Final Peds Flashcards
Ages
Infant - birth to 1 year
Toddler - 1-3 year
Preschool - 3-6 year
School age - 6-12 years
Adolescent - 12-20
Age appropriate activities - Infant
Play soothing music, therapeutic hugging, speak in calming voice
Mobiles, noise-making, soft toys, and large blocks
Age appropriate activities - Todder
Approach carefully, use toys/books to distract, parallel play with them
Push-pull toys, Lg piece puzzle, and balls
Age appropriate activities - Preschool
Use play puppets, allow to touch equipment, allow choices, simple terms, count out loud, pretend play with them (give bear a shot)
Art & crafts, playing pretend, books
Age appropriate activities - School Age
Encourage questions, use diagrams, illustrations
Board games, action figures, models, video games
Age appropriate activities - Adolescent
Respect privacy, Do not force to talk, Use appropriate medical terms
Reading, listening to music, peer time
Types of Play
Infant - Solitary Play
Toddler - Parallel
Pres-schooler - Associated
School-Age - Cooperative
Infant Normal Assessment Findings
Wt: Birth weight Doubles by 5 months; Birth weight Triples by 1 year
Ht: Increases about 1 inch per month the first 6 months then occurs in spurts; birth length increases about 50% by 12 months of age
HC: About 10cm by 12 months of age
Respiratory variation makes them more susceptible to URI (narrow passages, etc)
Normal Motor Development
4 months - Head control, rolls from back to side, grasp objects with both hands
6 months - Rolls from back to front and holds bottle
9 months - Sits unsupported, creeps on hands/knees, and has crude pincer grasp
12 months - Sits down from standing, walks with one hand/on own, builds 2 block tower, makes simple marks on paper, and feeds self with cup and spoon
Feeding Recommendations
Breastfeeding
Breastfeed for 6 month
Iron supplement after 4 months
Bottle feeding
20 kcal/oz
10-12 mg Fe+
Progression to solids
4-6 months - Extrusion reflex
Iron fortified cereal are first food (rice, bareley, oatmeal)
New food 3-5 days
Toddler Health Promotion
Food Jags
Ritualism (same dishes or will not eat)
Physiogical Anorexia (decrease need for calories)
Picky Eaters
Toddler language Development
50-300 words by 2 yrs
Echolalia and telegraphic speech
Toddler Care Safety
Rear facing and back seat until 2 yrs
Pre-schooler Cognitive Development
Magical Thinking, imaginary friends, animism, and time
Pre-schooler Normal Social Development
Fears - loud noise, hospitalization, and mutilation of body
Imaginative play and dramatic play
School-Age Normal Social Development
Interested in peer’s perspective
Needs for acceptance (peer pressure begins)
School-Age Normal Assessment Findings
Diaphragmatic Breathing
Fontal Sinus develops by age 7
HR decrease and BP increase
Permanent teeth
Puberty - Girls 9-10 and boys 10-11
Adolescent Nutrition Promotion
Anorexia and Bulimia are common
2000 calories
Calcium 1300 mg daily
Iron - males 11 mg daily and females 15 mg daily
Adolescent hospitalized care
Develops Image disturbance
Maintain independence, participate in decisions
Encourage socialization with friends, may adhere to treatment/medication based on peer influence
Hypoxemia Assessment
First Sign is Tachypnea
Flaring of nose and ribs retraction
Hypoxemia Plan of Management and POC
Oxygen therapy (<91%), pulse oximetry, <86% life threatening, chest physiotherapy and suctioning
Asthma Management Medication
Long acting - Formoterol
Corticosteroids - Fluticasone
Mast-cell stabilizer - Cromolyn
Leukotriene - Montelukast
Asthma Labs/Diagnostic
CBC: ↑ WBC, ↑ Eosinophils
ABG: ↑ CO2, ↓O2
Allergy/RAST Testing: Identify triggers
SpO2: ↓ (normal if mild episode)
CXR: Hyperinflation/infiltrates
Pulmonary Function Test (PFT): measures lung capacity and overall lung function; not useful during acute exacerbation
Peak Inspiratory Flow Rates (PIFR):Measure forcefully exhaled in 1 second
Asthma Medication
Prevention
Long acting - Formoterol
Corticosteroids - Fluticasone
Mast-cell stabilizer - Cromolyn
Leukotriene - Montelukast
Acute Exacerbation
Short acting w/ anticholinergic - Albuterol w/ ipratropium
Corticosteroids - Prednisone
Status Asthmaticus
Intubation
Theophylline, Mg sulfate IV, heliox, ketamine
Cystic Fibrosis Medication Management
Chest PT w/postural drainage
O2 as prescribed
Monitor CO2 retention
Aerosol Therapy
Aerosol Therapy
Aerosol therapy
Pulmonary enzyme (dornase alfa) – decreases the viscosity of mucus, improving lung function
Bronchodilators & anticholinergics
Anti-inflammatory
IV or Nebulized antibiotics
Cystic Fibrosis Diagnostics
Sweat Chloride Test: >40 mEQ in <3 mon; >60 mEq for all other ages
Sodium > 90 mEq/L
Deficiency of fat-soluble vitamins (A,D,E,K)
Decreased pancreatic enzymes = thick mucus(pancreatic enzymes within 30 minutes of eating a meal or snack)
KUB: detects meconium ileus
Stool analysis: presence of fat and enzymes
CXR: Hyperinflation, bronchial wall thickening, atelectasis, or infiltrates
PFT: ↓ forced vital capacity/expiratory volume
Abdominal distention or difficulty passing stool; Bulky, fatty, greasy stools (STEATORRHEA)
Croup Physical Cues
“Barking cough”, inspiratory stridor, tachypnea, respiratory distress.
Infants: nasal flaring, intercostal retractions
Usually sudden onset at night, gone in the morning, self-limiting, and lasts 3-5 days
Croup Management Priorities
Administer dexamethasone (corticosteroid) to decrease inflammation
Racemic epinephrine (ᾀ-adrenergic effect of mucosal vasoconstriction to decrease edema); effects last up to 2H and symptoms may again worsen requiring another TX
HF Nursing Priorities
Oxygenation Intervention
Nutrition
150 calories/kg/day
24-28calories/oz bottle feeding can add vegetable oil or polycouse oil
Add HMF to breastmilk to make it more caloricly dense
HF medication
Beta Blocker (metoprolol): decrease HR and BP; increase vasodilation
S/E: dizziness, hypotension, and HA
Lasix (furosemide) - manage edema
K wasting. monitor BP, I/O, and weight
Captopril/Enalapril - reduce afterload
Monitor BP before and after administration
Digoxin
Apical pulse; hold if <90 bpm infant, <70 child, and <60 adolescents
Range 0.8-2.0 ng/mL
Signs of toxicity: N/V, anorexia, bradycardia, dysrhythmias
Antidote: digoxin immune fab
Coarctation of Aorta Assessment finding
Assess all pulses
Full bounding pulses in upper extremities
Weak or absent pulses in lower extremities
Tetralogy of Fallout Clinical characteristics
TET spells (progress to anoxia) -> knee chest position or squatting
Tetralogy of Fallout Nursing Management
Promoting oxygenation &ventilation: (Upright position, O2, suction)
Promoting nutrition: Small, frequent meals or OF/NG feeds; 150 calories/kg/day
Kawasaki Disease Assessment Findings
Autoimmune vasculitis
High fever for 5 days and unresponsive to antibiotics
Mouth and throat dry, fissure lips, strawberry tongue, and pharyngeal/oral mucosa edema, peeling of fingers, toes, and perineal areas
Conjunctivitis w/out exudate
Kawasaki Labs
CBC: Mild-Moderate Anemia Elevated WBCs
Thrombocytosis (↑ platelets) (acute phase)
Hypoalbuminemia – from vascular permeability
ESR/CRP: Elevated (inflammatory markers)
Angiogram: aneurysm formation – “string of beads”
Echocardiogram: Establish baseline for repeat
Kawasaki Treatment/Nursing Management
IV IG
Acetaminophen
High dose aspirin
Sinus Tachycardia Characteristics and Management
Characteristics
Infants rate is <220 bpm (160-220), in children < 180 bpm (130-180)
Management
Treatment is focused on the underlying cause
Sinus Bradycardia Characteristics and Management
HR <60
Children with a life-threatening bradyarrhythmia will have HR <60 with signs of altered perfusion (respiratory compromise, hypoxia, shock), EKG changes
Sustained bradycardia is commonly associated with arrest and is an ominous sign
Management
Usually recover spontaneously
SVT Characteristics and Management
Characteristics
Infants rate is >220 bpm, in children > 180 bpm with abrupt onset and termination, P wave are flattened, QRS narrow
Management
Compensated (alert): Vagal maneuvers (ice or blowing through a straw); adosine
Uncompensated (AMS): adenosine or cardioversion
Oral Dehydration
Attempted first for mild and moderate cases of dehydration
Management (over 4 hrs)
Mild: 50 ml/kg oral rehydration solution (ORS) within 4 hours
Moderate: 100 ml/kg ORS within 4 hrs
Replacement of diarrhea losses: 10 ml/kg for each stool
IV Rehydration
Severe Cases - Initiated when child has severe case of dehydration or is unable to tolerate oral fluids to correct fluid losses (persistent vomiting)
Bolus of 20 mL/Kg
Maintanance Fluid
100 ml/kg for first 10 kg
50 ml/kg for next 10 kg
20 ml/kg for remaining kg
Add for total ml needed per 24 hour period
Pyloric Stenosis Def
Pylorus muscle hypertrophies and thickens on the luminal side of the pyloric canal causing gastric outlet obstruction
Pyloric Stenosis Nursing Assessment
Forceful, projectile vomiting in first 3-6 wks of life
Olive mass in RUQ
Physical cues: dehydration, olive shaped moveable mass in RUQ, metabolic alkalosis
Pyloric Stenosis Nursing Priorities
Pre-repair
IV fluids, NG tube, NPO, I&Os
Post op (pyloromyotomy)
Wound care
Resume PO feedings in 1-2 days
Hirschsprung’s Definition
Resection and re-anastomosis surgery is necessary to restore proper bowel function typically done in four stages
Hirschsprung’s Expected Findings
Failure to pass meconium 24-48 hrs after birth, vomit bile, abd distention, and refusal to eat
Foul smelling/ribbon like stool
Hirschsprung’s Treatment
Surgical resection and anastomosis
Broad Abx, IVF, rectal washout
Nursing Management
Monitor signs of enterocolitis: fever, abdominal distention, chronic diarrhea or explosive stool, rectal bleeding, or straining – notify provider immediately
Acute Glomerulonephritis Diagnostics
Recent Strep/pharyngitis or skin infection
Tea color urine
Positive ASO titer (strep antibodies), hematuria, proteinuria, elevated BUN/creatinine, and elevated ESR
Acute Glomerulonephritis Nursing management
Manage HTN w/ diuretics and HTN meds, abx for infection
Monitor renal/neuro and fluid status
Hemolytic Uremic Syndrome Findings
Three features: hemolytic anemia, thrombocytopenia, acute renal failure
s/s: Pallor or toxic appearance, edema, oliguria, or anuria
Labs
Proteinuria, hematuria, leukocytes, casts
Elevated BUN/creat
Mild-severe thrombocytopenia
Hyponatremia/kalemia
Hemolytic Uremic Syndrome
PRBCs and platelets (only for active bleeding or severe thrombocytopenia); IVIG may be considered
Maintaining fluid balance, managing HTN, acidosis, & electrolyte abnormalities
Hypospadiea Physical Findings
Abnormal urethral opening on ventral surface of penis (penis hole is below)
Hypospadias Treatmet
Circumcision, urethral stent to correct chordee keep upright
Double diapering to protect stent or catheter from stool
GH Deficiency Manifestation
Physical cues
Note birth hx, severe head trauma, or brain tumor
Evaluate past/current growth patterns
Caused by injury to pituitary gland or hypothalamus
Sx: large prominent forehead, high pitched voice, delayed sexual maturation, delayed dentition and skeletal maturation
Diagnostics
Skeletal survey: 2+ SD < normal in bone age
CT/MRI: rule out tumors/other abnormalities
Pituitary function test will confirm
Growth chart deviations
GH deficiency Medication/treatment
Biosynthetic GH (somatropin)
Replaced via Sub-Q injections 0.18-0.3 mg/kg/week divided in equal daily doses at night time
GH continued until growth rates of less than 1 inch/year or bone age of >16/14
Congenital Hypothyroidism Clinical Manifestation
Physical cues
Poor sucking, hypothermia, constipation, lethargy, hypotonia, periorbital puffiness, cool/dry/scaly skin, bradycardia, RR distress, large fontanelles/delayed closure
Diagnostics/labs
Newborn screening
Free T4: Low
TSH: High
DKA Symptoms
Physical cues
Rapid onset, glucosuria, change in LOC, nausea, dry oral MM, blood sugar over >450, moderate ketones in urine
Lab cues
Metabolic acidosis, hyperkalemia, glucosuria, ketonuria
Management/Nursing actions
IV regular insulin drip, fluids, monitor blood sugar (cerebral edema)
Hydrocephalus Physical Cues
Physical cues: symptoms of increased ICP (sunset eyes, bulging fontanelles, widened sutures, poor feeding, increased head circumference)
Hydrocephalus Treatment/Management
Treatment: VP shunt
Placement: into the ventricle to give CSF an exit
Assessment: increased ICP sx (back to square one)
Complications: obstruction or infection; reoccurring surgical procedures to replace shunt
Seizures Nursing Care
Padding of side rails, rail raised, oxygen and suction at bedside, and bracelet
Supervision during activities, use protective helmet during some activities
Increased ICP Physical Cues
Infant have bulging fontanels
Early Sign: Sunset eyes, HA, blurred vision, tachycardia, and dizziness
Late signs: Cheyne-Stokes respiration, and Cushing’s triad (irregular breathing, HTN, and bradycardia)
ICP Management
Decreasing ICP: Elevate head of bead 30-45º, decreased stimuli, hyperthermia management (avoid shivering), sedation, avoid coughing/blowing nose/suctioning, stool softener
Medication: mannitol (osmotic diuretic)
Bacterial Meningitis Nursing Management
ICU admission with strict Droplet Isolation until 24H of antibiotics or orders to discontinue
Seizure precaution
Manage hyperthermia with NSAIDs, cooling blankets, cool compresses, and tepid baths
Meningitis Lab Findings
Lumbar puncture
CSF is cloudy, elevated WBC/protein, decreased glucose, positive gram stain
LP: CSF Results: WBCs ↑ + ↓Glucose +↑Protein, cloudy in color
Reye Syndrome
Physical cues (encephalopathy and increased ICP): jaundice, vomiting, lethargy, confusion, + Babinski, hyperreflexia
Lab cue
Elevated ammonia (treat with lactulose)
Elevated AST/ALT
Hypoglycemia (treat with D5)
Increased prothrombin time (treat with FFP or vit K)
Reye Priority of Care
Nursing management
Maintain hydration, position client, monitor coagulation, monitor pain, seizure precautions
Priority of care
Decrease ICP and supportive care for the sequelae r/t acute liver failure
Spina Bifida Cystica - Meningocele
Meningocele
Covering the spinal cord
Usually minor and no neurological deficits
Care: measures to prevent rupture of sac to include prone positioning before and after surgical repair; monitor head circumference and observe for signs of increased ICP
Care: NS moistened dressing to keep sac moist and prevent rupture, monitor for signs of latex allergy, report leaking from sack, prone positioning, no diapering
Complications: skin breakdown, latex allergy, increased ICP, bladder issues, bowel issues, orthopedic issues
Surgery can be delayed as long as there is not leaking
Myelomeningocele Management
Myelomeningocele
Most severe form
Enclosed in the spinal cord, varying degrees of neuromuscular deficits
Risk factors: lack of prenatal care and folic acid
Care: NS moistened dressing to keep sac moist and prevent rupture, monitor for signs of latex allergy, report leaking from sack, prone positioning, no diapering
Complications: skin breakdown, latex allergy, increased ICP, bladder issues, bowel issues, orthopedic issues
Cerebral Palsy Definition
Nonprogressive impairment of motor function, abnormal perception and sensation, cognitive disability, majority of causes occur before delivery. The manifestation depends on the affected part of the brain
Cerebral Palsy Management/ Nursing Care
Oxygenation/ventilation
Pain management
Baclofen, botulinum toxin A (botox), and carbidopa
Adequate nutrition, skin care, communication, psychosocial (independence), developmental
Physical, occupational, speech therapy
Cerebral Palsy Complication
Seizures, delayed G&D, hydrocephalus, aspiration, and injury r/t limited mobility
Function and quality of life vary
Fractur Complication
Compartment Syndrome
5 P’s: pain, paresthesia, pulselessness, pallor, and paralysis
Osteomyelitis
Infection in the bone
Sx: irritability, fever, tachy, edema, constant pain, and tenderness
Amblyopia Therapeutic Management
Patching (the stronger eye) for several hours a day OR Atropine drops in the stronger eye daily
Vision therapy
Eye muscle surgery
Acute OM assessment findings
NOTE: for child <3 yrs – pull pinna down and back; >3 yrs – pull pinna up and back.
On exam, tympanic membrane (TM will be dull, red, bulging, or opaque)
Acute OM Management
Symptomatic management of otalgia and fever
Acetaminophen and ibuprofen
Benzocaine (Auralgan) drops may also be prescribed for pain if the TM is not ruptured
Antibiotic therapy - Amoxicillin, Amoxicillin-clavulanate (Augmentin), Azithromycin – PO (10-14 days)
Pneumatic otoscope- used to visualize the TM and assess its movement
Bacterial Skin Infections
Impetigo (can turn into papules and vesicles)
Cellulitis (localized inflammation)
Staphylococcal scalded Skin Syndrome (burn-like appearance - leaves red, weeping surface)
Impetigo Physical Cues and Management
Physical Cues
Common infection of superficial layers of epidermis - primary or secondary. Papules → vesicles or pustules w/honey-colored exudate/crusts; itchy or painful; honey color
Management/Education
Soak impetigo lesions in appropriate solution before applying antibiotics
Treat topically with antibiotic ointment or oral antibiotics; hygiene/linens, avoid contact
SSSS
Cues
S.aureus produces a toxin that causes the skin to exfoliate causing diffuse erythema and tenderness and a burn-like appearance – leaves red, weeping surface (face, neck, axillary, groin)
Treatment/Education
Mild: Oral antibiotics
Severe: IV antibiotics, fluid management, burn treatment
Cellulitis
Patho
Localized infection or inflammation; Firm, swollen, red area of skin and subcutaneous tissue (red, warm, swollen, pain, tenderness) & possible systemic effects (fever, malaise)
Treatment/Education
Oral or parenteral antibiotics
Rest and immobilize affected area
Atopic Dermatitis (eczema) Definition
A chronic condition that causes dry, itchy and inflamed skin that’s common in young children. An antigen response to environmental factors, temperature changes and sweating.
Atopic Dermatitis (eczema) Physical Cues and Diagnostic
Physical cues
Extreme itching
Erythema, inflammation
Variety of lesions/rash (plaques, papules, scaling, vesicles) on face, scalp, wrists or arms, elbows/antecubital, knees/popliteal areas
Diagnostic findings
Elevated IgE levels
Presence of wheezing
Atopic Dermatitis Management
Medications: Topical corticosteroids & Immunomodulators-tacrolimus
Avoid hot water and bathe 2X/day in warm water
Avoid soaps containing perfumes, dyes, or fragrances (Dove, Caress, Cetaphil, Aquanil)
Pat skin dry and leave moist while apply moisturizers (Eucerin, Aquaphor, Vaseline, Crisco) multiple times daily
100% cotton clothing and bed linens, avoiding synthetics and wool; Keep fingernails short
Antihistamines at HS may assist with itching; Behavior modification during waking hours (clickers, distraction, reward)
Skin lesion Risk Factor
Poverty, prematurity (<1 yr), chronic illness, intellectual disability, parent w/ abuse history, unrelated partner, alcohol/substance abuse, and extreme stressor
Tinea Locations
Pedis – feet
Corporis – arms or legs
Versicolor – hypopigmented areas on neck, trunk, proximal arms
Capitis – scalp, eyebrows, or eyelashes
Cruris – inguinal creases and inner thighs
Tinea Treatment
Tinea capitis: Oral griseofulvin
Other Tinea: Topical antifungal (clotrimazole) at least 4 weeks; Linens and clothing must be washed in hot water to reduce spread.
Hemophilia Definition
Deficiency of Factor VIII which is essential to activate factor X, which converts prothrombin to thrombin, without it, platelets cannot make clots
Hemophilia Physical Cues and Labs
Physical Cues
Joint swelling, pain, bruising, bleeding (nose, gums, hemoptysis, hematemesis, heavy menstrual); chest or abdominal pain (internal bleeding)
Lab Cues
CBC – possible low Hgb & Hct
Coags – PTT prolonged; normal PT & Platelets
Hemophilia Management
FIRST - Factor VIII administration
Apply direct pressure to external bleeding; if joint bleeding, apply ice or cold compresses and elevate extremity unless contraindicated by causing further injury
Desmopressin (DDAVP) (in mild cases) – triggers the endothelium of bld vessels to release Factor VIII
Iron Deficiency Anemia Assessment
Assessment Findings:
Irritability, HA
Unsteady gait, weakness,fatigue
Dizziness, sob, pallor skin, mm, conjunctiva assess for difficulty feeding, pica spooning of nails
Lab Cues
Decrease
RBC, Hgb, Hct, MCV, MCH, and Ferritin
Increase
RDW
Causes
Blood loss or iron depletion
Iron Deficiency Anemia Management
Nutrition (Fe+ rich food)
Red meant, tuna, salmon, eggs, tofu, enriched grains, dried beans and peas, dried fruits, leafy green vegetables, and Fe+ fortified cereal
Give with vitamin C, do not give with milk, color stools and black urine may be normal, , stain teeth, drink with straw, and may cause constipation
Sickle Cell Vaso-o-occlusive Crisis
Management
Priority of care
Pain control (NSAIDS and opioids)
Hydration (double maintenance fluid 150ml/kg/day)
Hypoxia (maintain O2 >92%)
O2 via NC if < 92%
Bone Marrow Aspiration
Procedure
Prone position
Iliac crest
Fentanyl/Versed (anesthetic/sedation
Pre-procedure
Infection prevention
Post-procedure
Hold pressure on dressing and monitor for bleeding and infection
General Neutropenic Precation
Private room
Meticulous hand hygiene before and after care
VS Q4H and assess for signs of infection Q8H and PRN
Avoid rectal temps, enemas, suppositories, urinary catheters, and invasive procedures
Restrict visitors
No raw fruits, vegetables, fresh flowers, or live plants in room
Mask on child when outside room
Soft toothbrush
Common Cancer Treatment
Anemia
Thrombocytopenia
Neutropenia
Management of N/V and anorexia
Radiation Therapy AE/Common complication/Management
Wash skin with mild soap & water
Avoid lotions/powders/ointments
Avoid sun or heat exposure
Diphenhydramine or hydrocortisone cream for itching
Antimicrobial cream to desquamation
Moisturize with aloe vera
ALL Clinical Manifestation and Lab Findings
Priority of Care
Preventing infection, treating pain, anemia, preventing bleeding
Lab Cues
Bone Marrow Aspirate (BMA) - most definitive test, determines lymphoid or myeloid and cell types, and prolific quantities of blasts. (Determine MLL or ALL)
CBC - Low Hgb, Low Hct, Low RBCs, low/normal/high WBCs
Blood Smear - may reveal blasts
LP – whether leukemic cells in CNS
CXR – to detect PNA or mediastinal mass
Treating Fever in Children
Infant
100.4 F
Child
102.2
Older Child
Appears sick, rash, V/D, signs of dehydration, and chronic medical problem
Fever in children Nursing Care
Assess temp q4-6hr; 30-60 min after medication
Use same site for temp
Experiencing discomfort or cannot keep up with the metabolic demands of the fever
Tylenol – po Q 4-6 hrs
Ibuprofen – Q 6-8 hrs (>6 mo.)
I/O and hydration
IGs
IgG – the only one that crosses the placenta + breastmilk. Protects against viruses, bacteria + toxins.
IgA – Defense against respiratory, GI, GU pathogens
IgM – indicates active infection
IgE – Increased in allergic states + severe allergic reactions + parasitic reactions
Lyme Disease Therapeutic and Nursing Management
Doxycycline if started early (age >8 yrs)
Amoxicillin should be given if <8 yrs to prevent teeth discoloration or cefuroxime if allergic
Treatment for 14-28 days
Pertusis Physical Cues and Therapeutic Management
Causes swelling & irritation of airways - Cold symptoms for 7-10 days followed by cough for up to 4 weeks, with recovery taking weeks to months
Physical Cues
Paroxysmal cough (coughing 10-30 times in a row) - “whooping cough”
Red face, cyanosis, and protruding tongue, and increase secretion
Cold symptoms for 7-10 days and 4 wks of cough
Management
Macrolide (“mycins”) antibiotics for infants >1 month
Azithromycin if <1 month
Pertussis vaccine for all contacts <7 that are unvaccinated or undervaccinated
Nursing Management
Tdap Vaccine
Airway obstruction, antibiotic compliance
Droplet precation
SCID Management and Treatment
Absent T and B cell function
Management/Treatment
Bone marrow transplant
IVIG to prevent bacterial prevention
Infection prevention
Juvenile Idiopathic Arthritis Assessment and Diagnostics
Assessment/Diagnostics
Irritability and fussiness may be first signs
Withdrawal from play, joint stiffness and pain in after sleep, guarding of joint, limping, inflammation at joint, and fever and rashes if systemic
Labs
Elevated WBC, EST, and CRP
+ANA and Rheumatoid factor
Moderate anemia
Lab Cues of Immunodeficiency/WBC types
Neutrophils – presence of acute bacterial infection or severe stressor
Eosinophils – allergic reactions
Lymphocytes (B&T) elevated in viral infections or chronic bacterial infection
Erythrocyte Sedimentation Rate (ESR) - inflammation marker
C-reactive protein (CRP) - inflammation marker
Complement C3 – when elevated, indicates immune system is active from an infection or injury
Rubeola (Measles) – Assessment cues & nursing actions
Physical Cues
Maculopapular rash: starts on face > neck > trunk > arms > legs > feet
Fever, Koplik spots, cough, nasal inflammation, malaise, conjunctivitis
Nursing Actions
Antipyretics, bedrest, fluids, humidification
Airborne Precautions until 4 days after the onset of rash
Vaccination within 72 hours or immune globulin (IgG) within six days
Vitamin A for hospitalized children 6 months to 2 years or if immunocompromised
Latex Allery Cross sensativity
Cross Sensitivity (35% to one of the food)
Kiwi, banana, peach, avocado, chestnut, fig, bell pepper, tomato. and white potato
Waxy fruits (?), the proteins in these fruits/others are also present in latex
Latex Allergy Management
Allergy intervention
