Final Exam Flashcards
1 tbsp = ____ tsp=____mL
1tbsp=3tsp=15mL
1 fl oz = ___tbsp =____mL
fl oz = 2tbsp =30mL
1 cup = ____ fl oz =_____mL
1 cup = 8 fl oz =250mL
1 tsp = _____mL
1 tsp=5mL
1mL=____ cc
1mL=1cc
What ages are appropriate for use of the FACES pain scale?
Ages 3-8 or developmental delay
What ages can you use the numerical pain scale?
Over 8 years with no developmental delay
What vaccines should be held if a child is immunocompromised?
Rota virus
MMR
Varicella
Flu
If a child has been given a steriod for over 3 weeks, does this effect vaccine schedules?
Yes, you would hold live vaccines
If a child has hip dysplasia, what type of brace is used and how long do they need to wear it?
A pavlik brace and they need to wear it for 24 hours
What is the rice method?
RICE is a mnemonic acronym for the four elements of a treatment regimen that was once recommended for soft tissue injuries: rest, ice, compression, and elevation. It
How do you monitor a child in a cast?
Swelling
Capillary refill
Pain
Ability to move fingers/toes (ATI)
In what demographic of children is impetigo common in?
Preschool and school age groups
What is the causitive agent of impetigo, and what does this also put the child at risk of?
Impetigo is caused by strep and this also can put the child at risk for AGN
What are the presenting symptoms of impetigo?
Appears as small red macules->the vesicles-> then exudate forms that appear as Honey crusted lesions
There is also another form bullous impetigo caused by s. aureus
What is the treatment for impetigo?
Muprocin for facial lesions and 1st gen cephalosporings for systemic infection
What are the nursing interventions for impetigo?
Educate on not touching infected areas (impetigo is highly contagious)
Keep child’s fingernails short
Emphasize hand hygiene
Which type of tinea fugal infection involves the hair follicle?
Tinea capis
What medication treats tinea capis?
griseofulvin
What nursing education should be given for the tinea fungal infections?
Do not share clothes or towels with those infected with tinea fungal infections
Diaper candidiasis is a ____________ __________ infection that is treated with?
Diaper candidiasis is a yeast diaper infection that is treated with topical nystatin
What education is given to parents of a child with diaper candidiasis?
Leave the diaper open to the air
Watch for diaper candidiasis if infant is being treated with antibiotics
What types of treatment is used for eczema?
Typically treated with lots of moisturizers like aquafor or topical steriods like hydrocortizone
What is coxsackie virus?
Hand, foot and mouth -> involves lesions on the hands, feet and mouth
What is a child with coxsackie virus at risk of?
Dehydration because of sores in mouth that makes them not want to eat
How is coxsackie virus treated?
Give tylenol for pain relief along with popsicles and pedialight to prevent dehydration
What is molluscom?
Skin colored papules with a depressed center that are self limiting, but can take up to 18 months to go away
How is molluscum treated?
It is not treated unless it is affecting the genital/eye area
What is important education for patients with molluscum?
Do not share towels/washcloths
What are the nursing interventions for head lice?
Place all stuffed animals in plastic bags for at least 14 days
Wash linens in hot water
Use prometherin shampoo for head lice
Comb hair for lice nits
A child that is pale, lethargic, not eating enough with a hgb level of <11 is suspected to have?
Iron deficient anemia
What is the treatment for iron deficient anemia?
Iron drops served with vitamin c rich fruit
Do not give milk within 1 hr before and after administration, and limit to 3/4 cups per day
After treatment of iron deficient anemia is completed, what should occur?
Hgb should be rechecked in a few weeks to see if family was compliant. and one more recheck for sucess.
What are the adverse effects of iron deficient anemia treatment?
Iron drops can change the color of poop to make it bright green and can cause constipation
What is the number 1 complication of sickle cell disease?
Vaso-occlusive crisis
If a patient is experiencing a vaso-occlusive crisis, what treatment is expected?
IV fluids 1.5 to 2 times the maintenance
Morphine PCA->oxycodone->mild tylenol
What is a sequestration crisis in sickle cell?
When sickled cells block the blood vessels leading out of the spleen, blood stays in the spleen instead of flowing through it, causing spleen to enlarge
In what age does a sequestration crisis occur, and what is normally the treatment?
Normally occurs in the younger child and a splenectomy is normally the treatment
What are hemophilia precautions?
No NSAIDS
No contact sports *** (Stand out feature)
Bleed precautions
What is epistaxis?
A bloody nose normally during allergy season
What are the interventions for epistaxis?
Lean child forward
Apply pressure to nose for 5-10 minutes
Can use cooling rag or ice
If bleeding continues for 20 minutes, seek help
A child that is fatigued, complaining of pain, getting more infections than siblings, has low hbg and anemia could be suffering from?
Acute lymphoblastic Leukemia
What is the key diagnosing factor for acute lymphoblastic leukemia?
Bone marrow biopsy
What ANC level qualifies a child for neutropenic precautions?
ANC <500 or ANCE<1000 with fever
What are some general neutropenic precaution guidelines?
Report chills, rash, chicken pox exposure
Child should wear mask outside of room
Sign on door of patient
Monitor all labs
Private room
Strict handwashing
Replace adhesive bandages qday
IV bags & tubing changed q 24 hours
Provider wears mask and PPE
What are some of the guidelines for thrombocytopenia precautions?
Use soft bristled toothbrush and no floss
No NSAIDS/Aspirin
No IM injections
Report any head trauma STAT
Monitor for active bleeding
What are the normal WBC count levels?
4,000-15,000
What are the normal platelet levels?
150,000-450,000
Any child with leukemia that has <50,000 platelet count will be?
Placed on thromycytopenic precautions
What is important to remember about diet in regards to diarrhea?
It is important to have protein in the diet
How is dehydration combated in cases of diarrhea?
1.5-2 times maintenance fluids
What is the top intervention in nephrotic syndrome?
Administration of albumin
What is a innocent murmur?
No anatomical or physiologic abnormality exists
What is a functional murmur?
No anatomical cardiac defect but physical abnormality is present
What is an organic murmur?
A cardiac defect with or without a physical abnormality
What are the 4 classes of CHB?
Increased pulmonary blood flow
Decreased pulmonary blood flow
Ductal dependent/Mixed defects
Obstructive defects
What are the CHB defects of increased pulmonary blood flow?
Atrial septal defect
Ventricular septal defect
Patent ductus arteriosis
Atria-ventricular canal
What are the CHB defects of decrease pulmonary blood flow?
Tricuspid Atresia
Tetralogy of fallot
What is tetralogy of fallot?
4 total defects including VSD, pulmonary stenosis, overiding aorta, RV hypertrophy
What are the ductal dependent/mixed defects?
Hypo-plastic left heart
Transposition of the great vessels
What CHB is treated with prostaglandin E?
Transposition of the great vessels to keep DA open
What are the CHB obstructive defects?
Aortic stenosis
Coartation of the aorta
Which CHB defect involves ‘death spells’?
Coartation of the aorta
What is Kawasaki’s disease?
Acute vasculitis with unknown cause that can progress to coronary artery aneurysms
What are the signs/symptoms of Kawasaki’s disease?
(Must have 5 for diagnosis)
Fever for 5+ days
Bilateral conjuctival inflammation w/no exhudate
Oral mucosa changes such as dry, crackled lips
Strawberry tongue
Reddened oral cavity
Extremity changes (peripheral edema, erythema, or desquamination of palms, or soles)
Polymorphous rash
Cervical lymphadenopathy
What are the nursing interventions for Kawasaki’s?
Monitor cardiac status:
Assess for signs and symptoms of heart failure
Daily weights
I&Os
Administration of fluids/meds
Supportive care
ECHO to monitor for coronary artery dilation/aneurysm formation
What are the medical interventions for Kawasaki’s?
Give IVIG over 10-12 hours in the first 7 days of illness
Administer high dose aspirin q6hrs
What is endocarditis?
Infection of the endocardial layer of the heart that most often results from a bactermia/fnugal infection
What are the signs/symptoms of endocarditis?
Unexplained low grade fever
Anorexia/weight loss
General Malaise
New murmurs
Dysrhythmias
HF
What is the treatment for endocarditis?
Bed rest
Admin of organism specific antibiotic/antifungal (2-8 weeks)
Will have to take prophylactic antibiotics for the rest of their life
What are the antibiotic/antifungals given for endocarditis?
Gentamycin/streptomycin
Amphotericin
What is rheumatic fever?
Inflammatory disease that occurs within 2-6 weeks after group A beta hemolytic strep that may result in valvular damage
What are the signs of rheumatic fever?
joint pain
Edema
Fever
Non-itchy rash to trunk and proximal extremites
Mitral valve murmur
Chorea (little, odd movements)
What are the treatments for pediatric hypoglycemia?
Glucose tablets (5 g per tablet) Glucose gel (15 g per tube) Sweetened fruit juice: 12 g carbohydrate per 4 oz (120 mL)