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Exam 2 Peds & IV therapy Flashcards

1
Q

1 IVstart site

A

AC space

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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

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3
Q

how can you decrease the risk of infection with IV’s

A

handwashing
use only once
approved antiseptic technique

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4
Q

name the 3 phases of intravenous therapy

A

pre-cannulation
cannulation (acessing the vein)
postcannulation (after its in)

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5
Q

what will anxiety cause in a pt that you are trying to start an IV

A

vasoconstriction

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6
Q

when choosing the best vein start where

A

distal to proximal

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7
Q

veins

A 
dark red blood
slow blood return
have valves
blood flow is towards heart
superficial
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8
Q

where do you place the tourniquet

A

2-6 inches away from insertion site

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9
Q

if you pt is hairy do you cut or shave hair

A

cut hair

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10
Q

butterfly’s are usually used for what

A

blood draws

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11
Q

cannula

A

hollow plastic tube, catheter

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12
Q

bevel

A

slanted edge on opening of the needle or cannula device

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13
Q

a 24 gauge catheter is used for what pt

A

infant

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14
Q

a 20 guage catheter is used for what pt

A

average adult pt

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15
Q

a 14 guage catheter is used for what pt

A

trauma pt

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16
Q

distal

A

farthest from heart

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17
Q

proximal

A

nearest to the heart

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18
Q

the bevel is always what?

A

up

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19
Q

what angle should your needle be at

A

15-30 degrees

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20
Q

when do you take off the tourniquet

A

after blood draw or right after IV stick if no blood draw needed

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21
Q

how many sticks are you allowed to have before you hve to get another nurse

A

2 sticks

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22
Q

if the IV fluid has stopped what should you check for

A

tube kink, vein valve occlusion, check all eqiopment

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23
Q

when do you need to get a MD order for IV sticks

A

foot access

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24
Q

when do IV sites have to be changed

A

Q96 hours or PRN

24 hours if started by Paramedic

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25
Q

When do you have to change the IV tubing

A

Q96 hours

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26
Q

when do you have to change the IV fluid

A

contains Rx: 24 hours

does not contain Rx: 48 hours

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27
Q

what do you lable the IVF bag with

A

time up & down, date time, inititals

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28
Q

when do you fluish a IV site

A

flush with 3mL of NS, Q8 hours, change the cap to a saline lock Q72 hours
Need to assess site Q4 hours

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29
Q

how often do you assess a PEDs IV site

A

Qhour

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30
Q

for pediatic patients what do you need to make sure is on IV line/pump

A

buretrol

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31
Q

what are comlications of the IO

A

osteomyletis, infiltration

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32
Q

when do you document a 3 mL flush

A

on pts with fluid restriction

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33
Q

what do you do if you remove a catheter and it is not intact

A

place tourniquet on PT immediately, Call MD

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34
Q

S/Sx of phlebtis

A

red warm, sore

DC IV then cool compress

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35
Q

S/Sx of thrombophelbitis

A

sore hard cord like vein, red line above site, edema, sluggish or stopped IV
DC IV, warm compress, assess

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36
Q

S/Sx of infection

A

red sore, edematous, drainage

DC IV site, culture of site and catheter tip, clean, dress site, observe pt for systemic s/sx

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37
Q

S/Sx of infiltration

A

edema, blanch at site, bumo at site, pain, redness, possible skin necrosis
assess, call MD, follow protocol for Rx

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38
Q

extravastation

A

keep IV site in place for possible antidote infusion

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39
Q

S/Sx of curculatory overload

A

dyspnea, cough, pitting edema with weight gain,

decrease IV rate, elevate head, dangle feet, VS, Breath sounds call MD

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40
Q

S/Sx of air embolism

A

chest, shoulder, lower back pain, hypotension, weak pulse, SOB decreased LOC
Tx: left side, MD, VS, O2, IV

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41
Q

S/Sx of body embolism

A

CP, shoulder lower back pain, SOB hypotension, weak pulse, decreased LOC
Tx: left side, tourniquet above IV site

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42
Q

S/Sx of septicemia

A

fever chills, tachy HA N/v, diarrhea

Tx: DC IV, cultures

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43
Q

IV push

A

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

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44
Q

if your IV push is not compatible with the IV fluid what do you do

A

stop machine, flush with 10mL NS, push Rx, flush with 10 mL then start IVF again

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45
Q

when flushing after a IV push medication the first mL should be pushed at what rate

A

the same as the 1st mL of the medication

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46
Q

is potassium chloride used in IVP

A

NO!!!!!!

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47
Q

always do what before a PEDs procedure

A

prepare child/parents

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48
Q

a fetus can feel pain at what gestation

A

20 weeks

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49
Q

when can you use the faces pain scale

A

age 3

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50
Q

can you give a plavebo

A

no its unethical

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51
Q

EMLA

A

numbs area give one hour prior to procedure

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52
Q

when est. trust with a PEDs pt who is the first person you should est this trust with

A

the caregiver, then the pt

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53
Q

kids are weighed

A

daily

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54
Q

when assessing the PEDs patient what order should you do the VS

A

RR
HR
B/P
temperature

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55
Q

when doing a rectal temperature you insert how far

A

until the temperature starts to register

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56
Q

when do the fontanels start to close

A

12-18 months

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57
Q

when checking skin turgor on a PEDs where would you check

A

abdomen

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58
Q

a bald spot on the back of a childs head could indicate

A

lack of moving the child

59
Q

at what age to infants get more control of thier head

A

4 months

60
Q

at what age can PEDs floow an object

A

3-4 months

61
Q

when taking a temperature how do you move the ear

A

down and back

62
Q

belly breathing means what

A

respiratory distress, having to work harder

63
Q

is a heart murmr normal

A

yes

64
Q

if the mother has gestational DM what could that indicate for the unborn baby

A

BIG baby

65
Q

Denver test

A

a developmental test, what kids should be doing at what age

66
Q

infant CPR

A

30-2

67
Q

pediatric doses should not exceed what

A

the minimum adult dose

68
Q

when giving medications and feeding kids what should you give first

A

give Rx first

69
Q

injection sites for PEDs

A

vastus lateralis perferred
dorsogluteal (only after child has been walking for one year)
ventrogluteal: child over 3
deltoid: 4-5 year olds

70
Q

what size IVF bags are hung for PEDs

A

500 mL only! want to prevent fluid overload

71
Q

S/sx of fluid over load

A

increase HR, BP

72
Q

when do you want to avoid aphthalmic medications

A

when the child is crying

73
Q

otic medication pull ear how

A

under 3 pull pina down and back

over 3 pull pina up and back

74
Q

what do you feed children when sick

A

whatever they want and whenever they want it

75
Q

normal temps for PEDs

A
  1. 6 oral
  2. 6 axillary
  3. 6 rectal
  4. 6 tympanic
76
Q

when do childrens temps spike quickly

A

afterrnoon and night

77
Q

at what temperature do you call the MD

A

100 degrees

78
Q

possible causes of seizures in PEDs

A

tumor, trauma, hypoglycemia, hyponurtemia, neurological problms, hx of seizures

79
Q

BP for PEDs

A

Systolic: for age 1-7 (age+90), for 8-18 (age+83)
diastolic: for age 1-5 (@56), age 6-18 (age + 52)

80
Q

if using a mist tent what do you need to watch for

A

change in PTs temperature

81
Q

if you have to weigh a diaper what is the weight = to?

A

1 gram is = 1 mL

82
Q

BMI for PEDs

A

height in inches

83
Q

what is phototherapy used for

A

jaundice

84
Q

transition period

A

newborn adjusts to extrauterine life

85
Q

when using bulb to clear airway use where first

A

mouth then nose

86
Q

Delee

A

deep suctioning of mouth, throat, nasal phyrnx and stomach

87
Q

why do you place baby on moms chest

A

helps with temperature, HR, and RR

88
Q

normal RR

A

30-60

89
Q

normal HR

A

110-160

90
Q

are apenic periods normal

A

yes! as long as they last no longer than 15 seconds

91
Q

what is abnormal in the PEDs respiratory effort

A

nasal flarring, grunting, retractions

92
Q

why do infants have heat loss

A

large surface area, limited subQ fat, superficial blood vessels

93
Q

4 types of heat loss

A

convection
radation
evaporation
conduction

94
Q

dont give kids ASA becasue

A

Reyes syndrome

95
Q

when a baby is cold they use what to regain temperature

A

extra calories and oxygen

96
Q

Apgar

A

asses cardiac pulmonary and neurosensory status

97
Q

acrocyanosis

A

blueing discoloratio nof hands and feet

Its NORMAL

98
Q

when checking umbilical cord what do you need to check

A

2 arteries and one vein

odor, drainage, bleeding, base for reddness

99
Q

ompahlitis

A

inflammatio nof umbilical cord

100
Q

when does the umbilical cord fall off

A

7-10 days

101
Q

is Wartons jelly normal

A

yes

102
Q

AGA

A

appropriate for gestational age

10th-90th percentile

103
Q

SGA

A

small for gestational age

below 10th percentile

104
Q

LGA

A

large for gestational age

above 90th percentile

105
Q

normal range for height

A

18-22 inches

106
Q

normal head measurement

A

12.5-14.5 inches

107
Q

normal chest measurement

A

12-14 inches

108
Q

why is vitamin K given to newborns

A

prevent hemorrhage

109
Q

give vitamin K where

A

lateral aspect of thigh

110
Q

when giving erythromycin when can it be removed

A

after one hour

111
Q

what is abnormal for the fontanelles

A

firm, bulging, or depressed

112
Q

vernix

A

protective white cheesy substance from sebaceous glands

113
Q

erythematous

A

beefy red coloring @ 6-12 hours after birth & return to normal

114
Q

milia

A

white papules

115
Q

lanugo

A

fine hair

116
Q

harlequin color

A

one side of the body pale while other side deep red

Tx: change postion

117
Q

sclera

A

white/blue

118
Q

strabismus

A

looking different directions

119
Q

nystagmus

A

twitching

120
Q

crackles are normal for a newborn for how long

A

first few hours

121
Q

a temperature decrease is a sign of

A

infection & respiratory distress

122
Q

jittering is a sign of what

A

hypoglycemia

123
Q

temperature needs to be what before you give a bath

A

97.7

124
Q

breast feeding is done when

A

8-12 times in a 24 hour period

125
Q

newborns need how many calories/kg.day

A

110-120 cal/kg/day

126
Q

hereditory metabolic disorder

A

newborn screening- PKU unable to metabolize and build ups and leads to perm brain damage

127
Q

where do you do a heel stick on a PEDs

A

lateral aspect of foot

128
Q

pulse ox for new born

A

right arm and left leg

129
Q

circumcision

A

keep petroeum jelly on it to protect, clamping crushes nerve endings and blood vessels

130
Q

is a high HR (180) & RR (90) normal for the first 30 minutes of life

A

yes

131
Q

lanugo peak

A

28-30 weeks then decreases

132
Q

inital period of newborn (first 30 minutes)

A

increase HR, RR, breif cyanosis, bowel sounds absent, good time for 1st feeding

133
Q

sleep phase

A

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
Q

second period of reactivity

A

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
Q

What are the meds newborns get first thing

A

Vitamin k
Erythromycin
Hep B

136
Q

Mongolian spots

A

Flat bluish area on lower back or butt

137
Q

Telangiectic nevi

A

Stork bite
On face or neck
Neck will stay forever

138
Q

Candida

A

Yeast

139
Q

Tinea

A

Ringworm

140
Q

Tina pedis

A

Athletes foot

141
Q

Tinea cruis

A

Jock itch

142
Q

Impetigo

A

Contagious skin infection

143
Q

Pediculosis

A

Lice

144
Q

Verrucae

A

Warts

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