Peds Ch 23-24 CCC PN105
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| What is retinoblastoma? | Malignant tumor of the retina; yellowish white reflex in pupil; loss of vision, strabismus, hyphema, pain
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| Shaken Baby Syndrome | causes brain to strike inside skull, results in retinal, subarachnoid, and subdural hematomas as well as cerviccal spine injuries and permanent disability or death
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| Milwaukee Brace instructions | worn 23 hours per day over a t-shirt to protect skin
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| Assess for scoliosis | check shoulder height bilaterally, check ribs for one side hump, check for asymmetry on back when leaning forward, prominent scapula
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| Why is osteomyelitis so painful? | affected vessels are compressed anc cause edema
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| treatment for osteomyelitis | IV antibiotics, pus drainage, analgesics for pain, bed rest
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| Serious complications of Bryant's traction | gravitational vascular drainage causing anoxia of muscles and vasospasms leading to contractures and paralysis; Volkman's ischemia (obstructed circulation)
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| How does the Russell traction work? | sling placed under knee suspending distal thigh over bed pulling vertically from sling and longitudally from foot plate
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| Decerebrate posture | all limbs are extended and hands are pronated (brainstem injury)
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| Decorticate posture | arms, wrists, and fingers are flexed to center of body, plantar flexion of feet (brain cortex injury)
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| long term effects of Legg-Calve's Perthes | marked distortion of femur head, leads to imperfect joint or degenerative arthritis
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| S/S of Duchenne;s muscular dystrophy | history of delayed motor development, calf muscles hypertrophied, progressive weakness, ankle contractures, Gower's maneuveres (rising from floor)
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| Concussion symptoms | headache, drowsiness, blurred vision, vomiting, dyspnea, unconsciousness, loss of memory before-during-after incident, skull fracture, bleeding
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| Meningitis common symptom | stiff neck and severe headache, delirium, irritability, restlessness, fever, vomiting (use transmission based droplet precautions)
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| How to diagnosis meningitis | spinal tap to check for pus on spinal column
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| teaching prevention of Reye's syndrome | avoid use of salicylate medications (aspirin) during viral infections like flu or chicken pox, get varicella vaccine
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| Febrile seizures | seizure response to rapid rise in temperature (above 102) - transient condition from 6mon-5yr of age; self limiting - teach parents correct use of antipyretics and colling measures
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| Safety nursing intervention of child having generalized tonic-clonic seizure | check for identification; protect from nearby hazards; observe and record all stage manifestations; maintain airway; afterwards, turn on side and loosed clothes; call for ambulance if over 5 min, pregnant, injured, or diabetic
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| Post-op care of tympanostomy with insertion of tubes | analgesics for pain, avoid water in ears, report excess draining or blood, followup to make sure condition is resolved and to check hearing
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| Treatment of ear infections | irrigations, topical antibiotics, analgesics for pain
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| How to instill ear drops in infants | pull pinna back and down
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| How to instill ear drops in children | pull pinna back and up
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| Signs of hearing impairment | no verbal attempts by 18mos, lack of response to sounds, behavior problems, poor academic progress, aggressive with other children
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| Why are infants prone to ear infections? | eustacian tube is wider, shorter, and straighter
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| What is the cardinal sign or hyphema? | bright or dark red spot in front of lower part of iris
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| Absence seizure (petit mal) symptoms | blank stare; temporary loss of awareness resulting in lack of continuity of thought process
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| After a generalized tonic-clonic (grand mal) seizure, the nurse would expect what action of the child? | postictal lethargy (short period of sleep)
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| tonic seizure | stiffening of muscles
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| clonic seizure | alternating stiffening and relaxing of muscles
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| 3 stages of grand mal seizure | aura (sudden cry); seizure; postictal lethargy (short period of sleep)
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| S/S of Reye's syndrome | sudden onset of effortless vomiting and lethargy, combativeness and altered consciousness; in infant, diarrhea, hypoglycemia, tachypnea, anemia, seizures
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| Musculoskeletal assessment of child | assess gait, muscle tone, neurological exam, and diagnostic tests (bone scan, CT, MRI, ultrasound)
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| Difference in child's skeletal system compared to adult | bone not completely ossified, epiphyses present, periosteum thicker and produces callus more rapidly, lower mineral content and greater porosity make stronger
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| 4 neurological checks | level of consciousness; pupil/eye movement; vital signs, motor activity
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| Juvenile RA goals | reduce joint pain and swelling; promote mobility and preserve joint function; promote growth and development; promote independence; help child and family adjust and alleviate stress
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| Juvenile RA interventions | physical and occupational therapy; supportive flat mattress with resting splints; moist heat and exercise; whirlpool baths; therapeutic play
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| What is amblyopia? | "lazy eye;" reduction or loss of vision occurring in children who strongly favor one eye
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| Amblyopia treatments | Early detection gives better results; eyeglasses for refractive errors (far/near sightedness) and patching (occlusion therapy) to force use of affected eye
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| S/S child abuse | observation of parent/newborn interaction; repeated hospitalization; multiple fractures; presistent feeding problesm; failure to thrive; chronic school absenteeism; child overly upset about hospital discharge; runaways
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| Assessing child abuse | divide body in 4 planes - injury in >1 is suspicious; too many clothes; retinal hemorrhage; failure to thrive; irritation of genitals; dirty clothes; skin rashes; location/color of bruises/scars/wounds; wound imprints/outlines on skin
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| Reporting obligations of child abuse | must report suspisicion of child abuse
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| Bruising, 1-2 days | bruise is swollen and tender
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| Bruising, 0-5 days | bruise is red or purple
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| Bruising, 5-7 days | bruise is green
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| Bruising, 7-10 days | bruise is yellow
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| Bruising, 10-14 days | bruise is brown
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| Bruising, 14-28 days | bruise is clear
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