FINAL 250 Flashcards
Fundus at 15 hr should be..
at the U, midline, bladder should be empty, with moderate rubra
Cardio changes during pregnancy
CO increase, BP decreases, stroke volume increases, physiologic anemia, after delivery the HR decreases
what to do when a fundus is boggy..
have them empty bladder, massage fundus, gice oxytocin, check bp
no methergine for cardiac mom
thermoregulation of newborn
prevent heat loss by evaporation- dry baby completely, put hat on them, dont give bath until stable temp at 97 degrees.
Rubin stages
taking in- mom focused on self
taking hold- regaining control and taking interest in baby
letting go- bonding with baby
capat succedaneum
swelling crosses the sutures line
happens immediately, resolves in few days.
cephalhematoma
bleeding between peritineum and skull - buldging fontanels
doesnt happen immediately, longer to heal.
what to do for pre term labor
hydrate
meds to stop labor - (tocolytics) trabutaline, mag sulfate, calcium channel blockers
look for infections - UA (urine analysis)
Risks for a prolapsed cord
and what to do
baby malpositioned - breech, baby not engaged - head not down low
Get mom in knee chest position, ER c-section (sometimes nurse or person doing exam that notices this, goes into surgery hold the head off the cord), 100% 02 by mask
s/s and tx for abruptio
dark blood, hard rigid abd, pain
ER- c-section
can cause DIC or fetal demise
s/s and tx of placenta previa
bright blood, soft abd, no pain
pad cont, contractions, fetal heart tone, no vag exam (do US), risk for PPH (especially if mag sulfate used)
Uterine atony
most common cause of PPH
massage fundus, empty bladder, oxytocin then methergine- cn cause hypotension, 02
Augmenting labor
massage the nipples (releases oxytocin), walk, change positions, give oxytocin
Resp distress syndrom (RDS)
number 1 complication of preterm or diabetic baby
lack of surfactant
grunting, cyanosis
Atraumatic care
explain on childs level of development
pain not a reason to stop care
health people 2010
easy access to health care, nutrition, decrease health disparities
Care in pediatric is..
family centered, open system
manifestations of pyloric stenosis
projectile vomiting after eating - no bile, dehydration - sunken fontanels, lytes imblances, in metabolic akalosis
Rheumatic fever tx
PCN for up to 5 years and with and surgery, ASA
cultures done for any sore throat
wilms tumor
monitor for HTN, DO NOT palpate abd, treat with chemo with or without radiation
TEF
coughing, chocking, cyanosis
regurge/ aspiration - suction !
NPO - straight to surgery
Hemophilia
factor VIII - most common
RICE
bleeding in joints - ROM and PT after, can give replacement factor VIII
non-contact sports
PKU diet
no protein, no milk - lolfenac for infants
unlimited fruits and veggies
serpation anxiety beings around
6 months, can last until about 2
car seats
must be used for all children
middle back seat, rear facing
Med admin
add 5ml of sweetener
no mixing with formula or primary foods
along side of mouth, upright, not when crying, if put syringe in infant mouth they will tend to stop crying and suck on syringe.
oral syringe
injections - 25 gauge, 5/8 in needle, vastus lateralis
check IV site every hour
Accidental poison..what to do..
call poison control
dont induce vomiting
take EVERYTHING with you (what was ingested, urine, vomit, etc)
Go to ER
have meds locked and up high.
Management of nephrotic syndrome
prednisone - usually high doses
albumin
protect from injection - room with non infectious child
check urine for protein
s/s pf sepsis
behavioral changes, feeding problems, elevated temp
asthma triggers
mold, pets, carpets, upholstered furniture, smoking in household
Kawasaki’s
tx with ASA high doses and IVIG
autoimmune
can lead to coronary artery aneurysm
s/s- strawberry tongue, red hands and feet, cracked lips
post op cleft lip and palate
LIP- elbow restraints, position supine or side lying, logans bar to decrease manipulation, cuddle to soothe baby- dont want to cry and put strain on sutures, NO utensils, feed upright - formula and soft foods only, allow breaks - have difficulty adjusting to nose breathing.
PALATE- position prone to promote drainage, can have hearing and speech problems
complications of leukemia
infection, fractures, bone pain, bleeding, anemia
AGN complcations, at risk for
acute renal failure- check bun, cr, I&O, daily weight, VS
stroke - give no added salt diet, diuretics, and HTN meds
s/s of bact meningitis
increase temp, increase WBCs, HA, nuchal rigidity
newborn - poor sucking, high pitched cry, lethargy
CP goals of care
to function as normally as possible
Tetralogy of fallot
4 defects: VSD, pulmonic stenosis, overring aorta, hypertrophy of right ventricle
may have tet spells
risk for emboli, seizures, loss of consciousness or sudden death following anoxic spell
home care pre op cardio surgery
teach parents to watch for tachycardia, tachypnea
most teaching abour surgery is done out of hosp
Coarcatation of the aorta
Assess BP - higher in upper extermities, lower in lower exterm
EKG, MRI will show - left sided heart enlargement due to bac pressure and also notching of the ribs from the enlarged collateral vessels
DM type 1 are at risk for what..
DKA - kussmaul resp, ketonuria, polyuria, excessive thirst, dry mucous membranes, acetone breath, are in metabolic acidosis.