soiling. encopresis
alteration in frequency,consistency or ease of passing stool. Constipation
Long intervals between passing stools Obstipation.
When is the first meconium stool passed. 24-36 hours.
What is hirschsprungs disease. Lack of innervation and normal peristalsis of intestines
The manifestations of Apendicitis. RLQ abdominal pain, rebound tenderness, NVD.
3 post-op goals of apendectomy. Pain management, prevent infection, early ambulation.
What is Meckel's diverticulum? A small blind pouch neat the ileocecal valve that fails to dissapear completely and may be connected to the umbilicus by a cord.
What is the most common congenital malformation of the GI tract? Meckel's diverticulum.
Crohn's disease. Cronic inflammation of all layers of the bowel wall.
What kind of diet is used to treat a patient with Crohn's disease? Well balanced, high protein, high calorie diet.
What is a duodenal ulcer? An ulcer involving the pylorus or duodenum.
Who are primary ulcers most common in? children over 6 years old without predisposing factors.
Who are secondary ulcers most common in? Infants less than 6 months old.
Esophageal atresia and tracheoesophageal fistula. tissues of the GI tract fail to separate properly from the respiratory tract in utero.
what is VATER Vertebral, anorectal, tracheoesophageal, renal
What is VACTERL Vertebral, anorectal, cardiovascular, tracheoesophageal, renal, limb.
The surgery to correct a hernia is known as what? Herniorrhaphy.
What is pyloric stenosis? Narrowing of the lower end of the stomach that occurs in relation to hypertrophy of the circular muscles of the pylorus or by spasms of the sphincter.
What are the manifestations of pyloric stenosis? projectile vomiting, constant hunger, dehydration, olive shaped mass in RUQ.
What is a pylorotomy? A surgical procedure in which pyloric muscle is incised to enlarge the opening to allow food to pass.
Intussusception. Slipping of one part of the intestine into another portion of the intestine below it (telescoping)
What are currant jelly stools? bowel movements of blood and mucus with no feces. (intussusception)
What is the leading malabsorption disorder in children? Celiac disease.
Manifestations of celiac disease. Failure to thrive. Large, bulky & frothy stools. Abdominal distension with atrophy of buttocks.
What must be restricted in a patient's diet, with celiac disease. Gluten.
True or false. Meckel's diverticulum is most common in boys. True.
What are the clinical manifestation's of crohn's disease Abdominal pain, fever, weight loss, anorexia, recal bleeding, anal fistulas.
What are the 3 C's of TEF Coughing, choking, cyanosis.
When does a strangulated hernia occur. before 6 months of life.
What can happen if intussusception is left untreated? The bowel can rupture and cause peritonitis.
What is the prefered route of medication administration in children. Oral/PO
Why would you not add medication to an infant's formula? Incase they don't finish all of the formula.
What are some things you can do to make it easier to administer meds to a toddler? Mix them with juice or fruit, use simple terms, be firm, use distractions, offer stickers or rewards.
Considerations when offering meds to a school-age child. concrete explanations, give choices, interact when possible, medical play.
Nursing considerations when administering meds to adolescent. more abstract explaination for meds, include in decision making. drink through straw to minimize distaste.
Prefered site for IM injection in infants and smaller children. Vastus lateralus.
What injection site do you want to avoid in children under 5 years of age and why? Dorsogluteal, this area is usually underdeveloped.
What is the appropriate needle gauge for a SQ injection 23-26
What is the appropriate needle gauge for a ID injection. 25-27
Prefered IV site for an infant younger than 9 months of age Scalp vein.
How do you administer ear drops in a child <3 years of age? Pull ear down and back before.
How do you administer ear drops in a child >3 years of age? Pull ear up and back before.
Where do you apply eye drops? In the conjunctival sac that is formed when lower lid is pulled down.
What illnesses are antibiotics commonly given for in children? Acne, Bacterial meningitis, cystic fibrosis, sepsis, otitis media.
What is the drug of choice in treating thrush? Nystatin (mycostatin)
What are the medications used to treat Tuberculosis? Isoniazid, rifampin, pyrazinamide
What drug is used to treat influenza? amantadine hydrochloride.
What is the drug used to treat herpes and chicken pox? acyclovir (Zorivax)
Drugs that are used to treat juvenile rheumatoid arthritis. Methotrexate(amethopterin, Folex, rheumatrex, trexal) cytarabine (Cytosar, depocst) Corticosteroids are also used.
Antiarrythmic used in children with cardio problems. Digoxin
What is an ACE inhibitor an antihypertensive.
What is digoxin contraindicated in? Uncontrolled ventricular arrythmias, AV block, idiopathic hypertropic subaortic stenosis, constrictive pericarditis.
What heart rates in infants and children would make you withold Digoxin? <70 child, <90 infant
Therapeutic Serum Digoxin levels 0.5-2 ng/mL
Created by: wlthompson49