Children ATI Flashcards
What kind of precautions to take with measles ? (Rubeola)
How long?
When it can be transferred ?
Airborne
Through out duration
4 days before to 5 days after rash
N95 mask, client wears surgical mask when transported, w/ neg airflow room
How long for Tb / varicella
Tb , reservoir (resp secretions) , varicella
Until 3 negative cultures - Tb
Until lesions crust over- varicella
Point of maximal impulse on an infant
Apical - lower left side 4th intercostal
S/s of rubeola /measles
Fever, conjunctivitis, cough, runny nose, red eyes, sore throat, rash, tiny white spots, reddish brown rash on face
Motor skills of a six month old
Rolls from back to stomach
Can hold a bottle
First teeth usually develop
Separation anxiety begins
Fear of strangers begin
Back fontanel closes by 6-8m
Average wt of a 6m infant is 16lbs
Growth spurt after 6m
Immunizations at six months
Dtap, IPV, PCV, hib , RV, HIB, hepB
Immunizations at birth
Hep b
Immunizations at two months
DTap , RV, IPV , Hib, pcv, hepB
Immunizations at four months
DTap, rv, IPV, hib, pcv
Breastfeeding provides a complete diet for infants till how old?
First 6 months
When are solid foods introduced?
4-6 months
What indicates sexual abuse
STD
UTI
Bruises on genitals
Hard to walk
Regressive behavior
Withdrawal
Personality changes
Blood or torn underwear
Unusual body odor
Higher risk of sexual abuse if?
Multiple injuries at diff stages of healing
Young parents ,
Partner not related to child
Low income
Lack of education
Substance abuse
Hx of abuse
No support systems
Child is one year old or younger / female
Premature infants
Divorce
Stressed/ unemployed
Crowded housing conditions
Higher risk for suicide if?
Female 20-30s
Psychiatric Illness/mood disorder
Uses barbiturates
Divorced or widowed
Doctors , lawyers, law enforcement , dentists
Due to Burn out, stress, guilt
Sexual or physical abuse
Adverse side effects of SSRIs
Serotonin syndrome, neuroleptic malignant syndrom, suicidal thoughts
Cervical traction for fractures
Bars and circle the Head, provider inside screws into the child outter skull
Wrench to release rods Incase cpr is needed
Move as a unit
Inspect pins regularly
Monitor integrity of skin below vest
Use stool softeners
Hydrate
Watch for infection
No powder under vest
Notify social services is suspected abuse
Neurovascular checks
Orthopedic specialist with fracture care in children
Care of children with heart failure
Give fluids, (2L) potassium , electrolytes
Feed q 3 hours
Increase calories/formula
Encourage moms who are breast feeding to alternate feedings w density formula
Decrease sodium to 2k mg /day or less
Increase protein
Small frequent meals and easy to chew foods
High potassium foods
Take daily WT
High potassium foods
Bran cereals , potatoes , tomato’s , bananas , melons , oj
B12 iron deficiency anemia -
Who is at risk ?
What foods to eat?
What vitamin helps absorb iron ?
Alcohol use, malabsorption syndrome, gastrectomy, improper iron intake
Meat,Fish, tofu, peas, beans, whole grains, dried fruit, cereal, formula
Vitamin C
What is the leading cause of accidental poisoning in small children ?
Iron overdose
Nasogastric intubation and external feeding s
NI- Removal of gases/stomach contents to relieve distention, nausea, vomiting
Lavage-Washing out the stomach treats bleeding, ingestion, poison, gastric dilation
Compression - Internal balloon to apply pressure to prevent hemorrhage
If client vomits - clear airway, comfort , and confirm placement with x Ray
External feedings-
Can not consume food orally
For meeting specific nutrition needs
Aspirate for residual volume
Flush 30mL tap water
Beta 2 adrenergic agonist?
Side effects of albuterol?
Ipratropen?
Teachings ?
SABA - used for acute exacerbations
Tremors , tachycardia
Dry mouth
Suck on candy to help dry mouth , take before exercise or activity,
Giving rectal meds
Insert beyond rectal sphincters
Hold buttocks together for 5-10 min after
Half lengthwise
Atraumatic care (quickly and use distraction)
Insulin pumps with regular insulin ?
Short acting insulin (regular insulin) onset
Gives specific amount of insulin on regular basis
30 minutes
Levothroxine teaching?
Increases metabolic rate , protein synthesis ,cardiac output, renal profusion , oxygen use, body temperature, blood volume , growth process
Can Result in hyperthyroidism, a fib, fractures, bone loss
Monitor TSH levels
Do not take after MI or heart problems
Do not use with and I also removed, calcium and iron supplements
It can break down vit k
Report signs of bleeding or bruising
Full effect takes 6 to 8 weeks
Take 30 to 60 minutes before breakfast
Two finals, monitor signs and symptoms of heart problems
Serum sodium in a child-
130-150 meq
First signs of dehydration are
Increase thirst
Dry mucus membrane
Capillary refill is greater than 2 seconds
Weight loss 3-5%
Specific gravity
PH
- 005-1.025
4. 6-8
Priority with open fracture- (compound )
Abcs , vitals, pain , neurological status , neurovascular status, supine position , remove jewelry , monitor urine , elevate limb, apply ice , proper alignment , rom , keep warm , alelgesics radiograph
What to check/report with fracture
Neurovascular-Numbness/ tingling
Warm not cool skin temp
Skin color distal to injury pigmentation
Cap refill with in 3 seconds
Pulse -Equal to unaffected side / strong
Before casting- observe skin area , clean, dry, pad bony prominences
Pain not relieved by medication or increased pain
Compartment syndrome signs
Infection , fever ,redness, inflammation
Infant with heart failure
Keep warm,
decrease activity,
frequent feedings and small meals q 3 hours for 30 min at a time ,
increase calories
Cool humidified O2
Mask nasal cannula
Suction as needed
Monitor O2 q 2-4 hours
Hyperthermia interventions
Cultures
Asses wbc , hematology test, electrolytes
Fluids
Rest
Minimize activity , cooking blanket
Antibiotics / antipyretics
Decrease shivering (blankets during chills)
Oral hygiene
Dry clothing/linens
Room temp at 70-80
Tonsillectomy interventions
Opioids / pain meds
Antibiotics
Place in position to help drainage
Elevate HOB
Check for bleeding (frequent swallowing, clearing throat, increase pulse, bright red, breathing/airway)
Ice collar
Sips of water
Encourage clear liquids after gag reflex comes back
Avoid red colored juice or milk based foods
Priority intervention for RSV? (Cold like symptoms rhinitis)
What to give?
What it can lead to?
First Maintain a clear airway and promote oxygen
Check lung sounds
Suction mouth and nose
Give fluids and pain reliever for fever and headache
Can lead to pneumonia and severe breathing problems in babies
Priority Finding for head trauma for a child
Personality changes
Lethargy
Irritability / agitation
Combative
Confusion
Vomiting
Seizures
Loss of consciousness
Increase liver enzymes and serum ammonia level
Coagulation times extended
Blurred vision, increased sleep , inability to follow simple commands , decrease in school work,
Buldging frontenal , high pitched cry , separation of cranial , poor feeding , sun setting sign , dissented scalp veins
Asthma interventions
Asses airway , resp rate, vitals, CBC , chest x Ray , ABGs , O2, Lung sounds , vaccinations , Saba - monitor for wt changes
Varicella zoster teaching?
Hand hygiene
Cover nose and mouth when coughing
Change and wash linens daily
If immunocompromised seek prompt medical care
Participate in decisions
Fever, fatigue , decrease in appetite , headache and rash that starts in center of trunk
Rsv expected finding
Fever Cough Increased breathing Wheezing Rales (cracking in lungs ) Runny nose (rhinitis)? Decrease appetite Sneezing Irritability Decreased activity Hard to breath
Nephrotic syndrome - actions
Rest Monitor I and o Weigh diapers Monitor urine for protein Vitals WT Monitor edema Abdominal girth daily Pitting color Texture of skin Cough Infection Deep breathe Hand hygiene Antibiotic therapy Salt restrictions Repo often Keep skin dry Elevate body parts
Presidone -
Take with meals Don’t stop suddenly Dont stop suddenly Eat foods high in potassium Monitor serum electrolytes and I and o Keep away from potential infection
Recommendations for acute diarrhea
Oral rehydration Inform school Stay home Skin care Avoid spread Change bed linens and underwear daily Clean toys and areas Shower often Avoid undercooked food Hand hygiene No sharing utensils Clip nails Thumb sucking no Avoid fruit juices , carb sodas , gelatin , caffeine , broth, banana , rice, applesauce, toast (brat) Monitor voids - give water, breast milk, lactose free formula Monitor i&O and WT daily Avoid rectal temp IV fluids Rotavirus immunization for - prevention Avoid antibiotics
Set Water temp to what?
120 degrees
How long to keep infants in back seat rear facing in car seat?
Until two years old or height recommended by manufacturer
9 month old
Standing position Crawls Dominant hand evident Knows object still exists when out of site Knows word no Obeys simple commands Seasonal flu vaccination
3 month old
Raises head and shoulders off mattress with slight head lag
No more grasp reflex
Coping noises
Interest in environment
Turns head to sounds of rattle
Consenents ate added
Nocturnal sleep pattern
When does operational stage take place ?
Age 7-11 years old
Concept of conversation
Conventional academic learning what age?
5-6 years old
Able to see perspective of others
problem solve
Two year old care
Low fat milk
Finger foods
Regular meal times
Avoid desserts
Avoid grapes , nuts, hot dogs
Bite size foods
11-12 hours sleep
Immunization at birth
Hep b
2 month , 4, 6 month immunization
HepB Rota virus DTap Hib Polio (IPV) Pcv13
When To give influenza vaccine
6m- yearly
10 year old vaccine
Tdap
12 year old vaccine
MMR
Varicella
HepA
11 year old vaccine
HPV
Meningococcal conjugate
DTap side effects
Hib side effects
Rv-
IPV
Mmr
Hep b
HPV
Fever of 105 or higher , seizures
Redness swelling temp of 101.0
Diarrhea vomiting
Tenderness
Local reaction , rash fever swollen neck , brain damage deaf
Varicella- seizures , pneumonia, decrease blood count , brain reactions
HepB - guillain barre syndrome
HPV- fainting
SIDS risk
Smoking Side sleeping or prone Premature Fam hx Poverty low apgar Overheating No pacifier No immunizations up to date
UTI sign
Jaundice Swelling in face Increase pulse Diaper rash Seizure
Limit cholesterol to what
300 mg - 200 a day
Bone marrow biopsy is performed with what
Local anesthetics
Hematologic disorder signs
Bleeding gums are blood in stool, brittle spoon shaped fingernails, muscle weakness, heart murmur, tarry stool’s, anemia, pain, short of breath, and Pale mucous membranes, jaundice, cool to touch hands and feet, dizzy, headache
Sins of heart failure
Sweating, tachycardia, fatigue, pale, cool, week pulses, hypertension
A1c
6.5-8 is ok in children
