EXAM #2 Flashcards

You may prefer our related Brainscape-certified flashcards:
1
Q

Cardiovascular disease prevention

A

-No smoking or alcohol
-Prenatal care
-Folic acid
-Family hx of defects

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are indicators of cardiac dysfunction?

A

-Poor feeding
-Tachypnea/cardia
-Failure to thrive/poor weight gain/activity intolerance
-Developmental delays
-Family and prenatal history

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Definition of a shunt:

A

Blood flow through an opening between two structures or vessels of the heart

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Definition of Murmur:

A

A sound heard when listening to the heart; reflects flow of blood within the heart
-Normal during periods of rapid growth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is CHF?

A

Inability of the heart to perform its function of pumping blood forward

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the s/s of congestive heart failure?

A

-Poor feeding and growth
-Irritability
-SOB
-Excessive sweating
-Hepatomeagly
-Edema
-Exercise intolerance
-Acities (older kids)
-Puffy eyelids
-Buldging fontanelles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

How to diagnose CHF:

A

-Hx & physical
-B-type natriuretic peptide
-Chest x-ray
-Exercise test
-Echocardiogram: looks at direction of blood flow
-MRI
-Cardiac cath

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Nursing care for CHF:

A

-Comfort care
-Oxygenation
-Skin care
-Continious V/S monitoring

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Medications for CHF management:

A

-Cardiac Glycoside (Digoxin)
-Loop Diuretic (Furosemide)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What HR should we hold Digoxin for a new born?

A

less than 100

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What HR should we hold Digoxin for a child?

A

Less than 70

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What HR should we hold Digoxin for an adolescent?

A

Less than 60

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What foods should be consumed when on loop diuretics

A

Foods high in potassium (banana, broccoli, grapefruit)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is cardiac catheterization used for?

A

Diagnosis and repair for CHF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Nursing management for Cardiac Cath:

A

-Pressure dressing
-Monitor V/S
-Check for pulse distally
-Immobilization of patient
-Bedrest for 6 hours afterwards
-Quiet play for 24 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What medications do we give for any congenital heart defect?

A

-Angiotensin Converting Enzymes (ACE) inhibitor (Captopril)
-Cardiac glycoside (Digoxin)
-Loop Diuretic (Furosemide)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Does pulmonary blood flow increase or decrease with acyanotic CHD?

A

Increase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Does pulmonary blood flow increase or decrease with cyanotic CHD?

A

Decrease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

ANY CHD that starts with a T or H is considered an _______ defect

A

Cyanotic defect. If it doesn’t start with T or H, is is acyanotic.
5 Ts and H (hypoplastic Left sided heart defect)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is the Increased pulmonary blood flow defect? What are the types?

A

An abnormal connection between two sides of the heart.
-Atrial Septal Defect
-Ventricular Septal Defect
-Patent Ductus Arteriosus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

How is blood flow affected in the Increased pulmonary blood flow defects?

A

-Increased pulmonary blood flow
-Decreased systemic blood flow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is an Atrial Septal Defect?

A

Simple defect of the atria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Clinical manifestations for Atrial Septal Defect:

A

-Possible Murmur or Thrill
-Possible right atrium enlargement
-Hepatomeagly (fluid overload)
-SOB
-Respiratory distress
-Periorbital edema
-Failure to thrive
-Increased risk for respiratory infection
-Increased risk for stroke

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is a Ventricular Septal Defect?

A

Defect in the ventricular septum.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Clinical Manifestations for Ventricular Septal Defect:

A

-Asymptomatic
-SOB
-Feeding difficulties
-Poor growth
-Easy fatiguability
-Recurrent respiratory infections
-Murmur
-Harsh murmur or thrill

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Nursing care for Atrial Septal Defect (ASD) and Ventricular Septal Defect (VSD):

A

-Monitor V/S until stable
-CHF management: Digoxin & Lasix

Monitor for complications:
-Chest pain, palpitations, sudden hypotension, dehydration or anemia.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Medical management for Atrial Septal Defect (ASD) and Ventricular Septal Defect (VSD):

A

-May spontaneously close by itself.
-Surgical repair or closure device.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Postoperative mangement for Atrial Septal Defect (ASD) and Ventricular Septal Defect (VSD):

A

-Limit exposure & cluster care
-Prophylatic antibiotics
-Offer small, frequent meals
-Suction secretions
-Keep warm and relaxed
-Monitor I & Os (limit fluids as ordered)
-Monitor K level
-Change position Q2 hrs
-Give oxygen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What is Patent Ductus Arteriosus?

A

Blood flows from the Aorta to the pulmonary artery through abnormal connection (normal in fetus).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Clinical Manifestations of Patent Ductus Arteriosus:

A

-Harsh Murmur
-Frequent colds
-Susceptible to RSV
-Fatigue
-Poor feeding & growth pattern
-Wide pluse pressure
-Bounding pulse

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Nursing care for Patent Ductus Arteriosus (PDA):

A

-Monitor V/S
-Wound-care (RITA)
-Allow time to close
-Ventilatory support
-Fluid restrictions and Diuretics
-Indomethacin (closes defect)
-Ibuprofen or NSAID
-Incubator or radiant warmer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Medical management for Patent Ductus Arteriosus (PDA):

A

-Thoracotomy
-VATS if medical mangement fails
-Coils and super glue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What is Coarctation of the aorta?

A

Narrowing or stricture of the descending aorta distal to the carotid arteries (2 links of sausage)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Clinical manifestations of Coarctation of the aorta:

A

-Murmur
-CHF signs
-Pain in the legs or cyanotic lower extremities due to lack of blood flow
-Increased pressure to head and upper extremities

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Nursing care for Coarctation of the aorta:

A

-Monitor upper and lower blood pressures
-May have postsurgical rebound hypertension = HTN (give antihypertensive agents for 6-12mths)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Medical management for Coarctation of the aorta:

A

-Cardiac Cath-baloon angioplasty & vulvuloplasty
-Give Captopril (Capoten) or enalapril (Vasotec) as well as Digoxin and Lasix

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

What is Tetralogy of Fallot?

A

Four associated defects:
-Pulmonary stenosis
-Right Ventricular Hypertrophy
-Overriding Aorta
-Ventral Septal Defect

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Clinical Manifestations for Tetralogy of Fallot:

A

-Tachypnea
-Dyspnea on Exertion
-Growth failure
-Cyanosis
-Harsh Murmur
-Rt ventricular hypertrophy.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

What are TET spells? What helps prevent them?

A

-Cyanotic event that is exacerbated by excitement or crying.
-Pre-oxygenate, knee-chest position, and morphine.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

What is transposition of great vessels?

A

Switching of the aorta and pulmonary artery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Clinical Manifestations of transposition of great vessels:

A

-Cyanosis
-SOB
-Poor feeding
-Clubbing of fingers and toes
-Murmur (sometimes)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Surgical interventions for transposition of great vessels:

A

Arterial switch operation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

What is hypoplastic left heart syndrome?

A

-Ventricle is small or hypoplastic and unable to maintain CO. Right ventricle must work quickly as the main pumping mechanism.
-Poor outcomes.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Nursing & surgical mangement for hypoplatic left heart syndrome:

A

-Prostaglandin given to keep PDA open
-Norwood procedure
-BT Shunt
-Glenn procedure
-Fontan procedure
-Pallative or End-of-Life care in severe cases.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

What labs should be monitored in cyanotic heart disease?

A

Hbg & Hct

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Important things to remember when giving Digoxin:

A

-Assess Apical pulse for one min
-Give consistently
-DO NOT administer if child throws it up

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

How often should you palpate the liver for R sided HF?

A

Q 4-12 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Pathophysiology of Kawasaki’s Disease:

A

Acute systematic vaculitis of unknown cause with increased risk of coronary artery aneurysm.
-May progess to myocarditis or rhythm disturbances
-May form scars

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

Clinical Manifestations of Kawasaki’s Disease:

A

-Skin Rash
-Cervical lymphadenopathy unilateral
-Strawberry tongue and cracking lips
-Conjunctivitis without exxudate
-High fever

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Nursing care/education for Kawasaki’s Disease:

A

-Support if they have aneurysm repair
-Medication
-Follow up appointments
-May be placed on anticoagulant therapy, blood testing and monitoring
-Activity restrictions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

Pharmacological treatment/management for Kawasaki’s Disease

A

-IV immunoglobulin/ gammaglobulin
-NSAIDs-Salicylates (Aspirin)
-Digoxin
-Angiorensin enzyme inhibitiors-reduces the after load on the heart
-Lasix

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

What is Rheumatic Fever/Disease?

A

RF: self limiting (3mths)
-From Group A B-hemolytic streptococcal pharyngitis

Acute phase: Connective tissue inflammation (joints, brain, serous surfaces & heart)

Proliferative phase: Heart valves are damaged leading to stenosis & regurgitation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

How to Dx Rheumatic disease:

A

JONES (major) PEACE (minor) Critera
*Joints polyarthritis (hot, swollen joints)
*Heart (carditis, valve damage)
*Nodules (subcutaneous)
*Erythema marginatum (painless rash)
*Syndenham chorea (flinching movement)

*Previous rheumatic fever
*ECG and PR prolongation
*Arthragias
*CRP and ESR elevated
*Elevated temperature

Presence of 2 major or 1 major & 2 minor criteria.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

Clinical manifestations of Rheumatic Fever/Disease

A

-Carditis & valvulitis
-Polyarthritis
-Erythema marginatum
-Subcu nodules
-Arthragia
-Fever elevated ESR or C-reactive protein
-Prolonged PR interval

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

Pharmacological treatment for Rheumatic Disease:

A

-Penicillin
-NSAIDs-Salicylates (Aspirin)

56
Q

Are newborns obligatory nose breathers?

A

Yes. Newborns tend to have non-productive coughs which makes them more susceptible to respiratory infections

57
Q

Clinical manifestations of respiratory dysfunction

A

*Respiratory distress: grunting, nasal flaring, retractions, cyanosis, tachypnea

Associated symptoms:
-Fever
-Anorexia
-Vomiting
-Nasal blockage & drainage
-Agitation/ excessive fussiness

58
Q

Cystic fibrosis pathophysiology:

A

Exocrine galdn dysfunction that involves the respiratory, GI, and reproductive systems.
-Thick mucus accumulates in glands and ducts
-Mechanical obstruction
-Pancreas ducts are blocked which prohibits that secretion of pancreatic enzymes that aid in digestion. May lead to diabetes
-Constant/increased respiratory infections

59
Q

Diagnostic testing for cystic fibrosis:

A

-Sweat chloride test: + 60
-Chest X-ray: consolidation & atelectasis
-Pulmonary function test: lowers over time
-Stool fat and enzyme analysis: Decrease in Fat soluble vitamins (ADEK)

60
Q

Signs and symptoms of cystic fibrosis:

A

-Wheezing/crackles
-Diminished breath sounds
-Generalized obstructive emphysema
-Patchy atelectasis
-Clubbing of fingers and toes
-Bronchitis & pneumonia
-Meconium ileus
-Steaorrhea
-Tachypnea, hypoxia and cyanosis
-Salty skin/tears (hyponatremia & hypochloremic)
-Hypoalbuminemia
-Distal intestinal obstruction syndrome
-Dehydration
-Sterility in males

61
Q

CF: Compression of pulmonary blood vessels leads to…

A

Pulmonary hypertension, respiratory failure, and death.

62
Q

Medical care for cystic fibrosis:

A

-CPT (chest physiotherapy) b/f meals 2/3 times per day
-Bronchodialator meds
-IS
-Antibiotics
-Chest tube insertion
-Steroids & NSAIDS
-Transplant
- Enzyme replacement with meals
-Salt supplementation

63
Q

What kind of meals should be implemented with cystic fibrosis?

A

High protein and high calorie
-Vitamin supplementation

64
Q

Education/discharge instructions for CF:

A

-CPT at home and then suction
-Do not eat before PT
-Monitor child’s weight

65
Q

Nursing interventions for CF:

A

-Wash hands
-Monitor temp q 4 hours, report temp over 101.3 or three temps greater than 100 in 24 hr
-Assess for s/s of infection
-Monitor CBC, protein, albumin, and cultures

66
Q

Etiology of pharyngitis:

A

Adenovirus and Group A Beta-hemolytic streptococci

67
Q

How to diagnose pharyngitis:

A

Throat culture with rapid step test.

68
Q

Signs and symptoms of pharyngitis:

A

-Abrupt onset
-Fever
-Sore throat
-Difficulty swallowing
-HA
-Abdominal pain
-Inflammed, red, and enlarged pharynx, often covered with exudate
-Anterior cervical lymphadenopathy
-Petechiae on the palate

69
Q

How to prevent pharyngitis & tonsillitis:

A

Hand washing, cover cough and avoid second-hand smoke

70
Q

Nursing management for pharyngitis:

A

Viral
-Supportive care
-Acetaminophen or ibuprofen
Bacterial
-Penicillin (amoxicillin) 10 days

71
Q

Education/discharge instructions for pharyngitis:

A

-Give full and all doses for antibiotics
-No school for 24 hrs until fever free
-Acetaminophen or ibuprofen
-New toothbrush

72
Q

Pathophysiology & etiology for tonsillitis:

A

Inflammation & infection of the tonsils by virus or Group A strep

73
Q

Signs and symptom for tonsillitis:

A

-Enlarged tonsils
-Dysphagia
-HA
-Malaise
-Halitosis

74
Q

What is a potential complication of tonsillitis?

A

Peritonsillar abscess

75
Q

Medical care for tonsillitis:

A

Tonsillectomy for chronic tonstillitis
-6 weeks after infection is resolved
-3 treated infections in one yr indicate need for surgery.

76
Q

Aftercare for tonsillectomy:

A

-Pain medications
-Keep patient on lateral side
-Avoid coughing, clearing of the throat and blowing the nose.
-Give ice packs
-Give water, ice chips and ice pop (do not give brown or red pops)
-Give gelatin foods, cooked fruit, sherbert, soup mashed potatoes if liquids are tolerated well
-Avoid milk and dairy

77
Q

Education and discharge instructions for tonsillectomy:

A

Avoid highly seasoned foods and aggressive brushing/garggling

78
Q

What may indicate that the child is bleeding after a tonsillectomy?

A

Continious swallowing, restlessness, increased HR, and pallor.

79
Q

Croup etiology:

A

-Parainfluenza virus or RSV
-Less often Group A, S
pnuemoniae, S aureus
Affects the larynx, trachea, and bronchi

80
Q

Signs and symptoms of Croup:

A

-Hoarseness
-“barking” cough
-inspiratory stridor
-Varying degrees of respiratory distress

81
Q

Medical mangement for Croup:

A

Corticosteriods, Nebulized epinephrine.

82
Q

Acute Epiglottitis Pathophysiology & Etiology

A

-Acute inflammation of the epiglottis
-Haemophilus influenzae type b (HiB)

83
Q

Acute epiglottitis Clinical Manifestations:

A
  • Rapid onset
  • Tripod positioning
  • Drooling, protruding tongue
  • Dysphagia
  • Muffled Speech
  • Retractions
  • Inspiratory stridor
  • High Fever 105
84
Q

Prevention of Acute epiglottitis:

A

Haemophilus influenzae type b (Hib) vaccine

85
Q

Diagnostic testing for Acute epiglottitis:

A
  • Steeple Sign (airway x-ray)
  • Thumb Sign (lateral airway x-ray)
86
Q

Nursing interventions for acute epigottitis:

A
  • Antibiotics
  • Cool mist humidification
  • Oxygen
  • IV fluids
  • Do not examine the throat due to risk of laryngospasm (emergency)
  • Monitor for drooling and tripod positioning (leaning forward) as these are signs of airway obstruction and warrant immediate attention
  • Trach/endotracheal tube available
87
Q

Acute Laryngotracheobronchitis (LTB) Etiology:

A
  • S. aureus, RSV, parainfluenza virus
88
Q

Clinical Manifestations of Acute Laryngotracheobronchitis (LTB):

A
  • Inspiratory stridor
  • Suprasternal retractions
  • Barking or “seal-like” cough
  • Increasing respiratory distress and hypoxia
  • Purulent sputum
  • High Fever
89
Q

Therapeutic Management for Acute Laryngotracheobronchitis (LTB):

A
  • Airway management: high flow nasal canula
  • Maintain hydration, I/O’s (orally or intravenously)
  • High humidity with cool mist
  • Nebulizer treatments, racemic epinephrine, steroids
90
Q

Pathophysiology & Etiology of Otitis externa (swimmer’s ear):

A
  • persistent excessive moisture causes an inflammatory reaction in canal, pinna, & TM.
  • Worse in warm climates and summertime
  • Long time submerged in water
  • Pseudomonas, Candida, & Aspergillus
  • Digital trauma, foreign body
91
Q

Clinical Manifestations of otitis externa (swimmer’s ear):

A
  • Feeling of pressure/fullness
  • Redness and edema of ear canal
  • Itching
  • Pain with chewing or when pinna or tragus is manipulated
  • No fever
  • Otorrhea
92
Q

Nursing Management for otitis externa (swimmer’s ear):

A
  • Focus on prevention
  • Keep canal dry
  • Warm compresses can help manage pain
93
Q

Medications for otitis externa (swimmer’s ear):

A
  • Ear drops (antibiotic/antifungal)
  • Glucocorticosteroids (prednisone)
  • Antipyretics/Analgesics
  • NSAIDS
94
Q

Etiology of otitis media:

A
  • Streptococcus pneumoniae, H. influenza &
    Moraxella catarrhalis are the most common bacteria
  • Passive smoke increase risk
  • URI, allergic rhinitis or hypertrophic adenoids
  • Breastfeeding babies have a lower risk both horizontal positioning and immature
    structure/function of the eustachian tubes predispose small children
95
Q

Clinical Manifestations for otitis media:

A
  • Ear Pain
  • Fever
  • Purulent discolored effusion and a bulging,
    red, immobile tympanic membrane
  • Irritability and ear pulling is the initial signs
    for infants who are non-verbal
96
Q

Pharmacologic management for otitis media

A
  • Antibiotic x 10-14 days
  • Acetaminophen or ibuprofen for pain management
  • Ear drops
97
Q

Patient education for otitis media:

A
  • Antibiotic administration
  • Hold child upright when feeding
  • Do not prop bottle
  • No Q-tips
  • No second hand smoke exposure
98
Q

Surgical management for tympanostomy:

A
  • Child may have temporary hearing loss
  • Keep bath water out of ear, keep out of lakes, no swimming for 2 weeks
  • No nose blowing for 7-10 days
  • Keep ears dry (earplugs or cotton balls)
99
Q

Pathophysiology of Bronchiolitis /Respiratory Syncytial Virus:

A

The bronchiole mucosa swell and lumina are filled with mucus and exudate

100
Q

Diagnostic Testing for Bronchiolitis /Respiratory Syncytial Virus:

A
  • ELISA-enzyme-linked immunosorbent assay
  • X-ray
101
Q

Clinical Manifestations for Bronchiolitis /Respiratory Syncytial Virus

A
  • URI, rhinorrhea
  • Fever
  • Non-productive cough, paroxysmal
  • Apnea
  • Intercostal retractions is a hallmark sign of this diagnosis
102
Q

Therapeutic Management for Bronchiolitis /Respiratory Syncytial Virus

A
  • Contact precautions
  • Monitor oxygenation, cool mist/hood/tent
  • Bronchodilator therapy
  • Hydration / IV therapy
  • Use of bulb syringe, saline drops to nares prior to all feeds (infants are nose breathers)
  • Continue to breast feed or pump if infant wont feed
103
Q

Etiology of Pertussis (Whooping Cough):

A
  • Caused by Bordetella pertussis
  • Children who have not been
    immunized/incomplete
  • Highest incidence in spring and summer
104
Q

Prevention of Pertussis (Whooping Cough):

A
  • Prevention Vaccines are available
  • DTaP is the childhood vaccine
  • Tdap booster vaccine for preteens, teens,
    and adults
105
Q

Clinical Manifestations of Pertussis (Whooping Cough):

A
  • Paroxysmal cough
  • Inspiratory whoop
  • Cyanosis
  • Red face/protruding tongue with cough
  • Vomiting
  • Conjunctival hemorrhage/facial petechiae
106
Q

Pertussis (Whooping Cough) Therapeutic Management:

A
  • Maximize nutrition
  • Provide adequate hydration
  • Rest and recovery
  • Antibiotics as prescribed
  • Keep open airway
  • Monitor oxygen saturation
107
Q

Pharmacological Management and isolation type of Pertussis (Whooping Cough):

A
  • Antibiotics (erythromycin or
    trimethoprim/sulfamethoxazole)
  • Isolation: droplet and contact
108
Q

Clinical Manifestations of Influenza:

A

Rapid onset of high fever, myalgia, headache, sore throat,
nonproductive cough

109
Q

What medication is given for influenza?

A

Tamiflu

110
Q

Nursing implications for Tamiflu

A

Start within 1st 48 hours

111
Q

Isolation type and Nursing care for Influenza:

A

*Droplet and contact

  • Supportive (antipyretics,
    rest, hydration)
  • Isolated until signs/symptoms subside
  • No aspirin
112
Q

Foreign Body Aspiration /Obstruction s/s:

A

Airway
* Inability to speak, drooling, cyanosis, syncope, stridor

Ear
* Drainage, hearing loss, pain, cerumen impaction

Nose
* Drainage, warped sense of smell, frequent blowing of nose or “sniffing,” mouth
breathing

113
Q

Therapeutic Management of foreign body aspiration/obstruction:

A
  • Retrieve foreign object
  • Educate on prevention!
  • Appropriate toys according to developmental age
  • Supervise children at all times
  • Be very diligent about toys or items that contain small piece
114
Q

Asthma Pathophysiology & Causes:

A
  • Inflammation and edema of the mucous membranes, accumulation of tenacious secretions from mucous glands, and spasms or the smooth muscle of the bronchi and bronchioles which decrease the caliber of the
    bronchioles
  • IgE mediated response
  • Extrinsic/environmental
115
Q

Clinical Manifestations of asthma:

A
  • Wheezing
  • Tachypnea
  • Non-productive cough
  • Chest tightness
  • Prolonged expiratory phase
116
Q

Asthma preventative measures & diagnostic testing:

A
  • Identify triggers
  • Allergy testing to determine sensitivities
  • Pulmonary function tests
  • Skin testing for allergens
117
Q

Complications of Asthma:

A
  • Status Asthmaticus; asthma attack not controlled by inhaled medication
  • Respiratory distress continues despite vigorous therapeutic measures
  • Emergency treatment: epinephrine 0.01 ml/kg subcutaneously (maximum dose 0.3 ml)
  • Emergency: silent chest (absence of wheezing in a previously wheezing patient
118
Q

Patient Education for asthma:

A
  • Symptom recognition
  • Allergen control or avoidance of precipitating activities or substances
  • Using a peak flow meter; monitor function with peak flow meter
  • Asthma action plan
  • Oral hygiene when using inhalers
119
Q

Pharmacological Therapy for asthma (long-term and short-term):

A

Short Term
* Short acting beta-agonists-Albuterol (#1)
* This is your rescue inhaler for symptomatic treatment

Long Term/Preventative
* Corticosteroids (The inhaled form is the anti-inflammatory drug of choice for persistent asthma.)
* Mast cell stabilizers (anti-inflammatory drugs)
* Long-acting beta-agonists (bronchodilators often used along with an anti inflammatory drug)
* Theophylline (a bronchodilator used along with an anti-inflammatory drug to prevent nighttime symptoms)
* Leukotriene modifiers (an alternative to steroids and mast cell stabilizers)
* Xolair (an injectable asthma medication used when inhaled steroids for asthma failed to control asthma symptoms in people with moderate to severe asthma who also have allergies)

120
Q

Bronchopulmonary Dysplasia Pathophysiology & Prevention:

A
  • long term O2 use causes dependence, damages tissue, causes fibrosis
    w/ decreased compliance.

Prevention
* Keep 02 at the lowest possible concentrations in newborns

121
Q

Diagnostics for Bronchopulmonary Dysplasia:

A

CXR will show cyst formation, increased density, and hyperinflation of the lungs

122
Q

Therapeutic and Phamacological Management for Bronchopulmonary Dysplasia:

A
  • Wean newborn’s off O2 ASAP

Pharmacological:
* Bronchodilators (Albuterol)
* Anticholinergic (Ipratropium)
* Xanthine (Theophylline)
* Inhaled Glucocorticoids (Fluticasone)

123
Q

Esophageal Atresia and Tracheoesophageal Fistula
Pathophysiology:

A

The esophagus ends in a blind pouch. Sometimes body naturally creates a fistula
connecting to the trachea.

124
Q

Esophageal Atresia and Tracheoesophageal Fistula
Clinical Manifestations:

A
  • Excessive drooling/secretions/frothing
  • Cyanosis
  • Respiratory distress/coughing
  • Choking with attempted feeds
  • Inability to pass NG/OG tubes
125
Q

Diagnostic Testing for Esophageal Atresia and
Tracheoesophageal Fistula:

A
  • Prenatal sonogram
  • CXR
126
Q

Therapeutic Management for Esophageal Atresia and
Tracheoesophageal Fistula:

A
  • Maintain patent airway
  • NPO immediately, high aspiration risk
  • Positioning
    *No NG tube
  • Surgical correction
    Obtain consent
127
Q

A 4 year old on aspirn therapy has rheumatic fever what should you monitor for:

A

Gastric alternation

128
Q

A child with a cyanotic heart disorder is going to have their teeth cleaned, what med should the nurse anticipate?

A

Amoxicillin

129
Q

What medication does the nurse anticipate for a child with hyperplastic heart defect?

A

Prostaglandins, keeps defect open

130
Q

What is Reye’s syndrome?

A

encephalitis-like illness that occurs when taking aspirn with a viral disease.
Watch out for N/V, lethargy, indifference, delirum and rapid breathing.

131
Q

What pathogen causes epigoltitis?

A

Hib

132
Q

Do not give fluids to a child who is drooling. T or F

A

True

133
Q

Do we give bronchodilators before or after chest physiotherapy?

A

before

134
Q

Which vaccine is not a live one?

A

Hep B

135
Q

What tool is used to determine the size of the VSD?

A

Echocardiogram

136
Q

What foods have good potassium?

A

Green leafy vegetables, grapefruit, oranges