Exam 3 Review Flashcards
As a nurse, what do you have to teach parents that have children with GER?
Administer protonics 30 minutes prior to feedings only one times a day.
What are the signs and symptoms for Hirshsprungs Disease in infants?
Failure to thrive. Ominous sign- explosive diarrhea, fever, enterocolitis. Constipation Abdominal distention. Diarrhea and vomiting.
When does the anterior fontanel close?
9-18 months
What is the main thing that adolescents or teenagers want during hospitalization?
They want their peers with there. They will be eager to have their peers come visit them.
Describe the pathophysiology of PKU.
The inability to produce an enzyme to break down essential amino acid (phenylalanine)
What is acute lymphoid leukemia (ALL)?
An unrestricted proliferation of immaute WBCs in the blood-forming tissues of the body
When do the signs and symptoms of GER occur?
Throughout the day but most frequently after meals and at night.
What is cellulitis?
A bacterial infection in a specific area or region of the body.
How are hyperthyroidism babies characterized?
As good babies that sleep all the time.
T/F: All children, even those with chronic or acute serious illnesses, need limits and discipline.
True.
What age can an infant roll over?
4 months
If baby is less than a year, what do you use for food when weaning off breast milk?
Iron fortified formula.
What is the cause of PKU?
It is an autosomal recessive disease,
What is tracheoesophageal fistula (TEF)?
The failure of esophagus to develop as a continuous passage.
What are the signs and symptoms of intussusception?
Severe colicky abdominal pain in a child with vomiting and currant jelly-like stools. Stools may be mucousy red like stools.
What are the signs and symptoms for Hirshsprungs Disease in childhood age children.
Constipation, ribbon like, foul-smelling stools, abdominal distention, visible peristalsis, fecal mass easily palpable, anemia, poor nourished.
What is the treatment for Type I diabetes?
Insulin SubQ
Regular insulin through IV
Insulin pump if child is older than 2 years old.
What are the initial signs and symptoms of Hirshsprungs Disease?
Usually severe and continuous constipation.
Is there a vaccine for the Rotovirus?
yes but it must be given in the first 3 months (it is a 3 series vaccine).
What is the treatment for newborns with PKU?
They are placed on a formula with a very low level of phenylalanine or continue on breast milk which is already low in penylalanine.
What is the treatment for pyloric stenosis?
A surgical procedure.
What are the signs and symptoms of pyloric stenosis (three p’s)
Projectile vomiting
Palpable olive-like mass
Visible peristaltic waves
What age does an infant double their birth weight?
6 months
Why is toddler in need of small frequent meals?
Because they are busy exploring and they will not sit to eat a big meal.
Why are patients with pyloric stenosis prone to metabolic alkalosis?
Because they are throwing up and there is no bile in it.
What is important patient teaching regarding cellulitis?
It spreads easily so wash hands!!
How do you prepare school age children for hospitalization?
By giving them more information.
What happens in Type 2 diabetes?
Insulin resistance due to the body failing to use insulin properly combines with relative insulin deficiency.
How do you cleanse the suture site post op cleft lip repair?
With a cotton tipped swab in saline water and a thing layer of antibiotic ointment.
T/F: Cognitive deficits and developmental delays are not associated with hyperthyroidism.
False.
How is poison ivy treated?
Lather irritated area in shower two to three times
What is the proper positioning post op for a repaired cleft palate?
On the abdomen to reduce risk of aspiration.
What age does the industry stage occur?
6-12 years.
How do you treat impetigo?
Remove honey colored crusts
Apply topical antibiotic
Use antibacterial soap for 5-7 days
How is Rotovirus typically spread?
Fecal-Oral route
What is intussusception?
When one portion of the bowel slides into the next. Sort of like a telescope.
What is the goal of treatment for Hirshsprungs Disease?
To surgically remove the diseased, nonfunctioning segment of the bowel and restore bowel function.
How is the repaired cleft lip protected post op?
By a thin, arched metal device called logan bow
What is a favorite word used by toddlers in the autonomy stage and why?
No because they are becoming independent and this is there control over the world.
How is lice infected bedding cleaned and dried?
Wash in high temperature water and dry on high heat for at least 20 minutes
How do you treat lice?
By destroying the eggs with specialized shampoos and high temperature water when washing bedding.
What is sickle cell anemia?
Its an autosomal recessive diease. The normal hgb is replaced with abnormal hgb S
What are signs and symptoms of PKU?
Musty smell from body Seizures Hyperactivity Irritability Vomiting Eczema
How do you treat acne?
Washing with soap and water Adequate rest Moderate exercising A well-balanced diet Wash hair more frequently
How does Type II diabetes form?
Immune-mediated diabetes mellitus. It is an autoimmune destruction of the beta cells.
Why are adolescents at risk for developing iron deficiency anemia?
Because of rapid growth and poor eating habits.
How many stages are there to the treatment for Hirshsprungs Disease?
Two stages.
In what order is a cleft lip/ palate repaired?
The lip is repaired first and then the palate is repaired second.
What are the signs and symptoms of iron deficiency anemia??
Pallor
Fatigue
Tachycardia
Cool skin
What is the treatment for Rotovirus?
Oral hydration to prevent dehydration, do NOT use BRAT diet.
What do parents need to be taught regarding elbow restraints?
Release the restraints one at a time and be sure to monitor skin for breakdown.
What food are important for infants?
Breast milk or iron fortified formula.
What medication is used to treat hypothyroidism?
Levothyroxine or synthroid.
What is scabies treated with and how long is the treatment?
A topical oinment that must stay on the skin for at least 8 hours.
What are the four characteristics of celiac disease?
Steatorrhea
General malnutrition
Abdominal distention
Secondary vitamin deficiencies.
How do you prevent hypoglycemia in children?
Give them adequate snacks.
Monitor blood glucose especially if they are going to be outside or exercise.
What leads to a sickle cell crisis?
When microscopic obstructions lead to an engorgement and tissue ischemia… Hypoxia occurs and causes sickling.
Describe the second stage of Hirshsprungs Disease.
When the child’s weight (20 lbs or 1 year old) or condition is deemed appropriate the surgeons close the stoma (reconnect the intestines) removed the diseased portion of bowel, and perform a pull-through procedure, which repairs the colon by connecting functional bowel to the anus. This usually establishes fairly normal bowel function.
What is the impact of PKU if it is not treated?
Profound cognitive deficits.
What is the treatment for sickle cell anemia?
Fluids
Oxygen
Pain medication
What is the first thing that you do when intussusception has reversed?
Notify the physician.
What are the CNS related signs and symptoms of acute lymphoid leukemia (ALL)?
Increased ICP
Headache
Vomiting
Papilledema and nerve palsy
What causes the skin irritation in poison ivy?
Burshin oil
According to Erikson’s 5 developmental theory what are two toys that are appropriate for babies
Rattlers and mobiles
How should food be served to toddler?
In small pieces.
What are signs and symptoms of appendicitis?
Periumbilical pain Nausea RLQ pain Increased WBC Later vomiting with a fever
According to Erikson’s 5 developmental theory what kind of play is associated with preschool age children?
Associative play.
How do you administer iron to older children?
Mix it in a cup with a straw.
What type of food does a post op cleft palate discharged baby need to avoid?
Bread, hard cookies, chips.
What are the different treatments for intussusception?
Radiologist guided pneumo-enema
Ultrasound guided saline enema
What is impetigo?
Staph infection which usually occurs on face or legs.
When do signs and symptoms begin to develop in infants with pyloric stenosis?
Between 2 and 5 weeks of life and typically 30 minutes after eating.
What age does the identity stage occur?
12-18 years.
What are the signs and symptoms of cellulitis?
Rapid onsent Ill Erythema Warmth Tenderness Chills Septicemia and edema of infected site
When does Type I diabetes typically occur?
In children or in slim adults.
What are some signs and symptoms of hypothyroidism in children?
Large fontanelles
Protruding tongue
Temperature instability (temp will drop quickly)
How long are babies typically in elbow restraints following cleft lip/pallet repair?
4-6 weeks.
A small percentage of children who have lingering problems from Hirshsprungs Disease could be at risk for?
Soilage or constipation
An overgrowth of bacteria in the intestines.
Can the mother breastfeed post op cleft lip repair?
Yes, may need a lactation specialist though.
What is the treatment for cellulitis?
Warm compress
Antibiotics
Describe the first stage of Hirshsprungs Disease.
The first stage relieves the intestinal obstruction by performing a colostomy, which creates an opening in the abdomen (stoma) through which bowel contents can be discharged into a waste bag.
What are signs and symptoms of scabies?
Infected areas will turn red and will begin to itch.
What are the nursing interventions for tracheoesophageal fistula (TEF)
Elevate the bed to 30 degrees to prevent aspiration.
Broad spectrum antibiotics to prevent pnemonia.
NPO immediately
Give passifier
Start IV fluids
Describe associative play.
Initiative play or dramatic type play.
What does Rotovirus cause?
Diarrhea
By what age should a child have their first tooth?
By 1 year.
T/F: Preschoolers enjoy playing with puppets and dress up and are into imitating parents.
True.
Acute lymphoid leukemia (ALL): What is induction therapy?
Corticosteroids, Vincristine, L-Asparaginase
How do you establish trust with infants?
By holding and feeding them if possible.
How is GER treated?
Small frequent feedings.
Sitting upright for 1 hour after feedings.
Thickening the formula for infants.
Left sided positioning during sleep and elevating HOB for children older than 1 year.
According to Erikson’s 5 developmental theory what are some toys that would be appropriate for preschoolers?
Tricycles, clay, paints, swings, sliding board
What are scabies?
Lesions created as the impregnated female insect burrows into the outermost layer of the epidermis to deposit her eggs and feces.
How do you help establish autonomy for a toddler in a hospital setting?
Help maintain rituals. You want to continue doing the same things they do at home.
What are the signs and symptoms of tracheoesophageal fistula (TEF)?
Coughing
Choking
Cyanosis
What is the treatment for hypoglycemia?
Juice or regular soda
Glucose tab or gel
Glucagon subQ
Describe the restaints used for post op cleft lip repair.
Soft elbow restraints.
What are some tests done to diagnose acute lymphoid leukemia (ALL)?
Bone marrow aspiration or biopsy.
Complete blood count
Lumbar puncture to evaluate CNS involvement.
What must parents be taught about administering medication for hypothyroidism?
It can be crushed or given in a small amount of juice or liquid and can be given through a syringe.
What are signs and symptoms of Type I diabetes?
Polyuria Polydipsia Polyphagia Weight loss Tachycardia Fatigue
What is the treatment for Celiac disease?
Gluten free diet (low gluten diet)
Eliminate wheat, rye, barley and oats with corn and rice.
What is iron deficiency anemia?
Anemia with reduced Hgb concentration.
When are newborns screened for PKU?
After 2-3 or at least 24 hours on formula or breast milk.
What is the proper positioning post op for a repaired cleft lip?
On their back, side or sitting up in a chair
What causes acne?
Testosterone
What are nursing care measures you can implement to help an ALL patient?
Use a private room
Screening and restriction of all visitors and health personal with active infection
Strict hand washing
What is an important nursing intervention for iron deficiency anemia?
Decrease oxygen demands (keep patient on bed rest or low activity).
What are the signs and symptoms for Hirshsprungs Disease in newborns?
Failure to thrive.
Failure to pass meconium stool within 24-48 hours after birth.
Reluctant to ingest fluids.
Abdominal distention.
What complications can arise from acute lymphoid leukemia (ALL)?
Anemia from decreased RBCs
Infection from neutopenia
Bleeding tendencies from decreased platelet production
Describe parallel play.
When one plays alongside another.
Which two age groups are at high risk of developing iron deficiency anemia?
Infants and adolescents/ teens
When are most children diagnosed with Hirshsprungs Disease?
Within the first few months of life.
When does Type 2 diabetes typically occur?
In older adults.
What do you look for in children with hypoglycemia?
Unusual behaviors.
According to Erikson’s 5 developmental theory what type of play is associated with adolescents/ teenagers.
Team sports, school activities, and peer group activities.
What age does the initiative stage occur?
4-5 years.
What are some examples of foods that should not be given to toddlers?
Peanuts, gummies, skittles.
What must you establish with school age children during hospitalization?
Time because they will try and negotiate time!
What do you teach parents to watch for after a pyloromyotomy?
To watch for vomiting (dehydration) because it can occur a few days after before it stops.
According to Erikson’s 5 developmental theory what type of play is associated with toddlers?
Parallel play
What are the 5 psychosocial developmental stages Erikson came up with?
Trust Autonomy Initiative Industry Identity
When does the posterior fontanel close?
3 months
What happens in Type I diabetes?
Pancreatic beta cells that produce insulin are destroyed.
What is the post op goal for a cleft lip repair?
Protect the operative site!
How do you assess pain for children?
Wong-Baker faces scale
What age do infants sit up unsupported?
8-9 month
After surgery for Hirshsprungs Disease what do you want to monitor for post op?
Bowel sounds (keep NPO until they have good bowel sounds)
Surgical site
Also keep parents at bedside for comfort of child
What is pyloric stenosis?
An obstructive disorder that causes constriction of the pyloric sphinter with obstruction of gastric outlet.
What types of food do you want to avoid if you have PKU?
Meats!
What can happen is hypothyroidism is left untreated?
Profound cognitive defects and developmental delays
Why are toddlers at risk for aspiration when eating?
Because they are often running around.
What causes iron deficiency anemia?
An inadequate supply of dietary iron.
What should be avoided in older children with GER?
Caffeine, chocolate, spicy foods, citrus, peppermint, tobacco and alcohol.
What are the signs and symptoms of acute lymphoid leukemia (ALL)?
Fever Pallor Tachycardia Lethargy Malaise Large joint/bone pain Petechiae (purple spots from bleeding under skin) Frank bleeding (rectal bleeding) Liver enlargement Spleen enlargement Enlarged lymph nodes
Why is it important to monitor the stool of an infant with intussusception prior to surgery?
Because if the stool is normal thatn the intussusception has reversed and the surgery can be canceled.
Why can’t laxatives, enemas or heat be used for kids with appendicitis?
Because these all stimulate bowel motility and increases risk of perforation.
When an acute lymphoid leukemia (ALL) is getting chemotherapy what do you need to watch for?
Anaphylaxis shock signs and symptoms which are:
Cyanosis
Hypotension
Wheezing
Uticaria (Stop drug treatment immediately)
According to Erikson’s 5 developmental theory what type of play is associated with school age children?
Cooperative play like games with rules and collective things
What is the cause of hypothyroidism?
Thyroxine (t4) is not produced.
What are some physical signs and symptoms and risks for patients with acute lymphoid leukemia (ALL)?
Increased risk for infection
Imbalanced nutrition
Decreased appetite
Hair loss
How do you administer iron to young children?
Use a dropper and do not get on tongue!!
What are triggers of a sickle cell crisis?
Dehydration
Cold
Stress
What must be checked during pre op for patients with pyloric stenosis?
Make sure there is no dehydration and metabolic alkalosis occurring.
Describe the feeding post op from a pyloromyotomy.
It will resume in 4-6 hours after. The feedings will be small and frequent. Feedings will be with glucose water and electrolytes (pedialyte)
What are the two reasons why you start infants with the iron-fortified cereal?
Idiopathic type 1 and because its the least allergenic and the iron storages in the body have been depleted.
What age does an infant triple their birth weight?
12 months
According to Erikson’s 5 developmental theory what type of play is associated with babies?
Solitary play or onlooker play
According to Erikson’s 5 developmental theory what are two toys that are appropriate for toddlers?
Toys that make noise or toys that can be pushed or pulled.
What age does the autonomy stage occur?
1 year -3 years old
What are signs and symptoms of sickle cell anemia?
Fever
Pain
Tissue engorgement
What is the mortality rate of surgical complications in infants with Hirshsprungs Disease?
20 %
Why are teens typically in trouble with nutrition?
Because they are prone to eating fast food and high fat foods like burgers and pizza.
What are signs and symptoms of drug toxicity to watch for with acute lymphoid leukemia (ALL) patients?
Nausea/ vomiting Anorexia Mucosal ulceration Neuropathy Hemorrhagic cysts Alopecia Mood changes Moon face
At what age or weight is a cleft palate typically repaired?
1 year or 20 lbs
When do you introduce iron-fortified cereal or formula?
5-6 months
Describe the surgical procedure used for pyloric stenosis.
Pyloromyotomy with a RUQ incision. It can be done laparoscopically which reduces the surgical time, feeding delay, and discharge.
