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NSG 332 Pediatrics > Exam 3 > Flashcards

Exam 3 Flashcards

1
Q

2 reasons kids are admitted to hospital

A

GI problems

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2
Q

responsibilities of small intestine

A
  • osmosis
  • carrier-mediated diffusion
  • active energy-driven transport (“pump”)
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3
Q

responsibilities of large intestine

A
  • absorption of water
  • absorption of sodium
  • role of colonic bacteria
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4
Q

what would you expect stool to look like in malabsorption?

A

watery

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5
Q

what is included in a GI assessment?

A
  • teeth
  • swallowing
  • auscultate 4 quadrants
  • palpate stomach
  • see what comes out
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6
Q

who is at greater risk for mortality and morbidity among infants and children?

A

those that are <5 years

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7
Q

does diarrhea cause metabolic acidosis or alkalosis?

A

metabolic acidosis

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8
Q

should an anti-diarrhea medication be given to kids?

A

no, something needs to get out and it can cause an ileus

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9
Q

what is important to monitor for and to do with those who have diarrhea?

A
  • oral rehydration therapy
  • IV
  • monitor K+ levels
  • I and O
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10
Q

BRAT diet

A

Bananas
Rice
Applesauce
Toast

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11
Q

should the nurse do anything for vomiting?

A
  • no; there is a reason for it
  • have the child sit upright so no aspiration
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12
Q

best medication for nausea/vomiting

A

zofran

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13
Q

leading cause of accidental death in <4 years

A

ingestion of foreign bodies

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14
Q

should the nurse attempt to take a foreign body out?

A

only if you can see it

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15
Q

should the nurse attempt to take a foreign body out?

A

only if you can see it

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16
Q

idiopathic (functional) constipation

A

no known cause

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17
Q

chronic constipation

A

may be due to environmental or psychosocial factors (don’t want to poop at school)

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18
Q

when should the first meconium be passed?

A

within 24-36 hours of life

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19
Q

if no meconium, what should the nurse assess for?

A
  • hirschsprung disease, hypothyroidism
  • meconium plug, meconium ileus, cystic fibrosis
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20
Q

an infant being fed what might develop constipation?

A

formula

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21
Q

encopresis

A

inappropriate passage of feces, often with soiling (accidents)

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22
Q

if the bowel is obstructed what kind of interventions need to be done?

A

may require 6-12 months of behavioral/dietary/pharmacologic interventions

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23
Q

hirschsprung disease

A
  • congenital aganglionic megacolon
  • absence of ganglion cells in colon
  • ribbon like stool
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24
Q

gastroesophageal reflux (GER)

A
  • transfer of gastric contents into esophagus
  • occurs in everyone
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25
Q

how can the nurse prevent GER/GERD in children?

A
  • thickening feedings
  • upright positioning
  • frequent burping during feeds
  • avoid overfeeding
  • positioning to promote gastric emptying
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26
Q

irritable bowel syndrome (IBS)

A
  • cause of recurrent abdominal pain in children
  • alternating diarrhea and constipation
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27
Q

clinical manifestations of acute appendicitis

A
  • epigastric pain -> McBurney’s point - RLQ abd
  • fever, nausea, vomiting, pain
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28
Q

if someone with signs of appendix suddenly begins to feel better, what would be concerning?

A

that it ruptured and now they are becoming septic

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29
Q

hypertrophic pyloric stenosis (HPS)

A
  • nonbilious projectile vomiting
  • visible peristalsis
  • FTT in infant who is “always hungry”
  • dehydration
  • metabolic alkalosis
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30
Q

pyloromyotomy

A

laparoscopic surgery of the pyloric stenosis

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31
Q

intussusception

A
  • telescoping or invagination of one portion of intestine into another
  • sudden onset of abdominal pain
  • abdominal mass “sausage like”
  • bloody stool
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32
Q

what kind of stools occur in intussusception?

A

“currant jelly-like stools”; caused form leaking blood and mucus into intestinal lumen

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33
Q

what are the top three treatments for intussusception?

A
  1. air enema
  2. hydrostatic (saline) enema
  3. if unsuccessful, surgery treatment
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34
Q

short bowel syndrome (SBS)

A
  • malabsorptive disorder
  • diarrhea and watery stools
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35
Q

esophageal atresia (EA) and tracheoespophageal fistula (TEF)

A
  • congenital defect where the esophagus fails to develop as a continuous single passage to stomach
  • ensure patient airway (suction)
  • NPO
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36
Q

what are signs that someone has EA or TEF?

A

Cough
Choke
Cyanosis

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37
Q

omphalocele

A
  • sealed in sac
  • bowel covered with peritoneal sac, seen at birth or on US
  • cover with wet, sterile dressing
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38
Q

gastroschisis

A
  • bowel herniates through a defect in the abdominal wall to the right of the umbilical cord
  • cover with wet, sterile dressing
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39
Q

school aged children ages

A

6-12 years

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40
Q

when do children typically lose their teeth?

A

usually between kindergarten and 12

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41
Q

how much should height increase per year?

A

2 inches per year

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42
Q

how much should weight increase per year?

A

2-3 kg per year

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43
Q

prepubescence

A

defined as 2 years preceding puberty

44
Q

what is the average age of puberty in girls and boys?

A
  • 12 in girls: breast, bud development
  • 14 in boys: testicular descention
45
Q

what is erikson’s stages in this age group?

A

industry vs. inferiority (don’t shame them)

46
Q

what is a good way to punish a child?

A

taking something away from them for a while

47
Q

what perceptions do children have about an illness?

A

that it is a punishment for something they did

48
Q

what kind of play do children participate in?

A

team play

49
Q

who is the primary influence in shaping a child’s personality, behavior, and value systems?

A

parents

50
Q

when is an ideal time for formal sex education?

A

middle childhood

51
Q

how would a child internalize stress?

A

withdrawing, delaying tactics, and daydreaming

52
Q

how would a child externalize stress?

A

aggression and delinquency

53
Q

stress responses that should be investigated

A
  • stomach pains or headache
  • sleep problems
  • bet-wetting
  • change in eating
  • aggressive or stubborn behavior
  • reluctance to participate
  • regression to earlier behaviors (thumb sucking)
54
Q

how much sleep should children be getting?

A
  • 9 1/2 hours during school age
  • 11 1/2 for 5 year olds
  • 9 hours for 11 year olds
55
Q

most common cause of severe injury and death in a school-aged child

A

motor vehicle crashes

56
Q

what are the rules for carseats and riding in the backseat of a car?

A
  • under 4’ 9” in a booster
  • 13 and under in the backseat
57
Q

what could bet wetting be a sign of?

A
  • regression
  • UTI
  • endocrine problems
  • stress
  • sexual abuse
  • if occurs at least 2 weeks for at least 3 months
58
Q

who is bet wetting more common in?

A

boys

59
Q

when does bet wetting end?

A

between 6-8 years

60
Q

how many mL of fluid is sufficient to hold a night’s urine?

A

300-350 mL

61
Q

drugs that help with enuresis

A
  • imipramine (tofranil)
  • oxybutynin
  • DDAVP
62
Q

encopresis

A

repeated voluntary or involuntary passage of feces

63
Q

who is encopresis more common in?

A

males

64
Q

when would encopresis be a concern?

A

if occurs once a month for 3 months

65
Q

characteristics of ADHD

A
  • inattention, impulsiveness, and hyperactivity
  • onset before age 7
  • more common in boys than girls
  • get them some activity!
66
Q

medications for ADHD

A

stimulants:
- dextroamphetamine (dexedrine or adderall)
- amphetamine
- caffeine is a stimulant; it calms them down

67
Q

side effects of medications used for ADHD

A
  • high risk of abuse, so use as last resort
  • insomnia
  • anorexia and weight loss
  • hypertension
  • if used long-term, may suppress growth
68
Q

symptoms of conversion reactions

A
  • abdominal pain
  • fainting
  • pseudo seizures (rule out with EEG)
  • paralysis
  • headaches
    visual field restriction
69
Q

when do psychotic orders appear?

A

after age 4-5

70
Q

what does TDAP vaccine focus on and what age is it adminitered?

A
  • focuses on pertussis
  • school requires it
  • age 11-12
71
Q

is it normal for kids to be weak or lethargic?

A

NO

72
Q

what is the most common permanent physical disability in childhood?

A

cerebral palsy (CP)

73
Q

most common form of CP

A

spasticity is most common with 68% of cases ~ muscles are stiff and tight

74
Q

signs of CP

A
  • poor head control after 3 months
  • stiff or rigid limbs
  • arching back/pushing away ~ head-to-heals
  • floppy tone
  • unable to sit without support at 8 months
  • clenched fists after 3 months
  • excessive irritability
  • no smiling by 3 months
  • feeding difficulties
75
Q

what pharmacologic interventions help with spasms in CP?

A

baclofen and diazepam (valium)

76
Q

what is good to include in the mother’s diet to avoid neural tube defects (NTD)?

A

folic acid

77
Q

most serious NTD

A

anencephaly

78
Q

anencephaly

A
  • do not have a brain
  • brainstem function keeps them breathing
  • incompatible with life
  • many are stillborn
  • provide comfort but no resuscitation
79
Q

myelomeningocele

A
  • 75% of spinal cord in lumbar area
  • hydrocephalus most frequently associated anomaly
80
Q

what kind of allergy would the nurse expect in someone with spina bifida?

A

latex allergy

81
Q

guillain-barre syndrome

A
  • ascending muscular weakness
  • Ground to Brain
  • can happen after flu shots
  • most deaths are due to respiratory failure, so have intubation ready
82
Q

tetanus

A

“lockjaw” produced by a toxin

83
Q

where would you find botulism?

A
  • in improperly sterilized home-canned foods for older children
  • honey and light or dark corn syrup in infants
84
Q

CMS acronym for assessing casts

A

Circulation
Movement
Sensation - have them look away

85
Q

most frequently broken bone in children

A

forearm ~ clavicle is 2nd

86
Q

RICE for sports injury

A

Rest the injured part
Ice immediately (30 minutes at a time)
Compress with wet elastic bandage
Elevation of the extremity

87
Q

ICES for sports injury

A

Ice
Compression
Elevation
Support

88
Q

hallmark signs of diabetes

A

poluria, polydipsia, polyphagia

89
Q

DKA acronym for clinical manifestations of DKA

A

D
Decreased LOC
Dehydration
K
Kussmal RR
Ketones
K+ = Kardiac
A
Acid
+ Anion - Acid gain
Airway

90
Q

what do you do first in kids with DKA?

A

rehydrate them! 1u = 1mL

91
Q

hypoglycemia S/S

A
  • shakiness
  • palpitations
  • nervousness
  • diaphoresis
  • anxiety
  • hunger
  • pallor
92
Q

what is more life-threatening: hypo- or hyper- glycemia?

A

hypoglycemia ~ always treat something as hypoglycemia

93
Q

treatment for hypoglycemia

A
  • consume 15 g of a simple car like fruit juice or a soft drink, 4-6 oz = 15g
  • recheck glucose in 15 minutes
  • repeat step 1 if still less than 70
  • avoid foods with fat
  • give complex CHO after recovery
94
Q

how do you treat hypoglycemia if the patient is not alert enough to swallow?

A
  • 50% D IV push
  • glucagon 1 mg IM or SQ
95
Q

what does insulin do to K?

A

decreases

96
Q

in GH deficiency, what is the primary site of dysfunction?

A

hypothalamus

97
Q

when does pituitary hyperfunction occur?

A

when someone reaches heights of 8 feet or more

98
Q

precocious puberty

A
  • sexual development before age 9 in boys or age 8 in girls
  • no causative factor in 80%-90% girls and 50% boys
99
Q

how do we treat precocious puberty?

A

lupron

100
Q

S/S of hypothyroidism

A
  • LOW AND SLOW
  • hair loss
  • apathy
  • lethargy
  • dry skin
  • muscle aches and weakness
  • constipation
  • intolerance to cold
  • receding hairline
  • facial and eyelid edema
  • dull-blank expression
  • extreme fatigue
  • thick tongue - slow speech
  • anorexia
  • brittle nails and hair
  • menstrual disturbances
101
Q

what is a concern with a goiter?

A

that the airway can be impacted

102
Q

what happen with thyroid hormones in hypothyroidism? hyperthyroidism?

A
  • hypo: TSH inc. T3 and T4 dec.
  • hyper: TSH dec. T3 and T4 inc.
103
Q

S/S hyperthyroidism

A
  • FAST AND ELEVATED
  • finger clubbing
  • tremors
  • diarrhea
  • menstrual changes (amenorrhea)
  • intolerance to heat
  • fine, straight hair
  • bulging eyes
  • facial flushing
  • tachycardia
  • inc. systolic BP
  • breast enlargement
  • weight loss
  • muscle wasting
  • localized edema
104
Q

rapid insulin

A

humalog and lispro

104
Q

rapid insulin

A

humalog and lispro

NSG 332 Pediatrics (4 decks)

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