final Flashcards
chicken pox - stay home until
Stay home until all lesions are crusted over
impetigo - stay home until
no school until after 24 hours of antibiotic admin
how to apply impetigo ointment
when applying ointment cream you must slough those crusty lesions off and then put the ointment on the lesion so it can get down to the infection
Careful with pain meds for unconscious children - why?
Careful with pain meds, opioids will make them sleepy and then we can’t tell if they are declining or if it’s just a side effect from the pain meds. Best to admin ibuprofen/Tylenol as long as we can
Increased HR and BP in an unconscious child could indicate
pain
cushing triad - what 3 things happen
what does it indicate
what should you do
- Increased systolic BP
- Decreased HR and RR
- Widening pulse pressure = systolic BP increase and diastolic BP decrease
ICP
- Call the HCP
- expect to admin mannitol – osmotic diuretic that helps decrease the increased ICP quickly
s/s
- raccoon eyes – bruising around eyes
- battle sign – bruising behind ears
- leakage of CSF from ears or nose – yellow halo ring leak out of ear onto pillow, or you can do a strip test for glucose bc CSF has glucose in it
- bilateral fixed pupils = suspect brain stem damage
Basilar skull fractures
s/s children –
- Fever
- Headache
- Brudzinski sign (nuchal rigidity) – chin to chest pain
- Kernig’s sign – hamstring pain
- Opisthotonos – c shaped spine
meningitis
Diagnosis – LP
- Increased WBC, pressure and protein
- Decreased glucose (bacteria is a protein, it is eating glucose)
- Cloudy CSF
- Positive culture
meningitis
steps of treating a child in a hypercyanotic spell
- Put child in knee to chest position (call for help)
- Give them oxygen
- Morphine – relaxes muscle allows blood flow to circulate better
- IV fluids
- Morphine
- multi day fever unresponsive to antipyretics
- rash
- swollen lymph nodes
- dry, cracked, red lips
- strawberry tongue
- bilateral conjunctivitis – looks like pink eye w/ out exudate
- erythema and swollen palms/soles
- vasculitis
- desquamation – peeling skin
- arthritis
- thrombocytosis – increased platelets
kawasaki - cardiac disorder
why is the recovery phase of kawasaki so dangerous
recovery phase s/s:
- asymptomatic
- all blood vessels return to normal
most dangerous!!! – child at home, not monitored as closely, increased platelets and swelling = embolisms = MI
how is kawasaki treated
treatment -
- salicylates (aspirin) for anti-inflammatory and anti-platelet effects
- high does ASA – anti-inflammatory effects
- low dose ASA – anti-platelet effects
- high dose IVIG
s/s:
- low grade intermittent fever
- anorexia
- malaise
- weight loss
- joint pain
- positive blood culture
- new or changing heart murmur
- Petechiae - tiny, flat spots of bleeding that appear under the skin or mucous membranes
- Janeway spots
- Osler nodes
- Splinter hemorrhages under nails
bacterial endocarditis
what 2 things do we need to check before giving digoxin
when to hold?
check apical HR for 1 minute before giving – HOLD if
infant/young kid HR <90
older kids <70
in hospital = check potassium levels before giving, hold if potassium is low
hold if child vomits
