exam 1 pp slides & ati Flashcards
is a defect in the heart, great vessels, or persistence of fetal structure after birth
occurs in 4-10 children per 1000 live births
Congenital Heart Disease
after Tonsillectomy when you see frequent swallowing it is a sign of _______
bleeding
Moro reflex:
Disappears by ____ months
3-4 months
lasts 1-2 weeks including; irritability, high fever for more than 5 days, conjunctival hyperemia, red throat, swollen hands and feet, maculo-papular rash on trunk and perineal area, unilateral enlargement of lymph nodes, diarrhea and hepatic dysfunction
is what stage of Kawasaki Disease
Acute stage
reflex where:
Hold them in a semi-sitting position, allow head and trunk to fall backwards ~30 degrees
Newborn symmetrically abducts and extends arms
Fans fingers and forms a C with thumb and index finger
Then adducts the arms to an embrace
Then returns to normal
Moro reflex
Babinski Disappears at __ months
12 months
elevated ESR and antistreptolisin O titer (ASO)
are labs for
Rheumatic Fever
Puberty: average age for girl is __, average age for boy is ___
12
14
Newborn’s weight should be measured ___________
must be done naked for accuracy
With Preschool age children
Average weight=___ lbs at age 3
32 lbs
__ years: well developed gross motor; may ride bike with training wheels
5 years
_____ years: trial and error problem solving (this can lead to injury)
10-12 years
what are the two main allergies of concern for immunization
Neomycin or gelatin
Diagnosed using sweat chloride test.
sweat is 2-5 times the level of sodium and chloride
Cystic fibrosis
PIAGETS stage where
Exhibits egocentrism-inability to understand another’s position
Increasing language skills
Play becomes more socialized
No idea of conservation
Magical thinking
2-7 years: preoperational thinking
Contagious mite infection
Usually contracted by close body contact with infected individuals
The mite will burrow into the skin and deposit eggs.
Then eggs hatch over 30 days and travel to skin (incubation is 1-2 months)
Scabies
ERICKSON stage where
Need to form a sense of trust
Learn to love and be loved
Provide visual stim for active involvement
Infant: trust vs. mistrust (0-1yr)
normal respirations for Newborn to 1 year
30 to 60/min
Relates to pain physically
Is able to perceive of psychological pain
Fears bodily harm and annihilation
May view pain as punishment for wrongdoing
Meaning of Pain and Influence for what age group
7 to 10 years of age
prolonged bleeding
umbilical cord cut
vitamin k injection
circumcision
are all clinical manifestations of
Hemophilia
By __ years: dress and wash self, tie shoes
5 years
Plant leaf that has a poisonous oil causing a delay hypersensitivity response. Trauma to the leaves releases the sap
Poison Ivy
Interventions:
Use OTC medications and follow directions
After washing hair remove nits with fine tooth comb
Wash linens, hats, combs and anything that has come in contact with the head
Do not share clothing, hats towels, and hair care items
Pediculosis Lice
9.5-11 is ____ IDA
mild
Prepubescence Typically occurs during pre-adolescence, varying in ages from _____(girls usually about 2 years earlier than boys)
9-12
Chronic inflammatory lung disorder with airway obstruction that can be partially or completely reversed, also includes increased airway responsiveness to stimuli
Most common chronic disorder that affects children
Asthma
normal respirations for 2 to 6 years:
21 to 25/min
Vaculitis (inflammation) of the small vessels that affects children with the mean age of 6 years old.
Etiology unknown
Treatment is supportive care
Henoch-Schönlein Purpura (HSP)
Methylxanthines:
Theophylline po- very rarely used
are used for what?
Daily Control Medications for asthma
___+ years=can give consent
__+ years=can give consent for reproductive health only (IL)
18 years
13 years
normal respirations for 6 to 12 years:
19 to 21 /min
Size Shape Type Location Warmth Color
Distribution
Linear
circular
general
Dry or oozing
should all be considered when assessing
rash
with cyanotic Congenital Heart Disease If a VSD or ASD are present, the right sided pressure exceeds the left resulting in ____________
right to left shunt
Permanent teeth
Cognitive development
Prepubescence
are all common with what age group
school age
Coughing
Wheezing – expiratory that can become progressive to obstruction with no air movement heard
SOB
Tachypnea
Prolonged expiration
Flaring, retractions, head bobbing
Anxiety
Fatigue – increases with hypoxia
are all clinical manifesations of _______
Asthma Exacerbation
Crackles or rhonchi
Fever
Chest pain
Cough
are clinical manifestations of
Pneumonia
Palmar disappears at ____ months
Plantar disappears at __ months
3-4 months
8 months
By __ months, plays simple games (Peak-a-boo and So big) as well as show emotions (ie anger jealousy, fear, hugs, kisses)
12 months
Newborn’s Doubles birth weight by ____ months
5-6 months
for toilet training
Sphincter control: Retain urine: for at least \_\_ hours Bowel control: ~\_\_ months Day time control: ~ \_\_ years Night control: ~ \_\_ years Must be aware of the act of elimination
Sphincter control: ~ when able to walk Retain urine: for at least 2 hours Bowel control: ~30 months Day time control: ~ 2 years Night control: ~ 3-4 years Must be aware of the act of elimination
Corticosteroids:
Methylprednisolone, prednisone, prednisolone – oral/IV/IM
Important to finish dosing, will be weaned most likely
are used for what?
Rescue Medications for asthma
___ months: ~300 word vocabulary, verbalizes need for toileting, food and drink
24 months
Continued weight gain and growth
Improved gross and fine motor
Self care acts
Socialization
are all common with what age group
Preschool
Age __:may count correctly but poor mathematic number concept
Age 4
Assess stool for steatorrhea – excessive stool fat.
Assess for failure to thrive due to malabsorption
Often these children will have distended abdomens with thin extremities
Assess for appetite as they may have a large appetite, but their body is unable to absorb large amounts of food
Assess for rectal prolapse
are all assment techniques for ______
Cystic Fibrosis (GI system)
Varies based on degree of illness and respiratory distress.
Outpatient therapy (not in RD) is oral antibiotics (unless viral), rest, pain and fever treatment and follow up with instructions on when to seek immediate help
Inpatient therapy includes antibiotics IV, and supportive care
Oxygen, IV fluids, fever management, rest and monitoring
are all included in the treatment plan for
Pneumonia
what age should the inintial immunization of DTaP be adminsterd
2 months
should iron be administerd with or without food
empty stomach
By _____ years should be treated as an adult
15-16 years
one way to treat PDA and to get it to close is ____
NSAID
4 clinical manifestations of Acyanotic Congenital Heart Disease
Increased Pulmonary Blood Flow
increased HR
increased RR
increased metabolic rate
with toddlers is growth linear or step like
step like
what age should the inintial immunization of IPV be adminsterd
2 months
Almost no head lag at _ months (should be no head lag by _ months)
4, 5 months
By __ months: develop object permanence, can wave bye-bye
10 months
With Preschool age children
Height gain __ inches per year
3 inches
Tonic Neck (also called fencing reflex) disappers at what age?
Disappears at 3-4 months
Characterized by a bright red maculopapular rash in the diaper area
Causes can be:
clothing dye, laundry detergent, body soap, bubble bath, tight clothes, wool or rough clothing, and irritation from a soiled diaper
Contact Dermatitis:
Diaper Rash
Rhinitis Mild fever Malaise Anorexia for 2-3 days Barking cough and hoarseness Child may appear restless, anxious may have inspiratory stridor Retractions/Respiratory DistresS
are all clinical manifestations of
Croup
the PCV should be given __ times
5 times
2 months, 4 months, 6 months, 12-15 months, 2-6 years
Step-like growth Improved coordination Rapid expansion of sensory and language development Importance of play Sibling rivalry Temper tantrums Regressive behavior Toilet training
are traits of a __________
Toddler
ERICKSON stage where
Learns what kind of person they will be
Adjust to new body image (puberty-rapid physical changes)
Seek emancipation from parents
Experiments with different roles
Peer group very important
Provide for adolescent to discuss feelings
Adolescent: identity vs. role confusion (12-18yr)
ERICKSON stage where
Learns independence
Makes decisions for self
Offer simple choices
Praise decision making
Toddler: autonomy vs. shame (1-3yr)
For Bronchiolitis/RSV
Prophylaxis: _______ for ex-preemies or at risk infants
once a month IM injection during the season for passive immunity
Synagis
nausea, emesis, anorexia, abdominal pain, diarrhea, fatigue, drowsiness, muscle weakness.
are signs of
digoxin toxicity
normal respirations for 12 years and older:
16 to 19/min
what age should the inintial immunization of Hep A be adminsterd
12-23 months
with males
Facial and axillary hair ~ 2 years after pubic hair first appears (usually between ______ years old)
10-15 years
reflex where
Suspend in horizontal prone position and suddenly thrust downward
Hands and fingers extend forward
Parachute
ERICKSON stage where
Basic problem solving
Initiative-demonstrated when a child formulates and carries out a plan of action
Preschool: initiative vs. guilt (3-6yr)
HPV, Pertussis is what kind of vaccination
and can be administered
Recombinant vaccine:
IM
Newborn’s Starts with responding to stimuli, smiles around __ months
2 months
____ months: runs clumsily, walks up stairs holding hands, builds a tower of 3-4 cubes
18 months
the rotavirus should be given __ times
3 times
2 months, 4 months, 6 months
___________ in a child causes bradycardia that will lead to cardiac arrest if not reversed.
Hypoxia
what age should the inintial immunization of influenza be adminsterd
between 6 months - 6 years
infection with fungus
can be in hair, trunk, groin, foot areas
treated with antifungal
tinea
Anorexia Anemic Constipated Nausea and vomiting Dark line in gum
are all clinical manifestation of
Lead Poisoning
8-9.4 is ________ IDA
moderate
___ months: understands simple commands
15 months
priority intervention for EpiglotTitis is to ____
prep for intubation
Caused by a gram negative Bacteria
Starts as upper respiratory disease then worsens with a prolonged coughing and crowing or whooping upon inspiration that can last 4-6 weeks
Coughing can induce cyanosis, emesis and large amounts of secretions
Complications can be pneumonia, hemorrhage and seizures
Pertussis
Rhinitis Cough Tachypnea Grunting Lethargy Poor feeding Wheezing Prolonged expiratory phase Decreased air entry Retractions Apnea Spells Low grade fever early in infection
are all clinical manifestaions of ________
Bronchiolitis and Respiratory Syncytial Virus (RSV)
Rotaovirus is what kind of vaccination
and can be administered
Live Oral
oral
MMR Varicella is what kind of vaccination
and can be administered
Live virus vaccine:
SQ
A yeast-like fungus that is most often found in the GI tract, skin and vagina
It grows most often in moist warm areas
Can result from oral antibiotic therapy and hyperglycemia
Candidiasis or Thrush
infants with RR >__ should not be fed
> 60
Coxsackievirus is ________ isolation
contact
____ months: up and down stairs, 2 feet on each stair, turns pages of a book one at a time
24 months
Play is the work of childhood
It magnifies physical and psychosocial development
Parallel play at this stage(will play with other kids but will be doing their own thing)
Toy safety (must keep this in mind in the hospital environment as well)
are all common with what age group
toddler
With Bronchopulmonary Dysplasia (BPD)
more than 30% O2 at 36 weeks
Severe:
the MMR should be given __ times
2 times
12- 15 months, 4-6 years
when you receive antibodies – can be passed in utero, in breastmilk, immunoglobulin through IV
passive
reflex where:
Touch/stroke cheek along side of the mouth
Use nipple during breast feeding
Turns head towards nipple
Rooting
hypothermina for a newborn is a sign of ________
infection
Caused by RNA Virus
droplet and contact
starts as discrete red rash
vacciene prevention
Rubella
German measles
chest PT postural drainage Nebulizer care cpt vest Mucolytics – pulmozyme, hypertonic saline exercise transplant
are all interventions for _____
Cystic Fibrosis (respiratory )
Rooting disappears at what age
Disappears at 3-4 months
Tetanus is what kind of vaccination
and can be administered
Toxoid:
IM
Refinement of coordination Visual acuity achieves 20/20 by now this is when learn what they are good at have best friend have favorite subject
are all common with what age group
school age children
what age should the inintial immunization of HIb be adminsterd
2 months
Complete head lag at _ month
1 month
___ years: use of reasoning and understanding
9-10 years
Newborn’s Triples birth weight by __ year
1 year
__ years: skip and hop on 1 foot, tie shoes, throw ball over head, draw a stick figure with 3 parts
4 years
Temper tantrums
Normal behavior for this age group but can be quite difficult to deal with for parents and care givers
Important not to “give-in” during a temper tantrum
are all common with what age group
toddler
Startle reflex Disappears by __ months
4 months
PIAGETS stage where
Think in abstract terms Draw logical conclusions Make hypothesis and test them Adaptable and flexible Cannot predict long term consequences
12+ years: formal operational thinking
6-8 weeks: child will appear normal but lingering signs of inflammation may be present
is what stage of Kawasaki Disease
Convalescent stage
palpable purpura, joint pain, colicky abdominal pain, GI bleeding with blood in stool, and hematuria.
are clinical manifestations of
Henoch-Schönlein Purpura (HSP)
Diagnostic Testing for Iron Deficiency Anemia
Hemoglobin level
normal heart rate for newborn
80-180
Inflammation of salivary glands
orchitis (swelling of testicles), encephalitis
Most contagious 1-2 days before the swelling and up to 9 days after
Contact and droplet isolation
mumps
Molars ~ __ years
Central incisors ~ ___ years
6 years
7-8 years
_________ disease causes lesions on cheeks, gums, sides of tongue, hands and feet for 7-10 days
Hand foot and mouth
With Preschool age children
Weight gain ____ lbs a year
4-6lbs
PIAGETS stage where
Thought becomes increasingly logical and coherent
Conservation of matter
Concrete thinkers: view things as black/white, right/wrong, no gray area
Able to classify, sort facts, do problem solving
7-11 years: concrete operational thinking
________ are major cause of death in Sickle cell anemia
bacterial infections
Physical changes-Tanner stages
Socialization
HEADSSS
Nutrition
are all common with what age group
Adolescence
Inhaled Corticosteroid:
Fluticasone, triamcinolone, beclomethasone, budesonide, mometasone, flunisolide
are used for what?
Daily Control Medications for asthma
Partial head lag at __ months
2 months
No dairy products with dose
Use dropper or straw for liquid to avoid staining teeth
Advise stool can become tarry
are all for administration of
iron
Newborn’s Length: should be measured _________
flat surface, top of head to bottom of heel with leg extended
keep covered warm bath ice pack distractions trimmed fingernails no baby whipes or baby powder
are al interventions for
rash
normal heart rate for 2 years to 10 years
60-110
Inherited autosomal recessive disease of the exocrine glands.
Faulty gene is on chromosome 7
Most common genetic disease in the US in the Caucasian population
Average age of life span is mid 30s+/-
Pancreatic enzymes are not released or released in small amounts
Exocrine organs are obstructed by the increased and constant production of mucus
Cystic fibrosis
is acute sudden onset of fever, sore throat, and small discrete grayish papulo-vesicular ulcerative pharyngeal lesions
Herpangina
normal respirations for 1 to 2 years:
25 to 30/min
does informed consent need to be signed to give a child an immunization
yes
what age should the inintial immunization of rotavirus be adminsterd
2 months
A highly contagious superficial infection of the skin seen most often on the face and extremities
contact isolation
Assess for a macular rash that progresses to a papular/vesicular rash that oozed and forms a moist honey-colored crust.
Ask about bug bites
Assess if others may have the same rash
Impetigo
Newborn’s Abdominal circumference: should be measured ________
navel
Massage, music, warm compresses, cold compress, video games, movies
Focusing on breathing, concentrating on a pleasant thought, or progressive contracting and relaxing of muscles
Are non-pharmacologic Pain Management for what age group
11 years and older
normal heart rate for 10 years and older
50-90
Newborn’s Head circumference: should be measured ___________ (up to age 2)
above eye brow
with toddlers Height increases about __ inches per year
3 inches
Postmortem examination fails to find or confirm a cause of death
Peak age is 3months and 90% occur before 6 months
Peak times are spring and winter
The “Back to Sleep” campaign
Sudden infant death Syndrome
4 Nursing interventions for a child with CHD – pre-surgical
Maintain hydration
oxygen
daily weights
periods of rest
Most often the bacteria is Hameophilus influenzae or H-flu and incidence HAS decreased with Hib vaccine
EpiglotTitis
with Adolescence
Growth spurt: final _____% of linear growth; gain up to __% of ideal adult body weight
20-25%
50%
Abstract thinking
Still not good at predicting long term consequences of actions
Interest in exploring ideals
Understand that the whole is more than the sum of parts
Longer attention span
are all common with what age group
Adolescence
Are you in school? Do you attend regularly? What is your favorite or most difficult subject? How are your grades? Plans for after high school?
Education
what age should the inintial immunization of hep B be adminsterd
birth
EpiglotTitis
Treated with ________ and ________precautions
antibiotics
droplet
Less than 8 is ________ IDA
severe
Acute febrile, systemic vascular inflammatory disorder that affects small and midsize arteries, including the coronary arteries.
Unknown etiology
Kawasaki Disease
Condition of redness, scaling vesicles and crusting.
Usually presents as allergic response or a reaction to stress
Most common sites are the warmer, wetter areas of the body
Nursing Interventions include; reduce itching and scratching (prevents secondary infection), avoid irritating fabrics, apply steroidal topical creams and antihistamines as ordered
Eczema/Atopic Dermatitis
the Hep B immunization should be given ___ times
3 times
birth, 1-2 months, 6-28 months
Hand/foot and mouth disease or Herpangina are both caused by this virus
Coxsackievirus
Age 3-5
Preschool
Have you ever had sex or come close to having sex?
Are your partners boys, girls or both?
Do you use any protection?
Has anyone ever touched you sexually without your permission?
Sexuality and sexual abuse
Defined as the 2 years precedinig puberty
Prepubescence
Voice change ~ _____ years
11-14 years
Short acting beta2 agonists – SABA:
Albuterol, levalbuterol (xopenex) either with nebulizer or MDI inhaler
are used for what?
Rescue Medications for asthma
Newborn’s Chest circumference: should be measured ________
below nipple line
Fever
Severe abdominal pain
Painful edema of hands and feet
Arthralgia
are all clinical manifestaions of
Vaso-occlusive crisis:
ERICKSON stage where
Development of new interests and involvement in activities
Provide short projects for child
Feels rewarded for accomplishment-this develops
confidence and joy in learning
School age: industry vs. inferiority (6-12yr)
Long Acting Beta1-agonists – LABA:
Dry powder inhaler, should not be used as single therapy in children- typically combined with corticosteroids
are used for what?
Daily Control Medications for asthma
Newborn’s Gain _____ ounces of weight every week
5- 7 ounces
when your body makes antibodies – (immunization or get the disease )
active
Who lives with you?
Have you lived with ____ your whole life?
How do you get along with ____?
Home
__ years: unbutton front of clothes, dress and undress self; feeds self completely
3 years
2-4 weeks: cracking lips and fissures, desquamation of the skin on the tips of the fingers and toes, joint pain, cardiac disease and thrombocytosis
is what stage of Kawasaki Disease
Subacute stage
Posterior fontanel closes by __ months
2 months
HEADSSS
is an abreviation for
HOME EDUCATION ACTIVITIES DRUGS/ALCOHOL/TOBACCO SEXUALITY AND SEXUAL ABUSE SUICIDE AND DEPRESSION SAFETY ISSUES
Occurs with anything that disrupts the systemic vascular resistance and pulmonary blood flow
(Waking in morning, crying, feeding, exercise, warm bath, defecation)
cyanotic Congenital Heart Disease
hypercyanotic or tet spell
high fever for 5 days or longer Bilateral bulbar conjunctivitis without exudate strawberry tongue Erythema Of the palms and feet Dermatitis Of the trunk Cervical lymphadenopathy
are all signs of
Kawasaki Disease
chronic lung disease following premature birth and respiratory support provided in the neonatal period.
Typically occurring in infants less than 30 weeks gestation and less than 1000g at birth requiring ventilation.
Bronchopulmonary Dysplasia (BPD)
High fever with sore throat
Dysphonia, muffled, hoarse or absent voice sounds
Dysphagia, difficult swallowing
Drooling, refuses fluids or resists swallowing due to pain
Distressed respiratory effort with inspiratory stridor
they become extremely anxious
maintain a tripod position and refuse to lay down
are all clinical manifestations of ___________
EpiglotTitis
Symptoms fewer than 2 days a week
Night time awakening no more than once a month
No interference with normal activity at school or sports
Using short acting beat2-agonist for symptoms less than 2 or few days a week
No more than one asthma flare a year requiring oral steroids
Greater than 80% predicted peak flow
are signs of _________
controlled asthma
By __ months they begin to recognize their parents and fear strangers
6 months
Anticholinergic:
Ipratropium (Atrovent) –MDI or nebulized
are used for what?
Rescue Medications for asthma
the DTAP should be given __ times
5 times
2 months, 4 months, 6 months, 15-18 months, 4-6 years
after an imunization is administers the child should be observed for _____ minutes
15
the varicella should be given __ times
2 times
12-15 months, 4-6 years
Viral disease that is transmitted with direct contact through airborne spread of secretions or contact with lesions
Most contagious 1-2 days before rash and continues until all lesions are crusted over
can be vaccinated at any time
chicken pox
Occurs when the lungs are no longer able to maintain effective gas exchange
This can be due to acute or chronic respiratory conditions or neuromuscular conditions
Respiratory Distress
Monitor ABC’s
Oxygen therapy
Positioning for comfort to breath
Frequent assessment of WOB, oxygenation and ventilation, color, heart rate, RR, breath sounds
Administer IV fluids or bolus as needed
are nursing interventions for
asthma
Assess for presence of itching that worsens at night
Look for presence of a rash between fingers, wrists, genitals, waist, buttocks, knees, and elbows. Generally does not affect the face
Assess for same condition in other members of the family
Observe skin for the “burrows” that may be linear, curved or S shaped. It could be in the form of macules, papules or erythematous lines.
Scabies
Rapid growth and high energy expenditures
Support development of good eating habits-are they buying their own food? Who is making food choices in the home?
Concerns: obesity, anorexia, anemia
Adolescence
Complaints of itching, burning and irritation
In the mouth is looks like white plaque with a bright red surface underneath
Skin lesions appear red and moist
Interventions
Administer oral antifungal suspension for oral thrush
Keeping the skin dry is important for healing
Wear loose fitting clothing
Decrease humidity in the home
Candidiasis or Thrush
Leukotriene Receptor Antagonist:
Montelukast, zafirlukast. PO
are used for what?
Daily Control Medications for asthma
2 Pre-surgical instructions for Tonsillectomy
Child should be free of infection for at least one week prior to surgery
No ibuprofen or aspirin 1-2 weeks prior to surgery
Peer group identity, cliques-peers are the most important group, though they still seek approval of parents
Form close intimate relationship-major goal
Sexual exploration
Wants freedom
Discipline problems, exploration, risk-taking behavior
Adolescence
the IPV should be given __ times
4 times
2 months, 4 months, 6-18 months, 4-6 months
Anterior fontanel closes by ______ months
12-18 months
Talking about favorite places, TV, humor, music, breathing, counting, eye fixation, ooze tubes, spiral timers, video games, movies
Are non-pharmacologic Pain Management for what age group
7 to 11 years of age
often also have frequent infections with breathing and swallowing difficulty
occurs in conjunction with pharyngitis
can be treated with antibiotics or surgery
Tonsillitis
normal heart rate for 3 month - 2 years
70-150
Age __: notice prejudices and bias in outside world; use time oriented words with greater understanding
age 5
Does anyone at your school use…..? Do any of your friends use….? Have you ever tried …..? Attempts to quit? Family members using drugs/alcohol/tobacco?
Drugs/Alcohol/Tobacco
Age __: ~900 word vocabulary, simple 4 word sentences; begins to share
age 3
Usually viral in origin - most often Para influenza
Predominately occurs in children 6 months to 6 years with a peak at 2-3 years of age
Croup
with toddlers Birth weight should quadruple by ____ years
2.5 years
Photophobia
Koplik spots on the buccal mucosa
Confluent rash that begins on the face and spreads downward.
Rash is dark red to purple and blotchy maculo-papular
are all symptoms of _____
Measles/Rubeola
With Bronchopulmonary Dysplasia (BPD)
: need O2 for 28+ days, but RA when go home
Mild
with school age children
Weight increases by ___ kg per year
2-3kg
5 nursing inerventions for respiratory distress
Position
Suction
O2
NG/OG (code situation)
NPO
most important things to prevent bleeding with a Tonsillectomy is to _________ & __________
hyrdate with water
pain management with scheduled dose
Clinical Manifestation:
Depends on severity of IDA
Includes pallor, fatigue, irritability
most common in adolescent women and toddlers
Iron Deficiency Anemia
Children with RSV have increased incidence of reactive airway disease or_______ later in childhood
asthma
Bed rest
Assist with ambulation
Administer antibiotics (penicillin or erythromycin) long term
Administer aspirin for anti-inflammatory and anticoagulant actions
are all nursing intervenions for
Rheumatic Fever
5 clinical manifestations of Cyanotic Congenital Heart Disease
Cyanosis Dyspnea Loud murmurs Diaphoresis Increase in the RBC
type of Congenital Heart Disease where there is increased pulmonary blood flow
Acyanotic
5 Cystic fibrosis Interventions (GI)
Pancreatic enzymes should be administered with meals and snacks
high protein diet
Diet should also include added salt
Infants may need pre-digested formulas, such as Pregestimil, and also may need enteral feedings at night
Give multi-vitamins – especially A,D,E and K (fat soluble) in a water-soluble form
Breast growth and public ____ years
7-14 years
With Preschool age children
Length at birth is doubled by age __
age 4
Female physical changes
Axillary hair ~_ years after pubic hair begins
2 years
Newborn’s Height increases by 1 inch per __ months
6 months
Often a complication of CHD, especially cyanotic CHD
Congestive Heart Failure
Age 6-12
school age
Lead Poisoning treatment
chelation therapy
HOB up to assist with respiration
Strict I/O and weight daily at same time
Increased calorie formula such as Polycose
Increase calories with additives to formula or breastmilk
are al nursing interventions for
Congestive Heart Failure
Bronchiolitis is a lower respiratory tract viral illness, predominantly caused by RSV.
It is characterized by inflammation of the bronchioles, increased mucous production, airway edema, small airway obstruction and air trapping.
Bronchiolitis and Respiratory Syncytial Virus (RSV)
IPV, Hep B, Hep A is what kind of vaccination
and can be administered
Killed virus vaccine:
SubQ or IM For IPV
Singing, storytelling, reading books, breathing, blowing bubbles, ooze tubes, movies, music
Are non-pharmacologic Pain Management for what age group
3 to 4 years of age
Present or past suicidal ideation?
Attempts?
Depression: changes in energy, appetite, weight, sleep disturbances, difficulty concentrating
Warn parent/guardian if teen is contemplating suicide, even if not at immediate risk
Suicide and depression
With Bronchopulmonary Dysplasia (BPD)
need O2 for 28+ days and less than 30% O2 at 36 weeks
Moderate:
reflex where:
Gently turn head to one side
Arm and leg of that side will extend while the others flex
Thought to prevent rolling over too soon
Tonic Neck (also called fencing reflex)
Is able to give reason for pain
Perceives several types of psychological pain
Has limited life experiences to cope with pain as adults might cope despite mature understanding of pain
Fears losing control during painful experience
Meaning of Pain and Influence for what age group
13 years of age and older
no treatment
dehydration is comon
fecal oral transmission
contact isolation
starts with a high fever
Diarrhea
vacciene is available
Rotavirus
Infection Alcohol or substance abuse Mother with diabetes Family history of heart defects Genetic defects such as down syndrome
are all risk factors for
Congenital Heart Disease
Occurs with a defect that obstructs pulmonary blood flow to the lungs OR due to a defect that permits NO connection of the right sided blood flow to the lungs
cyanotic Congenital Heart Disease
By __ months, increased anxiety over parent leaving, responds to the word No
8 months
Administer blood products as ordered Manage pain - avoid aspirin Family education ice at least 15 mins of pressure
are all nursing interventions for
Hemophilia
the Hib should be given __ times
4 times
2 months, 4 months, 6 months, 12-15 months
PIAGETS stage where
Learn about world through senses and motor activity
Progress from reflex activity to repetitive behaviors to imitative behaviors
Develop sense of cause and effect
Curiosity, experimentation, and exploration result in the learning process
Develop object permanence
0-2 years: sensorimotor
Touching, stroking, patting, rocking, playing music, using mobiles, pacifier for less than 9 months with glucose solution
Are non-pharmacologic Pain Management for what age group
0 to 2 years of age
with school age children
Height increases by __ inches per year
2 inches
Children will naturally squat to help relieve _________
hypercyanotic spells
HIB, Mennigococcal, pneumococcal is what kind of vaccination
and can be administered
Conjugate vaccine:
IM
Pain control Hydration Oxygenation warm compress Prevention and treatment of infection Blood transfusion may be needed or exchange transfusion
are all nursing interventions for _____
sickle cell anemia
with Digoxin Prior to administration an apical pulse should be taken. per order hold if less than normal for age or set number. Typically in infants it is hold for less than ___, child less than _____
<90
<70
what age should the inintial immunization of MMR be adminsterd
12 - 15 months
the Hep A should be given __ times
2 doses
12-23 months
___ months: walks without help, builds a tower of 2 cubes
15 months
2 medications for Congenital Heart Disease
digoxin
lasix
Relates to pain primarily as physical, concrete experience’
Thinks in terms of magical disappearance of pain
May view pain a punishment for wrongdoing
Tends to hold someone accountable for own pain and may strike out at that person
Meaning of Pain and Influence for what age group
2 to 7 years of age
Occurs 1 – 3 weeks after an untreated streptococcal infection
tachycardia
2 or more large joings become inflammed
non purritic rash
facial grimicing
subcutanous
chorea
are all clinical manifestations for
Rheumatic Fever
Age __: ~2100 word vocabulary; talks constantly; cooperative and sympathetic to others; may start to question parents’ thinking and principles
age 5
with school age children
__ years: knows right from left
7 years
Singing, storytelling, breathing, talking about favorite places, talking about or watching favorite TV shows, listening to music, ooze tubes, movies
Are non-pharmacologic Pain Management for what age group
5 to 6 years of age
Differentiate self from parents
Increased independence, ritualism and negativism
Skills of independence may result in tyrannical, strong-willed and volatile behavior
Picky eaters (physiologic anorexia)-but mealtime is still an important social time with the child and their family
Avoid food jag (when will only eat 1 thing)
are all common with what age group
toddler
what age should the inintial immunization of MCV be adminsterd
2-6 years
when does the Parachute reflex appear and how long does it last
Appears ~7-9 months
Persists indefinitely (you need this reflex so you don’t fall and seriously hurt yourself)
As a newborn they have ~10% chance of a meconium ileus
Cystic Fibrosis
Age 12-20
Adolescence
Caused by blood-obligate parasite that must feed every day.
Live close to the scalp
Easily transmitted from person to person
Assess for egg shell cases (nits), intense pruritus of the scalp, secondary infections due to scratching
Pediculosis Lice
With Preschool age children
By age __= average weight is 41.2lbs, average height is 43.3 inches
age 5
Assess for degree of respiratory distress
Assess cough – is it worse than normal? Has the mucus changed?
Assess oxygenation status – skin color and clubbing
Assess for barrel chest from air trapping
Look for nasal polyps or sinusitis
Assess for s/s of infection – usual s/s of fever, tachypnea, and pain may be absent
Treatment for infection usually involves 2-3 antibiotics and an antifungal
are all assessment techniques for
Cystic Fibrosis (respiratory )
The hallmark of these disorders is that shunting of blood goes from left to right – oxygenated blood on the left side shunts back to the right and reenters the lungs.
Acyanotic Congenital Heart Disease
Inflammation or infection of the bronchioles and alveolar spaces of the lungs.
Pneumonia
do children or adults go into respiratory arrest faster
children
Mast Cell Inhibitors:
Cromolyn sodium, nedocromil as MDI or Nebulized
are used for what?
Daily Control Medications for asthma
Age __: ~1500 word vocabulary; questioning is at a peak (why, why, why); imaginary friend; selfish and impatient; may be verbally and physically aggressive; exaggerates, boasts and tattles; may start to rebel if the parents expect too much
age 4
Inflammatory connective tissue disorder resulting from an autoimmune response to an infection (beta-hemolytic streptococcal infection).
most comon aquired heart defect
Rheumatic Fever
Recessive Trait Hereditary Disease
Causes partial or complete replacement of normal hemoglobin with abnormal hemoglobin S in red blood cells.
Sickle Cell Anemia
Menstruation typically occurs between _____ years. If no period by 17 will need an endocrine work up
10-16 years
Refers to the clinical syndrome of stridor, cough, and hoarseness that results from laryngeal inflammation and edema causing upper airway narrowing.
Croup
with toddlers Weight gain slows to _____pounds per year
4-6 lbs
what age should the inintial immunization of varicella be adminsterd
12- 15months
Bronchiolitis and Respiratory Syncytial Virus (RSV)
is ________ isolation
contact isolation
How do you spend your free time?
Job? Schedule?
Name of friends, best friend?
Activities
Regressive behavior
When there are major changes (ie addition of a sibling, moving, etc) some regressive behavior is normal (such as bedwetting or wanting to drink from a bottle again)
These behaviors should correct by themselves, if not this could be a red flag that warrants further investigation
are all common with what age group
toddler
Hypoxia can occur due to high altitudes, poorly pressurized airplanes, hypoventilation, vasoconstriction with cold weather, or emotionally stressful event, dehydration
can cause
Sickling
______&_________ has reduced the risk and prevalence of BPD in premature infants
BPD is a major cause of mortality and long-term morbidity in infants
Antenatal corticosteroids and surfactant
humidity (shower steam)
cold air
cool mist humidified tent
are all nursing interventions for _______
Croup
Guns in the home?
Feel safe at school?
Involved in physical fights at home, in the neighborhood or at school?
How are conflicts handled at home/school/work?
Do you carry weapons?
Are gangs present in high school?
Friends in gangs? Have you ever been in a gang?
Safety issues
A potentially life threatening infection of the epiglottis that most often affects children ages 2-6 years old. Swelling can occlude the trachea rapidly - in minutes to hours.
EpiglotTitis
Hereditary bleeding disorder, usually exclusively male disorder with female carriers – X linked recessive disorder
Deficiency of clotting factors
Hemophilia
Fecal oral and respiratory transmission
Infections 2-3 days before rash to days after rash disappears
Coxsackievirus
Sibling Rivalry
This is the age when some children might get younger siblings
Need to make feel like they are still an important part of the family
are all common with what age group
toddler
what age should the inintial immunization of PCV be adminsterd
2 months
2 treatments for Convalescent stage
IVIG
Aspirin
with Digoxin Draw levels as ordered – normal blood level is ______ ng/ml
0.8-2
__ years: jump off step, tower 9-10 cubes, take stairs with alternating feet; ride tricycle
3 years
normal heart rate for 1 week - 3 month
120-180
screening for TB can be done at age ______
12 months
Magical thinking
Starts to understand time
Preschool
reflex where:
Make a loud noise
Arms adduct with flexion of elbows
Hands clench
Startle reflex
reflex where:
Place finger in palm of newborn’s hand or at base of toes
Fingers and toes curl downward
Good for parents in NICU who cannot hold their babies, enables the parents to feel like they are making a bond
Palmar-Plantar Grasp
with iron administration for optimal absorption with ______
orange juice
type of Congenital Heart Disease where there is decreased pulmonary blood flow
Cyanotic
reflex where:
Stroke upward from heel along lateral aspect, across ball of foot
Toes hyperextend and big toe dorsiflexes
Babinski
