Exam 2 Flashcards
what do NSAIDS affect and give an example commonly used in peds?
they affect kidneys; ketoralac (toradol), ibuprofen (advil), celebrex, naproxen
should a infant be given aspirin?
no, it can cause Reye’s syndrome
what does acetaminophen affect?
the liver; only give 5x a day
what does morphine and narcotics affect?
respiratory, BP, constipation
should kids under 1 be given ibuprofen?
no
most under treated thing in peds
pain
FLACC pain scale
Face
Legs
Activity
Cry
Consolability
comfort scale
- 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
wong-baker FACES pain scale
six cartoon faces; as them to rate their pain according to how they feel
numeric pain ratings
ask older children to rate their pain 1-10
CRIES neonatal pain scale
Crying
Requiring increased oxygen
Increased vital signs
Expression
Sleeplessness
nonpharmacologic pain interventions
distraction, relaxation, guided imagery, cutaneous stimulation, aromas, sugar, positioning, kangaroo holding, skin to skin
when using morphine what should you be sure to do?
count respirations for a full minute before and monitor after giving
what is diazepam (valium) help with?
spasms
what are the best routes for absorption?
sublingual and rectal
most common chronic illnesses or disabilities?
respiratory (asthma), speech and sensory impairments, mental disorders, nervous system disorders
what are family’s emotional reactions to a special needs child?
denial
anger
bargaining
depression
acceptance
examples of live attenuated vaccines
- MMR: acute illness, immunocompromised, which can affect pregnancy
- varicella: blood transfusion (can’t give to peds)
what do mumps affect?
reproductive system and deafness
when is MMR/varicella given?
at 12-15 months and 4-6 years
in case of adverse reaction of a vaccine, what should a nurse have nearby?
epi and O2
examples of bacterial diseases
- diptheria
- pertussis (whooping cough)
- scarlet fever
- pneumococcal disease
- epiglottitis
how to treat bacterial diseases
- antibiotics
- bed rest
- support
- prevention
examples of viral diseases
- chicken pox (varicella)
- roseola
- hand foot and mouth
- mumps
- erythema infectiosum (fifth disease)
- measles (rubeola)
- rubella (german measles)
- influenza (flu)
- skin infections
how to treat viral diseases
- tylenol/ibuprofen
- rest
- fluids
diptheria
- direct contact transmission
- “bulls’ neck”, white or gray mucous membranes, fever, cough
- treatment: antibiotic, rest, and support
chicken pox (varicella)
- direct contact and respiratory secretions
- treatment is just supportive
- child is contagious before rash appears and until vesicles are crusted
roseola
- herpes virus type 6
- high fever, then fever gone and rash
- may have lymphadenopathy
- encephalitis consequence is rare
hand foot and mouth
- coxsackie virus
- can lead to myocarditis
- fever, malaise
- rash, sore throat blisters
mumps
- paramyxovirus
- sterility, orchitis, sensorineural deafness, myocarditis
- malaise, fever, headache
- can go to testes and ovaries
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
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
pertussis (whooping cough)
- direct contact from droplets
- whoop or gasp 4-6 weeks cyanosis may occur during episode
rubella (german measles)
- direct contact from droplets
- low-grade fever, headache, malaise, sore throat, rash
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
influenza (flu)
- droplet precautions
- abrupt fever
- treat by prevention, antiviral treatment if detected early, supportive care
pneumococcal disease
- pneumonia, otitis media, sinusitis, localized infection
- treatment is prevention, antibiotics, supportive care
- droplet prec.