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NUR 131 exam 2
| Question | Answer |
|---|---|
| males can become serile from mumps | |
| inc 10-21 days, inf day or 2 before eruptions, direct droplet | varicella Zoster, chicken pox |
| complications of varicella | secondary bacterial inf, CNS comps, seizures, pneumonia, reyes |
| enterovirus, facal-oral, oral-oral, inc 1-3 wks, HA abd pain, malise, stiff trunk, neck | poliomyelitis |
| inc 1-3 wks, dur 4 wks, rhinorrhea,barking cough, V, salivation, cough may last several months, droplet trans | pertussis, whooping cough, |
| vacination for whooping cough | Tdap at 2-4-6 months at 4mths they are immune. |
| inc 2-5 days, inf 2wks to mths, droplet, sore throat, foul smelling, gray membraine on tonsils , fever, hearth failure, | diptheria |
| tx for diptheria | diptheria antitoxin and antibiotics |
| tx for pertussis | erythromycin, corticosteroids |
| live/attenuated vacines that have to b adm in 15 min | MMR, nasal flu, varacella, |
| non infectious vaccines, inactive by heat/chem, cause body to produce antibodies, need several doses | |
| bacteria; toxins that have been inactivated by heat/chem | toxids |
| antibodies, temp passive immunity, nfor exposures | humaqn immune globuline, "Hbig" |
| bacteria found in soil, anarobic bacteria, HA, stiffness in jaw/neck | tetanus |
| bacterial menigitis, brain damage, deafness, immunize infant-15mths | HIB-hemophilus Influenza type B |
| not required vacc, recommended for 2-4-6-15 mths for menigitis and sepsis in infants | streptococcus pneumonia meningitis Prevnar7 |
| vaccine prevents chronic inf that can cause liver desease/cancer | hepatitis b |
| if mom has heptitis b and gives birth | infant gets hep b vac and hep b immune globulin |
| hept b vac | IM at birth, 1 mth, 6 mth |
| data compiled usinf lot numbers of vaccines | VAERS vaccine adverse effect reporting |
| expected side effects os vaccines | low grade temp x 24-48 hr, soreness at inj site, rash/fever 10 days after w MMR |
| majority of accute illness in children are caused by | resp inf |
| upper resp tract | oronasopharynx,laryns, upper part of trachea |
| most prevalent desesase of early childhood | otitis media |
| theraputic management of otitis media | amoxicillin 80-90mg/kg/day divided into two doses, tx fever/pain, myringotomy, tympanostomy, adenoidectomy |
| inc of eardrum | myringotomy |
| tonsils are... | lymphoid tissue that protect resp/ailmentary tracts from invasion of org |
| NS care after tonsilectomy | comfort, low activities, soft/liquid diet, cool mist vapor, warm salt water gargles, losenges, analgesic,antipyretic meds |
| Homecare for tonsilectomy | avoid, spicy foods, gargles/virgorus brushing, coughing/clearing throat, analgesics/ice collor for pain, mouth oder common |
| hoarseness, barking cough, inspiratory stridor, resp distress from swelling of throat | croup |
| laryngotracheobronchitis occurs in | very young children |
| epiglottitis occurs in | older children |
| serious obstructive inflam process that occurs in children 2-8mths. requires immediate attentions, child has fever sits upright in tripod position | accute epiglottitis |
| air raid | airway closed, inc pulse, restlessness, retractions, anxiety inc, inspiratory stridor, drooling. emergency tracheomoty |
| most common croup syndrome affects children under 5 | acute laryngotracheobronchitis, starts in upper goes lower. |
| lower resp tract | lower trachea, mainstem bronchi, segmental bronchi, segmental bronchoiles, and alveoli |
| inflm of the trachea and bronchi, virus, dry hacking nonproductive cough, productive in 2-3 days | bronchitis, tx analgesics, antipyretics, and humidity |
| acute inf, bigest cause of hosp of children, can develop asthma, narrowing bronchioles prevents air from leaving, emphysema | RSV-tx cool humidified O2, meds, separate room, contact standard precausions, monitor O2 |
| symptoms of RSV | wheezing, retractions, crackles, dyspnea, tachypnea, diminished breath soundfs |
| pain of pneumonia can b confused w appendicitis | |
| can cause wheezing, asymmetric breath sounds, dec airway entry, dyspnea | foreign body aspiration |
| chronic inflam disorder of the airwyas, expiratory wheezing, chest tightness, breathlessness and cough | asthma |
| viscosity of mucous gland secretions clogs lungs, obstructs ducts of pancreas preventing digestive enzymes going to intestines | Cystic Fibrosis-tx dec fat, inc salt, antibiotics, fat sol vits, bronchodilators, mucolytics, pancreatic enzymes |
| prevention of sids | no smoking, gaps in crib, toys, blanket below arms, on back, dont sleep with |
| separation anxiety | protest=aggressive, dispair=crying stops, detachment=interested |
| severe emotional threat for adolescents | peer group separtion |
| focus on childs developmental age not chronilogical | |
| greatest stress of hosp of child | separation anxiety |
| infants=trust, todlers=autonomy, tantrums, preschoolers=magical, school age=independence, adolescents=liberation | |
| preschoolers think their thoughts can cause death, schoolage think its from their misdeeds, 9 and up understand | |
| deoxygenated blood goes... | from r side of the heart and pulmonary circulation |
| oxygenated blood goes.. | to the left side of the heart and tissues |
| lungs transfer oxygen.... | from the atmosphere to the alveoli |
| gases in and out of the lung | ventilation |
| pump oxygenated blood to eh tissues and return deoxygenated blood to the lungs | perfusion |
| trans of resp gases, O2 to blood, CO2 to be exhaled | diffusion |
| most important factor controling resp depth | CO2 |
| active process stiulated by chemical receptors in aorta | inspiration |
| passive process that depends on elastic recoil of lungs | expiration |
| desease that loses teh elastic recoil of the lungs cuasing inc work for breathing | COPD |
| chemical produced in lungs tgo prevent alveoli from collapsing | surfactant |
| effort required to expand and contract the lungs | work of breathing |
| left sided heart failure findings | crackles, hypoxiaq, SOB on exertion, nocturnal dyspnea |
| right sided heart failure findings | wt gain, distended neck veins, hepatomegaly,spienomegaly and dependent peripheral edema |
| maximun O2 for CO2 retainers | 24-28% |
| leading cause of atherosclerosis | peripheral artery disease-progressive narrowing of vessels in u/l extremities |
| peripheral artery disease | effects 60-80 yrs, hispanics women, afro am, parethesia, red foot down, white foot up,intermitent claudation |
| PAD clinical ass | ED, tight shiny skin, no hair on shins, pain at rest, gangrene |
| PAD risk facotrs | smoking, lipid elevation, HTN, DM, history, obesity |
| PAD complications | atrophy of skin/muscles, delayed healing, wound inf, amputation |
| diag studies for PAD | doppler, duplex imaging(map blood flow), ankle-brachial index(compares BPs, angiography, MRA |
| dilated, tortuous, subcutaneous veins | varicose, congenital weakness, bad valves, saphenous vein system |
| clinical mans of varicose veins | discomfort, swelling, nocturnal leg cramps, |
| swelling of vein caused by a blood clot | thrombophlebitis |
| clinical findings for DVTs | edema, extremity pain, parethesias, warmth, redness, temp 100.4, pos holmans sign |
| diagnostic tests for DVTs | venous compression ultrasound, duplex ultrasound, CT, MRI, phlebogram |
| prevention of DVTs | mobile, positioning q 2hr, f/e of feet, knees, hips q 2-4hrs, teds, compression (not on effected side), anticoag |
| anti coag therapies | vitamin K antagonists, indirect thrombin unhibitors,direct thrombin inhibtors, factor Xa inhibitors |
| vitamin K antagonists | warfarin (Coumadin), INRs (2.0-3.0), antidote=vit K, no NSAIDS, ASAs, herbal sups, green leafies |
| indirect thrombin inhibitors | unfractionated/low-molecular wt heparin, aPTT (N 25-35; T 46-70), LMWH=no tests, antidote=protamine sulfate |
| direct thrombin inhibitors | lepirudin (Refludan) |
| factor Xa inhibitors | Arixtra |
| immune reaction that causes severe sudden reduction in the platelet count w a paradoxic increase in venous/arterial thrombosis | HIT heparin induced thrombocytopenia |
| two major groups of cardiovascular disorders | congenital and acquired |
| congenital heart disease | anatomic abnormalities present at birth that result in abnormal cardiac function. CHF, Hypoxemia |
| acquired heart disorders | disease processes or abnormalities that occur after birth. inf, autoimmune responses, environmental factors, familiala tendencies |
| abnormal opening between atria | atrial septum defect-blood flows from l to r atrium |
| clinical findings of ASD | CHF, low growth, sys/dys murmur, dysthrythmias, pulmonary vascular obstructive desesase, emboli |
| surgical tx of ASD | patch for lg defects, repai/cardiopulmonary bypass, valve replacement |
| abnormal opening between teh r/l ventricles | ventricular septal defect-pinhole to absense of septum, may close |
| clinical findings for VSD | CHF, murmur |
| surg tx for VSD | pulmonary banding, complete repair, sutures, patch |
| most common cardiac defect in children | AV septum defect-blood flows between all 4 chambers |
| clinical findings for AVSD | CHF, loud sys murmur, cyanosis more w crying, |
| surg tx for AVSD | banding, complete repair, |
| failure for fetal ductus arteriosus to close wi the 1st few week of life | patent ductus arteriosus-murmur |
| cyanotic at birth, worses w age systolic murmur, anoxic p feeding/crying | tetralogy of fallot |
| risks of tetralogy of fallot | emboli, seizures, LOC, sudden death |
| high BP, bounding pulse in arms, weak/absent femoral pulses, | coarchtation of the aorta |
| risks of coarchtation of the aorta | HTN, ruptured aorta, aortic aneurysm, stroke |
| inability of teh heart to pump an adequate amount of blood to the meet systemic circulation needs | CHF |
| causes of CHF in children | strucutral abs, septal defect, myocardial failure, ventricle impared, demand on heart |
| med for CHF | digoxin, Lanoxin |
| digitalis glycosides | inc cardiac output, dec heart size, relief of edema |
| angiotensin-converting enzyme, ACE inhibitors | vasodilation, dec BP, reduce afterload |
| beta blocker | dec HR, BP, vasodilation |
| diuretics | lasix, depletes vit K, Pot sups |
| cheifncause of death in downs | resp tract inf combined w heart anomolies |
| occurs after streptococcal inf in school age children | rheumatic fever |
| meds for rhematic fever | penicillian, erythromycin, salicylates, bedrest |
| inadequate supply of dietary iron | iron deficiency anemia-12-36mths at risk from milk, dec RBC production, reduction of O2 to tissues |
| clinical findings in iron deficiency anemia | pallor, tachycardia, HA, SOB, pica |
| ascorbic acid (vit c) aides in absortion of iron | |
| inherited autosomal recessive disorder, abnormal HGB shape | sickle cell anemia-circulation obstruction due to sickled RBC |
| clinical findings of sickle cell anemia | hypoxia, vasoocclusive, aplastic inf, acute splenic aquestration |
| tx of sickle cell | hydration, splenectomy, antis for inf, |
| NS care for sickle cell | dec fever, resp probs, hydrate, daily wt, pain, heat, no cold compresses, pulse ox |
| group of bleeding disorders w deficiency of one of the factors necessary for coagulation | hemophilia- mostly boys, factor VII=hem A, factor IX-hem B |
| tx for hemophilia | no asprin, use NSAIDS, monitor bleeding, non IMs, RIce |
| rice | REST, ICE, COMPRESSION, ELEVATION |
| acquired hemorrhagic disorder | idiopathic thrombocytopenic purpura-occurs 2-10 yrs of age, normal blood marrow inmature release of platelets/eosinophils |
| excessive destruction of platelets | thrombocytopenia |
| discoloration caused by petechiae | purpura |
| clinical findings of idiopathic thrombocytompenic purpura | bruising, bleeding from mucus mems, hematomas on lower extrems, |
| tx of idiopathic thromvbocytopenic purpura | quiet activities, no asprin/NSAIDS, acetaminophen prn, prednisone, IV immune globulin, anti D antibody |
| most common bacterial skin inf of childhood | impetigo-can b secondary inf caused by staph aureus |
| clinical findings of impetigo | yellow crusting lesions with yellow drainage |
| tx for impetigo | wash TID soap water, remove crust, bacitracin/bactroban, |
| superficial inf caused by fungi called dermatophytes | tinea inf=capitis=head, corporis=ringworm, cruris=jock itch, pedis=athletes feet |
| tx for capitis, corporis | oral griseofulvin, selenium blue shampoo, topical antifungals (monostat/lamisil TID), keep dry and cool |
| tx of cruris, pedis | compresses, epsom soaks, tolnaftate liquid/powder, |
| triggers of Herpes 1 and 2 | sun, stress, menses, dec immune, smoking, drinking, dec sleep, steroids |
| tx for herpes | oral antiviral=acyclovir, valtrex 500mg bidx5days, cool compresses |
| lice on humans | pediculosis=direct contact |
| tx of lice | remove nits/eggs daily, 1% permethrin (Nix/RID), laundry hot water/dryer, spray to furniture |
| contagious condition caused by itch mite | scabies=close contact |
| clinical findings of scabies | intense itching, rub hands/feet together, writs, finger webs, elbows, umbilicus, axillae, groin, butt, |
| tx of scabies | 5% permithrin cream (Elimite), laundry in hot water/dryer, |
| results from direct skin to irritant contact | contact dermititis=diaper rash, usde steroid cream |
| allergic skin condition | atopic dermititis=eczema |
| tx of eczema | vasoline, eurcerine, neivia, mild soap, hydrocortisone cream |
| disorder of sebaceous hair follicles, most common condition caused by testosterone | acne vulgaris |
| clinical findings of acne vulgaris | closed white/black heads, paules, pustules, nodules and cysts, upper body |
| ts for acne valgaris | rest, exercise, well balanced diet, reduce stress, cleansing |
| isotretinoin-accutain | tx of acne valgaris, causes depression, must b on 2 forms of BC, causes birth defects |
| most common intestinal parasite in US | giardiasis-person to person |
| clinical findings of giardiasis | diarrhea, V, cramps, greasy stool, |
| force of stress on the ligament results in displacement of the bone end from its socket | dislocation |
| ligament is partially or completely torn or stretched by the force created as a jt is twisted or wrenched, sudden | sprain |
| microscopic tear, occurs over time | strain |
| 5 Ps for NS care for fractures | pulselesssness, pain, palor, paralysis, parathesia |
| purpose of traction | fatigue the involved muscle so no spasms, realign, immobilize |
| intermittent traction | for muscle spasms and to dec back pain |
| exerts force directly on the body surface on children <30#. | skin traction |
| exerts greater force and is tolerated more than skin | skeletal traction=metal device inserted in bone |
| pins/wires inserted in soft tissue and bone,metal structure | external fixation |
| plantar flexed foot w inverted heel and adducted forefoot, more in boys and one foot | club foot |
| slipped capital femerol epiphysis | upper femoral growth plate, related to rapid growth, obesity, girls 12, boys13 1/2 |
| clinical findings for slipped capital femerol epiphysis | limp, gait disturbance,pain in groin, thigh or knee, gets worse w activity |
| tx for slipped capital femerol epiphysis | stabilize, bedrest, traction and external fixation |
| legg calve perthes disease | aseptic necrosis of femoral head, more in boys 4-8yrs, self limiting, |
| clinical findings of legg calve perthes | limp, hip,thigh, knee jt soreness, limited ROM, |
| tx of legg clave perthes | rest, NWB, traction to stretch abductor muscle, abduction cast pelvic or femoral osteotomy |
| scoliosis | no tx if <10-20*, depends on age and >20-40 requires surgery |
| boston wilmington brace | prevents further curvature, wear 20-22 hrs, |
| surgical intervention of scoliosis | metal to stabalize spine, ly flat, log roll, unplug bed controls, PT asap, no trampolines/gymnastics |
| Osgood-schlatter disease | bilater knee pain exacerbated by running jumpingclimbing stares. from over use, no kneeling |
| bacterial inf of the bone from staph aureus | osteomyelitis |
| clinical findings | tenderness, warmth, swelling, pain |
| progressively degenerative inherited diseases affecting muscle cells of specific muscle groups | muscular dystrophy |
| most common dystrophy | duchenne |
| clinical findings of MD | meet miles stones until 3, 3-7 muscles hypertrophied, waddling gait, cant do stairs, scoliosis, in WC by Jr High, no cure |
| preparation NPO from midnight, bowel preparation such as magnesium citrate | Barium enema, |
| Similar preparation as for the barium enema, clear liquids the day before, light sedation is required | Colonoscopy |
| protrusion of viscus through an abdominal opening or a weakened area in the wall of the cavity where it is normally contained | hernia |
| blood supply is cut off, surgery is immediate | strangulated |
| hernia is trapped outside peritoneal cavity | incarcerated |
| hernia moves back into peritoneal cavity | reducible |
| hernia is when it escapes through the posterior inguinal wall | direct inguinal |
| hernia is when the protrusion escapes through the inguinal ring . | indirect hernia |
| a weakness in the abdominal wall where in men the spermatic cord and in women the round ligament emerge. | inguinal hernia |
| mesh reinforced weakened area, distended ab from not voiding, strangulated may result in colostomy | |
| decrease in frequency of bowel movements. | constipation |
| maloderous stool,ab distention, vomiting, constipation no flatus | bowel obstruction |
| detectable obstruction from surgery | mechanical obstruction |
| neurochemical or vascular disorder, after ab surgery | nonmechanical obstruction |
| tx for obstruction | NG tube, strict I/Os, IV fluids, NPO |
| Care of Nasogastric tubes | teeth cleaning and mouth washes, lube for lips, irritation of nose, tube patency |
| 1/4 or 1/2 colon removed at decending or transvers | colostomy |
| entire colon removed, sm intestine used for stoma | ileostomy |
| Psychological preparation for colostomy | Change of body image Loss of control over elimination Odors |
| dusky blue stoma indicates | ischemia |
| brownish bluish stoma indicates | necrosis |
| ns care for hemmoroids | prevent constipation,no Avoidance, OTC drugs, sitz bath |
| leading cause of illness in children under the age of 5 years | Acute diarrhea/ oral-fecal, close body contact |
| most common cause of diarrhea in children under 5 | rotovirus-fecal/oral |
| dull pain in preimbilical area then to RLQ, low fever, N, anorexia, rebound pain | appendicitis |
| sudden relief of appedicitis pain | rupture |
| Dx of appendicitis | inc WBC, abnormal sonogram, clinical signs |
| tx for inflamation of verniform appendix | anitbiotics,rehydration, laproscopic removal |
| tx for ruptured verniform appendix | IV fluids, anitibiotics, electrolytes, NG suction until bowel activitiy returns |
| Common cause of acute intestinal obstruction in children less than 5 years of age | intussusception- telescoping of ascending colon, current jelly stools |
| Tx for intussusception | Conservative-radiologist guided air enema or saline enema, cut bad spot out |
| Mechanical obstruction caused by inadequate motility of part of the intestine, occurs in 1 in 5000 live births. | Hirshprungs disease-downs, 10% heredity |
| Hirshsprungs disease | nerve cells are missing from last part of intestine |
| Clinical manifestations of hirshsprings disease | abdominal distension, feeding intolerance, bilious vomiting, a delay in passing meconium, |
| Tx for hirshsprungs disease | remove the aganglionic portion of the bowel to relieve obstruction and restore normal bowel function |
| NS care post op for hirshsprungs disease | ab girth, low fiber, high cal/protein,stoma care, |
| zones of personal space` | intimate, social, public, personal |
| zones of touch | social, consent, intimate |
| phases of relationship | Preinteraction, Orientation, Working, Termination |
| A sign that an inflamed appendix is worsening | pain in the right lower quadrant? |
| sign of intussusception | blood and mucus in stools? |
| non surgical treatment for intussusception | radiologist guided air enema? |
| May be indicated by sudden pain relief in a child with acute appendicitis | rupture of the appendix? |
| Priority postoperative intervention in a child with Hirschbrungs disease | stoma care? |
| leading cause of illness in children under the age of 5 | infectious diarrhea? |
| The priority intervention for children with infectious diarrhea | rehydration? |
| Interventions that promote regular bowel movements in children | increasing fluids and fiber in the diet, and establishing a regular bowel routine? |
| The way the Rotavirus is spread | fecal and oral transmission? |
| A sign of Hirschbrungs disease | constipation since birth and foul smelling stools? |
| Consistency of stool from an ascending or transverse colostomy | semi formed stool? |
| The reason that ileostomy output is liquid | the output has not entered the colon? |
| A priority nursing intervention when caring for a patient following placement of an ileostomy | skin care around the ileostomy site? skin care around the ileostomy site? |
| A sign of ischemia in a stoma | a dusky blue color? |
| A sign of acceptance following a colostomy placement | willingness to take of the ostomy? |
| A cause of a nonmechanical bowel obstruction | abdominal surgery? |
| A mechanical blockage that can cause an intestinal obstruction | a surgical adhesion? |
| A complication following a hemorrhiodectomy | constipation? |
| Hernia in which the blood supply is cut off | a strangulated hernia? |
| Reason for administration of magnesium citrate before a barium enema | achieve good visualization of the bowel? |
| The day that discharge for hospital starts | the day of admission? |
| What is the termination phase? | The final phase in the helping relationship |
| When intake or output should be charted | as soon as the patient has finished the drink or voided? |
| The zone of personal space in which the nurse hugs a grieving relative | the intimate zone of personal space? |
| A task that is not within the scope of practice of an LPN | taking a verbal order from a physician? |
| Might happen if a rectal temperature is taken in a child with Hirschbrungs disease | perforation of the bowel ? |
Created by:
vstein
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