Exam 4 Flashcards
Starred slides
Bacterial meningitis
-Causes, transmission, precautions, vaccines
- caused by streptococcus peneumoniae, neisseria meningitides, influenza
- transmission-> droplet from infected person
- use STANDARD precautions and droplet transmission
- Vaccines; Hib and pneumococcal conjugate vaccines have decreased incidents of infection
Meningitis
- clinical manifestations in infants and children
- Infants-> fever, bulging fontanel, poor sucking and feeding, lethargy, and irritability
- Children-> headache, nuchal rigidity, opisthotnos, + Kernig and Brudzinksi signs, photophobia, N/V, and confusion
Meningitis diagnosis
- Diagnosis-> lumbar puncture BEFORE antibiotics, measure spinal pressure, check spinal fluid for WBCs, protein, glucose, clear/purulent, gram stain
Meningitis Treatment
- appropriate transmission precautions, IV antibiotics and steroids, antipyretics, and anticonvulsants
- aspiration of subdural effusion
- MONITOR NEUROLOGIC STATUS q2h
Cerebral palsy Nursing Care
- interview child & family, determine needs, level of development, stage of acceptance and set realistic goals
- encourage child to maintain self care activities and set goals for new ones
Disciplining a child w/an intellectual disability
discuss w child the first time, put in a time out the second time after already having to discuss it a first time
Drowning in infants, treatment
- Infants more commonly drown in bathtubs
- Toddlers and preschoolers drown in pools or small bodies of water
- Treatment-> immediate CPR, continued until at medical facility
The nervous system-> CNS, Peripheral N.S, Autonomic, at birth
- CNS-> brain and spinal cord
- CSF: in brain and spinal c, cushions/protective mechanism
Sensory organs-> Eyes
- detetct light/stimuli from env
- @ 2 months, eyes can focus and follow object w eyes
- @ 7 months, depth perception has matured
- visual acuity-> 20-100 and 20-4– until 5 yrs
Vision Impairment-> Refractive errors
- Refraction: light rays bend through lens to retina
- Myopia: nearsightedness
- Hyperopia: Farsightedness
- Astigmatism: unequal curve in cornea that bends light rays in diff directions
Eye injury and foreign objects in eye
- Small foreign objects
- Ecchymosis of eye (black eye), most concerning
- Small objects-> AVOID the use of COTTON-TIPPED applicators to remove object
Eye injury–> Sympathetic ophthalmia s/s
photophobia, pain, dimness of vision, detached retina, atrophy of eyeball
Eye surgery Nursing Care
- use of play to teach is helpful-> play with blindfold before surgery to become accustomed
- Restraints may be needed
- speak to child when entering and leaving room
Hearing Impairment Nursing Care
- stand/sit face to face, be sure child can see you before touching them , demonstrate procedure before performed, night light, proper care of hearing aid, learn ASL
Otitis media
- Spontaneous Rupture
- Myringotomy (incision of ear drum)
- S. rupture= purluent drainage, pain caused by the pressure buildup will be relieved
- Myringotomy est drainage and to insert tiny tubes into the tympanic membrane to facilitate drainage
Insertion of foreign bodies into the ear/nose
- HOW to remove from ears
- Nose
- Ears-> irrigation and forceps
- Nose-> speculum used to inspect and remove. Risk of infection if objects remain inside.
Acute or Non recurrent Seizures
- Febrile seizures
- 102 f- 106 f, convulse w fever of 100 f to 102 f
- often a symptom of acute infection
Clinical manifestations and diagnosis of febrile seizures
rapid onset, restlessness and irritability, body stiffens, LOC, clonic movements, irregular breathing, unable to swallow saliva
Focal (partial) onset seizures
- what it causes
- onset may include….
- child awake and aware during seizure
- causes localized motor activity, limited to one side of body or may spread to other parts
- onset seizure includes sensory symptoms (aura)-> the 5 senses.
-NUMBNESS, TINGLING, PARESTHESIA, or PAIN
Generalized onset seizures
- TONIC-CLONIC SEIZURES, 4 stages
- Prodromal period
- Tonic phase
- Clonic phase
- Posictal Period- >CYANOTIC & RESP ARREST–> MONITOR BREATHING
Generalized onset seizures
- ABSENCE SEIZURES
child loses awareness and stares straight ahead, muscle twitching
- after seizure-> child is alert and continues convo like nothing happened
Seizure Disorders
- STATUS EPILEPTICUS
lasts longer than 30 min, doesn’t return to normal concoisuness.
- requires immediate treatment to decrease perm brain injury, resp failure, and death
Seizure dsorders
STATUS EPILEPTICUS treatment
Diazepam and lorazepam, rectal or IV
Seizure disorders Treatment (slide 51)
- Anticonvulsant; carbamazepine, ethosuximide, phenobarbital; phenytoin, valporic acid
- Vagus nerve stim
- Ketogenic diets
Seizure disorders, Nursing Care
- keep child safe during seizure
- hx, raised padded side rails, harmful objects kept away, O2 & suction kept at bedside, bed lowered during sleep
