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Final Exam Cards Flashcards

1
Q

S&S of Sickle Cell

A

pressure, clotting, sickled cells, classic signs of anemia

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2
Q

Why doesn’t sickle cell present in infants

A

they still have fetal hemoglobin in circulation

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3
Q

Hirschprung’s Disease

A

autosomal dominant genetic mutation in which the infant fails to pass meconium in the first 48hrs- abdominal distention, diarrhea, constipation

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4
Q

How is hypospadias fixed?

A

surgery then circumcision at 12-18 months of age

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5
Q

Nursing care of post op scoliosis repair

A

LOGROLL when necessary, maintain skin integrity, control pain, anticipate OOB by POD 2-3, monitor neurovascular status

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6
Q

Munchausen by Proxy signs

A

*Child with multiple medical problems that do not respond to treatment or do not follow an expected pattern
*Physical or lab findings inconsistent with medical history, or are clinically impossible
*Caregiver is not reassured by “good news” or results
*Caregivers who are unusually calm in the face of child’s health crisis.
*Symptoms that only occur when caregiver is present, or symptoms that are alleviated when caregiver is absent
*Caregivers that are fascinated by medical details
*Caregivers who are very upset with medical team and demand more procedures or tests or transfers to another facility.

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7
Q

Developmental hip dysplasia S&S

A

Hip joint laxity, asymmetrical gluteal and thigh folds, limb length discrepancy, trendelenburg’s sign, ortolani’s and barlow’s, Allis’ sign

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8
Q

Torticollis management

A

PROM exercises, move the crib in a different direction from the door so the baby will look at the side opposite the preferred gaze, if the condition does not resolve, and 90% do, surgical release is performed

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9
Q

Cerebral Palsy Progression

A

Presents with Opisthotonos (exaggerated arching of the back, abnormal motor functioning, feeding difficulties, stiff or rigid limbs, altered muscle tone, delayed milestones (esp. gross motor development) hand preference before 6mos of age, diapering difficulty due to hip spasticity

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10
Q

How do we treat MRSA

A

Vanco, Clindamycin

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11
Q

Short term side effects of radiation therapy

A

Nutrition, Nausea/vomiting, Mouth sores, Fatigue, Reddened or itchy skin, Hair loss, Pancytopenia, Changes in taste and smell, Sleepiness (somnolence syndrome), Swollen parotid glands, Decreased saliva

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12
Q

Long term side effects of radiation therapy

A

Cognitive function, Radiation-site specific problems, Delayed/absent puberty, Fertility, Secondary tumors

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13
Q

Pressures on the left side of the heart are (what) than the right side

A

greater

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14
Q

Right sided heart failure signs

A

RV function is reduced causing increased CVP and systemic venous hypertension, hepatomegaly, edema in extremities

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15
Q

Left sided heart failure signs

A

LV dysfunction, increased pressure in the LA and pulmonary veins, lungs become congested with blood=pulmonary edema

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16
Q

How do we provide culturally sensitive care?

A

Talk to the parents and ask what they do to take care of a sick child
If the practice is safe for the child, try to incorporate it into the care
Always listen!

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17
Q

How do we treat lice?

A

*Treat with OTC lice products in children OVER 2 years old
*After treatment, comb out the nits with a fine-tooth comb
*repeat treatment in 7 to 10 days to kill any newly hatched nits

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18
Q

How long does bone healing take in children?

A

2-12 weeks

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19
Q

Nursing care of kids who are victims of sexual abuse

A

*Bring in the SANE nurse
*Never promise not to tell
*Preserve evidence- no showering until evidence is collected
*Reassurance

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20
Q

Cleft Palate- Parental Education

A

*Prone position ok
*Speech therapy
*Soft foods only until advanced by MD or NP
*NO pacifiers, NO straws, NO utensils, NO popsicles- child must use cup for feeds
*Educate parents on s/s otitis (altered Eustachian tube positioning)

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21
Q

Pre cardiac catheterization care

A

Height/Weight, Cardiac assessment (include pulses), Explain procedure to child and parent, Assess for any s/s infection, NPO (watch hydration), Monitor glucose level in babes

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22
Q

Post cardiac cath care

A

Monitor pulses (esp. those distally to cath site), Neurovascular assessment of extremities, VS, Monitor s/s bleeding, I&O, Bed rest 6-8 hours post procedure with affected leg straight and flat, Glucose levels in babes, Manage bleeding by direct pressure 1 inch above cath site

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23
Q

Teaching Parents about Cardiac Caths

A

Pressure dsg stays on for 24hrs then band aid, Keep dressing dry, no baths until ok’d by NP or MD, Call with any redness, swelling, excessive pain, warmth to cath site, School ok, heavy lifting or rigorous exercise not ok until NP/MD gives permission

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24
Q

Symptoms of decreased pulmonary blood flow

A

Tachypnea, dyspnea, cough, wheezes

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25
Q

S&S of Autism

A

*Failure to maintain eye contact
*Failure to respond to social cues
*Ritualistic behavior, need to follow strict routine. Deviation from routine can cause extreme anxiety
*Self-stimulatory behaviors-rocking, hand flapping, spinning. Some behaviors can cause injury to self
*Preoccupation with insignificant details
*Perseverance on words or objects

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26
Q

Autism Treatment

A

*Individualized therapy has been shown to work best
*Social behavior training, anxiety reduction, behavior modification
*Antidepressants and antipsychotics have been used
*Inclusion or mainstreaming…pros and cons…

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27
Q

Treatment of AML

A

BMT after remission, chemo, more intense

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28
Q

Treatment of ALL

A

Chemo, steroids, serial LP’s, frequent labs

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29
Q

Nursing care/ support of children with disabilities

A

*Developmental approach
*Consistency
*Emphasize abilities
*Plan care involving child and family
*Encourage independence
*Assist with coping
*Facilitate hope
*Help to establish future goals

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30
Q

Leukemia pt education

A

Pts are encouraged to return to as normal a life as possible, mitigating infection risk

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31
Q

Kids and Diets

A

Introducing foods slowly, 1 new food per week, limit sugar, toddlers can’t have anything they can choke on

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32
Q

Diets and CF

A

high protein, high calorie

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33
Q

Bacterial Meningitis Nursing care

A

*Place patient on Isolation(respiratory/droplet)
*Start antibiotics STAT
*IV hydration
*Monitor for increased ICP and institute nursing care for pts with increased ICP
*Control temperature
*Close contacts with patient need prophylactic treatment (Cipro, Rifampin)

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34
Q

Management of bleeding with hemophilia

A

*Prevent bleeding
*Replace missing factor
*Mouth lacerations: watch ABCs, may need to be NPO until bleeding managed
*Dental work/Teeth Extractions: pre and post administration of antifibirinolytic agent
*Planning/ coordination for dental/ surgical procedures

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35
Q

Hemarthrosis S&S

A

joint stiffness, tingling and pain with increasing inability to move joint. Warmth, redness, swelling and pain are also common

36
Q

How to treat hemarthrosis

A

ICE pack, NWB, elevate affected limb above heart, immobilization-NO PROM exercises until acute injury phase is done

37
Q

Teaching and Health promotion for Hemophilia

A

*Teaching re: disease awareness
*Teaching/ Support for home infusion
*Health promotion/Prevention- Sport choices (non contact), Healthy weight and good fitness, Normalization – Chronic Illness, Use of prophylactic infusions

38
Q

Osteogenesis Imperfecta- Parental education

A

*Teach parents to carry documentation of OI
*Never push or pull
*Lift from the buttocks
*When changing diaper, do not grab both legs together at ankles, lift from buttocks
*Bathe in a padded infant tub
*When dressing, “roll” clothes on, do not pull arms and legs through openings
*Touch is important to people, so not be afraid to cuddle and touch…just do it carefully!!!

39
Q

Nursing care of Myelomeningocele

A

*Avoid rectal temps!
*Prevent infection, esp when sac is visible.
*Cover sac in sterile, moist, non-adherent dressing.
*Surgical closure of sac within first 24 hours
*VP shunt if necessary
*Orthopedic care
*GU care-continence

40
Q

Glomerulonephritis S&S

A

*Edema (periorbital then progresses to body [pulmonary])
*Hematuria, Cola colored urine, protein in urine, ↑USG, Oliguria, Hypertension
*Know that the disease is usually self limiting, with 98% of kids achieving full recovery

41
Q

Glomerulonephritis nursing care

A

oCare of the child with edema
Loop diuretics
Skin care, repositioning
Diet should be low salt or no added salt
Strict I&O, daily weights, if necessary, fluid restriction
oMonitor for infection
oHypertension
Monitor Q4-6 hrs
Antihypertensives
USE THE CORRECT CUFF and BE CONSISTENT!

42
Q

Nursing care for pertussis

A

*Erythromycin or Bactrim for 14 days or
*Azithromycin-5-7 days
*If someone in the house has pertussis, Pertussis Prophylaxis is recommended for family members if there’s an infant in the house < 6 months
*Prevent coughing episodes: encourage restful activities
*Monitor hydration, nutrition
*If child is treated at home, notify public health department

43
Q

Leukemia labs

A

oWBCs: Increased
oHemoglobin: Decreased
oPlatelets: Decreased
oNeutrophils: Decreased
oBlast Cells Present

44
Q

AML symptoms

A

Lymphadenopathy, Fatigue, Fever, Recurrent Infections, Petechiae, bleeding (nose and gums)

45
Q

ALL symptoms

A

fatigue, fever, pallor, petechiae, bleeding, bruising, bone pain, lymphadenopathy, HSM

46
Q

Mild intermittent Asthma

A

brief exacerbations with daytime and nighttime symptoms 2xweek or less

47
Q

Mild persistent asthma

A

exacerbations more than twice a week but less than once a day. Nighttime symptoms more than twice a month

48
Q

Moderate persistent asthma

A

daily symptoms and nighttime symptoms more than once a week

49
Q

Severe persistent asthma

A

continuous daytime symptoms with limited physical activity and frequent nighttime symptoms

50
Q

Prevention of TLS

A

Allopurinol, lysis labs, hydration, diuretics, electrolytes

51
Q

ADD/ADHD Diagnosis

A

*Inattention, Impulsiveness, Hyperactivity
*Symptoms need to occur in at least 2 settings, ages 4-18yrs

52
Q

Epiglottitis

A

oCharacterized by muffled voice, drooling, agitation, lack of spontaneous cough, tripod position
oDO NOT ATTEMPT TO VISUALIZE THE AIRWAY! X-ray will confirm
oKeep child calm and sitting up; abx and steroids stat.
oWe give Hib vaccine-so this condition is rare.

53
Q

LTB

A

“classic croup” most common type of croup, preceded by a URI, gradual onset, low grade fever, symptoms worse at night, cough is brassy, barky “seal like”, inspiratory stridor, cough, vocal hoarseness, X-rays not helpful in dx

54
Q

Acute spasmodic laryngitis

A

“midnight croup” paroxysmal attacks that occur at night, not preceded by an illness. Kids go to bed fine, then wake up with the barky cough, child is anxious, there is no fever

55
Q

Croup nursing care

A

*Have emergency equipment available
*Remain calm and reassuring
*Accompany the child to all tests (nurse)
*Cool mist/humidified air
*Clear liquids-but hold all po liquids in periods of respiratory distress or acute illness

56
Q

Red flags for child abuse

A

*Spiral fractures, bruising in unusual places (torso), parent/ relative answering for child/ assertive, child is in fear of this relative
*Injury is inconsistent with explanation and developmental level

57
Q

Compartment syndrome

A

*Unrelieved or increased pain
*Pale, dusky, edematous tissue distal to injury
*Pain on PROM
*Pulselessness and loss of sensation (so pain suddenly subsides)
*This is an EMERGENCY. Immediately notify physician. Prep patient for cast adjustment and possible fasciotomy.

58
Q

Tonsilectomy post op

A

*Prone or side lying
*NO suction!
*Check for bleeding frequently (frequent swallowing is a clue)
*Emesis with old blood is common, bright red blood is not
*Pain management
*Ice collar
*Clear, cool liquids-nothing red!

59
Q

Local reactions and vaccines

A

Shot sites can have swelling, redness and pain. Most often, these symptoms start within 24 hours of the shot. They most often last 3 to 5 days. With the DTaP vaccine, they can last up to 7 days.

60
Q

Fever and vaccines

A

Fever with most vaccines begins within 24 hours and lasts 1 to 2 days.

61
Q

Delayed reactions and vaccines

A

With the MMR and chickenpox shots, fever and rash can occur. These symptoms start later. They usually begin between 1 and 4 weeks.

62
Q

Anaphylaxis

A

Severe allergic reactions are very rare but can occur with any vaccine. They start within 2 hours

63
Q

Polio vaccine allergies

A

allergic to streptomycin, neomycin, polymyxin

64
Q

Varicella/ MMR vaccine allergies

A

allergic to neomycin and gelatin

65
Q

Flu vaccine allergy

A

allergic to eggs or latex

66
Q

Hep B vaccine allergy

A

allergic to baker’s yeast

67
Q

Meningitis vaccine allergy

A

allergic to latex

68
Q

Pt ed for antibiotics

A

*Always take the entire prescription
*Possibility of diarrhea
*Store them properly
*Have a back up contraception- decreases effectiveness of OC
*Know when to take with food or an empty stomach
*Watch hearing with aminoglycosides

69
Q

Vesicant nursing care

A

*Give in the PICC line
*Watch for extravasion
*Give good skin care
*Blood return pre, during and post

70
Q

Central Apnea

A

CNS does not transmit signal to breathe

71
Q

Obstructive Apnea

A

Upper airway obstruction, chest wall movement present

72
Q

Mixed Apnea

A

combo of central and obstructive

73
Q

UN millenium goals

A

*Eradicate extreme poverty and hunger
*Achieve universal primary education
*Promote gender equality and empower women
*Reduce child mortality
*Improve maternal health
*Combat HIV/AIDS, malaria and other diseases
*Ensure environmental sustainability
*A global partnership for development

74
Q

Parental ed for tantrums

A

Don’t feed into it, if you give them the energy, you “approve” of the behavior

75
Q

Explaining CT scan to kids

A

*Developmentally appropriate
*“So this machine is going to take pictures of the inside of your body, it’ll take x episodes of Cocomelon to be done, and you have to stay still so the pictures can come out clear”

76
Q

Peak flow meter

A

*Peak Flow Meter: measures peak expiratory flow (max flow of air that’s expelled in 1 second). Individual result. Establish personal best value by doing Peak Flow twice a day for 2-3 weeks when child is stable (afternoon is best)- measures lung disease, 80-100%

77
Q

Pavlick harness

A

*Observe for any asymmetry on assessment, observe walking when appropriate
*For Babes in Pavlick Harness:
oWear Onsie-straps shouldn’t touch skin
oDiaper should be under straps
oSkin integrity-how should you educate parents?

78
Q

RBC transfusions

A

*Increases CBC, increases fluid volume
*Less lethargic, more alert, feeling better, less risk for hypoxia

79
Q

Celiac disease education

A

*NO wheat, barley, oats and rye
*OK to eat corn, rice and millet
*If celiac is severe, you may also be lactose intolerant
*So overall, we want a diet that is high in calories, high in proteins, contains simple carbs and is low in fats. We avoid high fiber foods until bowel inflammation is resolved.
*Lots of education…if there is a nutritionist on the team, make sure they meet the patient
*Developmentally approach the problem and anticipate compliance issues
*Work to get a “buy in” from the parents
*Community education- schools, coaches

80
Q

Car seat safety

A

*Rear facing- birth-2 years
*Forward facing- 2-4 years
*Booster- 4-8 years
*Seatbelt- 8 years+
*Sitting in the front- start at age 12

81
Q

Stuttering

A

*Encourage the child to speak slowly
*Do not rush or finish the word or sentence for them

82
Q

Iron deficiency anemia- pt ed

A

*Give iron supplements with fruit juice, not milk
*Administer liquid iron through straw or perform oral care after administration
*Monitor for constipation, pallor, weakness, fatigue

83
Q

Thrombocytopenia

A

reduced platelets, expect bleeding disorders

84
Q

Anemia

A

reduced RBCs, expect anemia

85
Q

Pancytopenia

A

reduction of all blood cells, expect anemias and bleeding disorders

86
Q

Care of the hospitalized child

A

include the family and recognize their diversity, respect coping mechanisms, expect regression, promote normalcy

87
Q

Atraumatic care

A

prevent or minimize child separation from the family and bodily injury/ pain, promote a sense of self control

Peds (4 decks)

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