Exam 4 Review Flashcards
1
Q
What is Status Asthmaticus treated with?
A
Epinephrine
2
Q
What kind of teaching needs to be educated to parents of children wearing a pavlik harness?
A
Massage skin once a day.
3
Q
How long does the child who drowned need to be monitored for after they become alert?
A
At least 24 hours.
4
Q
What are the signs and symptoms of nephrotic syndrome?
A
Massive proteinura
Hypoalbuminemia
Hyperlipemia
Edema
5
Q
Cardiac procedures: What do you do if a child is bleeding post catherization?
A
Apply pressure to the site
6
Q
What two characteristics are always associated with ASD?
A
A heart murmer and NO cyanosis
7
Q
Why are antibiotics given to pediatric patients with heart defects?
A
To prevent endocarditis
8
Q
Why do patients with down’s syndrome have feeding difficulties?
A
Because of hypotonia.
9
Q
What does Increased amount of protein determine is patients with golmerulonephritis?
A
Increased severity of renal disease
10
Q
Describe Step 4 of asthma.
A
Severe and persistent
Continual symptoms, frequent night time symptoms.
11
Q
How do you assess pain in pediatrics?
A
Agitation and restlessness
12
Q
What are the recommendations made for pediatric patients that suffer from a UTI?
A
No bubble baths
Wear cotton underwear
Increase fluids
13
Q
When does the subacute phase of Kawasaki Disease begin and end?
A
Its begins when the fever resolves and the lasts until all signs and symptoms of Kawasaki Disease have disappeared.
14
Q
What is important to remember in regards to signs and symptoms of autism?
A
That the signs and symptoms vary greatly.
15
Q
What class of medications increase the risk of toxicity when mixed with digoxin?
A
Antibiotics
16
Q
What must be assessed often with a child that has Menigitis?
A
Neuro checks
17
Q
How is Cystic Fibrosis diagnosed in children?
A
A positive sweat test.
18
Q
Which defect that causes increased pulmonary blood flow is considered persistant?
A
PDA- patient ductus anteriosus
19
Q
How is juvenile idiopathic arthritis treated?
A
Pain meds
Swimming for exercise
Warm compresses
20
Q
True/ False: You must prop the bottle when feeding a child with otitis media
A
False
21
Q
What can cause pharyngitis?
A
Strep
22
Q
True/False: ASD can cause CHF.
A
True
23
Q
What two types of bacteria are common causes of ear infections?
A
H flu and pneuamococcol
24
Q
What needs to be monitored for a patient on lasix?
A
Intake and Output
25
What causes Pertussis?
Bordetella pertussis
26
What is the biggest concern regarding head injuries?
Increased intracranial pressure.
27
How is an ASD is treated?
With a surgical patch closure or cardiac cath can now be performed to dispatch a closure device that patches the whole.
28
Describe the nasal discharge of a pediatric patient with an acute respiratory infection.
Thin and watery or thick and purulent
29
What can prevent Epiglotitis?
Haemophilus influenzae type b vaccine
30
What position do you put a child in when they are presenting with symptoms of Tetralogy of Fallot (Cyanosis, increase RR and HR?)
Put baby in KNEE CHEST position. This will increase venous return & cause blood flow to the lungs.
31
What are the symptoms of OME?
Rhinitis
Cough
Diarrhea
32
Where do you check pulses of a child who just had a cardiac procedure and is post op?
Below the catherization site
33
What are the nursing implications for febrile seizures?
Education.
These patients usually do not need seizure medications.
Will monitor and send home from the hospital in a day.
34
True/False: Second hand smoke inscreases otitis media?
True
35
What kind of precautions are used when taking care of a patient with RSV?
Contact and standard precautions
36
True/ False: Infants and young children between six months to three years of age react more severely to acute respiratory tract infections.
True
37
How is Wilm's Tumor typically discovered?
A mass in the abdomen that is felt when giving the child a bath.
38
How long do you listen to the apical pulse when a patient is on digoxin?
1 full minute
39
What are the clinical manifestations of autism?
```
Social impairment
Language impairment
Behavioral impairment
Cognitive impairment
Inability to maintain eye contact
```
40
What are the three major defects that are associated with increased pulmonary blood flow?
ASD - atrial septal defect
VSD - ventricular septal defect
PDA - patient ductus anteriosus
41
What is the biggest concern regarding care of a drowning patient?
Hypoxia
42
What is Wilm's Tumor?
Tumor in kidney usually developed in embryo.
43
Describe decorticate posturing.
Posturing towards the body.
44
What bacteria commonly causes glomerulonephritis?
Strep
45
What device's use is encouraged daily for Asthma patients?
Peak flow meter
46
How is club foot treated?
Serial casting that is changed every one to two weeks
47
What syndrome is associated with Kawasaki Disease?
Monocutaneous lymph node syndrome
48
What causes Reye's Syndrome?
Reyes syndrome usually follows a viral infection and the use of aspirin to control fever during the infection.
49
What causes smoky or tea colored urine in patients with glomerulonephritis?
Bleeding in the upper urinary tract
50
What seasons is RSV is considered in season?
Winter and Spring
51
What is coarctation of the aorta?
Narrowing near the insertion of the ductus arteriosus which results in increased pressure proximal to the defect ( head and upper extremities) and decreased pressure distal to the obstruction (body and extremiteis).
52
When is pertussis vaccine given?
2/4/6 months and again later in life.
53
How is Reye's Syndrome treated?
```
They are admitted to ICU
Airway (on ventilator)
Reduced maintenance fluids
Quiet atmosphere with dim lights
Reduced stimulation
```
54
Who does osteosarcoma typically affect?
Men that are between 10 and 30.
55
What is retinoblastoma?
Mutation of the cells of the retina resulting in a malignant tumor
56
If a pediatric patient is in CHF, what may need to be given during procedures?
Oxygen
57
What are the signs and symptomc of CHF?
```
Tachycardia and Tachypnea at rest
Dyspnea
Retractions
Activity intolerance
Weight gain
Cardiomegaly
```
58
What are medical interventions related to increased intracranial pressure?
Intubation
| Medically induced coma
59
What causes otitis media?
Fluid back up in the Eustacian tube.
60
When is tube placement necessary?
When recurrent OME and adenoidectomy is only done with recurrent AOM and chronic OME with nasal obstruction.
61
What type of clothing should a child with Kawasaki Disease wear?
Light weight clothing
62
What is digoxin's mode of action?
It increases contractility which slows down the heart.
63
How do you assess LOC in different in infant?
Look at their behavior, see if they recognize their parents.
Shrill cry is normal.
Is the infant irritable?
Is the infant eating?
64
What is the treatment for Kawasaki Disease?
Gamma Globulins
| Aspirin
65
Can you circumcise a patient with hypospadias or epispadias?
No
66
What are the two types of cerebral palsy?
Spactic
| Dyskinetic
67
Why do you assess the temperature and color of the extremity after a child has had a cardiac procedure?
To see if there is an arterial obstruction
68
What are the signs and symptoms of menigitis?
```
Irritability
Anorexia
Nuchal rigidity
Positive Kernig's sign
Coma
```
69
Describe Step 2 of asthma.
Mild and persistent
| Symptoms occur greater then two times per week and night time greater then twice per month.
70
What are the 6 signs and symptoms of digoxin toxicity?
```
Anorexia
Nausea
Vomiting
Diarrhea
Visual disturbances
Bradycardia
```
71
What is osteosarcoma?
The most common type of bone cancer
72
Because the Larynx and glottis are higher in the neck, what is at risk?
Aspiration
73
Where is osteosarcoma usually occur?
Arm, leg and pelvis.
74
What is a pavlik harness?
A harness that is worn by the child for 23 hours a day.
75
What does hypotension represent in a child post op?
Hemorrhage (its a late sign though!!)
76
What is a sign of bleeding after a T and A procedure?
Excessive bleeding
77
True/ False: When a child has an ear infection, they cannot lay flat in the crib with a bottle.
True
78
What are three causes of ADHD?
Genetic
Environmental
Physiological
79
What is the etiology of autism?
It is unknown, except for fragile X syndrome.
80
What is the treatment of streptococcal tonsillitis/ pharyngitis
Antibiotics
Anti-inflammatories
Bedrest
81
What is Otitis Media?
An ear infection.
82
How do you administer ear drops to a patient who is older than 3?
Pull the ear up and back
83
Which defect that causes increased pulmonary blood flow is the most common?
VSD
84
How are symptoms of Bronchiolitis (RSV) treated?
With a humidified oxygen and hydration.
85
What MUST be monitored when taking care of a child with Kawasaki Disease?
Temperature
86
Besides drugs, what is another from of treatment for ADHD?
Therapy or counseling.
87
What needs to be given to cystic fibrosis patients before they eat?
Pancrease
88
How do you move a patient who just had rods placed for treatment of scoliosis?
Log rolling
89
What age group does acute Laryngotracheobrochitis (LTB) typically affect?
Children 5 and younger
90
How s PDA- patient ductus anteriosus repaired?
With a cardiac cath
91
How is asthma treated?
Allergen control
Drug therapy
Chest physiotherapy
92
Describe post op care after a T and A.
```
Cool and clear liquids only!
No citrus flavor
No carbonated drinks
No extreme hot or cold
No red liquids
No milk or milk products
```
93
Describe the Convalescent phase of Kawasaki Disease.
All of the signs and symptoms have disappeared however, lab values are still abnormal for 6-8 more weeks.
94
What are common triggers of seizures in children?
Smell
Sound
Aura
Extreme tiredness
95
When a child has pharyngitis, when can they return to school?
After the child has been on antibiotics for 24 hours.
96
True/False: With osteosarcoma there is no pain at the tumor sight.
False.
97
True/ False: Research indicates that AOM should not be initiatly treated with antibiotics but to wait for 72 hours for spontaneous resolution unless the child is less then two years old and has a fever and severe ear pain.
True
98
Describe post op care for myringotomy.
No swimming in deep water for two weeks
No nose blowing for 7-10 days
Keep ears dry
99
What is the surgical management of Otitis Media?
Tympanostomy tube placement and adenoidectomy or known as a T and A
100
What does immobilization cause to the musculoskeletal system?
It causes venous status
101
Why are thyroid, cricoid and tracheal cartilage easily collapsible?
Because they are immature
102
What is the reason why diaphragmatic movement is inhibited in pediatrics?
Because they have a larger abdomen.
103
What are common side effects of the medications used to treat ADHD?
```
Dependence
Arrythmias
Hypertension
Growth Suppression
Sleep Problems
```
104
Why can't you suction or stimulate coughing when treating a patient with increased intracranial pressure?
Because stimulating coughing and suctioning can increase intracranial pressure.
105
Define Enuresis.
Inappropriate voiding 2 times a week for three months
106
What are the signs and symptoms of CHF?
Tachycardia
Diaphoretic
Weight Gain
Cardiac output decreased due to fluid overload
107
What is Kernig's sign?
Unable to extend the leg when the hip is flexed anteriorly at the hip.
108
What are the symptoms of acute otitis media?
Acute ear pain
| Fever
109
What is cystic fibrosis?
Exocrine gland dysfunction that
| produces multisystem involvement.
110
What is the prevention of neural tube defects?
Folic Acid
111
What is the diet for a patient suffering from nephrotic syndrome?
Low-to-moderate protein
| Sodium restrictions when large amount of edema present
112
How is Nephrotic syndrome managed?
```
Bedrest
Diet
Steroids
Immunosuppressant therapy
Diuretics
```
113
Describe the tongue in pediatric patients and the possible dangers related to the anatomy.
Its large and vulnerable to swelling and its easily occluded.
114
What does a parent need to do if their child's tympanostomy tubes fall out?
Just let the doctor know. It is not a medical emergency
115
What is the score range for the pediatric Glasgow Coma Scale?
3 (BAD) -15 (GOOD)
116
When is Pertussis at its highest incidence?
Summer and Spring
117
Who do you refer a patient with retinoblastoma to?
An ophthalmologist
118
Why do you perform CPR immediately on a patient suffering from drowing?
The outcome is better the less time the child was hypoxic.
119
Why do you assess dressings for a child that is post op?
Bleeding or hematoma
120
How long should you watch for bleeding after a T and A procedure?
7-10 days
121
True/ False: Any child that has drowned needs to be hospitalized.
True
122
Which phase of Kawasaki Disease is the child at greatest risk for developing coronary artery aneurysms?
Subacute Phase
123
What are common triggers of asthma?
```
Smoke
Chemicals
Exercise
Cold air
Pets and other animals
Foods
Emotions
```
124
How do you try to manage pain for pediatric patients (non pharmacological)?
Keep a non stimulating and quiet environment.
| Also remember to assess often and document the assessment
125
How does the pre-school age view death?
They do not understand that death is forever.
| They believe that they may be the cause for the death.
126
What can laryngotracheobrochitis lead to if left untreated?
Respiratory acidosis
Respiratory failure
Death
127
How do you administer ear drops to a patient who is younger than 3
Pull the earlobe down and back
128
How many classifications are used for diagnosing the stepsof Asthma?
Four
129
How do you treat hypotonia in patients with down's syndrome?
Feed slowly if bottle or breast feeding
| Use long handled straight spoon when starting regular foods
130
What are the medications that are used to treat ADHD?
Adderall
Ritalin
Dexedrine
131
What are the treatment options for autism?
Behavioral therapies
Strict home routine
Protection from injury
132
Cardiac procedures: What discharge information must be taught?
Watch the cath site
| Avoid strenuous activity/ exercise for the first few days
133
True/ False: Children with cerebral palsy suffer from very low IQ's
False, their IQ is not affected by their cerebral palsy at all.
134
How is RSV treated?
Symptomatically
Oxygen mist
IV fluids
135
Describe the murmer that is heard from a patient with VSD.
A loud holosystolic
136
What is the cure for cystic fibrosis?
There is no cure but the patient can get a lung transplant
137
What are two signs that a child is suffering from epiglotitis?
They are leaning forward in the tri-pod position.
| They are drooling excessively.
138
What is Menigitis?
Inflammation of the meninges.
139
What is not visible when examining a child suffering from epiglotitis?
The throat
140
How does a child get cystic firbosis?
They inherit the defective gene from both parents with an overall incidence of 1:4
141
How is Wilm's Tumor treated?
Surgery
| Chemo therapy
142
True/False: Pertussis is not contagious.
False
143
What is the first thing you do when taking care of a drowning patient?
CPR
144
What is one of the first signs that a baby may have Cystic fibrosis?
Meconium ileus
145
What type of diet does a child with Kawasaki Disease need to be on?
Bland foods
| Avoid citrus or other irritating foods
146
True/False: Epiglotitis is considered a medical emergency.
True
147
What causes Rheumatic fever?
B-hemolytic streptococcal tonsillitis
148
What age is mostly affected by Kawasaki disease?
Under 5 years old (75 % of cases)
149
Why do you check pulses in pediatric patients for one full minute?
To assess for dysrhythmia and bradycardia
150
True/ False: You can stop an antibiotic for an ear infection once the child is feeling better.
False
151
What is cerebral palsy?
Its a chronic disability with impaired muscle movement.
152
Why does a febrile seizure occur?
Because of a high fever
153
What two medications are used for pediatric cardiac patients?
Digoxin
| Lasix
154
What kind of diet does a child with Cystic Fibrosis need to be on?
High protein and High caloric
155
Name three different obstructive heart defects.
Coarctation of the aorta
Aortic stenosis
Pulmonic stenosis
156
What chromosome is associated directly with Down's syndrome?
Three number 21 chromosomes - trisomy 21
157
Why is humidified oxygen used for patients who have croup?
Its used to help them breath better.
158
What are common clinical manifestations of Down's Syndrome?
```
Cognitive deficits
Facial and cranial deformities
Muscular hypotonia
Simian creases
Lax joints
```
159
What are the signs and symptoms of glomerulonephritis?
```
Oliguria
Edema
Hypertension
Circulatory congestion
Hematuria
Proteinuria
Smoky or tea colored urine
```
160
Describe Step 3 of asthma.
Moderate and persistent
| Daily symptoms, nighttime symptoms 1 night per week.
161
Describe the nasal passages, the glottis and the trachea in pediatrics?
They are all narrow compared to the adult.
162
True/False: ASD will always have symptoms.
False, it can be symptomatic
163
What are the clinical manifestations of Spina Bifida?
Possible paralysis from the waist down
164
How is hydrocephalus treated?
With ventro-peritoneal shunt.
165
True/ False: Tetralogy of Fallot can start off mild and progress with time.
True
166
What are the clinical manifestations of RSV?
Rhinorhea
Low grade fever
Non productive cough
Apnea
167
What are the clinical manifestations of hydrocephalus?
```
Increased head circumference
Sun setting eyes
Irritability
Nausea and vomiting
Bulging fontanelles
Dilated scalp veins
```
168
How does the teenager view death?
They think that they are invincible and it won’t happen to them.
They grieve together with their peers.
They go to site of accident or death to congregate.
169
Why is digoxin considered a dangerous drug?
Because the therapeutic window is so small.
170
How is Menigitis treated?
Ventilator
Environment
Antibiotics
171
Describe decerebrate posturing.
Posturing away from the body.
172
What is a patient at risk for if they have PDA?
Bacterial endocardidits
173
What type of foods need to be given to a patient on lasix?
Potassium enriched foods
174
True/ False: Temporary hearing loss is not normal following tympanostomy tube placement.
False, it is normal.
175
What occurs because there are fewer functional airway muscles?
Less compensation for edema, spasm and trauma.
176
What infection is the number one cause of hospitalization for children younger than 1?
Bronchiolitis (RSV)
177
What is Asthma?
Chronic inflammatory disorder of the airway
178
What are the clinical manifestations of coarctation of the aorta?
Increased blood pressure and bounding pulses in the arms
Weak or absent femoral pulses and cool lower extremities with lower blood
pressure
Mild cyanosis
179
What are the signs and symptoms present during the acute phase of Kawasaki Disease?
```
Abrupt high fever that is not responsive to antibiotics
Irritability
Rash
Red eyes
Peeling hands and feet
Red tongue
```
180
Describe Step 1 of asthma.
Mild and intermittent
| Symptoms occur less then two times per week, nighttime symptoms less then two time per month.
181
What is a child at risk for after getting a ventro peritoneal shunt?
Infection
182
What is the nursing role when taking care of a child who has seizures?
Protect them from injury.
| Document the seizure.
183
True/False: Do not palpate Wilm's Tumor.
True
184
What are the three categories associated with the pediatric Glasgow Coma Scale?
Eye
Verbal
Motor
185
How does the school age child view death?
They are interested in death and funerals
186
What is the pharmacologic management for Otitis Media?
Amoxicillin for 10 - 14 days.
187
What are the two classes of medications used to treat asthma?
Anti-inflammatory Drugs
| Bronchodilators
188
How is coup cough characterized?
Hoarseness
Barking cough
Inspiratory stridor
Varying degrees of respiratory distress
189
What are signs and symptoms of hypoxia?
Cyanosis
Polycythemia
Clubbed and delayed growth and development
190
What causes hydrocephalus?
Overproduction of CSF due to blockage
191
What are signs and symptoms increased intracranial pressure?
```
High pitched cry in infant
Fontanelles
Separated suture lines
Difference in coma
Stupor
Obtunded
```
192
What are common factors that cause increased intracranial pressure?
Head injury from motor vehicle accident.
Head injury from accident at home.
Tumor.
Hydrocephalus.
193
What do parents of a child who received shunts for hydrocephalus need to be educated on?
The shunts may need revisions as child grows.
| Watch for signs of infection (if there is infection, the shunts may need revisions)
194
How is Scoliosis treated?
With a brace or possibly rod placement
195
What are the four defects associated with Tetralogy of Fallot?
1. overriding aorta (its not in the right position)
2. has a BIG VSD– this itself causes blood to move from the right to the left side.
3. pulmonic stenosis which is decreased blood to the lungs
4. right ventricular hypertophy which means its too thick.
196
What are some nursing interventions when taking care of a child with ADHD?
Maintain environment
| Physical safety measures
197
What is important to remember to teach parents about tylenol and motrin?
They need to hide the medicine after the first dose is given.
198
What is PDA- patient ductus anteriosus?
It is the failure of the ductus arteriosis ( artery connecting the aorta and pulmonary artery) to close within the first weeks of life.
199
What are the two type of Spina Bifida?
Menigocele
| Myelomenigocele
