Final Flashcards
Infant Dehydration s/s
Sunken Fontanelles Sunken Eyes & Cheeks Sunken abdomen Pale or mottled skin Few or no tears Dry mouth and tongue
Child Dehydration s/s
Tachycardia
Hypotension
Tachypnea
Infant Gross Motor Skills
2-3 mo.: Raises Head/Chest, Slight head lag pulling to sitting
4-5 mo.: Roll over
6 mo.: Rolls both ways, sits w/o support, responds to name, explores toys with hands and mouth
9 mo.: Crawl
10 mo.: Pull to Stand
12 mo: sit from stand, walk
Toddler Gross Motor Skills
12-15 mos: Walk independently, feed self finger foods
18 mos: Climbs stairs, stacks blocks, removes shoes and socks
24 mos: Runs, kicks balls, carries several toys, climbs on furniture
36 mos: Pedals tricycle
School Age Behaviors
Group Play, Team Sports Associative Play Less fearful of harm to body, still scared of kidnapping and surgery Praise and accomplishment Rewards Sticker Chart Can teach self-injection of insulin
Infant, Toddler, Preschool, School Aged types of Medical Play
Infant: Solitary
Toddler: Parallel
Preschool: Associative, Domestic Mimicry
School Aged: Associative
Infant signs of Increased Intracranial Pressure
Head Enlargement Tense, Bulging Anterior Fontanelle Bossing Frontal Bone Setting-Sun eyes Scalp Veins Dialated Cranial Sutures Separated
Older Child signs of increased Intracranial Pressure
Headache/Nausea/Vomiting
Ataxia (Lack of Voluntary Muscle Movement)
Strabismus (rapid, side to side eye movement)
Diplopia (double vision)
Pupil response - sluggish or unequal
Changed LOC
Seizure
Post Febrile-Seizure Teaching
Stems from rapid rise in core temp Generalized seizure lasting up to 15 min Treat Symptoms Not Life Threatening Identify cause of high temp and treat Safety is priority Can send rectal diazepam home for high risk children or anxious parents
Trisomy 21 Physical Traits
Smaller nasal passages
Protruding tongue, often-open mouth
Dry muscous membranes make eating and babbling/talking a challenge
Otitis Media Complications
Hearing loss
expressive speech delay,
perf. of tympanic membrane
meningitis (extreme case)
Otitis Media Treatment
Antibiotics (and must finish treatment)
ADHD Support
Advocacy in school (IEP)
Behavioral Techniques - Positive reinforcement, quiet place to regroup, understanding peers/teachers
Stimulant meds
Short and Long term goals
Failure to thrive interventions
No distractions, provide meal times, structure
Appendicitis Nursing Management
Observe for sudden relief of pain Monitor Temp Keep NPO for surgery Administer IV pain meds Post-op may include antibiotics
Bronchiolitis Nursing Considerations
Isolation Suction Elevate HOB Do not feed if Resps > 60 Secondary to RSV
Ideopathic Thrombocytopenic Purpura (ITP) Education
Increased risk of bleeding Falls, Head Bleeds Padding Furniture, Crib Helmet No NSaids
Sickle Cell Crisis Summary
Anemia from sickling
Tissue Hypoxia
Pain, most often in joints
Acute Chest - Clumping in lungs, hypoxia, med emergency
Stroke
Stress - trauma, infection, fever, exertion, cold exposure
Iron Def. Anemia Family Teaching
Taking Iron can cause dark green stools
Cows Milk Too Early can cause. Should not be only source
Red Meat, Tuna, Salmon, Eggs, Tofu, Enriched Grains, Beans and Peas, Fruit, Leafy Green Veggies
Generic Cancer Presentation
Bruising Pale Bleeding Lethargy Infection Swelling
Lice Treatment
Fine Tooth Comb (removing eggs and lice)
OTC Pediculicides
Everyone in the home needs to be checked
Treat the home - high heat wash dry, bag pillows/animals, vacuum
Impetigo Treatment
Oral or topical antibiotics
Contact Isolation
Can remove honey-colored crust, but use gloves as it has bacteria
Adolescent Immunizations and considerations
HPV Flu Shot Boosters tDAP Keep in mind how adolescents might view immunization
Kawasaki s/s
Bilateral conjunctivitis without exudate Mouth and throat dry Strawberry tongue Hyperdynamic precordium Diffuse erethematous polymorphous rash Cervical lymphadenopathy tender joints Edema to hands and feet Desquamination of fingers, toes, palms of hands
Cardiac Cath discharge teaching
Apply pressure if bleeding and call for help Must lay flat for 4-8 hours Monitor for post-surgery complications Site care Avoid tub bath for approx 3 days
Treatment for Precocious Puberty
Lutenizing Hormone (Depo)
Hypoglycemia Intervention
Protein + Carb e.g. Peanut Butter & Crackers
First Trimester Danger Signs
Spotting/Bleeding Painful Urination Severe and Persistent vomiting Fevers over 100.3 (38) Lower abd. pain w/ dizziness or shoulder pain
Second Trimester Danger Signs
Regular Contractions Calf Pain Gush/Leakage of Fluid No fetal movement for >12 hrs First semester danger signs
Third Trimester Warning Signs
Sudden Weight Gain Periorbital or Facial Edema Severe Upper Abd. Pain Headache w/ Visual Changes Previous Signs
Pregnancy Discomforts
T1: Urinary freq or incont., fatigue, n/v, breast tenderness, constip., stuffiness, bleeding gums/nose, cravings, leukorrhea
T2: Backache, variscosities, hemmorhoids, flatulence w/ bloating
T3: T1, SOB, dysspnea, heartburn/indigestion, dependent edema, braxton hicks cont
When to use RhoGAM?
Mom Neg & Baby pos, give mom rhogam
28 wks and after birth
Post Partum Assessments
BUBBLEE
Breasts, Uturus, Bladder, Bowels, Lochia, Episiotomy/Perineum, Extremeties, Emotional Status
Postpartum Vital Sign Changes
Temp: slight elev in first 24 hrs
Pulse: 40-80 (puerperal bradyc)
Resp: 16-20
BPM: Normal
Infant Expected Vitals
97.9-99.7/36.6-37.6
110-160 BPM
30-60 RR
Normal Newborn Reflexes
Sucking Moro (Loud Sound) Stepping Tonic Neck Rooting Babinski (Big Toe up, other toes down) Grasp
Heart Disease Anticipitory Care in Pregnancy
Encourage Rest, Labor Down, Decrease mom’s effort, might use forceps or vacuum
Uterine Tachysystole/Hyperstim Treatments
Give bolus of fluids (might be dehydrated)
Can add oxygen
Move position
Can give tocolytic
Preterm Appearance and Concerns
Appearance: Poor muscle tone, minimal subq fat, plentiful lanugo, abundant vernix, thin skin, fused eyelids, few to no creases in palms and soles
Concerns: Hypoglycemia, Hypothermia
Neonatal Sepsis s/s
High HR Low BP Temperature Instability (Fever or Hypothermia) Decreased Level of Consciousness Lethargy
Hemolytic Uremic Syndrome (HUS) Triad
Thrombocytopenia
Hemolytic Anemia
Acute Renal Failure
Younger and Older Child UTI s/s
Younger: Can’t express, s/s = fever, fewer changes, crying, stomach ache
Older: Flank/tummy pain, burning, urgency
Acute Glomuleronephritis / Nephrotic Syndrome Summary
Both: Some proteinuria, hypoalbumenemia, dark urine, high specific gravity urine, edema
AGN Only: Starts 10-14 days post-Strep, Hypertension, Hematuria, No treatment, just treat symptoms, resolves spontaneously
Nephrotic Syndrom Only: Massive Proteinuria, May need prednisone, Adherance to steroid treatment, succeptible to infection
Education: Low sodium diet, may stay in hopsital with high BP
Mgmt: Strict i/o, daily weights, low sodium/fluids
Trichomoniasis Treatment
Oral metronidazole
Treat both partners
Eliminate sexual exposure until both treated or will pass back and forth
Can get from surfaces like Hot tubs or Drains
Type of Vaginitis
Parasitic
Candidaisis Assessment
Yeast infection, not STI
Can be infection after too much antibiotic use
Treated with antifungals
Higher occurrence in pregnancy due to more estrogen
Diabetes increases risk
Symptothemral Contraception
Combination of two or multiple methods to predict ovulation
Mittelschmerz (ovulation pain)
Spinnbarkeit (Stringy/stretchy cervical mucus)
Basal Body Temp
Breast Cancer s/s
Persistent changes in breast Lump/Thickening Persistent Nipple Irritation Unusual swelling or asymmetry Lump or swelling in axilla Changes in skin color or texture Nipple Retraction Tenderness or Discharge
Endometrial (uterine) cancer s/s
Painless bleeding at abnormal timing Genital/Low back Pain Purulent Discharge Dysuria Pelvic Pain Wt. Loss Change in bladder/bowel habits
Pelvic Inflammatory Disease Assessment
Cervical Motion Tenderness Temp of 101 or greater Abnormal discharge Pelvic Pain Caused by untreated STIs
Polycystic ovarian syndrome s/s
Hirsutism Alopecia Virilization Menstrual irreg. & infertility Polycystic ovaries (12+ folicles on ovaries) Obesity Insulin res. Metabolic syndrome Acne
Ovarian Cancer Risks
No Pregnancies Early Menarche/Late menopause Age High fat diet/obesity talcum powder Long HRT Infertility
