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MCN 109 > April 23 109 Lecture > Flashcards

April 23 109 Lecture Flashcards

1
Q

Occurs when any substance interferes with normal body functions after it is swallowed, inhaled, injected, or absorbed.

A

Poisoning

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2
Q

Who are prone to poisoning?

A

Infants and toddlers

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3
Q

Why are infants and toddlers prone to poisoning?

A

Because they explore their environment through oral experimentation, because their sense of taste is not discriminating.

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4
Q

2 major types of poisoning

A
  1. Product that never meant to be ingested or inhaled
  2. Products that can be ingested in small quantities but can be harmful if ingested in large amounts
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5
Q

Example of poisonous products that are never meant to be ingested or inhaled.

A

✔ shampoo
✔ paint thinner
✔ pesticides
✔ houseplants (leaves)
✔ carbon monoxide

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6
Q

Example of Products that can be ingested in small quantities but can be harmful if ingested in large amounts

A

✔ drugs/ medicine
✔ medicinal herbs
✔ alcohol
✔ bacterial toxins (food poisoning for e.g. E, Coli)
✔ heavy metals (lead paint)
✔ venom (animal, insects)

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7
Q

Causative agent of staphylococcal Food poisoning

A

Staphylococcal enterotoxin produced by strains of staphylococcus aureus

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8
Q

Incubation period of staphylococcal Food poisoning

A

1 - 7 hours

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9
Q

Period of communicability of staphylococcal Food poisoning

A

Carriers may contaminate food as long as they harbor that organism

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10
Q

Mode of transmission of staphylococcal Food poisoning

A

Ingestion of contaminated food

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11
Q

Assessment for Staphylococcal Food Poisoning

A

✔ severe vomiting and diarrhea
✔ abdominal cramping
✔ excessive salivation
✔ Nausea within 2-6 hours of eating

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12
Q

Therapeutic management for Staphylococcal Food Poisoning

A

Intensive supportive therapy with fluid and electrolyte replacement

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13
Q

Effective drug against staphylococcus

A

cefotaxime

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14
Q

Prevention for Staphylococcal Food Poisoning

A

proper refrigeration of food

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15
Q

A poisoning that occurs most commonly in children between the ages 2 and 3 years and in all socioeconomic groups

A

Poisoning as an unintentional injury

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16
Q

Poisoning as an unintentional injury commonly occurs in what age group?

A

Between the ages 2 and 3 years and in all socioeconomic groups

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17
Q

Common agents in poisoning as an unintentional injury

A

✔ soap
✔ cosmetics
✔ detergents or cleaners
✔ plants

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18
Q

What is the best method to deactivate a swallowed poison?

A

Administration of activated charcoal (orally or by way of an NG tube)

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19
Q

Drug most frequently involved in childhood poisoning today

A

Acetaminophen Poisoning

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20
Q

Acetaminophen when taken in large doses can cause?

A

Liver destruction

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21
Q

What will the child experience immediately after ingestion in acetaminophen poisoning?

A

✔ anorexia
✔ nausea
✔ vomiting

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22
Q

Diagnostic test for acetaminophen poisoning

A

✔ serum aspartate transaminase (AST/ SGOT) - enzyme made by liver cells
✔ serum alanine transaminase (ALT/ SGPT) - present in liver and heart cells
✔ liver enzymes

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23
Q

Therapeutic Management for acetaminophen poisoning

A

✔ Activated charcoal - given 1 to 4 hours after consuming
✔ Acetylcysteine -antidote
✔ Continue to observe for jaundice and tenderness over the liver
✔ Assess AST and ALT levels

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24
Q

Loading dose

A

140 mg/ kg

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25
Q

Maintaining dose

A

70 mg/kg, repeated q4, in total of 17 hours

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26
Q

Ingestion of a strong alkali, such as lye, which is often contained in toilet bowl cleaners or hair care products

A

Caustic Poisoning

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27
Q

Areas where caustic poisoning cause burns and tissue necrosis

A

✔ mouth
✔ esophagus
✔ stomach

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28
Q

5 assessments for caustic poisoning

A

✔ oral edema
✔ marked edema on mouth and lips
✔ drools saliva
✔ immediate pain in the mouth and throat
✔ inability to swallow

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29
Q

Analgesic used in caustic poisoning to achieve pain relief

A

morphine

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30
Q

Therapeutic Management for caustic poisoning

A

✔ assess the child for the degree of pain involved
✔ intubation may necessary to provide a patent airway
✔ assess vital signs closely, especially the respiratory rate

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31
Q

A poisoning where substances contained in products such as kerosene and furniture polish

A

Hydrocarbon Poisoning

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32
Q

Major effect in hydrocarbon poisoning

A

respiratory irritation

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33
Q

A poisoning where it is swallowed by small children because it is an ingredient in vitamin preparations, particularly pregnancy vitamins

A

Iron Poisoning

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34
Q

What can iron poisoning lead to?

A

signs and symptoms of gastric irritation

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35
Q

Assessment for iron poisoning

A

immediate effects of nausea and vomiting, diarrhea, abdominal pain

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36
Q

Assessment for iron poisoning after 6 hours

A

necrosis of the tube lining of GI tract

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37
Q

Assessment for iron poisoning after 12 hours

A

✔ melena
✔ hematemesis
✔ lethargy and coma
✔ cyanosis
✔ vasomotor collapse

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38
Q

Therapeutic Management for iron poisoning

A

✔ stomach lavage
✔ administration of cathartic/laxative
✔ Maalox or Mylanta
✔ chelating agent such as IV or IM deferoxamine
✔ exchange transfusion
✔ upper GI x-ray series
✔ liver studies
✔ test any stool passed for occult blood

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39
Q

Other word for lead poisoning

A

Plumbism

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40
Q

A poisoning that interferes with blood cell function by blocking the incorporation of iron into the protoporphyrin compound that makes up the heme portion of hemoglobin in RBC

A

Lead Poisoning (Plumbism)

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41
Q

Lead Poisoning (Plumbism) can lead to

A

hypochromic, microcytic anemia

42
Q

This is the most serious effect from lead poisoning and occur most in the toddler or preschool child

A

Lead encephalitis

43
Q

Assessment for lead poisoning

A

✔ Anorexia, lethargy, abdominal pain
✔ learning difficulties
✔ 2 successive blood lead levels of > 10 µg/ dL

44
Q

Usual sources of lead

A

✔ paint chips or paint dust
✔ home-glazed pottery
✔ fumes from burning
✔ swallowed batteries

45
Q

Therapeutic Management for lead poisoning

A

✔ measure intake and output
✔ injections of EDTA (chelating agent)
✔ if the lead level is 15 µg/ dL or higher, child must be removed from the environment
✔ if the lead level is >20 µg/100mL, oral chelating such as succimer may be prescribed
✔ lead levels >45 µg/ 100 mL may be admitted to the hospital for chelation therapy with dimercaprol or edetate calcium disodium

46
Q

A poisoning where accidental ingestion or through skin or respiratory tract contact when children play in an area that has been recently sprayed

A

Pesticide Poisoning

47
Q

Pesticide Poisoning can lead to

A

muscle paralysis

48
Q

Assessment for pesticide poisoning

A

✔ nausea and vomiting
✔ diarrhea
✔ excessive salivation
✔ weakness of respiratory muscles
✔ confusion
✔ depressed reflexes
✔ seizures

49
Q

Therapeutic management for pesticide poisoning

A

✔ activated charcoal
✔ remove clothing if contaminated
✔ wash child’s skin and hair
✔ wear gloves while bathing the child
✔ intravenous atropine and cholinesterase reactivator, pralidoxime (Protopam Chloride)

50
Q

A leading cause of death in children and adolescent

A

Accidents (trauma/injury)

51
Q

Why are adolescents vulnerable to multiple and severe trauma?

A

because they are mobile in bikes, motorcycles and in automobiles and active in sports

52
Q

2 factors that increases the chance of injury

A

Speed and congested surroundings

53
Q

Children are Vulnerable to Injury due to

A

✔ natural curiosity
✔ Investigative, impulsive, impatient
✔ less careful, hyperactive
✔drive to test on new master skills
✔ attempted activities before developmental readiness
✔ self-assertion and challenges to rules
✔ desire for peer approval

54
Q

_____ is an event, independent of human will, caused by outside force acting rapidly and resulting in physical or mental injury

A

Accident

55
Q

It is an intentional or unintentional damage to the body due to exposure to an external agent

A

Injury

56
Q

There can be 3 forms of injury which are:

A

✔ Thermal
✔ Mechanical
✔ Chemical

57
Q

It is the leading cause of death and disability in children and young adults

A

Childhood Accidents

58
Q

It is the leading cause of death in children over 1 year

A

Childhood Accidents

59
Q

Number of deaths associated with childhood accidents worldwide per year

A

more than 5 million deaths

60
Q

Incidence of childhood accidents

A

✔ every hour, 1 child dies from an injury
✔ about 1 in 5 child deaths is due to injury
✔ every 4 seconds, a child is treated for an injury in an emergency department

61
Q

Common Accidental Injury in INFANTS

A

✔ cuts
✔ falls
✔ suffocation
✔ ingestion
✔ burns

62
Q

Preventions for infants in having accidental injury

A

✔ never keep them alone
✔ do not give them small tiny toys
✔ avoid solid food items, keep away stove, fire

63
Q

Common Accidental Injury in TODDLERS

A

✔ thermal
✔ aspiration
✔ drowning
✔ falling
✔ electrocution

64
Q

Preventions for toddlers in having accidental injury

A

✔ supervise constantly
✔ avoid negative words
✔ keep away harmful agents
✔ floor should be dry
✔ clothing

65
Q

Common Accidental Injury in ADOLESCENTS

A

✔ instrument injury
✔ road traffic accident
✔ electric current
✔ sport injury

66
Q

Preventions for adolescents
in having accidental injury

A

✔ safe environment
✔ training
✔ constant supervision
✔ guidance
✔ education

67
Q

Nurses role in Common Accidental Injury and its Prevention in Different Age Group

A

✔ fore thought
✔ discipline
✔ time

68
Q

Nursing responsibilities in Common Accidental Injury and its Prevention in Different Age Group

A

✔ health education
✔ provision of safe environment
✔ safe child care and prevent the accident from happening
✔ assist in medical care to prevent the disability
✔ take public health measures to prevent road traffic accidents such as teaching them traffic rules, implement policies, etc.
✔ Participate in policy making and research activity in accident prevention

69
Q

It is the most common chronic rheumatologic disease in children and is one of the most common chronic disease of childhood

A

JUVENILE RHEUMATIC ARTHRITIS (JRA)

70
Q

other name for juvenile rheumatic arththritis

A

Juvenile Idiopathic Arthritis (JIA)

71
Q

They provide a supportive framework and protective covering for the body, such as the musculoskeletal system and skin and mucous membranes

A

Connective tissues

72
Q

Causes of JRA

A

✔ Genetics
✔ Infectious agents
✔ Female hormones
✔ Environmental factors
✔ Occupational exposures

73
Q

a specific gene marker in JRA

A

HLA (human leukocyte antigen)

74
Q

Example of environmental factors in JRA

A

exposure to cigarette smoke, air pollution, and insecticides

75
Q

Clinical manifestations for JRA

A

✔ Arthritis
✔ Loss of motion
✔ Synovitis
✔ Swelling
✔ Joint inflammation

76
Q

It is a limitation of joint motion in association with pain, warmth, or erythema of the joint.

A

Arthritis

77
Q

A condition where fingers may appear swollen, and the range of motion becomes painful.

A

Synovitis

78
Q

Diagnostic tests for JRA

A

✔ Inflammatory markers
✔ Complete blood count and metabolic panel
✔ Antinuclear antibody test
✔ Radiography
✔ Computed tomography and magnetic resonance imaging (CT SCAN)
✔ Ultrasonography

79
Q

Management for JRA

A

✔ Exercise
✔ Synovectomy
✔ Osteotomy and arthrodesis
✔ Total hip and knee replacements

80
Q

Medications for JRA

A

✔ Nonsteroidal anti-inflammatory drugs (NSAIDs)
✔ Disease- modifying antirheumatic drugs (DMARDs)
✔ Corticosteroids
✔ Immunomodulators

81
Q

It is not a simple curve to one side but in fact a more complex three-dimensional deformity that often develops in childhood.

A

Scoliosis

82
Q

Greek word of scoliosis

A

skolios (twisted) and refers to a sideward (right or left) curve in the spine

83
Q

3 main plane in scoliosis

A

✔ lateral curvature in frontal - kyphosis
✔ anteroposterior - lordosis
✔ vertebral axial rotation- scoliosis

84
Q

term used specifically to describe scoliosis that occurs in children younger than 3 years of age

A

Infantile Scoliosis

85
Q

Scoliosis occurring in 4 to 9 years of age

A

Juvenile scoliosis

86
Q

Scoliosis occurring in 10 to 18 years of age

A

Adolescent scoliosis

87
Q

What are the “tip-offs” to scoliosis

A

✔ uneven waist
✔ leaning to one side
✔ prominent shoulder blade/s
✔ uneven shoulders
✔ elevated hips

88
Q

When does these “tip-offs” begin?

A

8 years of age

89
Q

Types of scoliosis

A

✔ Functional Scoliosis
✔ Structural Scoliosis
✔ Idiopathic Structural Scoliosis

90
Q

It is a curvature due to a problem that does not involve the spine, such as having legs that are different lengths or muscle spasms caused by pain

A

Functional Scoliosis

91
Q

A type of scoliosis where the curvature is flexible and will go away if the problem that causes to lean to the side goes away

A

Functional Scoliosis

92
Q

A type of scoliosis where the spine curvature is not flexible and does not go away with a change in position

A

Structural Scoliosis

93
Q

A type of scoliosis where 80% of children and seen in school-aged children at 10 years/ older

A

Idiopathic Structural Scoliosis

94
Q

Conditions associated with idiopathic Structural Scoliosis

A

✔ born with vertebrae that do not develop normally
✔ underlying problem in the brain
✔ cyst or a tumor
✔ cerebral palsy
✔ muscular dystrophy

95
Q

Causes of scoliosis

A

✔ Mechanical factors
✔ Genetic and external factors
✔ Other associations include older mothers from poorer families, breech presentations, and premature and low-birth weight babies.

96
Q

Diagnostic tests for scoliosis

A

✔ Radiography
✔ Computed tomography (CT) scan
✔ Magnetic resonance imaging (MRI)

97
Q

RVAD

A

rib-vertebral angle difference

98
Q

Non-surgical therapeutic management for scoliosis

A

✔ electrical stimulation
✔ observation
✔ brace management
✔ exercise therapy
✔ pedicle screw instrument
✔ halo traction

99
Q

Surgical therapeutic management for scoliosis

A

✔ growing rods
✔ localizer cast
✔ traction to the pelvis through another sling
✔ pediatric Isola spine system

100
Q

Nursing management for scoliosis

A

✔ Degree of curvature
✔ Provide privacy
✔ Assess emotional status

101
Q

Period of time a child with scoliosis must be reassessed

A

every 4 - 6 months

102
Q

Interventions for scoliosis

A

✔ Promote mobility
✔ Prevent injury
✔ Prevent skin irritation
✔ Promote positive body image
✔ Promote compliance with therapy

MCN 109 (5 decks)

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