Disorders of the Preschool Child
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| The burn wound is classified according to | percentage of body surface involved, the depth and location of the injury, and association with other injuries
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| Priority treatment and nursing care for burns | first priority is airway and breathing; second priority is circulation/fluid resuscitation
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| Nutritional management and burns | NPO for first 24-48 hours if burn is severe; high-protein, high-calorie diet; oral feeding preferred but may need nasogastric feedings; small, frequent feedings of favorite foods-may add supplements to meet requirements
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| Amblyopia | a decrease in or loss of vision, usually in one eye
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| Amblyopia cause | the vision loss is not caused by structural eye damage but results from the brain “turning off” confusing visual images
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| Occlusion therapy maintenance | may be difficult to maintain due to ridicule from peers and impact on self-esteem. Much support is necessary.
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| Strabismus | ocular misalignment; a condition in which the child is not able to direct both eyes toward the same object
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| Strabismus can lead to what other eye problems? | esotropia or exotropia
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| Esotropia | an inward deviation of one or both eyes
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| Exotropia | outward turning of one or both eyes
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| Surgery to correct strabismus is reserved for | patients in whom nonsurgical methods are likely to be unsuccessful
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| Surgery procedures and expectations for strabismus | short hospitalization; usually no need for restraints, if so child will be told before; minimal eye dressings; parents should stay with child during hospitalization
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| Leukemia | most common type of cancer in children
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| Areas of body affected by leukemia | All tissues of the body are affected, either by direct infiltration by cancer cells or by the change in the blood that is carried to them
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| Leukemia treatment | Glucocorticosteroids are used, such as prednisone
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| Steroids and leukemia | mask the symptoms of infection, may induce personality changes and cause the child’s face to become moon-shaped
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| Leukemia and chemotherapy medication side effects | varying degrees of nausea, diarrhea, alopecia, fever, anuria, anemia, and bone marrow depression
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| Leukemia nursing care | mouth is inspected daily for ulcerations and hemorrhage from the gums; Water-Pik may be used to massage and toughen the tissue; A soft sponge brush may be used or wiping the mouth with gauze; Apply lip balm or petroleum jelly to cracked, dry lips.
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| What to avoid when managing bleeding in leukemia patients | Alcohol-based mouth washes, milk of magnesia , hydrogen peroxide, and lemon glycerin swabs
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| The Child with Possible Posttonsillectomy Bleeding | Frequent swallowing (a cardinal sign of bleeding); Pallor; Restlessness; Increased pulse; Vomiting bright red blood; Decreasing BP; Visible blood on careful examination of the throat with a flashlight
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| What to avoid postoperatively in patients with tonsillitis and adenoiditis | citrus juices, carbonated drinks and milk products; extremes in food or beverage temperature; red colored food or beverages
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| Psychological considerations of Duchenne Muscular Dystrophy | have to do with the chronic and progressive nature of this disease and its fatal outcome.
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| Duchenne Muscular Dystrophy treatment and nursing care | Encourage the child to be as active as possible as long as possible; Provide support for daily issues; Public health nurses, home health agencies, family therapists, and eventually hospice care provide care and support to child and family.
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| Generalized tonic-clonic (grand mal) seizure symptoms | sudden loss of consciousness with a cry; fall; rigid muscles followed by muscle jerking; rolling of eyes; pallor or blue skin color associated with slowing or cessation of breathing; possible loss of bowel or bladder control
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| Generalized tonic-clonic (grand mal) seizure duration | a few minutes
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| Generalized tonic-clonic (grand mal) seizure after effects and postictal state | breathing resumes; child is sleepy and confused and often sleeps 30 minutes to 2 hours after the seizure. Postictal state may involve vomiting and intense bifrontal headache. Seizure may be preceded by an aura.
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| Absence (petit mal) seizure symptoms | sudden cessation of motor activity or speech with a blank facial expression and flickering of the eyelids (uncommon in children less than 5 years old); chewing movements
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| Absence (petit mal) seizure duration | a few seconds (usually less than 30 seconds)
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| Absence (petit mal) seizure after effects | child resumes full activity, unaware of what happened during seizure; no aura or postictal state, may experience various seizures during the day; can cause learning difficulties if not recognized
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| (Typical) myoclonic seizure symptoms | repetitive seizures consisting of brief muscular contractions with loss of body tone and falling or slumping forward; can cause injuries to face and mouth. Can be associated with generalized tonic-clonic seizures
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| (Typical) myoclonic seizure onset | between 6 months and 4 years; may have learning, language, emotional, and behavioral problems; however, more than 50% are seizure free several years later
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| Infantile spasms symptoms | brief symmetric contractions of the neck, trunk, and extremities; involve sudden flexion of the neck, arms, and legs onto the trunk; extension of the trunk and extremities; or a combination
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| When do Infantile spasms commonly occur | while patients are drowsy or immediately on wakening
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| Infantile spasms onset | between 4 and 8 months; may or may not be associated with underlying neurological disorder or trauma
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| Landau-Kleffner syndrome | a rare condition of unknown cause
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| Landau-Kleffner syndrome symptoms | often confused with autism; loss of language occurs in a previously normal child; many have an associated seizure disorder; hearing is normal; behavior problems are common
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| Landau-Kleffner syndrome onset | 5 ½ years, affecting more boys
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| First aid for a child with a convulsive seizure includes | protecting the child from harm, loosening clothing around the neck, turning on the side to maintain an airway, and reassuring the child when consciousness returns
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| Observe the seizure and record | activity immediately before the seizure began; body movements; changes in color, respiration, or muscle tone; incontinence; and parts of the body involved When possible the seizure is timed
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| During seizures do not | place any object into the mouth of the seizing child; try to hold the seizing child down
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| Epilepsy treatment and nursing care | Rescue breathing is done if child is not breathing when the seizure is finished
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| UTI nurse teaching on proper hygiene | avoid bubble baths or irritating diaper wipes; wipe from front to back
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| UTI preventive measures | wearing cotton underwear, adequate fluid intake, encouraging children to not put off going to the bathroom when needed, investigating and treating signs of intestinal parasites (pinworms), and avoiding bubble baths
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| Acute Glomerulonephritis Treatment and Nursing Care | Activity should be limited until gross hematuria disappears; low-sodium diet; Fluid restriction; Protein is not usually restricted
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| Developmental Disability Treatment and Nursing Care | Good communication with parents is essential
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| Developmental Disability support areas include | home living, education, human development, community living, employment, health and safety, behavior, social, and protection and advocacy
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| The parents of a developmental disabled child need | support, compassion, and understanding, not pity; they must face their own feelings and develop a positive attitude
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| What can help nurses acquire enthusiasm for what developmentally disabled children and their families can accomplish | Sharing ideas and feelings with experienced professionals who work with developmentally disabled individuals
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