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