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MCN 2 > 11 NURSING CARE OF HIGH RISK INFANT > Flashcards

11 NURSING CARE OF HIGH RISK INFANT Flashcards

1
Q

_____ is a term used to describe an infant with little interest in feeding.

A

“Poor feeding in infants”

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2
Q

_____ can become a problem when the infant is losing weight or having trouble gaining the right amount of weight for their age

A

Feeding

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3
Q

The effortless return of swallowed formula or breast milk through the mouth or nose after feeding

A

Spitting Up

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4
Q

Almost all infants spit up, although _____babies appear to do this more than _____ babies, possibly due to overfeeding

A

formula fed, breastfed

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5
Q

The baby who spits up a mouthful of milk (rolling down the chin) two or three times a day (or sometimes after every meal) is experiencing _____ , early infancy spitting up

A

normal

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6
Q

Associated signs such as diarrhea, abdominal cramps, fever, cough, cold, or loss of activity suggest _____

A

Illness

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7
Q

As cited by (Pilliteri, 2018), _____ the baby thoroughly after a feeding often limits spitting up. Parents may try sitting an infant in an infant chair for half an hour after feeding.

A

Burping

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8
Q

Means the backward movement of stomach contents up the esophagus )the “swallowing tube”) into the mouth

A

Regurgitation

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9
Q

Occurs when the sphincter in the lower portion of the esophagus, which leads into the stomach, is relaxed and allows gastric contents to be regurgitated back into the esophagus.

A

Gastroesophageal Reflux

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10
Q

It is usually noted within the 1st 18
months

A

Regurgitation

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11
Q

This condition may correct itself as.
the _____ matures, the child eats solid foods, and the child is more often in a sitting or standing position

A

esophageal sphincter

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12
Q

Clinical Manifestation of Feeding Problem

A

● Immediately after feeding the child vomit the contents of the stomach
● The vomit is effortless
● The child with GER is irritable and hungry

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13
Q

Diagnostic for Feeding Problem

A

Endoscopy

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14
Q

This will confirm the relaxed esophageal sphincter

A

Endoscopy

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15
Q

Treatment for Feeding Problem

A

● Formula thickened with rice cereal
● Placing the child in an upright position during and after feeding
● Placement of NGT (nasogastric Tube)
● Giving medications like histamine 2 (H@) receptor antagonist, ie. Omeprazole etc.

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16
Q

Surgical Treatment for Feeding Problem

A

Nissen Fundoplication

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17
Q

In this procedure, a part of the upper portion of the stomach is wrapped around the lower part of the esophagus to create a valve-like structure to prevent the regurgitation of the stomach contents.

A

Nissen Fundoplication

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18
Q

Nursing Care for Feeding Problem

A

● Thicken feedings with rice cereal (to decrease the likelihood of aspiration)
● Offer small frequent feedings and burp 2-3 times every after feeding
● Positioning the child before and after feeding
● Elevate the head when in prone position

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19
Q

Notify HCP when infant has feeding problem if:

A

● Infant vomits 1⁄3 or more of most feedings
● Chokes when vomiting
● Experiences forceful emesis

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20
Q

Cannot digest lactose, the primary carbohydrate in milk, because of an inborn deficiency of the enzyme lactase

A

Lactose Intolerance

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21
Q

Encompasses at least four different conditions that involve a deficiency of the enzyme lactase, which is needed for the hydrolysis or digestion of lactose in the small intestine.

A

Lactose Intolerance

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22
Q

Types of Lactose Intolerance

A

Congenital Lactose Deficiency
Primary Lactose Deficiency
Secondary Lactose Deficiency

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23
Q

This inborn error of metabolism involves the complete absence or severely reduced pressure of lactase, is extremely rare, and requires a lifelong lactose free or extremely reduced lactose die

A

Congenital Lactose Deficiency (congenital alactasia)

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24
Q

Management of Congenital Lactose Deficiency (congenital alactasia)

A

Limit intake of food and drink containing lactose - helps control symptoms

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25
Q

Clinical Manifestation of Congenital Lactose Deficiency

A

Abdominal pain
Bloating
Flatulence
Diarrhea after the ingestion of lactose

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26
Q

The onset of symptoms occurs within the _____ to several hours of lactose consumption

A

30 minutes

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27
Q

Treatment of Congenital Lactose Deficiency (congenital alactasia)

A
  • elimination of offending dairy products, however, some advocate decreasing amounts of dairy products rather than the total elimination, especially in small children
  • Over the counter lactose enzyme supplements may be helpful in these cases
  • In infants, lactose-free or low-lactose formula may be used until diarrhea has resolved
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28
Q

Also known as Late-Onset Lactase Deficiency

A

Primary Lactose Deficiency

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29
Q

Is the most common type of lactose intolerance and is manifested usually after 4 or 5 years of age, although the time of onset is variable

A

Primary Lactose Deficiency

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30
Q

_____ manifests as lactose intolerance and is characterized by an imbalance between the ability for lactase to hydrolyze the ingested lactose and the amount of lactose ingested

A

Lactose malabsorption

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31
Q

Due to illness or injury. Once the underlying cause is treated lactase level may be restored

A

Secondary Lactose Deficiency

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32
Q

May occur secondary to damage that has occurred in the intestinal lumen which decreases or destroys the enzyme lactase

A

Secondary Lactose Deficiency

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33
Q

Diseases such cystic fibrosis, sprue, celiac disease, or kwashiorkor and infections such as giardiasis, HIV, or rotavirus may cause a temporary or permanent _____

A

lactose intolerance

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34
Q

Diagnosis for Lactose Intolerance

A

Hydrogen Breath Test
Testing of stool pH and glucose

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35
Q

The person drinks a lactose-loaded beverage and then the breath is analyzed at regular intervals to measure the amount of hydrogen. Normally, very little hydrogen is detectable in the breath, but undigested lactose produces high levels of hydrogen. The test takes 2-3 hours

A

Hydrogen Breath Test

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36
Q

Specific to infants, lactose malabsorption may be diagnosed by evaluating fecal ph and reducing substances. Fecal ph in infants is usually lower than in older children, but an acidic pH may indicate malabsorption.

A

Testing of stool pH and glucose

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37
Q

Nursing Care Management for Lactose Intolerance

A
  • Explaining the dietary restrictions to the family
    reviewing sources of lactose, including hidden sources
  • Identifying alternate sources of calcium, such as yogurt
  • Discussing the importance of calcium supplementation
  • Reviewing strategies for controlling symptoms
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38
Q

Cause is often multifactorial and involves a combination of infant organic disease, dysfunctional parenting behaviors, subtle neurological or behavioral problems, and disturbed parent-child interactions

A

Failure to Thrive

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39
Q

Primary etiology is inadequate caloric intake regardless of the cause

A

Failure to Thrive

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40
Q

FTT inadequate growth resulting from an inability to obtain or use _____ required for growth
is a term that is traditionally used for children who have failed to develop and grow normally

A

calories

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41
Q

Occurs when a child is either not receiving adequate calories or is unable to properly use the calories that are given

A

FTT

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42
Q

Classifications of FTT

A

Inadequate Caloric Intake
Inadequate Absorption
Increased Metabolism
Defective Utilization

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43
Q

Incorrect formula preparation, neglect, food fads, excessive juice consumption, poverty, breastfeeding problems, behavioral problems affecting eating parental restriction of caloric intake, or central nervous system problems affecting intake

A

Inadequate Caloric Intake

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44
Q

Cystic fibrosis, celiac disease, Crohn’s disease, vitamin or mineral deficiencies, cow’s milk allergy, biliary atresia, or hepatic disease

A

Inadequate Absorption

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45
Q

Hyperthyroidism, congenital heart disease or chronic immunodeficiency

A

Increased Metabolism

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46
Q

Genetic anomaly such as trisomy 21 or 18, congenital infection, or metabolic storage diseases

A

Defective Utilization

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47
Q

If FTT is _____, the weight, but not the length/height, is below accepted standards (usually the 5th percentile)

A

acute

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48
Q

If FTT is _____, both weight and length/height are low, indicating ongoing malnutrition

A

chronic

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49
Q

Diagnostic Evaluation of FTT

A
  • Diagnosis of FTT is initially made clinically through identification of signs and symptoms
  • An assessment of the home environment and parent-child interaction may be helpful as well
  • Other tests (eg. lead toxicity, anemia, stool-reducing substances, occult blood, ova and parasites alkaline phosphatase, and zinc levels) are selected only as indicated to rule out organic problems
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50
Q

Clinical Manifestations of FTT

A

Growth failure
Developmental delays- social, motor, adaptive, language
Undernutrition
Apathy
WIthdrawn behavior
Feeding or eating disorders, such as vomiting, feeding resistance, anorexia, pica, rumination
No fear of strangers (at age when strangers anxiety is normal)
Avoidance of eye contact
Wide eyed gaze and continual scan of the environment (“radar gaze”)
Stiff and unyielding or flaccid and unresponsive
Minimal smiling

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51
Q

The prognosis for children with FTT is related to the _____

A

cause

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52
Q

Factors that are related to poor prognosis of FTT

A

severe feeding resistance
lack of awareness in parents
poor parental cooperation
low family income
low maternal educational level
adolescent mothers
preterm birth
IUGR (intrauterine growth restriction)
early age of onset of FTT

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53
Q

The primary management for FTT is to reverse the cause of ____

A

growth failure

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54
Q

If malnutrition is severe, the initial treatment is directed at reversing the malnutrition while avoiding _____

A

refeeding syndrome

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55
Q

Goal is to provide sufficient calories to support _____. (Rate of growth greater than the expected rate for age.)

A

“catch-up” growth

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56
Q

A suggested goal for catch-up growth is _____ the average rate of weight gain for the child’s corrected age.

A

2 to 3 times

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57
Q

_____ play a critical role as part of the interprofessional team in the diagnosis of FTT through their assessment of the child, parents, and family interactions

A

Nurses

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58
Q

The nurse documents the child’s feeding behaviors, as well as the parent-child interaction during feedings, and assesses other caregiving activities, including _____.

A

play

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59
Q

An accurate assessment of initial weight, hc, length/height, and daily weight is an essential component of nursing care for children for children with _____

A

FTT

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60
Q

_____ practices often contribute to growth failure. Therefore, parents should be given specific, step-by-step directions for formula preparation, as well as a written schedule of feeding times.

A

Maladaptive feeding

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61
Q

_____ techniques may be used with older infants and toddlers to interrupt maladaptive feeding patterns.

A

Behavior modification

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62
Q

Nursing care of children with FTT involves a _____ approach

A

“family systems”

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63
Q

Four Primary Goals in the Nutritional Management of children with FTT

A
  1. Correcting nutritional deficiencies and achieving ideal weight for height
  2. Providing adequate calories for catch-up growth
  3. Restoring optimum body composition
  4. Educating the parents of primary caregivers about the child’s nutritional requirements and age-appropriate feeding methods
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64
Q

Generally occurs in infants under 3 months of age and is marked by loud, intense crying

A

Paroxysmal Abdominal Pain (Colic)

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65
Q

Cause is unclear and probably results for several reasons. It may occur in susceptible infants from overfeeding or from swallowing too much air while feeding.

A

Colic

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66
Q

Formula fed babies tend to have more symptoms than breastfed babies, possibly because they swallow more air while drinking or because formula is harder to digest.

A

Colic

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67
Q

Colic can be characterized by

A

P - Peak pattern (crying peaks around 2 months of age, the decreases)
U - Unpredictable (crying can come and go for no reason)
R - Resistant to soothing (baby may keep crying no matter what you can do to try to soothe them)
P - Pain-like look on baby’s face
L - Long bouts of crying (crying can go on for hours)
E - Evening cry (baby cries more in the afternoon or evening)

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68
Q

Etiology of Colic

A

Feeding too rapidly
Overfeeding
Swallowing excessive air
Improper feeding technique (especially positioning and burping)
Emotional stress or tension between parent and infant

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69
Q

Therapeutic Management for Colic

A
  • The use of medications such as antispasmodics, antihistamines, and antiflatulents are sometimes recommended
  • Simethicone (Mylicon) may help relieve the symptoms of colic; however, in most controlled studies no medications completely resolved the symptoms of colic
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70
Q

Nursing Care Management for Colic

A

Initial step in managing colic is to take a thorough and detailed history of the usual daily events.

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71
Q

Key Points in taking History for Colic

A

the infant’s diet
diet of the breastfeeding mother
timing of the crying
relationship of crying to feedings

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72
Q

Nursing Care Management for Colic

A

Presence of specific family members during crying
Habits of family members, such as smoking
Activity of the mother or usual caregiver before, during, and after crying
Characteristics of the cry (e.g. duration, intensity)
Measures used to relieve crying and their effectiveness
The infant’s stooling, voiding =, and sleeping patterns

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73
Q

It is also known as the Flat Head Syndrome

A

Positional Plagiocephaly

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74
Q

A condition in which specific areas of an infant’s head develop an abnormally flattened shape and appearance.

A

Positional Plagiocephaly

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75
Q

This can occur when there is crowding in the womb or when the baby is placed in the same position (such as on his/her back) for extended periods of time

A

Positional Plagiocephaly

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76
Q

Babies are vulnerable to _____ because their skulls are soft and malleable at birth

A

plagiocephaly

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77
Q

Causes of Positional Plagiocephaly

A

The most common cause of flattened head is the baby’s sleep position
Premature babies are more likely to have a flattened head
Can also be caused by position in the womb

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78
Q

Signs and Symptoms for Positional Plagiocephaly

A

The back of the baby’s head is easy for parents to notice
The baby usually has less hair on that part of the head
When looking down at the baby’s head, the ear on the flattened side may look pushed forward

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79
Q

In severe cases of positional plagiocephaly, the _____ might bulge on the side opposite from the flattening, and may look uneven.

A

forehead

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80
Q

If _____ of plagiocephaly is the cause, the neck, jaw, and face also might be uneven.

A

torticollis

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81
Q

To check for torticollis, the doctor may watch how a baby moves the _____.

A

neck and head

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82
Q

Treatment Options for Plagiocephaly

A

Positional Therapy
Helmet or Band therapy
Physical therapy for neck stretching, if torticollis (neck tightness) is present

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83
Q

The orthotist will create a duplicate of the baby’s head using a plaster impression or a 3-D scan. The band will be precisely fabricated and customized to the baby’s head to achieve improved symmetry and proportion

A

Positional Molding Helmet Band Therapy

84
Q

Adjustments to the helmet need to be made every _____ because a baby’s head grows very quickly. This involves adjusting the foam lining and/or portions of the outside plastic helmet

A

1-2 weeks

85
Q

Do not purchase _____without first consulting a physician specialist.

A

helmets

86
Q

When treatment for plagiocephaly starts at the optimum age of 3-6 months, it usually can be completed within _____

A

12 weeks

87
Q

Correction is still possible in babies up to age _____, but will take longer

A

18 months

88
Q

The baby will wear a helmet/band _____ hours per day with the exception of _____ hour set aside for bathing and cleaning.

A

23.5, one-half

89
Q

The baby’s _____should be monitored to make sure there are no deep red areas developing. If there is an area that has too firm contact with the band, the skin may break down, causing scarring or other issues.

A

skin

90
Q

Prevention of PP should begin shortly after birth by placing the infant to sleep supine and alternating the infant’s head position nightly, avoiding prolonged placement in car safety seats and swings, and using prone positioning or “tummy time” for approximately 10-15 minutes three times per day while infant is awake

A

Therapeutic Management for Positional Plagiocephaly

91
Q

Infants should be placed prone on a firm surface during awake time (tummy time) for at least _____

A

10-15 minutes three times a day

92
Q

Sometimes known as crib death because the infants often die in their cribs.

A

Sudden infant Death Syndrome

93
Q

The third leading cause of infant mortality in the United States, accounting for approximately 8% of all infant deaths and claiming the lives of 3500 US infants each year

A

SIDS

94
Q

Physical factors associated with SIDS include

A

Brain defects
Low birth weight
Respiratory infection

95
Q

Sleep environmental factors

A

Sleeping on the stomach or side
Seeping on a soft surface
Sharing a bed
Overheating

96
Q

Sex - _____ are slightly more likely to die of SIDS.

A

Boys

97
Q

Age - Infants are most vulnerable between the ____ and ____ of life.

A

second and fourth months

98
Q

Race: for reasons that aren’t well-understood, _____ infants are more likely to develop SIDS.

A

nonwhite

99
Q

Family History - babies who’ve had _____ or _____ die of SIDS are at higher risk of SIDS.

A

siblings or cousins

100
Q

Secondhand Smoke - babies who live with _____ have a higher risk of SIDS.

A

smokers

101
Q

Being premature - both being born early and having a _____ increase your baby’s chances of SIDS.

A

low birth weight

102
Q

Other Risk factors for SIDS

A

Maternal Smoking
Co-sleeping
Prone Sleeping
Soft Bedding

103
Q

About 50-60% of infants manifest _____

A

cyanosis

104
Q

Half of the infants who had SIDS experience _____ before death.

A

breathing difficulties

105
Q

Although most infants are apparently healthy, many parents state that their babies “ were not themselves” in the hours before death.

A

Abnormal Limb Movements

106
Q

Laboratory Studies - For a living patient, initial laboratory studies include a _____, _____ and _____

A

complete blood count (CBC), electrolyte concentrations, and urinalysis.

107
Q

Nursing Care Planning and Goals for SIDS

A

Family caregivers will seek appropriate support persons for assistance.
Family caregivers will use available support systems to assist in coping with fear.
Family caregivers will share feelings about the event.
Family caregivers will verbalize measures to prevent SIDS.

108
Q

Nursing Interventions for SIDS

A

Allow expression of feelings
Appropriate referrals
Encourage use of community resources
Monitoring Subsequent infants

109
Q

The immediate reaction of the staff should be to allow the family to express their grief, encouraging them to say goodbye to their infant, and providing a quiet, private place for them to do so.

A

Allow expression of feelings

110
Q

Referrals should be made to the local chapter of the National SIDS Foundation immediately; Sudden Death Alliance is another resource for help.

A

Appropriate referrals

111
Q

In some states, specially trained community health nurses who are knowledgeable about SIDS are available; these nurses are prepared to help families and can provide written materials, as well as information, guidance, and support in the family’s home.

A

Encourage use of community resources

112
Q

Caregivers are particularly concerned about subsequent infants; recent studies have indicated that the risk for these infants for the first few months of life to help reduce the family’s stress; monitoring is usually maintained until the new infant is past the age of the SIDS infant’s death.

A

Monitoring Subsequent infants

113
Q

Evaluation for SIDS, Goals are me as evidenced by:

A

Family caregivers sought appropriate support persons for assistance.
Family caregivers used available support systems to assist in coping with fear.
Family caregivers shared feelings about the event.
Family caregivers verbalized measures to prevent SIDS.

114
Q

Formerly referred to as an aborted SIDS death or a near-miss SIDS, generally refers to an event that is sudden and frightening to the observer in which the infant exhibits a combination of apnea, change in color (e.g., pallor, cyanosis, redness), change in muscle tone (Usually hypotonia), and choking, gagging, or coughing that usually involves a significant intervention such as CPR provided by the caregiver who witnesses the event.

A

Apnea and Apparent Life-Threatening Event (ALTE)

115
Q

Then resolve episode including at least one of the following: (BRUE)

A

Cyanosis or pallor
Absent, Decreased, or irregular breathing.
Marked change in muscle tone (hypertonia or hypotonia) and/or
Altered responsiveness.

116
Q

The guidelines also state that a _____is diagnosed only when there is no explanation for a qualifying event after completion of a thorough history and physical examination

A

BRUE

117
Q

Age limit < 1 yr old

A

BRUE

118
Q

No particular age limit

A

ALTE

119
Q

Airway not included

A

BRUE

120
Q

Choking and Gagging

A

ALTE

121
Q

Absent breathing, diminished breathing, and other irregularities

A

BRUE

122
Q

Apnea (Central or occasionally obstructive)

A

ALTE

123
Q

Cyanotic/Pale

A

BRUE

124
Q

Cyanotic / Pallid / Erythematous / Plethoric

A

ALTE

125
Q

Marked change in tone, including hypertonia or hypotonia

A

BRUE

126
Q

Any change in muscle tone

A

ALTE

127
Q

Altered level of responsiveness (May indicate serious cardiac, respiratory, metabolic, or neurologic event)

A

BRUE

128
Q

Only if there are no other causes

A

BRUE

129
Q

Might have included such as GORD / LRTI / Meningitis / Sepsis

A

ALTE

130
Q

Are openings or splits in the upper lip, the roof of the mouth or both.

A

Cleft lip and Cleft palate

131
Q

The most common birth defect in the United States and occurs with a frequency of 1 in 600 live births

A

Cleft lip (CL) with or without cleft palate (CP)

132
Q

It is more common in males and _____ alone is common in females.

A

Cleft lip (CL) with or without cleft palate (CP), cleft palate

133
Q

Exposure to environmental factors or teratogens may be responsible for _____ at a critical point in embryonic development.

A

clefts

134
Q

A _____ can occur unilaterally or bilaterally, and it may present a simple notch in the upper lip or extend completely to the base of the nose.

A

cleft lip

135
Q

Cleft lip is the most common orofacial cleft. _____ deficiency may also be associated with incomplete anterior midline closure.

A

Folic acid

136
Q

Cleft lip s an opening of the palate and occurs when the palatal process does not close as usual at approximately _____ of intrauterine life

A

9 to 12 weeks

137
Q

Surgical Intervention for Cleft Lip and Palate

A

Cheiloplasty
Palatoplasty

138
Q

10 weeks old, 10lbs, and hemoglobin of 10

A

Rule of Tens

139
Q

Typically performed at 3 months of age (as early as 3 months of age)

A

Cheiloplasty

140
Q

Most widely used procedure for unilateral cleft lip repair

A

Cheiloplasty

141
Q

Creation of velopharyngeal valve for swallowing and speech

A

Palatoplasty

142
Q

Preservation of midface growth

A

Palatoplasty

143
Q

Based on the timeline we repair it as early as 9-12 months age (minimize speech abnormalities)

A

Palatoplasty

144
Q

Facial growth may be less affected if surgery is delayed until 18-24 months, but feeding, speech, socialization may suffer.

A

Palatoplasty

145
Q

A condition that occurs when the portion of the bowel folds “TELESCOPES” into itself, resulting in obstruction.

A

Intussusception

146
Q

more common in males than in females and is more common in children younger than 2 years old.

A

Intussusception

147
Q

Most common cause of intestinal obstruction in infants and young children with ⅔ of then happening among infants under 1 year of age.

A

Intussusception

148
Q

Common Signs & Symptoms of Intussusception

A
  1. Sudden onset of intermittent crampy abdominal pain
  2. Severe pain (children usually draw up their knees and scream)
  3. Vomiting
  4. Diarrhea
  5. Currant-jelly stools, gross blood or hemoccult positive stools
  6. Lethargy
149
Q

Nursing Intervention for Intussusception

A

Assess severity of pain
Observe for Presence of bilious vomiting
Assess for signs and symptoms of peritonitis
Physical examination: Palpate abdomen for presence of sausage-shaped mass upper mid abdomen - a hallmark sign for intussusception.

150
Q

Nursing Management for Intussusception

A

Intravenous fluid as ordered by the Physician
Provide emotional support to the anxious parents
Provide appropriate preoperative and postoperative education to the family

151
Q

Also called as Congenital Aganglionic Megacolon

A

Hirschsprung’s Disease

152
Q

A congenital anomaly that results in mechanical obstruction from inadequate motility of part of the intestine.

A

Hirschsprung’s Disease

153
Q

It accounts for about one fourth of all cases of neonatal intestinal obstruction. The incidence is 1 in 5000 live births

A

Hirschsprung’s Disease

154
Q

Absence of nerve plexuses due to disruption of the distal migration of neuroblasts along the intestines

A

Hirschsprung’s Disease

155
Q

Therapeutic Management for Hirschsprung’s Disease

A

Surgical resection of the aganglionic bowel and reanastomosis of the remaining intestine.

156
Q

Providing post operative care and observe for possible complication of enterocolitis signs and symptoms:

A

Fever
Abdominal distention
Chronic diarrhea
Explosive stools
Rectal bleeding
Straining

157
Q

_____ are among the more common congenital malformations caused by abnormal development.

A

Anorectal malformations

158
Q

Includes several forms of malformation without an obvious opening. Frequently a fistula (an abnormal communication) leads from the distal rectum to the perineum or GU system. The fistula may be evidenced when meconium is evacuated through the vaginal opening, the perineum below the vagina, the male urethra, or the perineum under the scrotum.

A

Imperforate Anus

159
Q

Occurs once in every 5,000 live births. Rectourinary fistula is the passage of meconium in the urine.

A

Imperforate Anus

160
Q

Surgical closing of any small tube-like openings (fistula), creating an anal opening, and putting the rectal pouch into the anal opening

A

Anoplasty

161
Q

Surgical Intervention for Imperforate Anus

A

Anoplasty

162
Q

Associated with fever 102 to 104 Fahrenheit or 38.9 to 40.0 Celsius.

A

Febrile Seizures

163
Q

Febrile Seizures associated with fever _____ Fahrenheit or _____ Celsius.

A

102 to 104, 38.9 to 40.0

164
Q

_____ usually occur due to a sudden spike of temperature.

A

Febrile seizures

165
Q

The seizure only lasts _____ or less.

A

1 to 2 minutes

166
Q

A febrile seizure is a seizure associated with a febrile illness in a child who does not have a _____.

A

CNS infection

167
Q

By definition, children who have a febrile seizure cannot have a history of neonatal or unprovoked _____

A

seizures

168
Q

Occurring in 2% to 5% of children between the ages of 1 month and 5 years

A

Febrile Seizures

169
Q

Nursing Intervention for Febrile Seizures

A

After a seizure subsides, to sponge the child with tepid water to reduce the fever quickly

170
Q

A condition caused by an imbalance in the production and absorption of CSF in the ventricular system.

A

Hydrocephalus

171
Q

This condition could also be termed a hydrodynamic SSF disorder.

A

Hydrocephalus

172
Q

Can be defined broadly as a disturbance of cerebrospinal fluid (CSF) formation, flow, or absorption, leading to an increase in volume occupied by this fluid in the central nervous system.

A

Hydrocephalus

173
Q

Types of Hydrocephalus

A

Communicating
Non-Communicating

174
Q

No Blockage in the ventricular system.

A

Communicating

175
Q

Blockage in ventricular system - Most common cause of hydrocephalus.

A

Non-Communicating

176
Q

Clinical manifestation of Hydrocephalus

A

Head enlargement (increasing occipitofrontal circumference) is the predominant sign.

177
Q

Nursing Management for Hydrocephalus

A

Maintaining cerebral perfusion
Minimizing neurologic complication
Recognizing and preventing shunt infection and malfunction
Maintaining adequate nutrition
Promoting growth and development

178
Q

Meningitis can be caused by a variety of organisms, but the three main types are:

A

bacterial or progenic, caused by pus-forming bacteria, especially meningococci and pneumococci organisms
viral or aseptic, caused by a wide variety of viral agents
tuberculous, caused by the tuberculosis bacillus.

179
Q

The majority of children with _____ have either bacterial meningitis or viral meningitis as the underlying cause.

A

acute febrile encephalopathy

180
Q

Age affected by Escherichia coll: Streptococcus group B Listeria monocytogenes pseudomonas aeruginosa; streptococcus species

A

Newborns and Infants (birth to 3 mos)

181
Q

Age affected by Streptococcus pneumonia; Neisseria meningitides (meningococcal meningitis) Haemophilus influenzae type B

A

Infants and children (3 mos to 6 years)

182
Q

Age affected by Streptococcus pneumonia; Nissena meningitidis (meningococcal meningitis) Mycobacterium Tuberculosis.

A

Older children And adolescents (6 yrs. To 16 yrs.)

183
Q

A major priority of nursing care of a child suspected of having meningitis is to administer _____ as soon as they are ordered.

A

Antibiotics

184
Q

The child is placed on respiratory isolation for at least _____ after initiation of antimicrobial therapy.

A

24 hours

185
Q

Nursing Alert for Meningitis

A

Reducing intracranial pressure (ICP) and maintain cerebral perfusion
Administer antibiotics immediately
Oxygen Inhalation - Ensure proper ventilation, reduce the inflammatory response and prevent injury to the brain.
Reducing fever - reduce metabolic needs of the brain. TSB, reduce environmental temperature.
Treat fluid volume deficit - Intravenous fluids
Control seizures - use of anticonvulsant drugs, anti- inflammatory drugs
Prevent injury resulting from altered LOC or seizure activity
Initiate appropriate droplet isolation until 24 hours of antibiotic therapy -to prevent transmission

186
Q

Part of a group of birth defects called neural tube defects.

A

Spina Bifida

187
Q

Caused by a defect in the neural arch generally in the lumbosacral region

A

Spina Bifida

188
Q

A failure of the posterior laminae of the vertebrae to close; this leaves an opening through which the spinal meninges and spinal cord may protrude.

A

Spina Bifida

189
Q

Posterior laminae of vertebrae fail to fuse

A

Spina bifida occulta

190
Q

Dimpling at the point of poor fusion, abnormal tufts of hair or, discolored skin

A

Spina bifida occulta

191
Q

Membranes herniate thru unformed vertebrae -protrude as a circular mass change size at the center of the back-lower lumbar or lumbosacral region

A

Spina bifida with meningocele

192
Q

With eternal saclike

A

Spina bifida with meningocele

193
Q

The spine, spinal cord and spinal canal do not form or data normally

A

Spina bifida with myelomeningocele

194
Q

A sac of fluid comes thru as opening in the to’s back

A

Spina bifida with myelomeningocele

195
Q

Most severe and the spinal cord and meninges
protrudes

A

Spina bifida with myelomeningocele

196
Q

Prevention of Spina Bifida

A

Folic acid 60 mg with prenatal vitamin and mandatory inclusion of folic acid in all cereals and grain products.

197
Q

Risk Factors of Spina Bifida

A

Folic acid deficiency
Maternal age under 20 and over 40 year
Maternal education below 12 grade level
Low socioeconomic status

198
Q

Result of an extra chromosome 21

A

Trisomy 21 or Down Syndrome

199
Q

1:700 children

A

Trisomy 21 or Down Syndrome

200
Q

Characteristic facial features, short stature; heart defects, shorter lifespan._ etc.

A

Trisomy 21 or Down Syndrome

201
Q

Has been correlated to the age of the mother but can also be result of nondisjunction of father’s chromosome 21

A

Trisomy 21 or Down Syndrome

202
Q

_____ first described the condition in 1866, but its cause was a mystery for many years.

A

Langdon Down

203
Q

In 1932, it was suggested that a _____ might be the cause, but the anomaly was not demonstrated until 1959.

A

chromosomal anomaly

204
Q

A congenital malformation in which both cerebral hemispheres are absent.

A

Anencephaly

205
Q

The condition is usually incompatible with life, and many affected infants are stillborn. For those who survive, no specific treatment is available.

A

Anencephaly

206
Q

Nursing Management for Anencephaly

A

Provide emotional support to the grieving family.

MCN 2 (4 decks)

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