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Mom/Baby > Exam 3 > Flashcards

Exam 3 Flashcards

1
Q

Schema

A

Individuals cognitive structure or framework of thought

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2
Q

Eriksons infancy stage

A

Birth-18mo
Trust vs mistrust

Attachment to primary caregiver

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3
Q

Eriksons early childhood

A

18mo-3yrs
Autonomy vs shame and doubt

Gaining control over self and environment

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4
Q

Eriksons late childhood (preschool)

A

3-6yrs
Initiative vs guilt

Becoming purposeful and directive
Start lying, give choices, imaginary friend

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5
Q

Eriksons school age

A

6-12yrs
Industry vs inferiority

Developing social, physical, and learning skills

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6
Q

Eriksons adolescence stage

A

12-20 yrs
Identity vs role confusion

Developing identity

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7
Q

Interventions to help in infancy stage (eriksons)

A

Hold and touch infant regularly
Comfort after painful procedures
Meet basic needs
Play active role when infant is hospitalized

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8
Q

Interventions to help in the early childhood stage

A

Allow self-feeding
Child removes and puts on own clothes
Let child make choices, ensuring safety

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9
Q

Interventions to help in the late childhood stage

A

Offer medical equipment for play
Respect child’s choices and expressions of feelings

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10
Q

Interventions for school age stage

A

Encourage to continue schoolwork when hospitalized
Bring fav activities to hospital

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11
Q

Interventions for adolescence stage

A

Health history and exams without parent
Allow choice in plan of care

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12
Q

Sensorimotor

A

Birth-2yrs
Learns reality and how it works
Infant doesn’t recognize objects to exist if out of visual field

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13
Q

Preoperational stage

A

2-7yrs
Thinks in terms of past, present, future
Solutions to problems
Egocentric
Requires concrete examples

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14
Q

Concrete operational stage

A

7-11yrs
Classify, order and sort facts
Solves concrete problems with logic
Abstract thinking
Starts thinking how others may view a situation

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15
Q

Formal operational stage

A

11yrs-adult
Thinks abstractly and logically

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16
Q

Vaccines at birth

A

Hep B (1st dose)

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17
Q

Vaccines at 1 month

A

Hep B (2nd dose)

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18
Q

Vaccines at 2 months

A

IPV(polio), DTaP, Hib, PCV, Rotavirus (RV)

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19
Q

Vaccines at 2 and 4 months

A

DTaP, Hib, IPV (polio), PCV, RV (rotavirus)

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20
Q

Vaccines at 6 months

A

DTap, Hib, HepB, IPV, PCV, RV

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21
Q

Vaccines at 12-15 months

A

Hib, PCV, MMR, Hep A (1st dose), varicella

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22
Q

Vaccines at 15-18 months

A

DTap

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23
Q

Vaccines at 18-33 months

A

Hep A (2nd dose- 6-18 months after 1st dose)

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24
Q

Vaccines at 4-6 yrs

A

DTaP, IPV, MMR, varicella

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25
Q

Vaccine at 11-12 yrs

A

MMR (If not given at 4-6 yrs old), Tdap, MCV4, HPV (2nd dose 2 months later and 3rd dose 6 months after 1st dose)

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26
Q

flu vaccine in children

A

given yearly starting at age 6 months

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27
Q

Hep B vaccine

A

IM
contraindicated if allergy to aluminum hydroxide or yeast

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28
Q

Rotavirus vaccine (RV)

A

PO to replicate in infant’s gut
held if severe vomiting or diarrhea

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29
Q

Haemophilus influenzae type b (Hib)

A

IM
protects against infections caused by H. influenzae

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30
Q

MMR

A

SubQ
contraindicated if allergy to gelatin, eggs or neomycin

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31
Q

Baby weight

A

doubled at 5-6 months
tripled at 12 months

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32
Q

When is the head circumference equal to the chest

A

1-2yrs old

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33
Q

When does the anterior fontanel close

A

18 months

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34
Q

When does the posterior fontanel close

A

4 months

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35
Q

1 yr old VS

A

T 97-99
HR 90-130
R 20-40
BP 90/56

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36
Q

When are solid foods introduced

A

5-6 months
one at a time to identify allergens

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37
Q

Honey in children

A

avoid adding in formula, water, or other fluid to avoid botulism

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38
Q

infant skills at 2-3 months

A

smiles
turns head side to side
follows objects
holds head in midline

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39
Q

infant skills at 4-5 months

A

grasp objects
switches objects from hands
rolls over
begins to show memory
aware of unfamiliar surroundings

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40
Q

skills at 6-7 months

A

creeps
sits with support
imitates
exhibits fear of strangers
holds arms out
mood swings
waves bye

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41
Q

skills at 8-9 months

A

sits steadily unsupported
crawls
stands while holding on
begins to stand without help
Teething
Mama/dada

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42
Q

skills at 10-11 months

A

change from prone to sitting
walks while holding onto furniture
stands securely
entertains self for periods of time

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43
Q

skills at 12-13 months

A

walks with one hand held
takes few steps without falling
drinks from a cup
3-5 words

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44
Q

skills at 14-15 months

A

walks alone
crawl upstairs
shows emotions like anger and affection
will explore away from parent in familiar surroundings

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45
Q

infant play

A

solitary
soft stuffed animals
crib mobiles
rattles
water toys
push toys when able to walk

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46
Q

skills at 12-13 months

A

walk with one hand held

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47
Q

skills by 2 yrs old

A

running
vocab of 300 words

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48
Q

skills by 3 yrs old

A

walks backwards and hops on one foot

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49
Q

toddler play

A

parallel and therapeutic play
push-pull toys, blocks, sand, finger paints and bubbles, large balls, crayons, dolls, toy telephones, cloth books, wooden puzzles

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50
Q

preschooler skills

A

hop, skip, run smoothly
balance
alternates feet when climbing stairs
age 6- ties shoes
asks “why” questions
3 yrs old: 3-4 word sentences
4 yrs old: 5-6 word sentences

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51
Q

preschooler play

A

cooperative
imaginary friends
build and creates things - simple and imaginative
understands sharing
dress up, paints, paper, crayons

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52
Q

school age play

A

competitive
rules and rituals are important in games
drawing, collecting, pets, guessing games, board games, TV, reading, radio, PC games

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53
Q

cholesterol levels for children (2-19)

A

total <170
LDL <110
HDL >45

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54
Q

Early signs of HF

A

tachycardia
tachypnea
scalp sweating
fatigue/irritability
sudden weight gain
respiratory distress

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55
Q

digoxin in children

A

level- 0.8-2
hold if HR <90 for infants and <70 in older children
monitor K because low K can cause toxicity

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56
Q

signs of dig toxicity

A

anorexia
poor feeding
N&V
bradycardia
dysrhythmias

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57
Q

dig administration

A

1 hr before or 2 hours after feedings

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58
Q

manifestations of decreased CO

A

activity intolerance
decreased peripheral pulses
feeding difficulties
hypotension
irritability/restless/lethargy
oliguria
pale, cool extremities
tachycardia

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59
Q

Atrial septal defect (ASD)

A

Abnormal opening between right and left atria: increased flow of oxygenated blood into right side of heart

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60
Q

Atrial septal defect (ASD) symptos

A

could be asymptomatic
right heart enlargement
signs of HF
Decreased CO

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61
Q

Management of Atrial septal defect (ASD)

A

closed during cardiac cath
open repair with bypass performed before school age

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62
Q

Atrioventricular septum defect

A

incomplete fusion of the endocardial cushions
most common in down syndrome

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63
Q

Atrioventricular septum defect symptoms

A

murmur
mild-mod HF
cyanosis increases with crying
decreased CO

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64
Q

Managing Atrioventricular septum defect

A

pulm artery banding for severe sx
complete repair with bypass

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65
Q

Patent ductus arteriosis

A

failure of the shunt connecting the aorta and pulm artery to close within first weeks of life

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66
Q

symptoms of Patent ductus arteriosis

A

machinery-like murmur
asymptomatic or signs of HF
widened pulse pressure and bounding pulses
decreased CO
Increased pulm blood flow

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67
Q

Managing Patent ductus arteriosis

A

indomethacin to close patent ductus in premies
cardiac cath

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68
Q

Ventricular septal defect

A

abnormal opening between right and left ventricles
many close spontaneously during first year of life

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69
Q

symptoms of Ventricular septal defect

A

murmur
Signs of HF
decreased CO

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70
Q

aortic stenosis

A

commonly caused by malformed cusps
causes resistance to blood flow from lft ventricle into aorta= decreased CO

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71
Q

Signs of aortic stenosis

A

murmur
decreased CO
activity intolerance
chest pain
dizziness when standing for long periods

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72
Q

coarctation of the aorta

A

narrowing near insertion of ductus arteriosus

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73
Q

signs of coarctation of the aorta

A

BP higher in upper extremities than lower
bounding pulses in arms
weak/absent femoral pulses
cool lower extremities
HF
decreased CO
HA, dizziness, fainting
epistaxis from HTN

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74
Q

Managing coarctation of the aorta

A

balloon angioplasty - restenosis can occur

75
Q

pulmonary stenosis

A

narrowing at entrance of pulmonary artery
resistance causes right ventricular hypertrophy and decreased pulmonary blood flow

76
Q

pulmonary atresia

A

extreme form of pulmonary stenosis: total fusion and no blood flow to the lungs

77
Q

symptoms of pulmonary stenosis

A

murmur
cyanotic
decreased CO
HF

78
Q

tetralogy of fallot

A

four defects- VSD, pulm stenosis, overriding aorta and right ventricular hypertrophy

79
Q

signs of tetralogy of fallot

A

acute cyanosis at birth or mild cyanosis that progresses over first year of life
murmur
acute episodes of cyanosis (blue/tet spells) while crying, feeding or pooping
clubbing of fingers (children)
poor growth
squatting (knee to chest)

80
Q

tricuspid atresia

A

failure of tricuspid to develop
complete mixing of oxygenated and deoxygenated blood in left side of heart= decreased pulm blood flow

81
Q

signs of tricuspid atresia

A

cyanosis
tachycardia
dyspnea
clubbing (children)

82
Q

hypoplastic left heart syndrome

A

underdevelopment of left side of heart

83
Q

signs of hypoplastic left heart syndrome

A

mild cyanosis and signs of HF until arteriosus closes- leads to cardio collapse- fatal first few months of life if left untreated

84
Q

Pre-op cardiac cath

A

accurate ht and wt
check for allergy to iodine
assess for diaper rash (if entry through femoral artery)

85
Q

Post op cardiac cath

A

monitor o2 for 4 hrs
assess lower extremity pulses and color/temp

86
Q

rheumatic fever

A

inflammatory autoimmune disease that affects connective tissue of the heart, joints, skin, blood vessels and CNS

ask about sore throat- often manifests 2-6 wks after untreated group A strep

87
Q

S/S of rheumatic fever

A

chorea
fever
carditis
erythema marginatum ( skin lesions on trunk and spreading horizontally
abd pain
subQ nodules (over joints)
polyarthritis
elevated ESR

88
Q

chorea

A

involuntary movements of extremities and face
affects speech

89
Q

managing rheumatic fever

A

joint pain- alt heat and cold presses
massaging
bedrest if febrile
seizure precautions if chorea
need abt prophylaxis before dental work

90
Q

kawasaki disease

A

acute systemic inflammatory illness
cause unknown but may be from organism or toxin
aneurysms can develop

91
Q

acute stage of kawasaki disease

A

fever
conjunctival hyperemia
mucositis (cracked red lips and strawberry tongue)
Peeling skin
swelling of hands and feet and erythema of palms and soles
rash
enlargement of cervical lymph nodes
increased irritability
arthritis
gallop sounds and tachycardia

92
Q

subacute stage of kawasaki disease

A

begins when fever resolves
cracking lips and fissures
desquamation (peeling) of skin on tips of the fingers and toes
joint pain
thrombocytosis

93
Q

epiglottitis

A

bacterial form of croup
most freq in 2-8 yrs old
onset abrupt- mostly in winter
emergency- can lead to airway obstruction

94
Q

symptoms of epiglottitis

A

high fever
sore, red, inflamed throat
pain when swallowing
absence of spontaneous cough
dysphonia (muffled voice)
dyspnea and drooling
agitation
retractions
inspiratory stridor
tachycardia
tripod positioning

95
Q

edu for epiglottitis

A

dont take temp orally
dont place in supine position
no throat culture

96
Q

laryngotracheobronchitis (croup)

A

viral or bacterial
freq in 5yrs old or less

97
Q

croup stage 1

A

low grade fever
hoarseness
seal bark/brassy cough
inspiratory stridor
fear
irritability and restlessness

98
Q

croup stage 2

A

continuous respiratory stridor
retractions
accessory muscles
crackles +wheezing
labored respirations

99
Q

stage 3 croup

A

continued restlessness
anxiety
pallor
sweaty
tachypnea
signs of anoxia and hypercapnia

100
Q

stage 4 croup

A

intermittent cyanosis progressing to consistent cyanosis
apneic episodes progressing to cessation of breathing

101
Q

edu for croup

A

use cool air vaporizer or breathe in cool, fridge air
no cough/cold medicine

102
Q

bronchitis symptoms

A

fever
dry, hacking nonproductive cough worse at night

103
Q

RSV- Respiratory syncytial virus

A

viral infection that can cause bronchiolitis
spread by droplet
primarily in fall, winter and spring
any age- but most problems in younger than 6 months

104
Q

RSV signs

A

signs of common cold
eye/ear drainage
wheezing
air hunger
periods of cyanosis

105
Q

cystic fibrosis

A

exocrine glands excrete extra thick secretions that can cause obstruction

106
Q

Tx for bacterial pneumonia

A

tent
suctioning
chest physiotherapy before meals
postural drainage Every four hours
child should lay on affected side
droplet isolation
closed chest drainage if purulent fluid

107
Q

Sweat chloride test

A

For cystic fibrosis
High levels of chloride indicate positive test
Cl >60 or >40 in infants

108
Q

Cystic fibrosis signs

A

Child tastes “salty”

109
Q

High risk conditions for SIDS

A

Prone position
Soft bedding
Overheating
Co-sleeping
Mom smoked cigarettes
Exposure to tobacco smoke after birth

110
Q

projectile vomiting can indicate what

A

pyloric stenosis or increased ICP

111
Q

rotavirus

A

serious gastroenteritis
most severe in children 3-24 months
enteric isolation- effective handwashing

112
Q

severe dehydration

A

NPO to rest bowl
fluid replacement by IV
If K ordered, have child void before administering and check renal function

113
Q

cleft lip/palate

A

abnormal opening in the lip or palate
cause is hereditary and environmental factors (radiation or rubella virus, maternal smoking, teratogenic meds)

114
Q

cleft lip/palate Tx

A

closure usually performed by age 3 -6 months
repair usually around 1 year old to help speech development
at risk for developing freq otitis media which can lead to hearing loss

115
Q

cleft palate/lip management

A

infant held upright and direct bottle to side and back of mouth
feed small amounts and burp freq

116
Q

post op cleft lip repair

A

metal appliance or adhesive strips applied for lip protection
avoid prone position- position upright and on the back
clean surgical site after feedings with NS
elbow restraints

117
Q

post op cleft palate repair

A

oral packing secured to palate (removed in 2-3 days)
tongue stitch may be needed to prevent obstructing airway
softelbow or jacket restraints
no suctioning in mouth or putting anything in the mouth (temp, pacifiers, straws)

118
Q

esophageal atresia

A

esophagus doesn’t develop all the way to the stomach- ends with a fistula to trachea or small pouch

119
Q

esophageal atresia signs

A

Apnea >15 sec
frothy saliva in mouth and nose and excessive drooling
coughing + chocking during feedings
unexplained cyanosis
regurgitation and vomiting
abdominal distention
increased resp distress during and after feeding

120
Q

nursing interventions for esophageal atresia

A

supine upright position
NPO
keep pouch empty by intermittent or continuous suctioning
suction accumulated secretions from mouth and nose

121
Q

gastrostomy tube after esophageal atresia repair

A

purulent drainage= anastomotic leak
attached to gravity until infant can tolerate feedings and anastomosis is healed (5-7 days)
esophogram before feedings to check integrity of esophagus

122
Q

signs of aspiration

A

drooling, coughing, and dyspnea after feeding

122
Q

Managing GERD in infants

A

keep baby upright for 20-30 min after feedings
semisupine (car seat) increases reflux
small frequent feedings with predigested formula
thickened formula (cross-cut the nipple)

123
Q

hypertrophic pyloric stenosis

A

narrowing of canal between the stomach and duodenum
develops first few weeks of life

124
Q

hypertrophic pyloric stenosis signs

A

projectile vomiting
vomit contains milk, mucous or blood-tinged… no bile
peristaltic waves visible from left to right across epigastrium
olive shaped mass to the right of umbilicus

125
Q

signs of lactose intolerance

A

abd distention
crampy, abd pain; colic
diarrhea and excessive flatus

126
Q

signs of celiac disease

A

steatorrhea
acute diarrhea
anorexia
abd pain and distention
muscle wasting in buttocks and extremities
vomiting
anemia
irritability

127
Q

what to substitute for gluten

A

corn, rice and millet

128
Q

signs of appendicitis

A

pain in umbilical area descending to RLQ (Mcburneys point)
rebound tenderness
side-lying and abd guarding

129
Q

Hirschsprungs disease

A

mechanical obstruction because of inadequate motility in intestinal segment
absence of ganglionic cells

130
Q

signs of Hirschsprungs disease

A

newborns: failure to pass meconium, refusal to suck, abd distention, bile-stained vomit

children: ribbon like stool, alt constipation and diarrhea, vomiting, abd distention
delayed growth

131
Q

intussusception

A

telescoping of bowel

132
Q

signs of intussusception

A

colicky abd pain - knees to abd
vomiting gastric contents
jelly-like stools
hyper or hypoactive bowel sounds
sausage shaped mass in RUQ

133
Q

omphalocele

A

herniation of abdominal contents through umbilical ring
protrusion is covered by translucent sac that may contain bowel
rupture of sac results in evisceration

134
Q

interventions for omphalocele

A

after birth, protrusion covered with sterile gauze soaked in NS and plastic wrap applied on top
prepare for surgery

135
Q

gastroschosis

A

herniation of the intestine is lateral to the umbilical ring
no membrane covers the exposed bowel
loosely wrapped in plastic drape with soaked NS pads underneath- dont directly wrap around the exposed bowel is contraindicated

136
Q

hydrocele

A

abd fluid in scrotal sac

137
Q

encopresis

A

constipation and fecal incontinence

138
Q

signs of encopresis

A

soiling clothing
scratching or rubbing anal area
fecal odor
social withdrawal

139
Q

imperforate anus

A

incomplete development or absence of anus

140
Q

signs of imperforate anus

A

failure to pass meconium
absence or stenosis of anal canal
presence of anal membrane
external fistula to perineum

141
Q

Hep A

A

usually occurs in preschoolers or school age children less that 15
if asymptomatic, can still spread to others
2 series vaccine

142
Q

Hep B

A

mostly acquired during birth if mom has it
2 series vaccine

143
Q

Hep C

A

transmission at birth from mom
usually asymptomatic
chronic condition

144
Q

Hep D

A

occurs in children already infected with Hep B and can lead to cirrhosis

145
Q

Hep E

A

uncommon in children

146
Q

Hep vaccines cause what immunity

A

passive immunity

147
Q

Signs of hepatitis

A

RUQ pain
dark urine, pale stools
itchy
jaundice

148
Q

teaching for hepatitis

A

not isolated unless incontinent of stool
discouraged from sharing toys
disinfect diaper changing table with bleach and water
noninfectious 1 week after onset of jaundice

149
Q

giardiasis

A

commonly from crowded environments (daycares/classrooms)

150
Q

signs of giardiasis

A

diarrhea and vomiting
anorexia
failure to thrive
abd cramps and intermittent loose stools and constipation
steatorrhea

151
Q

pinworms

A

in temperate climate zones and transmitted in crowded environments

152
Q

signs of pinworms

A

intense perineal itching
irritable, restlessness
poor sleeping
bed wetting

153
Q

causes of glomerulonephritis

A

most common- strep infection 1-2 weeks before condition develops

154
Q

signs of glomerulonephritis

A

periorbital and facial edema
anorexia
decreased UO
cola-colored urine or hematuria
pallor
hypertension
proteinuria- foam in urine
increased BUN and Crt
increased anti-streptolysin O titer

155
Q

nursing interventions for glomerulonephritis

A

restrict Na
Restrict K due to inability to filter it out
seizure precautions due to HTN encephalopathy
report HA, bloody urine and edema

156
Q

nephrotic syndrome

A

massive proteinuria
hypoalbuminemia
hyperlipidemia
edema

157
Q

nephrotic syndrome signs

A

wt gain
facial swelling or any edema
decreased UO
ascites
dark, frothy urine
BP normal or slightly decreased
low protein in blood

158
Q

enuresis

A

“bed-wetting”
child unable to control bladder function when they have been able to before or at an age where they are expected to be able to (older than 5)

159
Q

managing enuresis

A

limit fluid at night
encourage to void before bed

160
Q

NIPS scale

A

Less than 2 months

161
Q

FLACC scale

A

2 months- 7 yrs

162
Q

Wong-baker faces

A

3-4 yr olds

163
Q

Wong-baker faces

A

3-4 yr olds

164
Q

Numeric scale

A

Used in 8yrs old or older
Must be able to count and understand value of numbers

165
Q

Ear assessment in children

A

<3 pinna down and back
>3 pinna up and back

166
Q

Unoccupied play

A

Infant
No purpose- random movement

167
Q

Solitary play

A

Infant/toddler
Play alone with their interest focused on own activity

168
Q

Onlooker play

A

Toddler
Watch other people play but don’t interact

169
Q

Parallel play

A

Toddler 1-3
Play independently but next to each other

170
Q

Associative play

A

Preschooler 3-6
Play together but with no group goal
Ex. Kick ball around

171
Q

Cooperative play

A

School age 6-12
Organized, plays in groups
Ex. Sports, board games

172
Q

Stepping reflex gone by

A

1month

173
Q

Rooting/sucking reflex gone by

A

3-4 months

174
Q

Palmer reflex gone by

A

3-4 months

175
Q

Tonic neck reflex gone by

A

3-4 months

176
Q

Moro/startle reflex gone by

A

6 months

177
Q

Plantar reflex gone by

A

8 months

178
Q

Crawling reflex gone by

A

6 wks
Reappears when learning to walk

179
Q

Babinksi reflex gone by

A

1 yr old

180
Q

Pharyngitis

A

From strep A
Needs Abts

181
Q

Pharyngitis signs

A

Sore throat
HA
Fever
Rash
Abd pain

182
Q

Teaching for pharyngitis

A

No school for 24 hrs after abt

183
Q

Teaching for post op tonsillectomy

A

No red dyes
No milk, citrus, hot fluids or soda
Freq swallowing=bleeding
Coughing, crying and screaming can cause bleeding
REPORT persistent ear ache

Mom/Baby (4 decks)

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