Final Exam Flashcards
Assessment for adolescent that came in with RR distress: what shows improvement?
Clear breath sounds
o2 sat improved
RR improved
HR improved
BP has improved
taking Oral intake
may still have crackles
What kind of orders can you anticipate for post care of a pt with HX of cardia valve damage and recent dental work? Came in with low grade fever, not wanting to eat. Petechiae and joint pain?
Anticipated
Antibiotics
Echocardiogram
Blood culture
Dental hygiene yes
Have him rest
How would we know that we had effective treatment with respiratory distress infants? (2yr old)
Clear breath sounds
RR regulate
HR normal(below 140)
O2 sats improved
retractions normal
nasal flaring(yes)
Improvement(no more cough)
NGN Taking care of leukemia pt what would you want to report to dr.? He came in with upper respiratory infection
Report
O2 sats 92
WBC elevated
Retractions
RR rate elevated
petechiae or pale
Do not report
Skin assessment is normal no bruising
Breath sounds clear no report
Hemoglobin normal
NGN (drop down) RSV pt how would you know if they were progressing on bronchitis or pneumonia
retractions
Respiratory
Lethargic
Strep
retractions YES
Respiratory(high)
Lethargic YES
Strep not cause of RSV
Compare seizure vs mild asthma. Seizure and change in epileptic medication, what do you want to report?
you want to follow up therapeutic levels for what medication?
Pt comes in afebrile white count within expected ranges has had cough for about a month and the cough comes on with mild exercise that’s induce through asthmas(asthma attack) would you expect this child to:
Liver failure
Steven johnson syndrome
Pneumothorax
Slight Wheeze
Breath sounds
Report: increase seizure activity
Want to follow up on: Dilantin(phenytoin) yes check therapeutic range
Expect child to:
Liver failure NO
Steven johnson syndrome NO
Pneumothorax- NO
Slight Wheeze
Breath sounds
NGN The nurse is reviewing an assessment finding for these diagnosis leukemia, sickle cell, and hemophilia
Bruising
Bleeding
Elevated WBC
Pain
Temperature
Leukemia: all of them
Sickle cell: elevated WBC, pain, temperature
Hemophilia: bruising, bleeding, pain
NGN What do you need to do when pt is discharged with intussusception?(discharge teaching)
Watch for bloody stools
Low fiber
IV antibiotics
Need Pancreatic enzymes
Contact precautions
Urine specimen
Watch for bloody stools YES
Low fiber- YES
IV antibiotics- YES
Need Pancreatic enzymes- NO
Contact precautions-NO
Urine specimen- NO
SATA Characteristics of duchenne muscular dystrophy?
Waddling gait
Lordosis
Calf muscles hypertrophy
SATA Tetralogy of fallot may have blue spells because of what anatomical defects? (Aorta affected)
Decreased pulmonary blood flow
Pulmonic stenosis
Shunting of desaturated blood from right to left
Overriding aorta
Squat to move volume of blood up
What do you expect to see in a 6 month old new well visit?
Closed posterior fontanels
What pain scale to use for a 6 month old, new well visit?
FLACC scale
Caring for school age and check mouth child is refusing to eat complain of mouth being sore and you see white in the mouth what is this called?
Thrush or candidiasis
Principal symptom of pinworm infections?
Perineal itching
You have a School age child who is admitted with vaso-occlusive sickle cell crisis. What would you include in his care?
Adequate hydration and pain management
6 week old with pyloric stenosis, what would you see?
Projectile vomiting
Preparing preschooler to have a cast be placed, what therapeutic actions can you use?
Wrap cast on doll or toy before
Kawasaki disease child what can long term therapy could put them at risk?
administering aspirin, which can cause bleeding Reye’s syndrome
Clinical finding with bedbugs?
Red rash
What happens when the ductus arteriosus is surgically closed?What is the goal of surgical closure of the ductus arteriosus?
Prevents the return of oxygenated blood to the lungs
What defect gives you an increased pulmonary blood flow?
ASD- atrial septal defect (Allows blood to go towards the pulmonary)
How can you minimize separation anxiety in the hospital with an infant or toddler?
Encourage parents to room in
You are giving a steroid to an idiopathic thrombocytopenic purpura child what do you monitor for? What can steroids disguise?
Infection
NGN 5 y/o with vaso-occlusive crisis of sickle cell w/ joint pain and fever for 3 days. Tylenol given, but doesn’t seem to work. What things would you need additional action on?
Remain in bed
PO fluids
Voided 200 mL of urine
Uncooperative
Chest pain and joint pain of 4
Nasal flaring and subcostal and substernal retraction
Bilateral expiration and inspiration wheezing upon auscultation
Uncooperative
Chest pain and joint pain of 4
Nasal flaring and subcostal and substernal retraction
Bilateral expiration and inspiration wheezing upon auscultation
NGN Hirschsprung’s disease(constipated)
2 actions and 2 parameters What would you anticipate to do for this child?
Constipation
Actions: Rectal biopsy, Pull through procedure
Monitor: Measure abdominal girth to watch for distention, Abdominal tenderness, FEVER and agitation
Diff breathing and irritability.
Adolescent how much taller can you get?(menarche) 95% of girls height.
1 year after your period
What would be a concern if you were seeing a pt in a clinic that mom says about his 6 year old?
The child has to squint to see the board
Infant who has a 2 day history of vomiting and fever. What is a reliable indicator of fluid loss?
Measure the body weight (weight loss)
According to Erikson, what is the plan of care for a 10 year old who will be hospitalized for an extended period Of time? (psychosocial needs)
Encourage the client to complete school work
Cerebral palsy child getting ready for discharge: what would be a priority in the plan of care?
Make adjustments in the environment
What do you do for a child having a seizure?
Position them laterally
What’s another name for pertussis?
Whooping cough
Seizure pt vomiting how do you position them?
Side lying
Psychosocial development Erikson, physiological stage for a toddler what would you see them doing?
Negative behavior of characterized by the need for autonomy
How can you discuss with teenagers to help with health promotion and taking what would you include in the teaching?
You need the child to increase sleep
Erikson’s stages in order
Trust vs mistrust
Autonomy vs shame
Initiative vs guilt
Industry vs inferiority
Identity vs role confusion
Evaluating a child who is descending stairs by placing both feet on each step by holding on to the handrail going down stairs?
3 year old