Chapter 8, 33-35 Flashcards
What is infancy?
stage of life from birth to one year of age weigh on average 6.6-7.6 pounds doubling their weight in six months and triple in a year with the head equaling 25 % of body weight infants grow at growth plates at ends of bones. Transition from fetal circulation to pulmonary circulation within first minutes or hours after birth with very short, narrower, less stable and more easily obstructed than at other stage being a nose and diaphragm breather until 4 weeks of age with nasal congestion causing difficulty breathing and diaphragm more prone to injury because of its lack of rigidity
How much sleep does an infant need?
16-18 hours change to 4-6 a day and 9-10 at night 2-4 months infant sleep through night and easy to awaken
What are the vital signs of infant?
16-18 hours change to 4-6 a day and 9-10 at night 2-4 months infant sleep through night and easy to awaken
What is fontanelle?
soft spot on top of skull not fused at birth with posterior closing in 2-3 months, and anterior closing 9-18 months telling hydration by if is it slightly below surface of kull and if its sunken dehydration and if bulging might be pressure unless crying
What is the moro reflex?
when startled, an infant throws his arms out, spreads his fingers, then grabs with his fingers and arms
What is the palmar reflex?
when you place your finger in an infant’s palm, he will grasp it
What is a rooting reflex?
when you touch a hungry infant’s cheek, he will turn his head toward the side touched
What is a sucking reflex?
when you stroke a hungry infant’s lips, he will start sucking
what is bonding?
the sense that needs will be met
What is trust versus mistrust?
concept developed form an orderly, predictable environment versus a disorderly, irregular environment
What is scaffolding?
building on what one already knows
What is temperament?
the infant’s reaction to his environment
What is the toddler phase?
stage of life from 12-36 months. Physical, mental and social development continues with body systems continuing to grow and refine themselves developing individually. 98.6-99.6 gain 4.4 pounds a year. Vital- 80-130 beats/minute, 20-30 breaths/minute, 70-100 mmHG BP. pulmonary system branch and grow increasing alveolar, about 90% of bad adult brain weight with fine motor, muscle mass and bone density increase, toddler more susceptible to illness, all primary teeth by end
What is the preschool age?
stage of life from 3-5 years. Vitals 80-120 beats/minute, 80-110 mmHg. Comparing oneself to others
What is the school age?
stage of life from six to twelve years. 98.6 degrees, gaining 6.6 pounds per year and growing 2.4 inches a year replacing with permanent teeth. 70-100 beats/minute. Better decision making skills allowed to make more decisions on own. With developing self esteem and affected by popularity, rejection, emotional support, and neglect. Moral development based on what is right and wrong from punishment using internal self-control for cognitive growth
What is adolescence?
stage of life from 13-18 years and is the transition to adulthood. Have rapid 2-3 year growth spurts, with enlarging feet and hands, then arms and legs, chest and trunk enlarging in final stage girls finished by age 16 and boys 18. 55-105 beats/minute, 12-20 respirations a minute. Menstruation begins and breast develops. Time of serious family conflicts as they strive for independence and parents strive for control. Achieving more independence and develop own identity, interested in sex, wants to be treated like adult with comfort of childhood and body image is important where self destructive behavior begins. Capacity for logical, analytic, and abstract thinking develop as personal code of ethics
What is early adulthood?
stage of life from nineteen to forty years. Middle adulthood- stage of life from 41 to 60 years develops lifelong habits and routines with vital signs on average of 70 beats/minute, 16-20 respirations/minute. With peak physical between 19-26 years old at optimal performance. Highest level of job stress with love developing childbirth most common new challenges and stress and accidents the leading cause of death
What is middle adulthood?
stage of life from 41 to 60 years. Reflecting On how far they have come and where they want go go such as midlife crisis. Some vision problems, high cholesterol, and health with cancer developing and weight control for women: menopause with heart disease higher later on. Task oriented for accomplishing goals approaching problems as challenges, empty-nest syndrome increased freedom
What is late adulthood?
stage of life from 61+. Twilight years, with vitals depending upon physical and health condition, vascular less efficient, blood volume decreases, less tolerant of tachycardia, respiratory deterioration decreased metabolism, sleep-wake disrupted. Living conditions to live at home? Self worth is she good quality, financial burdens with limited income and increasing expenses, sees death and dying
What are the cardiovascular changes in the elderly?
degeneration of valves and muscles, thickening and narrowing or coronary arteries, degernation of the conduction system
What is degeneration of valves and muscles?
reduced stroke volume and cardiac output may lead to orthostatic hypotension, decreased brain perfusion and reduced tolerance of activity leading patient to complain of dizziness, fainting, or weakness from sitting or standing position and meds for high blood pressure contribute. Prevalence of congestive heart failure increases so assess lung sounds and check for edema
What is thickening and narrowing or coronary arteries?
dysrhythmias, decrease in maximum heart rate. Heart rate may be irregular or abnormally fast or slow. Heart rate may not increase as much in response to blood loss, especially if patient is taking certain medicines for heart problems or high blood pressure
What is the degernation of the conduction system?
Thickening and narrowing of coronary and systemic arteries with decreased delivery of oxygenated blood to tissues; increased risk of heart attack, stroke, aortic aneurysm, and peripheral artery disease. Determine whether any complaints or changes in mental status or neurological problems are new. Remember, a heart attack in elderly may not present with chest pain
What are changes to the respiratory system?
Decreased elasticity of lungs; Diminished cough and gag reflexes
what is decreased elasticity of lungs?
decrease lung volume;decreased activity of cilia- decreased ability to increase oxygen intake when needed; increased risk of pneumonia. Check patient’s o2 status and give o2 if needed
What is diminished cough and gag reflexes?
increased risk of aspiration paying particular attention to patient’s ability to swallow secretions; suction as necessary. The patient may not cough, even with pneumonia or other respiratory infections
What are the changes of the digestive system?
decreased moment of intestinal tract, and changes in the gastrointestinal lining?
What is decreased movement of the intestinal tract?
decreased secretion of stomach acid, decreased sensation of taste, difficulty chewing and swallowing, decreased food absorption leading to constipation, bowel obstruction, weight loss and malnutrition. Maintains high index of suspicion for bowel obstruction, even with vague or minimal complaints of abdominal pain, fullness, constipation, or bloating
What are the changes in the gastrointestinal lining?
ncreased risk of cancers, relaxation of sphincters- increased risk of gastrointestinal bleeding, gastroesophageal reflux (heartburn), and fecal incontinence. Ask about blood in stool, black tarry stools or vomiting coffee grounds
What changes occur on the liver and kidneys?
Decreased breakdown and clearance of medications; decreased production of clotting factors and other blood proteins
What are the decreased breakdown and clearance of medications?
Decreased breakdown and clearance of medications; decreased production of clotting factors and other blood proteins- increased risk of drug toxicity and drug interactions; increased edema; decreased blood clotting. Always be suspicious of drug toxicity or interactions as a cause of altered mental status and other complaints with patients more prone to uncontrolled bleeding.
What are the changes in the endocrine system?
diminished thyroid function, and changes in insulin production?
What is diminished thyroid function?
decreased energy metabolism, problems with temperature regulation. Patients are more prone to both heat and cold related emergencies, even in relatively mild temperatures indoor or outdoordecreased energy metabolism, problems with temperature regulation. Patients are more prone to both heat and cold related emergencies, even in relatively mild temperatures indoor or outdoor
What is the pancras, or changes in insulin production or functions?
changes in insulin production or functions- more prone to type 2 diabetes and hyperglycemia. Consider diabetic emergencies as a cause of altered mental status
What are changes in the musculoskeletal system?
Decreased muscle mass and strength and Decreased bone mass and strength;
What are decreased muscle mass and strength?
arthritis- weakness, more prone to falls, unable to get up from falls, decreased mobility; patients may be less able to care for self. Assess for injuries from falls and immobility leading to decubitus ulcers (bedsores) and increased risk for pulmonary embolism
What are decreased bone mass and strength?
especially a problem in females- fractures may occur with minimal force and sometimes with little pain. Handle patients gently; assess for fractures after apparently minor mechanism of injury placing more padding because of strange looking structures
What are changes in the nervous system?
Decreased pain sensation, Decreased reaction and cognitive processing times, Increased risk of dementia, Increased risk of depression and sleep disorders
What are decreased pain sensation?
patients may sustain injury, such as hot water burns, without realizing it; patients may experience diffuse or vague pain, even with serious illness. Take all complaints of pain seriously and realize that conditions such as myocardial infarction may not have typical pain pattern sin elderly patient sor may not result in a complaint of pain at all
what are decreased reaction and cognitive processing times?
less able to avoid injury so assess for injuries allowing time for patient to follow instructions
What are the risks of dementia?
patients may be prone to injury, wandering away, being take advantage of, or abused; patients may neglect themselves. Carefully assess the patient’s degree of orientation, and be aware of signs of neglect and abuse
what are the risk of depression and sleep disorders?
may attempt suicide or neglect self; elderly with sleep disorders are more likely to be physically abused but don’t rule out medication overdoses or other types of self-harm in the elderly
What is integumentary system changes?
The skin becomes thin, dry, and fragile; nails become weak and brittle; hair becomes dry and more sparse- making it easily bruised and torn. Assess for using sof injury even with minor trauma nad handle them carefully.
What are some tips to communicate with the elderly?
ask how they felt this week versus last. Ask patient first and bystanders if not getting good info from, use title speak on same level, so they can hear you and speak loud. Acknowledge person’s fears reassure caregiver and loved one. Lock up house, care of pets, if true that most patients do well and return home hand on forearm talk about what done over course of lifetime
What changes to they have with their eyes?
Decreased vision, including poor night vision, peripheral vision, and farsightedness; possible blindness- from cataracts, glaucoma, and retinal degeneration meaning there is an increased risk for falls and other injuries, difficulty reading medication directions and signing consent forms. Position in front adjust lighting to reduce glare, find glasses, and help walking
What are their changes in hearing?
Decreased hearing, especially for higher-pitched sounds- shrinkage of structures in ear (lead to dizziness or difficulty with balance0 leading to difficulty hearing other. If television or radio it too loud turn down and speak clearly assisting with hearing aids if necessary
What are the changes in speech?
stroke, poor-fitting dentures, patient may become frustrated if cannot make themselves understood. Ask to put in dentures or ask to write
What do you do for scene size up for elderly?
is it well kept, what is the temperature, find out normal mental status if no life threats give time to talk asking one question at time. In physical exam explain what going to do before doing it replace clothing you remove as soon as possible with varying thresholds of pain
What are the scene size up for elderly with airway?
May be difficult to extend head and flex neck of older patient because of arthritis don’t force head back but pull jaw forward. If insecure dentures remove otherwise keep
What are the scene size up for elderly with breathing?
high risk of foreign body obstruction, poor chewed food and denture. If unable to ventilate reposition head and try again
What are the scene size up for elderly with circulation?
radial pulse is often irregularly irregular no cycle from dysrhythmia
What are the scene size up for elderly with priority?
not severe symptoms, keeping high index of suspicion. May not have normal pupils from surgery and systole is unusually high. Have patient take a few deep breaths if gets rid of cackles and may not have abdominal pain so be throughout in exam. Check for edema and fractures of wrist, humerus, and hip are common as well as spine in accidents and may not fit on backboard. They diminish slowly so really compar.
What are some problems that the elderly face?
Medications can look alike or easily mix. Ibuprofen and naproxen taken for arthritis lead to internal bleeding and GI problems. Drugs interact with each other, drug patient interactions
What is shortness of breath?
most likely caused by MI or from emphysema nad pulmonary edema
What is chest pain?
angina, MI, pneumonia, and aortic aneurysm
What are the mental status changes to the elderly?
drugs can have sedating effects, hypoglycemia, stroke, sepsis, hypothermia. Mood speech and activity for depression and suicide
What are the cases of pneumonia in the elderly?
fever and cough with sputum cannot cough effectively and immune systems cannot combat disease-causing organisms hypoxia lead to altered mental status
What are the cases of aortic aneurysm in the elderly?
causes abdominal pain in elderly when they feel abdominal it is bad tearing nature found between shoulder blades excruciating and accompanied by severe shock
What are the bowel obstruction or blockage in the elderly?
severe abdominal pain requiring surgery. Or diverticulitis in sac intestine food lodges causing inflammation and infection. Ask about blood in stools or vomit or coffee stool
What are the dizziness upon standing mean?
internal bleeding
What are the weaknesses?
cardiac dysrhythmias
What are shingles?
pain on one side of body over dermatome, with one of nerves small rash with blisters over red skin appears as belt-like on toso from back to chest or anywhere on body. Blisters dry out and scab over healing for a few more weeks. Headache, sensitivity to light, flu like symptoms like abdominal pain, diarrhea, chills, and fever
What are falls indicative of?
Falls are indicative of more serious problem like abnormal heart rhythms, stroke or internal bleeding from ulcer
What is a hazard?
torn or slippery rugs, chairs without armrests, chair with low back, chairs with wheels or castors, temperature too high or low, how water temp it too high, bathtub or slippery shower, stairs without handrails
What is physical abuse in the elderly?
pushing, shoving, hitting, sexual abuse, or shaking an older person
What is physical neglect?
improper feeding, poor hygiene, or inadequate medical care
What is psychological abuse?
threats, insults, or ignoring an older person
What is financial abuse and neglect?
exploitation or misuse of their belongings or money
What is pediatric?
of or pertaining to patient who has yet to reach puberty. Let kid sit in parent’s lap. If child doesn’t want to be around parent look for possible signs of abuse.
How are age ranges separated?
newborns and infants- birth to one year. Child: one year to puberty. Preschool: 3-5 years. School age: 6-12 years. adolescent : 13-18 years
What are fontanelles?
soft spots on an infant’s scalp formed by the joining of not-yet-fused bones of the skull. Front and back one back closes around four months, front can be open for 14-16 months can tell dehydration and if bulging intracranial pressure and crying heavily
What is retraction?
pulling in of the skin and soft tissue between the ribs when breathing. This is typically a sign of respiratory distress in children. Signs of a change from visible to reduced effort suggests the necessary for significant intervention
What is the head of a pediatric patient like?
is proportionally larger and heavier than an adult’s until age four, falling headfirst always expect head injury whenever serious mechanism of injury
What is the airway of a pediatric patient like?
infant and child neck muscles are immature, airway structures shorter and narrower, less rigid
What is the mouth and nose of a pediatric patient like?
are smaller more easily obstructed
What is the breathing of a pediatric patient like?
through nose in Newborns and infants/ anything out of the normal rang eis inadequate
What is the tongue of a pediatric patient like?
takes up more space in mouth
What is the trachea of a pediatric patient like?
softer and more flexible. Narrower and easily obstructed by swelling and foreign objects
What is the chest wall of a pediatric patient like?
softer, depend on diaphragms in newborns, infants, and children. Less developed and more elastic making labored or distressed breathing having intercostal retractions to
What is the thorax of a pediatric patient like?
shorter, and adjacent to full abdominal cavity, distention in child can create virtual obstruction to downward movement of diaphragm can’t increase lung capacities using abdomen to breath
What is the ribs of a pediatric patient like??
neonatal boxlike limiting deeper breathing when necessary.
What is the compensations for children of a pediatric patient like?
suction nose first, hyperextension or flexion of neck may result in obstruction, so fold towel under shoulders to keep airway in line. Don’t do finger sweeps on children
What is the abdomen of a pediatric patient like??
less protected in patients, organs exposed not protecting by ribs taking up more of chest and abdomen. Less developed chest muscles and more flexible bones making abdominal more susceptible to injury, force of trauma often transferred throughout entire abdomen
What is the body surface of a pediatric patient like?
childs area is large compared to body, making more prone to heat loss. Keep covered and warm, extent of burn is different
What is the blood volume of a pediatric patient like?
blood volume is less than blood. Infant having less than soda can, school age children fill up 2-liter bottle, adult fill up 2 liter bottle
What is the psychosocial of a pediatric patient like?
crying is normal and lack of crying upon your arrival is an altered mental status, eye level
What are the Characteristics of newborns and infants?
birth to 1 year newborns have minimal stranger anxiety and do not mind being separated from parents, older infants fear separation. Infants used to being undressed but like to feel warm, physically and emotionally. Younger infant follows movement with eyes. Older infants is more active and developing personality. Infants do not want to be “suffocated” by an oxygen mask
How do you care for newborns and infants?
have parent hold infant while examining. Keep warm, warm hands and stethoscope, keep infant warm and child covered during cool or cold weather. May be best to observe breathing from distance, noting patient’s work of breathing, level of activity, and skin color. Examine heart and lungs first and head last. This is perceived as less threatening to infant and less likely to start crying. Pediatric non rebreather mask may be held near face to provide “blow-by-blow” oxygen.
What are the Characteristics of toddlers?
1-3 years toddlers do not like to be touched by strangers or separated from parents. Toddlers may be believed that their illness is a punishment for being bad. Unlike infants, they do not like having their clothing removed. They frighten easily, overreact, and have a fear of needles and pain. Toddlers may understand more than they communicate. They begin to assert their independence. They do not want to be “suffocated” by an oxygen mask. Toddlers do not like to be restrained
How do you care for toddlers?
when appropriate, have a parent hold child while examining. Assure child that was not bad, remove an article of clothing examine area repace clothing. Respecting child’s modesty. Examine in a trunk-to-head approach to build confidence (touching head may be frightening). Explain what you are going to do in terms of toddler can understand. Assert control over situation, but give the toddler the opportunity to make some decisions. Restrain only when necessary and restrain well when indicated
What are the Characteristics of preschoolers?
3-5 years. Do not like to be touched by strangers or separated from their parents. They are modest and do not like their clothing removed. Preschoolers may believe that their illness is a punishment for being bad. They have a fear of blood, pain, and permanent injury. They are curious, communicative, and can be cooperative. They do not want to be “suffocated” by an oxygen mask
How do you care for preschoolers?
when appropriate, have a parent hold the child while examining. Respect child’s modesty, remove article of clothing examining area, then replace it. Have a calm, confident, reassuring, respectful manner so beware teasing a child children do not understand sarcasm
What are the Characteristics of school age?
6-12 years: age group cooperates but likes opinions heard. They fear blood, pain, disfigurement, and permanent injury. School-age children are modest and do not like their bodies exposed
How do you care for school age children?
allow simple decision-making. Allow child responsibility of giving history. Explain as you examine. Present a confident, calm, and respectful manner. Respect child’s modesty
What are the Characteristics of adolescents?
adolescents want to be treated as adults. Feel that they are indestructible but may have fears of permanent injury and disfigurement. Adolescents vary in their emotional physical development and may not be comfortable with their changing bodies. Adolescents are influenced highly by their peers and intimiadted by authority administrators or parent having conversations away from anyone who might ehar conversation often embarassed or worried or may act out. depression and suicide common, independent, hide medication, time for puberty distracting patient.
How do you care for adolescent
13-18 years- although they wish to be treated as adults, they may need as much support as children. Present a confident, calm, and respectful manner. Be sure to explain what you are doing. Respect modesty may consider assessing adolescents away form their parents. Have physical exam done by an EMT of same sex as patient if possible. Avoid causing embarrassment in groups. Be sensitive to adolescents dignity
What are the difficulties we face when dealing with childreN?
condition of sick and traumatized children can change rapidly, sometimes signs and symptoms in children are subtle and will be missed without close observation, child’s inability to fully understand what you are doing and why make them less compliant and capable of articulating what they are feeling. Talk with them simply asking yes or no questions go from trunk to head assessment
What is PAT?
Pediatric assessment triangle. categorize assessment across room. Appearance (mental status alertness verbal response acting appropriately muscle tone or interactivity consolably look gaze speech or cry appropriate), work of breathing (abnormal airway/breathing sounds, abnormal position, retractions and flaring), and circulation to skin (check pulse, subtle cyanosis and cap refill).
How do children interact with the environment?
normal behavior moves around, plays, is attentive, establishes eye contact, and interacts with parents sick child may be silent, listless, or unconscious not paying attention to you, limp.
What is circulation like in children?
check carotid pulse in chiild, and brachial or femoral pulse in infant. Five years or younger check cap refill, nails top of hand or foot and turn whit
When is a child a priority patient?
gives poor general impression, unresponsive or listless, doesnt recognize parent or pimary caregiver, not comforted when held by parent and becomes calm and quiet when set down, compromised airway, resportaory arrest or inadequate brething or distress, possibility of shock, uncontroled bleeding or significant blood loss
What are the kinds of emergencies you see in neonates?
neonate birth to 30 days respiratory compromise with bad airways hyper extending or flexing it is dangerous. Usually parents worried such as acid reflux, agitation, toddlers with school age respiratory viral,
What are some common problems with infants?
Infants conditioned with acid reflux from nursing babies and mom has eaten something irritating infant with areas like sphincter and esophagus areas can be very irritated very easily. Don’t eat any cabbage, broccoli, cauliflower, tomato, peppers. but Nursing babies have better immune system from week-10 days and obligatory nose breathers.
Infants with formula rejecting formulas they dont like and ones that they do, suction nose first and crying allows them to breathe out of their mouth
fracture easier, bones bend easier so can have organ damage without bones, force great enough for some kind of break half breaking and pops up and splits than break right through. Equipment won’t always fit spinal injuries can’t always hold up own heads so stabilization is important using blow by blow oxygen. Are the diapers wet with urine. Don’t give child aspirin, acetaminophen quicker antipyretic, bring fever down. Ibuprofen address achiness associated with fever.
0-5 months- easier to be removed from parents
6-12- relate to parents and form to parents and certain language that is not verbal and can sit up and rawl.
What is SIDS?
SIDS: 6 out of 30 years. No lividity stone cold or rigor stiff going to work the infant may have you work child. Boys more than girls, winter more than summer, children under 21 and over 40, first-born, 8 mos. mom who smokes during pregnancy or smoke, homes heated with pellets wood-stoves, doing best i can can do x,y,z above what i did. Some have apnec death before and on monitor.
What are some common injuries with preschooler?
Preschool: 3-5 years similar to infants but lesser degree, airway not as large as infant, head not as big, mastering talking. Trauma is a common call, electrocution, biggest age-group that is abused with. Going to preschool so going to get more sick, tricycle down stairs
Expect to see bruising on areas with hard surface, forehead, shin-bones knees. In soft squishy areas, face, butts, and thighs taking greater amount of force.
What are some common injuries with school age children?
School age- dependent on approval from peers, and more independent from parents let them voice their opinions cooperative but like to talk. Fear blood pain disfigurement and permanent injury so keep explaining before you do it. Keeping them modest. Can better explain what they are feeling talk with you modestly may feel as punishment and be scared of you as looking like police, regress socially and emotionally in distress adolescence and early adults. Include parents, teachers, and care providers which will make them feel better. Hold childs hands, smile, look at their eyes. Ask if they understand, and never lie. be aware that they take things literally.
⅛ kids are diabetic
What is circulation assessment like in children?
check carotid pulse in child and brachial or femoral pulse in an infant, radial pulse in child and brachial pulse in infant. in infants and children five years old or younger check capillary refill
What do you do when examining a child?
give them a toy showing them what you are going to do and where calming child and parent and let them have the toy protect child from stares of onlookers and 5-8 are modest especially checking head as injuries produce soft spots and especially neck because of the heavy head causing more injureis being sore stiff or swollen and bones may not be broken (bend, splinter, and buckle) for spinal injury keeping infants head in neutral positiona nd child’shead in neutral plus sniffling with chin thrust forward and towel under shoulders. Check stomach for swelling indicating swallowed air, check genitals for bruising swelling or tenderness spleen and liver more susceptible. Keep your hand on childs thorax for whole ride to see any changes.
What do you do when treating a child?
give them a few extra breaths after suctioning because they ned oxygen more causing cardiac arrest more quickly and OPA and NPA are much more important having tip of them point down when inserting. When choking severe- 5 back blows 5 chest thruts children older than a year do heimlich
What is blow-by-blow oxygen?
oxygen passes over childrens face and is inhaled or put tubing in a paper cup no styrofoam. Use ventilations every 3-5 seconds up till puberty dible this in neonates/ FROPV not for infant and children
What are the causes of shock in children?
iarrhea and/or vomiting with resulting dehydration, infection, trauma (abdominal injuries), blood loss; allergic reactions, poisoning and cardiac events.
What is hypothermia?
wet clothes, hypoglycemi, brain disorders, severe infection, and shock, dont expose in cold
What do you not do when checking in a child’s airway/
Dont put tongue depressor in chiilds mouth to find foreign object can lead to spasms
What are the symptoms of shock in children?
apathy or lack of vitality, altered mental status; pale, cool, clammy skin; absence of tears when cryng, falling blood pressure, rapid respiratory rate, rapid or wek and thready pulse, falling blood pressure, and deayed cap refill
What is croup?
caused by group of viral illnesses resulting in infallamtion of larynx, trachea, and bronchi around 6 months-4 years of age at night follows a cold or other inffection with tissues becoming swollensymptoms are mild fever, horseness at night child will have seal bark cough, difficulty breathing, respiratory distrress nasal flaring retraction of inner muscles, restlessness, and cyanosis.
What is epiglottis?
bacterial infection swelling of epiglottis and partial airway obstruction especially in childrne unvaccinated any child with stridor may have it. Sudden onset of high fever, painful swallowing (drool to avoid_, tripod sitting still and more ill. Dont place anything in tongue as may set off spasms obstructing it
what is a fever?
ccompanies chicken pox, mononucleosis, pneumonia, epiglottitis, adn meningitis from heat exposure infection or disease. With a rash is worst and is common with seizues. Take clothing off cover child in cold towel fluid and cold ice
What occurs in aspirin poisoning?
hyperventilaiton or hypoventilation, vomiting and sweating skin feel hot causing seziures coma or shock
What occurs in acetaminophen poisoning?
restless (early) or drowsy with nausea vomitng and heavy perspiration with oss of consciousness
What is lead poisoning?
ingesitng chips chronic look for nausea with abdominal pain and vomitng, muscle cramps, headache, muscle weakness, and irritability
what is iron poisoning?
ferrous sulfate in tablets and liquids. 1g can be lethal withing 30 minutes to several hours with nausea blood vomiting and diarhea and shock delayed as gets better
What is petroleum product poisoning?
vomiting with coughing or choking can smell odor of gas kerosene or heating fuel.
What is a head injury?
commonly results in respiraotry arrest
What is child abuse?
slap marks, bruises, abrasions, lacerations, and incisions of all sizes and with shapes matching items wide welts from belts looped shape form cord or shape oof hand. Swollen limbs, split lips, black eyes and loose or broken teeth most commonly to back, legs and arms have multiple fractures in various stage so fhealing. Head injuries concussions and skull fractures closed head injurieswhen shaken. Abdominal ruptured spleens, livers, and lungs avulsed genetalia and internal bleeding from blunt trauma. Burns in creases behind knees and thoughts protected when flexed
What do you look for in a child that is abused?q
repeated responses for same child, past injuries back and butt, poor healing wounds or healed fractures no bumps knots at healed injury site is bad, past burns or fresh bilateral children dont do it twices, if parent says child falls a lot, fear from child on hos it occured no reaction to pain and no comfort from parents, doesnt wish to leave you alone with conflicitng or changing stories overwhelming with explanations of cuases. Inapropriately unconcerned, trouble contorllinganger, explosion drugs and alcohol or abuse
What do you look for in sexual abuse children?
burns or wounds to genitalia, brusinging lacerations or unexplained bloody discharge, seminal fluid or other discharges, may tell you. Hold back accusation
What is meningitis?
high fever, stiff neck, lethargy, irritability, headache, sensitivity to light, bulging fontanelles, painful movements doesnt want to be touched or helf, seizures, rash
What are seizures?
epilepsy, infections poisoning, hypoglycemia, trauma, hypoxia
What are the complications with tracheostomy tubes?
obstruction, bleeding from tube or around tube, air leaking around tube, infection, dislodged tube so suction tube as needed
What are the complications with IV lines?
infection, bleeding, clotting- off of line, cracked line so apply pressure where needed
