Exam 2 Peds & IV therapy Flashcards
1
Q
1 IVstart site
A
AC space
2
Q
5 purposes of IV therapy
A
provide maintenacne requirements for fluids & electrolytes
replace previous losses
replace concurrent losses
provide nutrition
administeration of meds/blood & blood components
3
Q
how can you decrease the risk of infection with IV’s
A
handwashing
use only once
approved antiseptic technique
4
Q
name the 3 phases of intravenous therapy
A
pre-cannulation
cannulation (acessing the vein)
postcannulation (after its in)
5
Q
what will anxiety cause in a pt that you are trying to start an IV
A
vasoconstriction
6
Q
when choosing the best vein start where
A
distal to proximal
7
Q
veins
A
dark red blood slow blood return have valves blood flow is towards heart superficial
8
Q
where do you place the tourniquet
A
2-6 inches away from insertion site
9
Q
if you pt is hairy do you cut or shave hair
A
cut hair
10
Q
butterfly’s are usually used for what
A
blood draws
11
Q
cannula
A
hollow plastic tube, catheter
12
Q
bevel
A
slanted edge on opening of the needle or cannula device
13
Q
a 24 gauge catheter is used for what pt
A
infant
14
Q
a 20 guage catheter is used for what pt
A
average adult pt
15
Q
a 14 guage catheter is used for what pt
A
trauma pt
16
Q
distal
A
farthest from heart
17
Q
proximal
A
nearest to the heart
18
Q
the bevel is always what?
A
up
19
Q
what angle should your needle be at
A
15-30 degrees
20
Q
when do you take off the tourniquet
A
after blood draw or right after IV stick if no blood draw needed
21
Q
how many sticks are you allowed to have before you hve to get another nurse
A
2 sticks
22
Q
if the IV fluid has stopped what should you check for
A
tube kink, vein valve occlusion, check all eqiopment
23
Q
when do you need to get a MD order for IV sticks
A
foot access
24
Q
when do IV sites have to be changed
A
Q96 hours or PRN
24 hours if started by Paramedic
25
When do you have to change the IV tubing
Q96 hours
26
when do you have to change the IV fluid
contains Rx: 24 hours
| does not contain Rx: 48 hours
27
what do you lable the IVF bag with
time up & down, date time, inititals
28
when do you fluish a IV site
flush with 3mL of NS, Q8 hours, change the cap to a saline lock Q72 hours
Need to assess site Q4 hours
29
how often do you assess a PEDs IV site
Qhour
30
for pediatic patients what do you need to make sure is on IV line/pump
buretrol
31
what are comlications of the IO
osteomyletis, infiltration
32
when do you document a 3 mL flush
on pts with fluid restriction
33
what do you do if you remove a catheter and it is not intact
place tourniquet on PT immediately, Call MD
34
S/Sx of phlebtis
red warm, sore
| DC IV then cool compress
35
S/Sx of thrombophelbitis
sore hard cord like vein, red line above site, edema, sluggish or stopped IV
DC IV, warm compress, assess
36
S/Sx of infection
red sore, edematous, drainage
| DC IV site, culture of site and catheter tip, clean, dress site, observe pt for systemic s/sx
37
S/Sx of infiltration
edema, blanch at site, bumo at site, pain, redness, possible skin necrosis
assess, call MD, follow protocol for Rx
38
extravastation
keep IV site in place for possible antidote infusion
39
S/Sx of curculatory overload
dyspnea, cough, pitting edema with weight gain,
| decrease IV rate, elevate head, dangle feet, VS, Breath sounds call MD
40
S/Sx of air embolism
chest, shoulder, lower back pain, hypotension, weak pulse, SOB decreased LOC
Tx: left side, MD, VS, O2, IV
41
S/Sx of body embolism
CP, shoulder lower back pain, SOB hypotension, weak pulse, decreased LOC
Tx: left side, tourniquet above IV site
42
S/Sx of septicemia
fever chills, tachy HA N/v, diarrhea
| Tx: DC IV, cultures
43
IV push
only given by RN, takes 10-20 seconds for the Rx to reach the brain and heart, one minute to circulate throught the entire body
44
if your IV push is not compatible with the IV fluid what do you do
stop machine, flush with 10mL NS, push Rx, flush with 10 mL then start IVF again
45
when flushing after a IV push medication the first mL should be pushed at what rate
the same as the 1st mL of the medication
46
is potassium chloride used in IVP
NO!!!!!!
47
always do what before a PEDs procedure
prepare child/parents
48
a fetus can feel pain at what gestation
20 weeks
49
when can you use the faces pain scale
age 3
50
can you give a plavebo
no its unethical
51
EMLA
numbs area give one hour prior to procedure
52
when est. trust with a PEDs pt who is the first person you should est this trust with
the caregiver, then the pt
53
kids are weighed
daily
54
when assessing the PEDs patient what order should you do the VS
RR
HR
B/P
temperature
55
when doing a rectal temperature you insert how far
until the temperature starts to register
56
when do the fontanels start to close
12-18 months
57
when checking skin turgor on a PEDs where would you check
abdomen
58
a bald spot on the back of a childs head could indicate
lack of moving the child
59
at what age to infants get more control of thier head
4 months
60
at what age can PEDs floow an object
3-4 months
61
when taking a temperature how do you move the ear
down and back
62
belly breathing means what
respiratory distress, having to work harder
63
is a heart murmr normal
yes
64
if the mother has gestational DM what could that indicate for the unborn baby
BIG baby
65
Denver test
a developmental test, what kids should be doing at what age
66
infant CPR
30-2
67
pediatric doses should not exceed what
the minimum adult dose
68
when giving medications and feeding kids what should you give first
give Rx first
69
injection sites for PEDs
vastus lateralis perferred
dorsogluteal (only after child has been walking for one year)
ventrogluteal: child over 3
deltoid: 4-5 year olds
70
what size IVF bags are hung for PEDs
500 mL only! want to prevent fluid overload
71
S/sx of fluid over load
increase HR, BP
72
when do you want to avoid aphthalmic medications
when the child is crying
73
otic medication pull ear how
under 3 pull pina down and back
| over 3 pull pina up and back
74
what do you feed children when sick
whatever they want and whenever they want it
75
normal temps for PEDs
98. 6 oral
97. 6 axillary
99. 6 rectal
98. 6 tympanic
76
when do childrens temps spike quickly
afterrnoon and night
77
at what temperature do you call the MD
100 degrees
78
possible causes of seizures in PEDs
tumor, trauma, hypoglycemia, hyponurtemia, neurological problms, hx of seizures
79
BP for PEDs
Systolic: for age 1-7 (age+90), for 8-18 (age+83)
diastolic: for age 1-5 (@56), age 6-18 (age + 52)
80
if using a mist tent what do you need to watch for
change in PTs temperature
81
if you have to weigh a diaper what is the weight = to?
1 gram is = 1 mL
82
BMI for PEDs
weight (lbs) x 703
--------------------------
height in inches
83
what is phototherapy used for
jaundice
84
transition period
newborn adjusts to extrauterine life
85
when using bulb to clear airway use where first
mouth then nose
86
Delee
deep suctioning of mouth, throat, nasal phyrnx and stomach
87
why do you place baby on moms chest
helps with temperature, HR, and RR
88
normal RR
30-60
89
normal HR
110-160
90
are apenic periods normal
yes! as long as they last no longer than 15 seconds
91
what is abnormal in the PEDs respiratory effort
nasal flarring, grunting, retractions
92
why do infants have heat loss
large surface area, limited subQ fat, superficial blood vessels
93
4 types of heat loss
convection
radation
evaporation
conduction
94
dont give kids ASA becasue
Reyes syndrome
95
when a baby is cold they use what to regain temperature
extra calories and oxygen
96
Apgar
asses cardiac pulmonary and neurosensory status
97
acrocyanosis
blueing discoloratio nof hands and feet
| Its NORMAL
98
when checking umbilical cord what do you need to check
2 arteries and one vein
| odor, drainage, bleeding, base for reddness
99
ompahlitis
inflammatio nof umbilical cord
100
when does the umbilical cord fall off
7-10 days
101
is Wartons jelly normal
yes
102
AGA
appropriate for gestational age
| 10th-90th percentile
103
SGA
small for gestational age
| below 10th percentile
104
LGA
large for gestational age
| above 90th percentile
105
normal range for height
18-22 inches
106
normal head measurement
12.5-14.5 inches
107
normal chest measurement
12-14 inches
108
why is vitamin K given to newborns
prevent hemorrhage
109
give vitamin K where
lateral aspect of thigh
110
when giving erythromycin when can it be removed
after one hour
111
what is abnormal for the fontanelles
firm, bulging, or depressed
112
vernix
protective white cheesy substance from sebaceous glands
113
erythematous
beefy red coloring @ 6-12 hours after birth & return to normal
114
milia
white papules
115
lanugo
fine hair
116
harlequin color
one side of the body pale while other side deep red
| Tx: change postion
117
sclera
white/blue
118
strabismus
looking different directions
119
nystagmus
twitching
120
crackles are normal for a newborn for how long
first few hours
121
a temperature decrease is a sign of
infection & respiratory distress
122
jittering is a sign of what
hypoglycemia
123
temperature needs to be what before you give a bath
97.7
124
breast feeding is done when
8-12 times in a 24 hour period
125
newborns need how many calories/kg.day
110-120 cal/kg/day
126
hereditory metabolic disorder
newborn screening- PKU unable to metabolize and build ups and leads to perm brain damage
127
where do you do a heel stick on a PEDs
lateral aspect of foot
128
pulse ox for new born
right arm and left leg
129
circumcision
keep petroeum jelly on it to protect, clamping crushes nerve endings and blood vessels
130
is a high HR (180) & RR (90) normal for the first 30 minutes of life
yes
131
lanugo peak
28-30 weeks then decreases
132
inital period of newborn (first 30 minutes)
increase HR, RR, breif cyanosis, bowel sounds absent, good time for 1st feeding
133
sleep phase
begins at 30 minutes and lasts up to 4 hours
| normal RR, HR, color pink, audible bowel sounds, good time for mom and baby to sleep
134
second period of reactivity
begins 4-6 hours after birth
RR & HR normal, color changes are rapid color changes because of vasomotor instability-mottling, bowel sounds are audible, good time for feeding
135
What are the meds newborns get first thing
Vitamin k
Erythromycin
Hep B
136
Mongolian spots
Flat bluish area on lower back or butt
137
Telangiectic nevi
Stork bite
On face or neck
Neck will stay forever
138
Candida
Yeast
139
Tinea
Ringworm
140
Tina pedis
Athletes foot
141
Tinea cruis
Jock itch
142
Impetigo
Contagious skin infection
143
Pediculosis
Lice
144
Verrucae
Warts
