exam 1 pp slides & ati Flashcards by britt rank

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

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after Tonsillectomy when you see frequent swallowing it is a sign of _______

bleeding

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Moro reflex:

Disappears by ____ months

3-4 months

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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

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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

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Babinski Disappears at __ months

12 months

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elevated ESR and antistreptolisin O titer (ASO)

are labs for

Rheumatic Fever

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Puberty: average age for girl is __, average age for boy is ___

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Newborn’s weight should be measured ___________

must be done naked for accuracy

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With Preschool age children

Average weight=___ lbs at age 3

32 lbs

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__ years: well developed gross motor; may ride bike with training wheels

5 years

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_____ years: trial and error problem solving (this can lead to injury)

10-12 years

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what are the two main allergies of concern for immunization

Neomycin or gelatin

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Diagnosed using sweat chloride test.

sweat is 2-5 times the level of sodium and chloride

Cystic fibrosis

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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

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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

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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)

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normal respirations for Newborn to 1 year

30 to 60/min

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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

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prolonged bleeding
umbilical cord cut
vitamin k injection
circumcision

are all clinical manifestations of

Hemophilia

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By __ years: dress and wash self, tie shoes

5 years

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Plant leaf that has a poisonous oil causing a delay hypersensitivity response. Trauma to the leaves releases the sap

Poison Ivy

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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

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9.5-11 is ____ IDA

mild

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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

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