Peds Test #1 Word Scramble
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Question | Answer |
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
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