Focus on These! Flashcards
ibuprofen (Motrin)
* dosage
* who can or cannot receive this?
KNOW THIS!!!!
10 mg/kg Q6H
- NOT given to children under 6 months of age
acetaminophen (Tylenol)
* dosage
* route
KNOW THIS!!!!!
15 mg/kg Q4-6 Hours
- given PO, PR, IV
What is the Gate Theory?
Since pain & non-pain impulses are sent along the same pathways, non-pain impulses can compete with pain impulses for transmission
3 Types of Pain Scales & Ages for each scale
KNOW THESE!!!!
- Nips - up to 1 y-o
- Flacc - up to 4 y-o
- Faces / Wong Baker - ages 4-5 y-o
PCA Pumps
Useful in children 6 years & older
* the child should be able to push the button on their own & be able to understand this will relieve their pain
- Children using a PCA pump should also be able to use a self-reporting pain scale
If respiratory depression occurs, PCA pump should be discontinued, pt stimulated, & deep breaths attempted. If there is no improvement, naloxone should be considered.
What are the 3 types of conjunctivitis?
KNOW THIS!!!!!
- Bacterial
- Viral
- Allergic
Bacterial conjunctivitis
KNOW THIS!!!!!
- 50-74% is bilateral
- purulent drainage (makes it hard to open the eyes
- edema (of the eyelid), red conjunctiva, enlarged preauricular glands
- leads to otitis media
Viral Conjunctivitis
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- Typically not bilateral, but can be unilateral
- Milder symptoms than bacterial conjunctivitis (edema, red conjunctiva, enlarged preauricular lymph nodes)
- serous (watery) discharge
Allergic Conjunctivitis
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- Mostly bilateral
- Rarely has discharge; if there is discharge it is serous (watery)
- Itchy eyes, conjunctivae have a “cobblestone” appearance
Otitis Externa
KNOW THIS!!!!!
Inflammation of the skin & soft tissue of the ear canal
* “Swimmer’s Ear”
TX: antibiotic ear drops + steroid
- **< 3 Years = ** pull the ear down & back
- > 3 years = pull the ear up & back
What is the difference in the treatment for otitis media & otitis externa?
- Otitis Media = oral antibitoics
- Otitis Externa = antibiotic ear drops
Otitis Media
KNOW THIS!!!!!
Inflammation of the middle ear
* Bulging TM (due to puss in the middle ear), redness over ear drum
- pulling at the ear, fever, diarrhea, vomiting, crying at night due to increased pressure when prone or supine
Epiglottitis
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Inflammation & swelling of the epiglottis
S/S: high fever (> 39 C), intense sore throat, drooling, tachycardia, tachypnea
* may be in tripod position to relieve breathing difficulties
* Thumb sign
* NO barky cough
- do NOT touch child, contact HCP & prepare intubation equipment
Asthma
KNOW THIS!!!!!
Hyper-Responsiveness causes excess mucous formation, musocal swelling, & airway contraction
- Certain environmental exposures also create additional risk for reaction such as smoke exposure (active & passive), pet dander, cockroach feces, & air pollution
Asthma
* S/S
* Physical Exam Findings
KNOW THIS!!!!!
S/S: suddon onset of breathing difficulty, cough, wheezing, SOB, tachypnea, intercostal retractions
PE Findings:
* inspiratory & expiratory wheezing
* +/- productive cough
* decreased air movement
Asthma Pathophys - Hyperresponsive State
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excess mucus formation, airway swelling & inflammation, & bronchoconstriction
- Once a trigger occurs, the airway has an exaggerated inflammatory response causing vasodilation, increased capillary permeability, mucosal edema, airway narrowing, & hyperinflation.
- Hyperinflation (trapped air) of the alveoli causes decreased perfusion of the capillaries & hypoxemia
What occurs in the pathophysiology of asthma once a trigger occurs?
KNOW THIS!!!!!
Once a trigger occurs, the airway has an exaggerated inflammatory response causing **vasodilation, increase in capillary permeability, mucosal edema, airway narrowing **
- Hyperinflation (trapped air) of the alveoli then causes decreased persuion of capillaries & hypoxemia
Asthma Treatment
KNOW THIS!!!!!
Short-acting beta-2 agonists (SABA)
* relax smooth muscles in the airway causing swift bronchodilation & reverse bronchiospasm
Corticosteroids
* decreases airway inflammation & works with SABA to help with bronchodilation
Anticholinergics
* inhibits bronchoconstriction & decreases mucus production
Always use a spacer
Short Acting Beta-2 Agonists (SABA) for treatment of Asthma
KNOW THIS!!!!!
Relaxes smooth muscles in the airways leading to swift bronchodilation & reverse bronchospasm
Corticosteroids for treatment of Asthma
KNOW THIS!!!!!
Decreases airway inflammation & works with SABA to help with bronchodilation
Anticholinergics for treatment of Asthma
KNOW THIS!!!!!
Inhibits bronchoconstriction & decreases mucus production
Treatment of Cystic Fibrosis
KNOW THIS!!!!!
Goal is to control inflammation of the airways
- SABA may be used for airway hyper-responsiveness or bronchospasm
- Treating any infection
- Reducing mucus accumulation
Hayden is a 2 year-old male who presents to the emergency department for a chief complaint of trouble breathing. Viral testing reveals that he has contracted respiratory syncytial virus (RSV). As the nurse, you recognize that which of the following conditions is most common with RSV?
a.) Acute otitis media (AOM)
b.) Bronchiolitis
c.) Epiglottitis
d.) Meningitis
b.) Bronchiolitis
What is bronchiolitis?
KNOW THIS!!!!!
Acute viral infections invade the muscoal cell lining the bronchial & bronchioles which irritates the airway.
This leads to swelling & excessive mucous production causing wheezing & crackles
You enter the room to assess Hayden (2 y-o with RSV & difficulty breathing). Based on his age, which of the following approaches would be most appropriate for his assessment?
a.) Give a short explanation just before you begin.
b.) Explain your assessment only to the parents since he is young & won’t understand.
c.) Draw a picture of you and the patient to explain what you are doing.
d.) Ask the parents to step out as to reduce the patient’s anxiety.
a.) Give a short explanation just before you begin.
Precocious Puberty
KNOW THIS!!!!!
**Growth plates close sooner than expected.
- leads to overall stunted growth due to advanced bone age
