406 9 Flashcards
Hyperbilirubinemia: if whole body is yellow or palms are yellow, there is danger of
kernicterus
MMR vaccine: contraindicated with allergy to
eggs or neomycin
the common cold is not a contraindication for
immunization
Fever of less than 102 is a normal SE for
DTaP
After immunization, to decrease pain
apply warm wash cloth and bicycle the baby’s legs when changing the diaper
After immunization you can give ___ Q 4 to 6 hours
tylenol
CF: child needs ___ of the usual calorie intake in order to grow and develop
150%
The organism usually responsible for epiglottitis
H. influenzae
Epiglottitis onset
sudden
Child assuming upright sitting position with chin out
and tongue protruding (“tripod position”)
Epiglottitis
Drooling and Muffled voice
Epiglottitis
Epiglottitis throat exam
don’t examine it
Bronchiolitis is characterized by
thick secretions
Bronchiolitis is caused by a
virus
Bronchiolitis should be on ___ isolation
contact
Assign nurses to clients with RSV (Bronchiolitis) who have no responsibility for any other
children
Otitis media: give child a ___ bath
tepid
Otitis media: position child
on the affected side
Otitis media: ___ compress on the affected ear
warm
If related to strep, treatment is very important because
of the risk for developing acute glomerulonephritis or rheumatic heart disease.
Tonsillitis
Tonsillitis: highest risk for hemorrhage is during the first 24 hours and
5 to 10 days after surgery
Acyanotic or Cyanotic: tetralogy of Fallot
Cyanotic
decreased pulmonary blood flow
Cyanotic
Right-to-left shunts
Cyanotic
increased pulmonary blood flow
Acyanotic
VSD
Ventricular Septal Defect
Acyanotic or Cyanotic: Ventricular Septal Defect
Acyanotic
There is a hole between the ventricles.
Ventricular Septal Defect
Oxygenated blood from left ventricle is shunted to right ventricle and recirculated to the lungs
Ventricular Septal Defect
Ventricular Septal Defect: Small defects may
close spontaneously
There is a hole between the atria
Atrial Septal Defect
Acyanotic or Cyanotic: Atrial Septal Defect
Acyanotic
Oxygenated blood from the left atrium is shunted to
the right atrium and lungs
Atrial Septal Defect
Acyanotic or Cyanotic: Patent Ductus Arteriosus
Acyanotic
Patent Ductus Arteriosus: Increased Pulmonary Blood Flow
Pulmonary Blood Flow
There is an abnormal opening between the aorta and the pulmonary artery
Patent Ductus Arteriosus
Patent Ductus Arteriosus: There is an abnormal opening between the
aorta and the pulmonary artery
Patent Ductus Arteriosus usually closes within
72 hours after birth
May require tx with indocin to close the hole
Patent Ductus Arteriosus
There is an obstructive narrowing of the aorta
Coarctation of the Aorta
Acyanotic or Cyanotic: Coarctation of the Aorta
Acyanotic
Left-to-right shunt
Acyanotic
Right-to-left
Cyanotic
Coarctation of the Aorta: A common finding is hypertension in the
upper extremities and decreased or absent pulses in the lower extremities
Acyanotic or Cyanotic: Aortic Stenosis
Acyanotic
an obstructive narrowing immediately before, at, or after the aortic valve
Aortic Stenosis
Aortic Stenosis: Symptoms are caused by low
cardiac output
Three T’s of Cyanotic Heart Disease
Tetralogy of Fallot
Truncus Arteriosus
Transposition of the Great Vessels
VSD
Aorta placed over and above the VSD
Pulmonary stenosis
Right ventricular hypertrophy
Tetralogy of Fallot
Tetralogy of Fallot: ____ occurs because unoxygenated blood is pumped into the systemic circulation
Cyanosis
Tetralogy of Fallot: Decreased ____ circulation occurs because of the PS
pulmonary
Tetralogy of Fallot: The child experiences __ ___, or hypoxic episodes
“tet” spells
Tetralogy of Fallot: child experiences “tet” spells, or hypoxic episodes; they are relieved by the child’s
squatting or being placed in the knee-chest position.
p_____ is common in kids with heard defects
polycythemia
Pulmonary artery and aorta do not separate
Truncus Arteriosus
Truncus Arteriosus: One main vessel receives blood from the left and right ____ together
ventricles
Truncus Arteriosus: Blood mixes in right and left ventricles through a large VSD, resulting in
cyanosis
The great vessels are reversed.
Transposition of the Great Vessels (Mixed Blood Flow)
Transposition of the Great Vessels: The pulmonary circulation arises from the left ventricle, and the
systemic circulation arises from the right ventricle.
This Cyanotic diagnosis is a medical emergency
Transposition of the Great Vessels (Mixed Blood Flow)
Transposition of the Great Vessels: administer
prostaglandin to keep the ductus open
Care of cardiac patient: diet:
feed small, frequent feedings
high-calorie formula
Care of cardiac patient: infants may need ___ feeding to save energy
tube feeding
Care of cardiac patient: because polycythemia increases risk for thrombus formation, you should maintain
hydration
Care of cardiac patient: neutral
thermal environment
CHF is more often associated with Acyanotic or Cyanotic?
Acyanotic
Acyanotic has abnormal circulation; however,
all blood entering the systemic circulation is oxygenated
Cyanotic has abnormal circulation, with
unoxygenated blood entering the systemic circulation
Rheumatic Fever Description: _____ disease
Inflammatory
the most common cause of acquired heart disease in children
Rheumatic Fever
Rheumatic fever is associated with an antecedent beta-
hemolytic _____ infection
streptococcal
Tachycardia, even during sleep
Rheumatic fever
Migratory large-joint pain
Rheumatic fever
Elevated erythrocyte sedimentation rate (ESR)
Rheumatic fever
Rheumatic fever: irregular involuntary movements that are called
Chorea
Rheumatic fever: Reassure child and family that chorea is
temporary
Rheumatic fever: Administer prescribed medications: ___ or ____
Penicillin or erythromycin
Rheumatic fever: Encourage ___ ___
bed rest
Rheumatic fever: assist with ____
ambulation
Down syndrome is associated with maternal age over
35
Down syndrome: teach parents the use of
bulb syringe for suctioning
Down syndrome: Feed to the
back and side of mouth
Down syndrome: Refer family to ___ ___ program.
early intervention
UTI: Teach to increase ___ oral fluids (e.g., apple juice, cranberry juice).
acidic
Cleft palate may not be identified until the infant has
difficulty with feeding
Initial closure of cleft lip is performed when infant weighs
approximately
10 pounds
Closure of palate defect is usually performed at 1
year
postoperative care for cleft LIP: position client on
side or upright (not prone)
postoperative care for cleft palate: position client on __ or ___
side or abdomen
Vomiting (free of bile) usually begins after 14 days of
life and becomes projectile
Pyloric Stenosis
Hungry, fretful infant
Pyloric Stenosis
Pyloric Stenosis: Metabolic ____
alkalosis
Palpable olive-shaped mass in upper right quadrant of
the abdomen
Pyloric Stenosis
Visible peristaltic waves
Pyloric Stenosis
Prognosis for Pyloric Stenosis surgery
excellent
Pyloric Stenosis: Position on ___ side in semi-Fowler position after feeding.
right
Pyloric Stenosis: ___ frequently to avoid stomach becoming distended and putting pressure on surgical site.
Burp
Acute, intermittent abdominal pain
Screaming, with legs drawn up to abdomen
Intussusception
Sausage-shaped mass in upper right quadrant while
lower right quadrant is empty
Intussusception
Intussusception: Monitor carefully for
shock and bowel perforation
There is a lack of peristalsis in the area of the colon
where the ganglion cells are absent
Aganglionic Megacolon
Aganglionic Megacolon: ___ ___ accumulate above the aganglionic area of the bowel
Fecal contents
Distended abdomen, chronic constipation alternating with diarrhea
Aganglionic Megacolon
Aganglionic Megacolon take temperature via
axillary
Aganglionic Megacolon: Teach family to begin toilet training after age
2
