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Mom/Baby > Exam 4 > Flashcards

Exam 4 Flashcards

1
Q

Signs of impending death

A

Pt feels hot but body feels cold
Loss of senses
Decreased appetite and thirst
Cheyne stokes resp
Weak, slow pulse
Decreased BP

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2
Q

Leukemia

A

Too much WBC not enough RBC for clotting

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3
Q

S/S of leukemia

A

Dx may occur when a “cold” doesn’t go away
Wt loss, petechiae, bruising
Bone/joint pain
Anemia
Thrombocytopenia
Low H/H and Plt
Immature WBCs

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4
Q

Leukemia precautions

A

Neutropenia and bleeding precautions:
private room, visitors wear mask, no fresh flowers, thoroughly cooked foods

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5
Q

Tx for leukemia

A

Low level chemo 4-5 wks
Bone marrow transplant if poor response to chemo

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6
Q

Sickle cell crisis

A

Sensitive to low o2 levels (o2 PRN)
#1 priority- IV site for hydration THEN pain (opioids)
Extend extremities- nothing bent

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7
Q

Teaching for sickle cell crisis

A

Avoid triggers: illness, stress, dehydration, high altitude

Repeated sickling= perm sickle cells

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8
Q

Meds for sickle cell crisis

A

Hydroxyurea antimetabolite= makes RBCs rounder and flexible

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9
Q

Blood transfusions

A

2 RNs verify order
VS q15 min
Y tubing w/ filter with only 0.9% NS
4 hrs MAX for 1 unit

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10
Q

Hemolytic reaction

A

HTN and HA

STOP infusion
New tubing and flush with NS

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11
Q

How toddlers view death (1-3)

A

Death is reversible
Egocentric= everything revolves around them
May act like they’re still alive
React to emotions of others

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12
Q

How preschoolers view death (3-6)

A

Death temp and reversible
Magical thinking= guilt or shame
May inappropriately giggle

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13
Q

Retinoblastoma

A

Caused by mutation in gene (sporadic or inherited)

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14
Q

S/S of Retinoblastoma

A

Cats eye reflex: whitish pupil “glows”
Strabismus (cross-eyed)- late sign
Heterochromia (different colored eyes)

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15
Q

Teaching for Enucleation (removal of the eye)

A

Socket is covered in mucosal lining
Fitting for prosthesis in 3-4 weeks
Face will be edematous and bruised
Usually little to no drainage (bright red drainage is red flag)
Eye patch changed daily
Prosthesis cleaned by placing in hot water and allowing to soak

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16
Q

Iron supplements teaching

A

Use straw (stains teeth)
Take on empty stomach
No milk
Vit C helps with absorption
Calcium stops absorption

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17
Q

Foods high in iron

A

Organ meats
Green leafy vegetables
Kale
Shellfish
Fortified dry cereal

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18
Q

Osteosarcoma

A

Bone tumor arising from osseous tissue
Most common in children in long bones (femur)

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19
Q

S/S of osteosarcoma

A

Bone pain (commonly mistaken for growing pains)
Swelling
Fractures limb
Limited ROM
Palpable mass
Extremity my feel warm

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20
Q

Ewing sarcoma

A

Arises from the bone marrow

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21
Q

S/S of Ewing sarcoma

A

Bone pain
Swelling
Fractures

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22
Q

Neuroblastoma (Wilms tumor)

A

Silent tumor primarily in abdomen that crosses midline (firm, irregular, non tender mass)
Palliative care

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23
Q

S/S of Wilms tumor

A

Painless
Wt loss
Fever
Anemia
Possible HTN
Urinary retention
Hematuria

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24
Q

Teaching for Wilms tumor

A

DO NOT PALPATE ABDOMEN = could cause rupture
Put sign on bed

25
Q

Hemophilia A

A

Clotting factor 8 missing
Caused by x linked recessive gene (mom passes down to son)

26
Q

S/S of hemophilia A

A

Prolonged bleeding
Hemorrhage
Bruising
Hemarthrosis
Spontaneous hematuria
Nose bleeds
Joint stiffness

27
Q

Tx for hemophilia A

A

Replace clotting factor 8
No contact sports (isometric exercises)
Corticosteroids
NSAIDS - no ASA
Desmopressin
RICE

28
Q

Nursing considerations for hemophilia A

A

NO IM injections
Only subQ (pressure for 5 min after)

29
Q

Causes of ICP

A

Trauma
Hemorrhages
Meningitis
Hydrocephalus

30
Q

S/S of increased ICP

A

Bulging fontanelles
Separated suture lines
Irritability
Drowsiness
Shrill cry/ seizures (late sign)
Increased head circumference
Distended scalp veins
HA
Forceful vomiting
Sunset eyes

31
Q

Interventions for increased ICP

A

Semi Fowler- NOT flat and not too high
Quiet and dim lit room
Low stimuli
No airway suctioning
Avoid baby crying
Mannitol
Strict I&O

32
Q

Sluggish constriction of pupils

A

From barbituates
Optic nerve injury
Brain stem lesions

33
Q

Pinpoint pupils

A

High/overdose

34
Q

Tx for increased ICP

A

Lactated ringers (isotonic solution) only
VP shunt= fluid drains into peritoneal cavity

35
Q

Bacterial meningitis

A

Droplet precautions- very contagious
Caused by haemophiles influenzae B

36
Q

S/S of bacterial meningitis

A

HA
Nuchal rigidity
Photosensitivity
Fever
Adv seizures

37
Q

Kerning sign

A

Positive for meningitis

On back, flex and then straighten leg= pain

38
Q

Brudzinski sign

A

Positive for meningitis
Head up ad neck flexed= pain when flexed knees/hip

39
Q

Dx for meningitis

A

LP (CSF is cloudy)

Preop= empty bladder before
During= round back
Post= monitor insertion site and lay flat on back

40
Q

Nursing care for VP shunt

A

Tx for hydrocephalus
Monitor for shunt malfunction (seizures and ICP Sx return) or infection

41
Q

Submersion injury

A

Irreversible brain damage after 4 min

42
Q

Nursing interventions for meningocele

A

No diaper
Keep prone
Keep sac sterile and moist (saline)

43
Q

Causes of cerebral palsy

A

Birth asphyxia
Prenatal brain abnormalities
Usually caused by birth injury

44
Q

S/S of cerebral palsy

A

Abnormal muscle tone and reflexes
Impaired motor skills
Contractures
Difficulty with speech and voluntary movement
Stiff rigid posture
Arching back floppy tone
Feeding difficulties

45
Q

Early red flags of autism

A

No smiling 3 months
No eye contact
No babbling
Failure to interact socially

46
Q

S/S Down syndrome

A

Slanted eyes
Short stare
Wide neck
Depressed nasal bridge
Short stubby digits
Hyper reflexive
Protruding tongue
Low set ears

47
Q

Comorbidities with Down syndrome

A

Hypothyroidism
Resp problems
Heart defects

48
Q

Reye’s syndrome S/S

A

Cerebral edema that leads to seizures and liver damage
Fever

49
Q

Dx of Reye’s syndrome

A

Liver biopsy (lay on right side after)
AST, ALT

50
Q

Decorticate posturing

A

Extremities towards body core

51
Q

Decerebrate posturing

A

Away from the body

52
Q

PKU

A

Dx after 24hrs of first feeding
Phenylamine >20 is PKU

53
Q

PKU S/S

A

Failure to thrive
Vomit
Digestive issues
Irritability
Hyperactivity

54
Q

Tx of PKU

A

Eliminate phenylamine (protein) from diet :
Meats, eggs, peanut butter, legumes, dairy, artificial sweeteners
Tyrosine supplement for child

55
Q

S/S of hypothyroidism

A

Cold intolerance
Receding hairline
Facial eyelid edema
Thick tongue
Dry skin
Brittle nails

LATE SIGNS
Wt gain, low LOC, thick skin,

56
Q

Lordosis

A

S shape in lower back

57
Q

Kyphosis

A

Upper back hump

58
Q

Pavlik harness

A

For nonmobile pts with hip dysplasia
Worn 24/7
Follow up every 2 weeks for adjustment

Spica cast for mobile pts

Mom/Baby (4 decks)

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