Busy. Please wait.

show password
Forgot Password?

Don't have an account?  Sign up 

Username is available taken
show password


Make sure to remember your password. If you forget it there is no way for StudyStack to send you a reset link. You would need to create a new account.
We do not share your email address with others. It is only used to allow you to reset your password. For details read our Privacy Policy and Terms of Service.

Already a StudyStack user? Log In

Reset Password
Enter the associated with your account, and we'll email you a link to reset your password.

Remove Ads
Don't know
remaining cards
To flip the current card, click it or press the Spacebar key.  To move the current card to one of the three colored boxes, click on the box.  You may also press the UP ARROW key to move the card to the "Know" box, the DOWN ARROW key to move the card to the "Don't know" box, or the RIGHT ARROW key to move the card to the Remaining box.  You may also click on the card displayed in any of the three boxes to bring that card back to the center.

Pass complete!

"Know" box contains:
Time elapsed:
restart all cards

Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.

  Normal Size     Small Size show me how

Peds Test #1

peds test 1

Well Child Checks-EPSDT Early, Periodic/Prevention, Screening, Diagnosis, Treatment
BP should be taken on >3yr, or younger if heart condition, newborn-6months 70/50, 1yr 75/55, 3-5yr 95/60, 10yr 100/65, 12yr 105/65, 14yr 110/70
Weight 3.5-50kg
Pulse newborn 100-160, 6months 110-160, 1yr 90-150, 3yr 80-125, 5yr 70-115, 10-14yr 60-100
Respirations newborn 30-60, 6months 24-38, 1-3yr 22-30, 5yr 20-24, 10-12yr 16-22, 14yr 14-20
If think heart murmur in infant assess 4 extremity BP
Anterior Fontanel Closure closes around 18 months
Posterior Fontanel Closure closes btw 2-3 months
Ears for <3yr pull pinna down/back, >3yr pull pinna up/back
Compensentory Mechanisims nasal flaring, grunting, retractions
Denver Developmental Screening Test/DDST birth-6yrs, not IQ test, screening-not diagnostic, not predictor of future abilities, compares performance on a variety of tasks to other children of same age, fours areas of functioning: personal/social, fine motor/adaptive, language, gross motor
NIPS/Neonatal Infant Pain Scale assessment tool using behavior cues, six item 0-2pt scale w/ total score0-7, used for term neonates up to 2mo, use in combo w/ nursing judgment
FLACC/Face, Legs, Activity, Cry, Consolability each of 5 categories scored from 0-2, total score 0-10
Wong-Baker Faces pain scale using 6 faces from smile to crying, corresponds w/ 0-10 pain scale
DTaP/Diptheria, Tetanus, Pertussis IM, 2,4,6mo + 15-18mo + 4-6yr, contraindications: gelatin allergy, serious side effect w/ prior dose
Hep B IM, birth + 2, 6mo, contraindications: pregnancy
MMR SC, LIVE, 12-15mo + 4-6yr, contraindications: allergy to eggs, mycins, pregnancy, immunosuppressed, immunoglobulin w/in 3mo, together w/ VAR or separated by 28days
VAR SC, LIVE, 12-18mo + >12yr two 4wks apart, contraindications: pregnancy, immunosuppression, allergy to mycins, recent blood transfusion, together w/ MMR or separated by 28days
Immunizations-SE/Adverse effects location rxn @ site: pain, redness, swelling, low grade fever, mild irritability/fussiness, less common SE: noncontagious rash, mild joint pain, adv effects: anaphylaxis, anaphylactic shock, encephalopathy/encephalitis, brachial neuritis, paralysis, death
Dehydration fluid loss>fluid intake, numerous causes, can be from prolonged vomiting/diarrhea, common in children, mild<5% loss, moderate 6-9% loss, severe>10% loss
Dehydration-Nursing Interventions prevention, correct underlying cause, oral rehydration, IVF rehydration, monitor IVF infusion/ fluid choice/amount, freq monitoring/reassessment, teaching s/sx dehydration/ORT, pharmacologic tx, monitor for complications-fluid overload/hypovolemic shock
#1 Indicator of Dehydration Serum CO2(same as arterial HCO3 22-28)
Dehydration-#1 improvement indicator weight gain
Maintenance Fluid Requirements <10kg:4ml/kg/hr, 11-20kg:40ml+(2ml/kg>10kg)/hr, >20kg:60ml+(1ml/kg>20kg)hr
Replacement fluid considerations Goals: preserve CV, renal, neuro function, Bolus: one time infusion, Rehydration plans: make take >24hrs, monitor serum CO2 level, NO potassium added until adequate void(no pee-no K)
Vision Screening should start by 5, most schools mandate
Hearing Screening in NBN, assessed in all well-child visits
Otitis Media inflammation & fluid in middle ear interfering w/ sound transmission, mostly bacterial, ^in winter months, may lead to deafness
Otitis Media-Children at Risk chronic middle ear infections, meningitis, deafness in family, maternal rubella, prematurity, birth trauma w/ hypoxia, high fevers
Otitis Media-Presentation accompanying URI, fever often >102, sharp constant ear pain, irritable, tugging at ears, bulging eardrum, decreased light reflex, drainage w/ rupture
Otitis Media-Nursing Interventions teach parents to feed upright/no bottle propping, keep upright 30 min post feed, admin antibiotics-amoxicillin, symptomatic care-antipyretics for fever-mild pain mgmt., may require tubes if chronic
Otitis Media-Chronic tube placement; allow to drain(polyeltholine pressure equalizing tubes), pre/post surg care, edu parents r/t care; earplugs for swimming, no diving/submerging, careful w/ water during shower
Otitis Media-Chronic-Complications risk for hearing loss, chart in book
Effusion fluid remains in ears after infection has cleared up-several episodes->hearing loss, maybe tubes
Tonsillitis inflammation/enlargement of a tonsil(palantine); adenoids-pharyngeal tonsils, viral or bacterial organism, possible peritonsilar abscess-need antibiotics to decrease infection before surg
Tonsillitis-Presentation sore throat, painful swallowing, ‘beefy’ red swollen tissue, mouth breathing, snoring/sleep apnea, halitosis, purulent exudate on tonsil, fever
Tonsillitis-Nursing Interventions symptomatic care-antipyretics for fever-analgesics for pain, antibiotics if indicated
Tonsillectomy-PreOp assess temp, stress ‘fixing’ throat in age appropriate terms, evaluate labs-WBC/Clotting time, check for loose teeth
Tonsillectomy-PostOp monitor VS q2-4hr, obs freq swling/throat clring, fresh/red bleeding, posit head to side-awake, avoid suct/straw, avoid acidic liq/crunchy/spicy food, maint IV til PO adeq, cool non-irrit liq-NO dark/red-adv diet, pain meds, maint flu based on intake
Tonsilectomy-Main reasons for readmit Dehydration & Hemorrhage->7-10days
Respiratory Problems-Acute generally reversible, vary in severity; RSV, epiglottitis, pneumonia, foreign body aspiration, croup, smoke inhalation, blunt chest trauma
Respiratory Problems-Chronic generally irreversible, characterized by exacerbations & remissions, obstructive sleep apnea, asthma, cystic fibrosis, bronchopulmonary dysplasia, tuberculosis
Epiglottitis inflamed, acute medical emergency, drooling, breathing faster, guarding, do NOT look at throat, emergency trach at bedside, corticosteroid-IV, calm child, conformation-soft tissue film, Tylenol/Motrin for fever, improving-want to drink
RSV infects epithelial cells, mucus-clogs, snorting, suck out w/ bulb syringe but fills back up, if respire 60+ STOP feeding, if 28 wk gestation or less-RSV candidate, Synagis IM inj 1x/month throughout flu season-Very expensive
Asthma chronic inflam disorder of the airways mkd by recurrent atcks of dysp & wheezing due to spasmodic constrict bronchi, highly correlated w/ suscept to environ allergens: smoke, animal dander, dry air, exercise, stress, most common chronic dx of childhood
Asthma-Presentation chest tightness, cough(harsh/nonproductive->secretions w/ ^mucus), wheezing on expiration/prolonged expiration, use of accessory muscles, thick mucus, decreased breath sounds as condition worsens, decreased O2 & ^CO2, decreased LOC if acute exacerbation
Asthma-Hallmark S/Sx bronchoconstriction, inflammation/edema, mucus production
Asthma-What to assess can child talk in complete sentences?, grunting, tripod, circum-oral cyanosis, initially-tachypnea, anxiety, wheezing on expiration->wheezing on inspiration
Asthma-Nursing Interventions-Hosp humid O2(decr anx,WOB,rate),IVF hydrat, monit resp stat(rate/eff,WOB,acc musc, grunt,flar,retract),admin meds(Epi,ster, broncho),monitor(O2 sats,x-ray,PEFR-max flow rate out 1sec,PBV,PFT),CPAP/intub(if unable to sustain)long exp times on vent,edu(MDI use,
Asthma-Nursing Interventions-Home Care coord care w/ parent/sch nurse(indiv health plan, edu about dis proc prn, support grps, log peak flow meter readings), admin quick relief meds prn & monitor resp, MDIs, assess for signs of exercise induced bronchospasm, avoid triggers
Muffled deterioration in respire/ heart rate
Cystic Fibrosis hered dis w/ widespread exocrine gland dysfunction; multisystem involvement w/ accum of excessively thick and tenacious mucus and secretions-respir problems everyday of life, eventually clogs glands(respiratory airways, GI enzyme secretion, repr ducts)
Cystic Fibrosis-Presentation recur respir(drug resis)infect, dry nonprod cough; patches atelect-mucus plugs(x-rays), thick purulent sputum/mucus(clear/ grey-tinged;NOT yellow/green),wheez-air trap, cyanosis/club,steatorrhea;gallbla prob, malnutr;avitaminosis,grwth delays;infert prob
Cystic Fibrosis-Nursing Interventions-Hosp report results sweat test, CPT and postural drainage, inhal Tx; O2 w/ caution, TCDB exer, humid environ, proph antibiotics, diet-panc enz w/meals/snacks; vit supp, high cal-high protein-low dairy,^fluids, home schooling,disc plan:family support services
Cystic Fibrosis-Nursing Interventions-Home Care coord care w/ parents/school nurse & create schedules for: meds, Ts(CPT, resp tx), diet, exercise, Consider: change in body image, freq hospitalizations, discipline iss, financial concerns, gene implic(sib), Identify prim HCP(pedi) basic healthcare, imm
Cystic Fibrosis-Complications Cardiomegaly, Cardio-Respiratory Failure, GI Obstructions
Pediatric Heart Conditions-Nursing Considerations sm freq feeds, upright position, squatting/tripod, monitor daily wts, pulse, BP, admin meds, provide rest, do not allow crying, emotional support, foster app play, immunize/protect from infection, strict I&O
Pediatric Heart Conditions-PreOp prepare for surg, monitor baseline CV status, assist collection of pre-op labs, edu/support parents
Pediatric Heart Conditions-PostOp monitor CV status constantly for 1st 24h, hemorrhage, chest tube output, bleeding from other sites, fluid balance(50-75% maintenance 1st 24h), promote resp fxn(IS), monitor for infection-incision site; peri-operative antibiotics, instr parents-home care
Cardiac Cath-PreProcedure NPO several hours except meds, oral sedative, VS,H&H, cap refill, pulses distal to expected cath insertion site, prepare child/parent
Cardiac Cath-PostProcedure monitor for complic; arrhythmias, bleeding, hematoma, thrombus, infection, VS, perf of lower extrem, monitor pressure dressing q15 minx4 then q30minx1; will be in place 6hrs, BR x6hrs w/ leg straight, avoid elevating HOB-no flexion of hip, monitor I&O-con
Acyanotic L to R shunt of blood, oxygenated blood mixed w/ unoxygenated blood, extra blood vol overloads pulmonary sx, pulmonary HTN: obstructive defects block blood flow from heart, VSD
Ventricular Septal Defect/VSD heart malformation that allows blood to flow btw 2 ventricles, ^blood flow to lungs->CHF & pulm HTN, 50% close spontaneously
Ventricular Septal Defect/VSD-Presentation loud harsh systolic murmur, dyspnea & freq respir infections, exercise intolerance/fatigue, freq squatting/syncope, X-ray reveals R ventricular hypertrophy, ECG shows R vent dysfunction, growth retardation
Ventricular Septal Defect/VSD-Nursing Interventions Lanoxin; cardiotonic to treat CHF-check BP/P
Cyanotic R to L shunt of blood, dilute oxygenated blood heads to body, chronic hypoxemia and cyanosis, Tetralogy of Fallot
Tetralogy of Fallot congenital heart condition consisting of four defects(VSD, PS, ventricular hypertrophy, over-riding aorta), surgical correction
Tetralogy of Fallot-Presentation hypoxia is primary prob since blood flow to lungs is restricted, cyanosis apparent after several months of age & becomes progressively worse, clubbing, abnormal heart sounds, murmur, ^rate/depth of respirations, hypoxic episodes/TET, freq squatting/syncop
Tetralogy of Fallot-Nursing Interventions multiple surgeries, antibiotics-prevention of endocarditis, diuretics-promote diuresis & prevent fluid overload, digitalis-cardiotonic, give prostaglandin E to keep PDA open in preparation for surgery, child too young for corrective surgery may have palli
TET Spells hypoxic episode where baby turns blue w/ crying or feeding, calm child(decrease anxiety/decreased WOB), positioning(knee-chest), O2 as needed, Medications: Morphine and/or Propanolol
Created by: neffielewis