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Peds > Exam 1 > Flashcards

Exam 1 Flashcards

1
Q

leading cause of death in children

A

unintentional injury

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2
Q

highest # of ED visits related to?

A

resp disorders

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3
Q

3 components of health supervision

A

developmental surveillance and screening (percentile curves, could be developmental or home problem)
injury and disease prevention
health promotion

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4
Q

injury and disease prevention

A

lead and iron deficiency screening at 1-2 years old
HTN screening at 3
eye issues early to prevent blindness

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5
Q

how much cows milk a day

A

16 oz bc anemia and no appetite

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6
Q

when to check for scoliosis

A

during rapid growth
females 2 years after period
males at 18

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7
Q

murmur in first 24h of life

A

normal

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8
Q

chickenpox complications

A

infected blisters, bleeding disorders, encephalitis, PNA

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9
Q

diphtheria disease complications

A

swelling of heart muscle, HF, coma, paralysis and death

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10
Q

Hib disease complications***

A

meningitis, intellectual disability, epiglottitis, PNA, death

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11
Q

hep a disease complications

A

liver failure, arthralgia, kidney, pancreatic, and blood disorders

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12
Q

hep b disease complications

A

chronic liver infection, liver failure, liver cancer

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13
Q

flu disease complications

A

PNA

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14
Q

measles disease complications

A

encephalitis, PNA, death
wipes immune system for 2 years
kills baby in 24h
can die from flu and encephalopathy

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15
Q

pertussis disease complications***

A

PNA and death

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16
Q

polio disease complications

A

paralysis, death

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17
Q

pneumococcal disease complications***

A

bacteremia, meningitis, death

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18
Q

rotavirus disease complications

A

severe diarrhea, dehydration

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19
Q

rubella disease complications

A

serious in pregnant women

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20
Q

tetanus disease complications

A

broken bones, breathing difficulty, death

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21
Q

important shots for meningitis

A

Hib (prevents epiglottis)
pneumococcal

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22
Q

pertussis

A

must be treated in 2 weeks
vaccinated again if you get it
paralyzes cilia
kills baby, not child

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23
Q

DTaP vaccine SE

A

Sore

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24
Q

live vaccines

A

varicella and MMR
no other vaccines for 28 days

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25
Q

motrin

A

don’t give until 6 months
better than tylenol
lasts longer and anti-inflammatory

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26
Q

aspirin in kids

A

NO, REYES!

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27
Q

immediate action for what kind of vomit

A

bilious (green/yellow) or bloody

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28
Q

dehydration causes

A

Highly susceptible to diarrhea illnesses
Higher metabolic rate
Inability to communicate their needs or self-hydrate
Increased insensible water loss
Decreased intake
Increased output
Altered GI function

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29
Q

decreased fluid intake causes

A

Financial, neuro (like diabetes or pituitary problem), febrile, discomfort, oral anomaly, tonsillitis, pharyngitis

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30
Q

increased output causes

A

Diarrhea, dumping, overfeeding, GERD, pyloric stenosis, hyperglycemia, gastroenteritis

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31
Q

altered GI function causes

A

Short bowel, malabsorption, cystic fibrosis

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32
Q

what to monitor for dehydration

A

Vital signs
Skin turgor
Fontanelle → sunken
I&O
Lab values

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33
Q

fontanelle

A

evaluate while sitting up
posterior closes by 2 months
anterior closes by 18 months

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34
Q

mental status in dehydration

A

alert
alert to listless
alert to comatose

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35
Q

fontanelles in dehydration

A

soft and flat
sunken
sunken

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36
Q

eyes in dehydration

A

normal
mildly sunken orbits
deeply sunken orbits

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37
Q

oral mucosa in dehydration

A

pink and moist
pale and slightly dry
dry

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38
Q

skin turgor in dehydration

A

elastic
decreased
tenting

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39
Q

heart rate in dehydration

A

normal
may be increased
increased, progressing to bradycardia

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40
Q

blood pressure in dehydration

A

normal
normal
normal, progressing to hypotension

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41
Q

extremities in dehydration

A

warm, pink, brisk, cap refill
delayed cap refill
cool, mottled, or dusky, significantly delayed cap refill

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42
Q

urine output in dehydration

A

may be slightly decreased
<1 ml/kg/hr
significantly <1 ml/kg/hr

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43
Q

Oral rehydration solution

A

pedialyte better than gatorade, used for mild-moderate rehydration

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44
Q

severe rehydration how do we rehydrate

A

lactated ringers

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45
Q

IV fluid intake rule

A

100-50-20 rule

46
Q

wet diaper rule

A

day 1: 1 wet diaper
day 2: 2 wet diapers
day 3: 3 wet diapers
day 4: 4 wet diapers
day 5: 6-8 wet diapers
progressively gets lighter

47
Q

how often to assess catheter output

A

hourly

48
Q

dyslexia

A

difficulty with reading, writing, and spelling

49
Q

dyscalculia

A

problems with mathematics and computation

50
Q

dyspraxia

A

problems with manual dexterity and coordination

51
Q

dyspraxia vs dysgraphia

A

idk

52
Q

ADHD

A

appetite suppression from meds
weigh every 3 months
eat a good breakfast before meds
insomnia so take meds in the morning

53
Q

FLACC scale scores

A

0 is relaxed and comfy
1-3 is mild discomfort
4-6 is moderate pain
7-10 is severe discomfort, pain, or both

54
Q

why is shushing good for babies

A

sounds like heartbeat in womb

55
Q

gate control

A

heat, cold, or massage to alleviate pain
switch after 15 minutes bc pain will always win

56
Q

ways to make infants happy

A

swaddling
shushing
sucking
touch
singing/music
light up toys
interesting sounds
peek-a-boo

57
Q

ways to make toddlers/preschool age happy

A

singing
blowing bubbles
puppet play
interactive books
music
movies
light up toys
looking at pictures

58
Q

ways to make school age happy

A

massage
deep breathing
tapping fingers
stress ball
focusing on a photo while counting
TV/video
alphabet challenge
telling a story
i-spy
humor
video games
playing a game
drawing
crafts
writing
puzzles

59
Q

ways to make adolescents happy

A

music
playing a game
VR
audio books
reading
diversional convos
self talk

60
Q

button batteries

A

burns all the way down, typically fatal
if over 1 year old, tablespoons of honey to coat
DO NOT drink water, throw up, or wait

61
Q

choking hazards

A

puffs if eaten with other things
toys that can fit through TP roll

62
Q

resp assessment

A

hard to clear airways due to size (more likely go get PNA)
assess color and effort (head bobbing and retraction are bad)
babies are nose breathers (suction before nasal cannula, maybe NS to thin secretions, mouth breathing is a bad sign)

63
Q

coughs for children and z-pak

A

don’t give z-pak! abx resistance
z-pak given for chlamydia and pertussis
Give for strep (the only time abx are given for sore throat) or ear infection IF child has fever

64
Q

what cough do we treat

A

croup

65
Q

parts of the mouth of a child

A

tongue is larger than rest of mouth
tonsils are also large, may grow into them
if coughing at night, could be postnasal drip, put pillows under and draw secretions
OXYGEN NEEDS AN ORDER

66
Q

nonrebreather for babies?

A

no

67
Q

strep

A

salt-water rinse for older (anti inflammatory)
petechiae!!!
may present w fever, stomach ache, vomiting, sandpaper rash, headache, and enlarged lymph nodes

68
Q

tonsillitis

A

seen in younger children, leads to kissing tonsils
usually viral
tonsillectomy is major bleeding risk, may cough and aspirate blood (call 911 if coughing blood)
don’t give red food after tonsillectomy so we can see if they throw up blood

69
Q

croup

A

seal cough
inflammation of vocal cords
only cough we treat (dexamethasone works for 3 days or prednisone, hyperglycemia)
seen from 3 months to 3 years
cold air, steam, and humidifier help
honey if child is > 1
dexamethasone messes up bloodwork bc long half life

70
Q

epiglottitis***

A

emergency!
DO NOT stick anything in mouth (be ready to intubate, can spasm and close)
Need hib vaccine, ask about status
AIR RAID

71
Q

AIR RAID

A

airway closed
increased pulse
restlessness
retractions
anxiety
inspiratory stridor
drooling

72
Q

bronchiolitis/RSV

A

no treatment, just symptomatic care (snot sucker and cannula)
faucet of clear mucus***
peaks day 6-10 (DRASTIC decline)
ALBUTEROL FOR WHEEZING
breastfeeding > bottle
small, frequent feeds
palivizumab
droplet/contact precautions
airway becomes obstructed, prevents full expiration, increased effort to breathe, makes them tired and dehydrated

73
Q

small bowel syndrome

A

nutrient malabsorption, excessive intestinal fluid, and electrolyte loss
less bowel=less absorption
diarrhea, dumping syndrome
malabsorption r/t how much small bowel gone, no ileocecal valve or color, and small bowel bacterial overgrowth

74
Q

ileum lost?

A

deficient B12 and bile salt malabsorption (BAD)

75
Q

how to manage short bowel syndrome

A

small, frequent feedings
burp the kid after every oz
goal is to minimize bacterial growth and get nutrition
abx
vit and mineral supplements
antidiarrheal and gastric suppressive meds
TPN (enteral is very slow)
may need intestine or liver transplant due to long-term TPN

76
Q

nursing management of short bowel syndrome

A

health history, diarrhea is primary symptom
history of bowel loss/resection
hydration status
inspect stool for color, consistency, odor, and volume
review labs (hydration and LFT)
encourage adequate nutrition
slow treatment, many enteral feedings leads to significant malabsorption
may need long-term IV access due to TPN (assess IV, fever and redness bad, sepsis)
administer enteral feedings very slowly to avoid malabsorption

77
Q

G-tubes for kids

A

long-term feeding tube
start with 24h continuous feed via pump
STRICT I&Os
assess stools closely
administer vitamins, minerals, anti-diarrheals, and abx
educate parents and use teach-back method

78
Q

pyloric stenosis

A

pyelitis is bottom of the stomach
After 4-6 weeks is when you know you have it
PROJECTILE VOMITING!!!! (3-6 weeks old)
small feeds initially but then food builds up causing the vomiting
palpate for hard, movable olive
needs to be surgically corrected

79
Q

intussusception

A

sausage shaped mass in upper abdomen
jelly stools
edema and bowel obstruction
in toddlers 1-2y old
flare and regress, can reduce on its own
sudden severe pain (screaming)
V/D, lethargy
celiac and CF are risk factors
barium enema or surgery

80
Q

jaundice in babies

A

starts at head and eyes, nipples require testing at nipple

81
Q

undiagnosed jaundice causes?

A

kernicterus (brain damage)
after 12-14 days

82
Q

health supervision does what

A

PREVENTS injury and illness

83
Q

if child does sumn concerning what do we do

A

Pass message to provider not parent

84
Q

passive immunity

A

short term 6 months
Breastmilk
Immunoglobulins

85
Q

active immunity

A

long term or lifetime
Immune memory
Acquired through vaccination or disease

86
Q

prevnar

A

pneumococcal vacc

87
Q

penticil

A

dtap, polio, hib

88
Q

sacral dimple what to do

A

open it up and make sure there’s no hole to the spine

89
Q

how long to do resp and cardiac assessment on child

A

full minute!

90
Q

SE of ACES

A

HTN
diabetes
inflammatory and autoimmune disorders

91
Q

3 types of ADHD

A

hyperactive-impulsive
inattentive
combined

92
Q

when do ADHD symptoms begin

A

age of 7 and they persist for 6 months+

93
Q

signs of ADHD

A

labile moods, frustration, emotional outbursts, peer rejection, poor school performance and poor self esteem
bad time management, organization, and ability to break project into small tasks
Forgetfulness
Risky behavior
Carelessness
Trouble getting along
Disorganization
Excessive talking
Daydreaming
Difficulties sitting still

94
Q

management of ADHD

A

Use of behavioral therapy and classroom restructuring
Medication management includes use of:
Psychostimulants
Non Stimulant norepinephrine reuptake inhibitors
alpha-agonist antihypertensive agents

95
Q

when are behaviors of autism noticed

A

infancy or between 12-36 months when child regresses

96
Q

management of ASD

A

reach optimal functioning
high structured educational environment
stimulants for hyperactivity, antipsychotics for repetitive and aggressive behaviors
some people use vitamins, herbs, music and art therapy, etc, not proven to be helpful

97
Q

nursing management of ASD

A

Extensive emotional support
Professional guidance
Education about the disorder
Help parents overcome barriers (education, developmental, and behavioral treatment programs)
Early intervention program under 3
IEP over 3 if enrolled in the public school system
rigid routines!

98
Q

QUESTT in pain assessment

A

question the child
use a valid pain scale
evaluate behavior to have baseline
secure parent’s involvement
take cause of pain into account
take action

99
Q

sinusitis in children

A

CHILDREN DON’T HAVE SINUSES! DON’T GIVE ABX

100
Q

percussion for resp assessment

A

flat or dull sounds over consolidated lung tissue (PNA)
tympany maybe with pneumothorax

101
Q

auscultation in children

A

Upper airway sounds are much louder - in children with thin chest walls be sure to listen to sounds over their trachea airway to differentiate between their lower airway sounds - you can mistake congestion and upper airway sounds for lower airway sounds

102
Q

oxygen for children

A

portable tank runs out fast on high flow, check each shift if they have a full tank
nasal cannula for infants and small children (humidify the air)
nonrebreather for older children
don’t give a lot of oxygen!

103
Q

RSV treatment

A

oxygen
ng suctioning with bulb syringe
hydration (small frequent)
bronchodilators
Hospitalization required in infants with tachypnea, significant retractions, poor oral intake, lethargy as they can deteriorate quickly requiring ventilatory support

104
Q

causes of short bowel

A

Necrotizing Enterocolitis (occurs in premature infant)
Small intestinal atresia
gastroschisis
malrotation with volvulus
trauma to small intestine

105
Q

GERD vs spitters

A

Real refluxers arch their back and scream and it’s bad but then they immediately wanna eat again bc acid hurts and they want to soothe that
Small frequent feedings
children will lose weight

106
Q

nursing management of intussusception

A

IV fluids and abx before lab and radiograph
emotional support
education
bilious vomiting=obstruction

107
Q

palivizumab (synagis)

A

ONLY for preterm babies
given once a month until 6 months old during RSV season (very expensive)
insurance doesn’t cover

108
Q

when to use FLACC vs N-PASS vs wong baker

A

flacc: for babies 2 months to 7 years who CAN’T express pain
N-PASS: 1 month to 36 months, newborns
wong baker: Ages 3+ who can understand the faces

109
Q

sickness in children

A

fever of 100.4 which is how we know immune system is working
increased pulse
sweating
dehydration

110
Q

how long does dtap work in passive immunity

A

6 weeks

111
Q

med administration

A

syringe is more precise
cups are aspiration risk for 3 and younger

112
Q

short bowel syndrome important thing to do

A

weight checks!

Peds (4 decks)

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