Exam 2 Flashcards
1
Q
what do NSAIDS affect and give an example commonly used in peds?
A
they affect kidneys; ketoralac (toradol), ibuprofen (advil), celebrex, naproxen
2
Q
should a infant be given aspirin?
A
no, it can cause Reye’s syndrome
3
Q
what does acetaminophen affect?
A
the liver; only give 5x a day
4
Q
what does morphine and narcotics affect?
A
respiratory, BP, constipation
5
Q
should kids under 1 be given ibuprofen?
A
no
6
Q
most under treated thing in peds
A
pain
7
Q
FLACC pain scale
A
Face
Legs
Activity
Cry
Consolability
8
Q
comfort scale
A
- used more in PICU settings
- used in unconscious and ventilated children
- eight indicators that you score 1-5 on: alertness, calmness/agitation, respiratory response, physical movement, BP, HR, muscle tone, facial tension
- add scores up: 17-26 is adequate sedation and pain control
9
Q
wong-baker FACES pain scale
A
six cartoon faces; as them to rate their pain according to how they feel
10
Q
numeric pain ratings
A
ask older children to rate their pain 1-10
11
Q
CRIES neonatal pain scale
A
Crying
Requiring increased oxygen
Increased vital signs
Expression
Sleeplessness
12
Q
nonpharmacologic pain interventions
A
distraction, relaxation, guided imagery, cutaneous stimulation, aromas, sugar, positioning, kangaroo holding, skin to skin
13
Q
when using morphine what should you be sure to do?
A
count respirations for a full minute before and monitor after giving
14
Q
what is diazepam (valium) help with?
A
spasms
15
Q
what are the best routes for absorption?
A
sublingual and rectal
16
Q
most common chronic illnesses or disabilities?
A
respiratory (asthma), speech and sensory impairments, mental disorders, nervous system disorders
17
Q
what are family’s emotional reactions to a special needs child?
A
denial
anger
bargaining
depression
acceptance
18
Q
examples of live attenuated vaccines
A
- MMR: acute illness, immunocompromised, which can affect pregnancy
- varicella: blood transfusion (can’t give to peds)
19
Q
what do mumps affect?
A
reproductive system and deafness
20
Q
when is MMR/varicella given?
A
at 12-15 months and 4-6 years
21
Q
in case of adverse reaction of a vaccine, what should a nurse have nearby?
A
epi and O2
22
Q
examples of bacterial diseases
A
- diptheria
- pertussis (whooping cough)
- scarlet fever
- pneumococcal disease
- epiglottitis
23
Q
how to treat bacterial diseases
A
- antibiotics
- bed rest
- support
- prevention
24
Q
examples of viral diseases
A
- chicken pox (varicella)
- roseola
- hand foot and mouth
- mumps
- erythema infectiosum (fifth disease)
- measles (rubeola)
- rubella (german measles)
- influenza (flu)
- skin infections
25
how to treat viral diseases
- tylenol/ibuprofen
- rest
- fluids
26
diptheria
- direct contact transmission
- "bulls' neck", white or gray mucous membranes, fever, cough
- treatment: antibiotic, rest, and support
27
chicken pox (varicella)
- direct contact and respiratory secretions
- treatment is just supportive
- child is contagious before rash appears and until vesicles are crusted
28
roseola
- herpes virus type 6
- high fever, then fever gone and rash
- may have lymphadenopathy
- encephalitis consequence is rare
29
hand foot and mouth
- coxsackie virus
- can lead to myocarditis
- fever, malaise
- rash, sore throat blisters
30
mumps
- paramyxovirus
- sterility, orchitis, sensorineural deafness, myocarditis
- malaise, fever, headache
- can go to testes and ovaries
31
erythema infectiosum (fifth disease)
- droplet or direct contact precautions
- persistent fever 3-7 days in child who is otherwise well appearing
- has a "slapped cheek" appearance
32
measles (rubeola)
- highly contagious: direct contact from respiratory system
- "koplick spots" on mucosa
- rash appears on 3-4 days of illness
- treat with antibiotics for secondary bacterial infections such as ear infection and pneumonia
- airborne if in hospital until day 5 of rash
33
pertussis (whooping cough)
- direct contact from droplets
- whoop or gasp 4-6 weeks cyanosis may occur during episode
34
rubella (german measles)
- direct contact from droplets
- low-grade fever, headache, malaise, sore throat, rash
35
scarlet fever
- group A beta hemolytic-streptococci
- prodromal stage: abrupt high fever, halitosis
- enanthema: tonsils large, edematous, covered with exudate, "strawberry tongue", sandpaper-like pink rash
- treat with penicillin and supportive care
- droplet prec. until 24 hours of ABX
36
influenza (flu)
- droplet precautions
- abrupt fever
- treat by prevention, antiviral treatment if detected early, supportive care
37
pneumococcal disease
- pneumonia, otitis media, sinusitis, localized infection
- treatment is prevention, antibiotics, supportive care
- droplet prec.
38
what are the most frequent infections worldwide?
intestinal parasites
39
giardiasis
- direct contact with contaminated water or food
- flagyl or tindamax and prevention of reoccurance
40
how does a tapetest work?
place over rectum, worms come out in pinworms
41
how to treat skin infections
- fungal agents: typically dermatophytoses; tinea or candida
- topical or systemic
42
lyme disease stages
- stage 1: "bull's eye:
- stage 2: rash on hadns and feet 3-10 weeks after inoculation
- stage 3: systemic involvement 2-12 months
43
when does the most growth and development occur?
12-36 months
44
how much should weight gain slow per year?
by 4-6 pounds
45
what should a child's weight be at 2.5 years of age?
birth weight should quadruple
46
how much should height increase per year?
about 3 inches per year
47
when does sphincter control begin?
age 18-24 months; potty training shouldn't start until this point
48
when should a child be able to throw a ball?
18 months
49
when do children recognize sexual difference?
by age 2; parents should refer to body parts by name and avoid negative labels about physical appearance
50
how many words should a child have in their vocab by age 2?
more than 300 words
51
parallel play
when two toddlers play next to each other but don't interact
52
when do temper tantrums increase?
when child is ill, hungry, frustrated, or tired
53
what should happen by 36 months?
walking, running, climbing, jumping
54
what should happen by 4 years?
skips and hops on one foot; catches ball
55
what should happen by 5 years?
skips on alternate feet, jumps rope, learns to skate and swim
56
at age 4-5, how should a child's language be?
four and five word sentences
57
at age 6, how should a child's language be?
understands all parts of speech; identify opposites
58
when should a child be independent in dressing, eating, and toileting
4-5
59
biggest cause of obesity in preschoolers
- juice and milk
- should only have 1 4 oz. juice a day
60
how long should a preschooler be getting a night of sleep?
about 12 hours per night
61
most common metal poisoning
lead ingestion, mercury toxicity is less frequent
62
what does lead poisoning affect?
affects renal, hematologic, and neurologic systems; developing brain and nervous systems are especially vulnerable
63
types of neglect
- physical neglect
- emotional neglect
- emotional abuse
64
how much would a venous blood sample be if lead poisoning was a concern?
5 mcg/dl
65
length of a virus
10-14 days
66
another name for common cold
nasopharyngitis
67
after a tonsillectomy, what would frequent swallowing be a sign of?
bleeding; not good
68
with mono, what do you want to be sure the child doesn't do?
participate in contact sports to decrease the injury to the spleen (on right side)
69
first line treatments for children in status asthmaticus
albuterol (bronchioles open up) and IV corticosteroid (helps with inflammation)
69
first line treatments for children in status asthmaticus
albuterol (bronchioles open up) and
70
discuss a little about CF
- autosomal recessive gene disorder
- abnormal gene located on the long arm of chromosome 7
71
what can occur in COVID in kids?
multi system inflammatory syndrome: elevate temp and elevated inflammatory markers (CRP and ESR)
72
when you think of Na, what should you think of?
Na = neuro problems
73
when you think of K, what should you think of?
K = cardiac problems
74
normal level of Na
135-145
75
normal level of K
3.5-5
76
rule for a fluid bolus
20 mL/kg of NS
77
how fast should you give a bolus in a life-threatening situation?
as fast as possible
78
what should the MAP score be?
above 60
79
what can too low of sodium lead to?
water intoxication
80
what can too high of sodium lead to?
dehydration
81
when should you begin to bag an child?
if the RR are under 10
82
hypovolemic shock
- dehydration
- rapid blood loss
- loss of other fluids
83
distributive shock
- sepsis
- anaphylaxis
84
what happens in decompensated shock and what should you do?
BP declines; give a bolus
85
what is the formula for how much of a bolus to give?
10 - 20 mL/kg
86
septic shock
- sepsis caused by infectious organism and patient's immune, inflammatory, and coagulant responses
- give them antibiotics
87
what should be administered to someone with anaphylaxis?
epi and fluid
88
what is important to know in the first two days of a burn?
- 1st 24 hours: shock and fluid loss
- 2nd 24 hours and so on: infection
89
upper airway obstruction characteristics
- foreign body, croupe, anaphylaxis
- will hear stridor
90
lower airway obstruction characteristics
- RSV
- will hear wheezing
91
lung tissue disease characteristics
- pneumonia
- will hear crackles
92
what is important to do when a child has RSV?
suction
