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FINAL Flashcards

1
Q

What are the six rights of pediatric medication?

A
  • Right patient: use two identifiers
  • Right medication: verify on the MAR; does the patient have allergies to the medication?
  • Right route: IV, IM, PO, etc.
  • Right dose: is the dose within the safe range?
  • Right time: when was the last time the medication was administered? Is the expiration date after today?
  • Right approach: each age group requires a different approach.
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2
Q

What is the pediatric right approach for toddlers?

A
  • Follow routines and rituals from home
  • Involve parents
  • Offer simple choices
  • Allow child to touch and handle equipment as appropriate.
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3
Q

What is the pediatric right approach for preschoolers?

A
  • Involve parents
  • Offer simple choices
  • Allow child to handle equipment.
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4
Q

What is the pediatric right approach for school-aged children?

A
  • Explain purpose of medication in simple terms
  • Seek their assistance such as holding their juice
  • Allow broader range of choice
  • Establish reward system to enhance cooperation as needed.
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5
Q

What is the pediatric right approach for adolescents?

A

Approach in the same manner as adults with respect and sensitivity to their needs and maintain privacy as much as possible.

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6
Q

What should be assessed in pediatric IV care?

A

IV site every hour.

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7
Q

Define infiltration in pediatric IV care.

A

When the fluid that leaks into the tissue is non-vesicant (does not irritate the tissue).

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8
Q

Define extravasation in pediatric IV care.

A

When the fluid that leaks into the tissue is a vesicant (irritates the tissue).

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9
Q

What are the two types of pain?

A
  • Acute pain: rapid onset of varying intensity; indicates tissue damage and resolves with healing of the injury.
  • Chronic pain: continues past the expected point of healing for injured tissue; may be continuous or intermittent.
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10
Q

What factors influence pain in children?

A
  • Age
  • Gender
  • Cognitive level
  • Temperament
  • Previous pain experience
  • Culture and family
  • Situational factors.
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11
Q

What does the acronym QUESTT stand for in nursing management of pain in children?

A
  • Question the child and parents
  • Use reliable and valid pain scale
  • Evaluate the child’s behavior and physiologic changes
  • Secure the parent’s involvement
  • Take the cause of pain into account when interviewing
  • Take action.
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12
Q

What is the Wong-Baker Faces pain scale used for?

A

Used with children 3-8 years of age.

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13
Q

What is the Oucher scale used for?

A

Used with children between 3-12 years of age.

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14
Q

What is the Visual Analog scale used for?

A

Can be used with children 5 and older.

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15
Q

What is the Numeric scale used for?

A

Can be used with children 8 and older.

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16
Q

What is the NIPS scale used for?

A

Measures pain in pre- and full-term neonates.

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17
Q

What is the FLACC behavioral scale?

A

Face, Legs, Activity, Cry, Consolability. Commonly used on children with cognitive impairments.

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18
Q

What are some non-pharmacological pain management techniques?

A
  • Relaxation
  • Distraction
  • Imagery
  • Biofeedback
  • Thought stopping
  • Positive self-talk.
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19
Q

What are the trimesters of pregnancy?

A
  • 1st Trimester: First day of LMP through 13 completed weeks.
  • 2nd Trimester: 14 weeks through 27 completed weeks.
  • 3rd Trimester: 28 weeks through 40 completed weeks.
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20
Q

What are the functions of the placenta?

A
  • Serves as the interface between mother and fetus
  • Protects the fetus from immune attack by the mother
  • Removes waste products from the fetus
  • Produces hormones that mature into fetal organs and control physiologic changes.
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21
Q

What hormones are produced by the placenta?

A
  • Human chorionic gonadotropin (HCG)
  • Prolactin
  • Human placental lactogen (hPl)
  • Estrogen
  • Progesterone
  • Relaxin.
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22
Q

What is the structure of the umbilical cord?

A
  • Formed from the amnion
  • Contains one large vein and two small arteries
  • Wharton jelly surrounds the vein and arteries to prevent compression.
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23
Q

What is oligohydramnios?

A

Too little amniotic fluid associated with poor placenta function, fetal renal abnormalities, and low birth weight.

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24
Q

What is polyhydramnios?

A

Too much amniotic fluid associated with maternal diabetes, neural tube defects, and other problems.

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25
Q

What are the two shunts during fetal life?

A
  • Ductus venosus: connects the umbilical vein to the inferior vena cava to bypass the liver.
  • Ductus arteriosus: connects the main pulmonary artery to the aorta to bypass the lungs.
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26
Q

What are presumptive signs of pregnancy?

A
  • Fatigue
  • Breast tenderness
  • Breast enlargement
  • Nausea and vomiting
  • Amenorrhea
  • Urinary frequency
  • Fetal movement (quickening).
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27
Q

What are probable signs of pregnancy?

A
  • Braxton Hicks contractions
  • Positive pregnancy test
  • Abdominal enlargement
  • Ballottement
  • Goodell sign
  • Chadwick sign
  • Hegar sign.
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28
Q

What are positive signs of pregnancy?

A
  • Ultrasound verification of embryo
  • Fetal movement felt by experienced clinician
  • Auscultation of fetal heart tone via doppler.
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29
Q

What is the fundal height during pregnancy between 20 and 36 weeks?

A

Should be the same in cm as the number of weeks gestation.

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30
Q

What are cardiovascular system adaptations during pregnancy?

A
  • Increased blood volume of about 50% above pre-pregnancy levels
  • Increased cardiac output and heart rate
  • Increased iron demands, fibrin and plasma fibrinogen levels, leading to hypercoagulable state.
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31
Q

What is supine hypotension syndrome?

A

Weight of the growing uterus presses on the vena cava and obstructs blood flow from lower extremities.

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32
Q

What are normal integumentary system adaptations during pregnancy?

A
  • Hyperpigmentation
  • Linea nigra
  • Striae gravidarum
  • Varicosities
  • Vascular spider veins
  • Palmar erythema.
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33
Q

What dietary recommendations are suggested during pregnancy?

A
  • Increase protein, iron, folate, and calories
  • Use USDA’s food guide MyPlate
  • Avoid fish that are high in mercury.
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34
Q

What is Nagele’s rule for estimating due date?

A

First day of LMP minus 3 months, plus 7 days, plus a year.

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35
Q

What does GTPAL stand for?

A
  • G (gravida): number of pregnancies including current pregnancy
  • T (term births): number of pregnancies ending between 38-42 weeks
  • P (preterm births): number of preterm pregnancies ending >20 weeks
  • A (abortion): number of pregnancies ending before 20 weeks
  • L (living children): number of children currently living.
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36
Q

What are infant physiological milestones?

A
  • Doubles birth weight by 6 months
  • Triples birth weight by 1 year
  • Posterior fontanelle closes at approximately 6-8 weeks
  • Anterior fontanelle closes at approximately 12-18 months.
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37
Q

What is the infant gross motor development at 2-3 months?

A

Kicks legs.

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38
Q

What is the infant gross motor development at 4 months?

A

Head control.

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39
Q

What is the infant gross motor development at 11 months?

A

Walks holding on.

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40
Q

What is the infant fine motor development at 2-3 months?

A

Grasps objects intentionally.

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41
Q

What is Erikson’s psychosocial development stage for infants?

A

Trust vs Mistrust.

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42
Q

What is Piaget’s phase for infant social development?

A

Sensorimotor Phase.

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43
Q

What are the nutrition recommendations for infants?

A
  • Breast milk: first 4-6 months
  • Solid food: 4-6 months, starting with rice cereal.
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44
Q

What is the ‘Safe Pad’ for infant safety?

A
  • Suffocation/Sleep position
  • Asphyxia/Animal bites
  • Falls
  • Electrical burns/other burns
  • Poisoning
  • Automobile safety
  • Drowning.
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45
Q

What is the toddler physiological development milestone for weight?

A

Birth weight triples by 2.5 years.

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46
Q

What is the toddler gross motor development at 12-13 months?

A

Walks independently.

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47
Q

What is the toddler psychosocial development stage according to Erikson?

A

Autonomy vs Shame and Doubt.

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48
Q

What are the nutrition recommendations for toddlers?

A
  • Limit milk intake to 16-24oz/day
  • Calcium intake: 700mg/day
  • Vitamin D: 600IU/day.
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49
Q

What is the recommended daily intake of calcium for preschoolers aged 1-3 years?

A

700mg

For preschoolers aged 4-8 years, the intake increases to 1000mg.

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50
Q

What is the recommended daily intake of Vitamin D for children?

A

600IU

This is crucial for bone health and calcium absorption.

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51
Q

What are the highest rates of unintentional injuries in toddlers attributed to?

A
  • Motor vehicle injuries
  • Burns
  • Accidental poisoning
  • Falls
  • Aspiration and suffocation
  • Bodily harm
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52
Q

What is a significant physical development milestone for preschoolers (3-6 years)?

A

Most growth in long bones of arms and legs; no longer has pot belly.

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53
Q

What gross motor skills should a 5-year-old be able to perform?

A
  • Jumps rope
  • Swims
  • Skates
  • Skips on alternate feet
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54
Q

According to Erikson, what psychosocial stage do preschoolers (3-6 years) experience?

A

Initiative vs. Guilt

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55
Q

What is a key cognitive development characteristic of preschoolers according to Piaget?

A

Pre-Operational Phase

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56
Q

What is the vocabulary expansion from age 2 to age 5?

A

From 300 words to more than 2100 words

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57
Q

What are common nutritional needs for moderately active preschoolers?

A
  • 1200-1400 total daily calories
  • 13-19g of protein/day
  • 700mg calcium for 1-3 year olds and 1000mg for 4-8 year olds
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58
Q

What is the average height increase per year for school-age children (6-12 years)?

A

2 inches per year

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59
Q

What is the psychosocial development stage for school-age children according to Erikson?

A

Sense of Industry vs Inferiority

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60
Q

What are the characteristics of Piaget’s Concrete Operations stage?

A
  • Logical thought processes
  • Learns by manipulating concrete objects
  • Understands relationships among objects
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61
Q

What is the average age of puberty onset in girls and boys?

A
  • Girls: 10 years
  • Boys: 12 years
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62
Q

What are the key components of the HEEADSSS Assessment for adolescents?

A
  • Home environment
  • Education/Employment
  • Eat/Nutrition/Elimination
  • Activities/Physical Activities
  • Drugs
  • Sexuality
  • Suicide/depression
  • Safety
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63
Q

What anatomical variation occurs in the pediatric respiratory system?

A

Newborns are obligatory nose breathers until about 4 weeks

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64
Q

What are the signs and symptoms of asthma?

A
  • Accessory muscle use
  • Shortness of breath
  • Tachypnea
  • High-pitched wheezing
  • Absent breath sounds
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65
Q

What is Croup also known as?

A

Laryngotracheobronchitis (LTB)

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66
Q

What is the first sign of puberty in adolescent girls?

A

Breast buds (thelarche)

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67
Q

What does the ‘S’ in the acronym HEEADSSS stand for?

A

Sexuality

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68
Q

What is the gold standard for diagnosing Cystic Fibrosis?

A

Sweat chloride test (diagnostic >60mEq/L)

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69
Q

What are the common symptoms of Epiglottitis?

A
  • Refusal to speak
  • Anxious appearance
  • Drooling
  • High fever
  • Stridor
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70
Q

What interventions are critical for managing an airway emergency in Epiglottitis?

A
  • Provide 100% oxygen
  • Emergency trach kit at bedside
  • Do not attempt to visualize the throat
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71
Q

What are common symptoms of Bronchiolitis?

A
  • Clear runny nose
  • Pharyngitis
  • Low grade fever
  • Cough followed by wheezing
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72
Q

What is the most common cause of severe injury and death in school-age children?

A

Motor vehicle-pedestrian and passenger motor vehicle injuries

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73
Q

What is the expected heart sound indicating closure of the mitral and tricuspid valves?

A

S1 (Lub sound)

74
Q

What does a high-pitched wheezing sound indicate in a respiratory assessment?

A

Possible asthma or airway obstruction

75
Q

What are the characteristics of Tetralogy of Fallot?

A
  • Pulmonary stenosis
  • Right ventricular hypertrophy
  • Overriding aorta
  • Ventricular septal defect
76
Q

What are the dietary recommendations for children with Cystic Fibrosis?

A
  • High-protein
  • High-calorie diet
  • Administer fat soluble vitamins (A, D, E, K)
77
Q

What percentage of adult body weight is gained during puberty?

78
Q

What is the common cause of Bronchiolitis in infants and toddlers?

A

Viral pathogen (RSV in most cases)

79
Q

What is the expected outcome for children with Bronchiolitis?

A

Usually self-limited and managed at home

80
Q

What is the most critical nursing intervention for a child with asthma in status asthmaticus?

A

Intubation

81
Q

What is the Tetralogy of Fallot composed of?

A

Pulmonary stenosis, Right ventricular hypertrophy, Overriding aorta, Ventricular septal defect

Tetralogy of Fallot is a congenital heart defect that affects normal blood flow through the heart.

82
Q

What are the symptoms of ‘TET spells’?

A
  • Cyanosis
  • Hypoxemia (O2 sat 65-85%)
  • Clubbing finger tips
  • Polycythemia

‘TET spells’ are acute episodes of hypoxia in children with Tetralogy of Fallot.

83
Q

What interventions are recommended during a TET spell?

A
  • Knees to chest
  • 100% oxygen

These interventions help increase blood flow to the heart and improve oxygenation.

84
Q

What are the signs of heart failure in children?

A
  • Weight gain
  • Puffiness around the eyes
  • Pale cool extremities
  • Decrease in wet diapers
  • Decreased feeding

These signs indicate that the heart is not effectively pumping blood.

85
Q

What is transposition of the great vessels?

A

Aorta connected to the right ventricle instead of the left, and pulmonary artery connected to the left ventricle instead of the right.

This condition requires surgical repair.

86
Q

What are the major criteria of Acute Rheumatic Fever according to the Modified Jones Criteria?

A
  • Migratory polyarthritis
  • Carditis
  • Subcutaneous nodules
  • Erythema marginatum
  • Sydenham chorea

These criteria help diagnose Acute Rheumatic Fever.

87
Q

What are the minor criteria of Acute Rheumatic Fever according to the Modified Jones Criteria?

A
  • Fever
  • Raised erythrocyte sedimentation rate or C-reactive protein
  • Polyarthralgia
  • Prolonged PR interval

These criteria are used alongside major criteria for diagnosis.

88
Q

What is Kawasaki Disease?

A

Acute vasculitis of blood vessels and coronary arteries, primarily affecting children aged 6 months to 5 years, especially of Asian or Pacific descent.

It is the leading cause of acquired heart disease among children.

89
Q

What are the signs and symptoms of Kawasaki Disease?

A
  • High fever > 5 days
  • Bilateral conjunctivitis
  • Dry, fissured lips
  • Strawberry tongue
  • Erythematous rash
  • Edema of hands and feet
  • Peeling of perineal region
  • Possible jaundice

These symptoms can lead to serious complications if not treated.

90
Q

What nursing management is required for Kawasaki Disease?

A
  • High dose aspirin
  • IVIG infusion
  • Monitor cardiac status
  • Promote comfort and provide education

Monitoring for arrhythmias and signs of heart failure is crucial.

91
Q

What is amniocentesis used for?

A

To obtain amniotic fluid sample for genetic anomalies in early gestation and fetal lung maturity in late gestation

It is performed under ultrasound guidance.

92
Q

What are the complications of amniocentesis?

A
  • Infection
  • Rupture of membranes
  • Preterm labor
  • Hemorrhage

These risks necessitate careful monitoring during and after the procedure.

93
Q

What is the Biophysical Profile (BPP) criteria?

A

All tests are scored 0 or 2 over a 20-minute span: Fetal heart rate reactivity, Fetal movements, Fetal tone, Fetal breathing, Amniotic fluid volume

A total score indicates fetal health.

94
Q

What are the signs of ectopic pregnancy?

A
  • Unilateral pelvic or abdominal pain
  • Rigid abdomen
  • Possible referred shoulder pain

Ectopic pregnancy can lead to serious complications if not identified early.

95
Q

What is gestational trophoblastic disease (GTD)?

A

Includes hydatidiform mole and choriocarcinoma; requires immediate evacuation of uterine contents

GTD presents with symptoms similar to spontaneous abortion.

96
Q

What is placenta previa?

A

Placenta implants over the cervical os, posing a major bleeding risk

It requires careful monitoring and typically a cesarean delivery.

97
Q

What are the signs of placental abruption?

A
  • Sharp, stabbing pain
  • Uterine tenderness
  • Heavy bleeding (dark red)

Aplacental abruption can lead to severe maternal and fetal complications.

98
Q

What defines chronic hypertension in pregnancy?

A

Blood pressure of 140/90 before pregnancy or before 20 weeks gestation

It occurs in about 20% of women and can complicate pregnancy.

99
Q

What are the signs of mild preeclampsia?

A
  • BP >140/90
  • No hyperreflexia
  • Scant to small proteinuria
  • Edema in lower extremities

Monitoring is crucial for progression to severe preeclampsia.

100
Q

What are the five P’s of labor?

A
  • Passageway (birth canal)
  • Passenger (fetus/placenta)
  • Powers (contractions)
  • Position (maternal)
  • Psychological response

These factors influence the labor process.

101
Q

What is the baseline fetal heart rate range?

A

110-160 bpm

Deviations from this range can indicate fetal distress.

102
Q

What is the significance of variable decelerations in fetal heart rate monitoring?

A

Indicate cord compression, with abrupt onset

Monitoring is essential to prevent fetal distress.

103
Q

What is the nursing management during the first stage of labor?

A
  • Comprehensive history
  • EDD
  • Fundal height assessment
  • Education
  • Assess FHR
  • Lab studies

Continuous assessment is crucial for maternal and fetal well-being.

104
Q

What is the definition of Intracellular Fluid (ICF)?

A

Fluid within cells

105
Q

What is the definition of Extracellular Fluid (ECF)?

A

Fluid outside the cells

106
Q

What is Intravascular fluid?

A

ECF contained within the blood vessels

107
Q

What is Interstitial fluid?

A

ECF surrounding the cells

108
Q

What percentage of total body water is present in infants?

109
Q

What percentage of total body water is present in adolescents?

110
Q

Why are children more prone to dehydration than adults?

A

Higher body surface area and immature kidney function

111
Q

What are the signs of Mild Dehydration?

A

Slightly decreased urine output

112
Q

What are the signs of Moderate Dehydration?

A
  • Alert to listless
  • Sunken fontanelles
  • Mildly sunken orbits
  • Pale and slightly dry oral mucosa
  • Decreased skin turgor
  • Decreased heart rate
  • Delayed capillary refill
  • Urine <1mL/kg/hr
113
Q

What are the signs of Severe Dehydration?

A
  • Alert to comatose
  • Deeply sunken orbits
  • Dry oral mucosa
  • Tenting skin turgor
  • Increased heart rate progressing to bradycardia
  • Hypotension
  • Cool, mottled, or dusky skin
  • Significantly delayed capillary refill
  • Urine output <1mL/kg/hr
114
Q

What is the biggest complication of Cleft Lip and Palate?

A

Poor feeding and aspiration

115
Q

At what age does surgical repair of cleft lip usually occur?

A

2-3 months

116
Q

At what age does surgical repair of cleft palate usually occur?

A

6-9 months

117
Q

What is the primary symptom of hypertrophic pyloric stenosis (HPS)?

A

Forceful, projectile, nonbilious vomiting after eating

118
Q

What lab findings are indicative of HPS?

A
  • Hematocrit >54%
  • Metabolic alkalosis
  • Low potassium (3.5 or less)
119
Q

What are the signs and symptoms of Intussusception?

A
  • Blood-streaked stool with mucus
  • Sausage-shaped abdominal mass
  • Non-projectile vomiting
  • Intermittent abdominal pain
120
Q

What is Hirschsprung’s disease?

A

Condition where the large intestine cannot pass stool due to absence of ganglion cells

121
Q

What are the signs and symptoms of Hirschsprung’s disease?

A
  • No passage of stool or thin ribbon-like stool
  • Distended abdomen
  • Refusing to feed or vomiting green bile
122
Q

What is the nursing management for Hirschsprung’s disease?

A
  • Assess intake and output
  • Use medications to slow stool output
  • Observe for signs of enterocolitis
123
Q

What is Glomerulonephritis?

A

Inflammation in the kidney with low protein in urine

124
Q

What is Nephrosis?

A

High protein in urine, low albumin, edema, high risk for blood clots

125
Q

What are the symptoms of Hypothyroidism?

A
  • Low energy
  • Low metabolism
  • Weight gain
  • Constipation
  • Hair loss
  • Low mood
126
Q

What is the classic medication for Hypothyroidism?

A

Levothyroxine

127
Q

What are the symptoms of Hyperthyroidism?

A
  • Agitation
  • High temperature
  • Heart palpitations
  • Weight loss
  • Diarrhea
128
Q

What is the definition of Diabetes Mellitus (DM)?

A

Impaired carbohydrate, protein, and lipid metabolism

129
Q

What is the fasting blood glucose level indicating diabetes?

A

> 126mg/dL

130
Q

What are the symptoms of hypoglycemia?

A
  • Irritability
  • Confusion
  • Diaphoresis
  • Tremors
  • Palpitations
131
Q

What are the signs of Diabetic Ketoacidosis (DKA)?

A
  • Anorexia
  • Nausea/vomiting
  • Lethargy
  • Fruity breath odor
  • Presence of ketones in urine/blood
132
Q

What is the pediatric Glasgow Coma Scale (GCS) score indicating a coma?

133
Q

What are the early signs of increased intracranial pressure (ICP)?

A
  • Headache
  • Dizziness
  • Vomiting
  • Blurred vision
  • Bulging fontanels
134
Q

What is the Salter-Harris Fracture Classification Type I?

A

Fracture straight through physis

135
Q

What are the Five P’s of Compartment Syndrome?

A
  • Pain
  • Pallor
  • Pulselessness
  • Paresthesia
  • Paralysis
136
Q

What is the normal postpartum temperature range, and when is a fever considered significant?

A

Low grade fever is normal within 24 hours; above 100.4°F may indicate infection.

Normal vital sign ranges postpartum include a pulse of 60-100 bpm, respiration of 12-20, and blood pressure between 85/60 to 140/90.

137
Q

What are the signs that require notifying a provider postpartum?

A
  • Fever > 100.4°F
  • Foul-smelling lochia
  • Large blood clots or bleeding saturating a peri-pad in an hour
  • Severe headaches
  • Visual changes (blurred vision or spots)
  • Calf pain, redness, or swelling
  • Swelling, redness, or discharge at episiotomy or abdominal sites
  • Dysuria or burning during urination
  • Shortness of breath without exertion
  • Depression or extreme mood swings.

These signs indicate possible complications that need immediate attention.

138
Q

Define involution and subinvolution in the context of postpartum recovery.

A

Involution: reproductive organs return to their non-pregnant state.
Subinvolution: failure of the uterus to return to a non-pregnant state, commonly due to retained placental fragments or infection.

A full bladder can temporarily cause subinvolution.

139
Q

What are the four stages of lochia and their characteristics?

A
  • Lochia rubra: Day 1-3, red
  • Lochia serosa: Day 4-10, pink or brownish
  • Lochia alba: Day 10+, yellow to white
  • Lochia should not have an ‘offensive’ odor or regress in color.

Lochia descriptions also include scant, small, moderate, and heavy, based on the amount on the pad.

140
Q

What are the degrees of lacerations in postpartum patients?

A
  • 1st degree: only skin and superficial structures
  • 2nd degree: extends through perineal muscles
  • 3rd degree: extends through anal sphincter muscle
  • 4th degree: continues through anterior rectal wall.

Understanding laceration degrees is crucial for appropriate care and management.

141
Q

What is the average time to return to ovulation for non-breastfeeding and breastfeeding women?

A
  • Non-breastfeeding: 10 weeks post delivery
  • Breastfeeding: 17 weeks post delivery.

Breastfeeding is not a reliable method of contraception.

142
Q

What are the primary causes of postpartum hemorrhage (PPH)?

A
  • Tone: uterine atony (most common cause)
  • Tissue: retained placental fragments
  • Trauma: lower genital tract lacerations
  • Thrombin disorder: disseminated intravascular coagulation (DIC).

Identifying the cause of PPH is critical for effective treatment.

143
Q

What methods can be used to stop postpartum bleeding?

A
  • Fundal massage
  • Medications: Pitocin, methylergonovine, misoprostol/Cytotec, tranexamic acid (TXA)
  • IV Therapy: 3 liters of IV solution per 1 liter of blood loss
  • Bimanual compression of the uterus
  • Uterine packing/Bakri balloon/JADA
  • D&C and/or hysterectomy
  • Blood replacement.

These interventions vary based on the severity of the bleeding.

144
Q

What are the signs of respiratory distress in newborns?

A
  • Circumoral cyanosis
  • Abnormal respiratory patterns (apnea, tachypnea)
  • Retractions of the chest wall
  • Grunting
  • Flaring of nostrils
  • Hypotonia.

Recognizing these signs is crucial for timely intervention.

145
Q

List the symptoms of hypoglycemia in neonates.

A
  • Jitteriness
  • Hypotonia
  • Irritability
  • Apnea
  • Lethargy
  • Temperature instability.

Early detection and treatment of hypoglycemia are vital to prevent complications.

146
Q

What bilirubin levels indicate jaundice in neonates?

A

Jaundice appears when bilirubin is between 5-7 mg/dL; considered pathologic if jaundice appears before 4 hours or if >13 mg/dL.

Kernicterus occurs at bilirubin levels >20-25 mg/dL, leading to lifelong brain damage.

147
Q

What are the stages of infectious disease?

A
  • Incubation: entrance of pathogen to appearance of first symptoms
  • Period of communicability: time during which an infectious agent may be transferred
  • Prodrome: onset of nonspecific symptoms to specific symptoms
  • Illness: signs and symptoms specific to infection type
  • Convalescence: acute symptoms disappear.

Understanding these stages helps in managing infectious diseases effectively.

148
Q

When should a provider be called for a fever in children?

A
  • Any child <3 months with rectal temp >38°C (100.4°F)
  • Any lethargic or listless child regardless of temp
  • Fever lasting >3-5 days
  • Fever >40.6°C (105°F)
  • Immunocompromised children.

Timely intervention is crucial for preventing severe outcomes.

149
Q

What are the signs and symptoms of sepsis in children?

A
  • Child does not look or act right
  • Increased irritability and inconsolability
  • Pallor
  • Temperature instability
  • Poor feeding
  • Changes in mental status
  • Rash
  • Increased work of breathing
  • Dehydration
  • Poor muscle tone
  • Seizures.

Recognizing these symptoms early is essential for effective treatment.

150
Q

What is the primary nursing management for sepsis in neonates?

A
  • Managed aggressively
  • PICU admission
  • IV antibiotic therapy immediately after cultures obtained
  • Discontinue antibiotics after 72 hours if cultures are negative and symptoms are resolved.

Aseptic technique is critical when working with septic children.

151
Q

What are the characteristics of scarlet fever?

A
  • Transmission: contact with respiratory secretions
  • Abrupt onset, fever, chills, body aches, nausea
  • Red and swollen pharynx, strawberry tongue, sandpaper-like rash
  • Diagnosis: rapid streptococcal antigen test.

Early diagnosis and treatment are crucial to prevent complications.

152
Q

What are the nursing management steps for diphtheria?

A
  • Treatment with antibiotics
  • Airway management
  • Administer Tdap or DTaP vaccine
  • Droplet precautions.

Timely intervention can prevent severe complications from diphtheria.

153
Q

What are the complications associated with measles?

A
  • Diarrhea
  • Otitis media
  • Pneumonia
  • Acute encephalitis.

Complications can lead to severe health issues, emphasizing the importance of vaccination.

154
Q

What is the incubation period for varicella (chickenpox)?

A

10-21 days.

Understanding the incubation period helps in managing and preventing outbreaks.

155
Q

What are the initial stages of a rash in chickenpox?

A

Rash begins as a macule 🡪 vesicle 🡪 erupts 🡪 crusts

156
Q

What nursing management precautions are recommended for chickenpox?

A
  • Contact and airborne precautions
  • Topical diphenhydramine cream after showers and baths
  • Acetaminophen for fever and pain
  • NO Aspirin; Reye syndrome risk
  • Antiviral therapy in immunocompromised children (Acyclovir)
  • Prevention (Varicella vaccine)
  • NO Live vaccines for immunocompromised children
157
Q

What is the causative agent of Exanthem Subitem (Roseola Infantum)?

A

Human herpesvirus type 6

158
Q

How is Exanthem Subitem transmitted?

A

Saliva of infected person enters through nose, mouth, and eyes

159
Q

What is the incubation period for Exanthem Subitem?

A

5-15 days, average 10 days

160
Q

When does the rash appear in Exanthem Subitem?

A

Rash appears 12-24 hours after high fever resolves

161
Q

What are the complications associated with Exanthem Subitem?

A
  • Febrile seizures
  • Encephalitis
  • Meningoencephalitis (rare)
162
Q

What is the characteristic rash appearance of Erythema Infectiosum (Fifth Disease)?

A

“Slapped cheek” appearance with circumoral pallor

163
Q

What is the incubation period for Erythema Infectiosum?

164
Q

What are the key symptoms of Erythema Infectiosum?

A
  • Prodromal low-grade fever
  • Headache
  • Mild respiratory symptoms
  • Rash resolves spontaneously in 1-3 weeks
165
Q

What is the causative agent of Erythema Infectiosum?

A

Human parvovirus B19

166
Q

How is Pediculosis capitis transmitted?

A

Direct contact with the hair of infected persons

167
Q

What is the incubation period for Pediculosis capitis?

168
Q

What is the primary symptom of Pediculosis capitis?

A

Extremely pruritic

169
Q

What treatment is recommended for Pediculosis capitis?

A
  • Wash hair with permethrin shampoo
  • Leave on for 10 minutes
  • Repeat in about a week
  • Comb nits and lice from hair
  • Treat bed mates prophylactically
170
Q

What are the contact precautions for managing Pediculosis capitis?

A
  • Wash clothing, bedding, towels in hot water
  • Use a hot dryer cycle
  • Seal non-washable items in airtight plastic bag for 10 days
171
Q

What is the causative agent of Scabies?

A

Sarcoptes Scabiei

172
Q

What is the incubation period for Scabies?

173
Q

What are the symptoms of Scabies?

A
  • Intensely pruritic, especially at night
  • Thin, irregular burrow tracks
174
Q

How is Scabies diagnosed?

A

Microscopic exam of skin scrapings

175
Q

What treatment is recommended for Scabies?

A
  • Scabicide (Permethrin cream)
  • Applied from neck down in older children
  • No permethrin in children <2mo
  • Treatment left on for 8-14 hours
176
Q

What is iron deficiency anemia?

A

Body does not have enough iron to produce hemoglobin

177
Q

What are common risk factors for iron deficiency anemia?

A
  • Maternal anemia
  • Poorly controlled diabetes during pregnancy
  • Prematurity
  • Cow’s milk consumption before 12 months
  • Lack of iron in formula or exclusive breast feeding
  • Restricted diets
  • Chronic/acute blood loss
178
Q

What are the physical exam findings for iron deficiency anemia?

A
  • Fatigue or lethargy
  • Pallor in skin, conjunctivae, oral mucosa
  • Spooning of nails
  • Tachycardia
  • Splenomegaly
179
Q

What dietary teaching is recommended for preventing iron deficiency anemia?

A
  • Iron fortified formula
  • Iron rich foods
  • Limit cow’s milk to 24oz/day
  • Avoid junk food
180
Q

What is the expected outcome of taking iron supplements?

A

Black stool is expected while taking iron

OB/PEDS (3 decks)

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