ill child - ati review Flashcards
Age-Appropriate Activities to Help a Child Cope During a Procedure
-preschooler
Explain procedures using simple, clear language. Avoid medical jargon and terms that can be misinterpreted.
Encourage independence by letting the child provide self-care.
Encourage the child to express feelings.
Validate the child’s fears and concerns.
Provide toys that allow for emotional expression (a pounding board to release feelings of protest).
Provide consistency in assigning caregivers.
Give choices when possible (“Do you want your medicine in a cup or a spoon?”).
Allow younger children to handle equipment if it is safe.
Hypertonicity (muscle tightness or spasticity); increased deep tendon reflexes; clonus; and poor control of motion, balance, and posture.
Impairments of fine and gross motor skills.
Can present in all four extremities (tetraplegia); all extremities affected, lower more than upper (diplegia); three limbs (triplegia); one limb
(monoplegia); or one side of the body (hemiplegia).
Gait can appear crouched with a scissoring motion of the legs with feet plantar flexed.
Babinski reflex.
Spastic CP (pyramidal)
Expected findings
Joint swelling, stiffness (tend to be worse in morning or after inactivity)
Mobility limitations
Fever
Rash
Gait with a limp
Delayed growth
Juvenile idiopathic arthritis
Client Education QPCC
Visit a dentist before therapy.
Use chlorhexidine mouth wash or salt rinses using ½ tsp table salt mixed with 1 tsp baking soda and 1 quart water.
Mucositis and dry mouth
Physical Findings
Active bleeding, which includes bleeding gums, epistaxis, hematuria, and/or tarry stools
Hematomas and/or bruising, even with minor injuries.
**Hemar`throsis ** as evidenced by joint pain, stiffness, warmth, swelling, redness, loss of range of motion, and deformities
Headache, slurred speech, and a decreased level of consciousness
Laboratory Tests
Prolonged partial thromboplastin time (aPTT)
Factor-specific assays to determine deficiency
Platelets and prothrombin time are within expected reference ranges
Whole blood clotting time is within expected range or prolonged
Diagnostic Procedures
DNA testing: Detects classic hemophilia trait in females
Hemophilia A
Deficiency of factor VIII
Referred to as classic hemophilia
Accounts for 80% of cases
Expected Findings
Tetany is the most common manifestation seen in clients in a hypocalcemia state. It is caused by neural excitability-spontaneous discharges from both the sensory and motor fibers (peripheral nerves).
Paresthesia of the fingers and lips (early manifestation)
Muscle twitches as hypocalcemia progresses
Seizure due to irritability of the central nervous system
Frequent, painful muscle spasms at rest in the foot or calf (Charley horses)
Hyperactive DTRs
Positive Chvostek’s sign (tapping on the facial nerve triggering facial twitching)
Positive Trousseau’s sign (hand/finger spasms with sustained blood pressure cuff inflation)
History of thyroid surgery or irradiation of the upper chest or neck, which places a client at risk for developing hypocalcemia
Laryngospasm if severe
Cardiovascular:** Decreased heart rate and hypotension** when hypocalcemia is severe
Gastrointestinal: Hyperactive bowel sounds, diarrhea, and abdominal cramps
Other manifestations: Anxiety, confusion
**hypocalcemia **
Calcium level less than 9.0 mg/dL.
Physical Findings
Dyspnea
Cough
Audible wheezing
Coarse lung sounds, wheezing throughout possible crackles
Mucus production
Short, panting speech
Restlessness, irritability
Anxiety
Sweating
Use of accessory muscles
Decreased oxygen saturation (low SaO2)
Tripod positioning
Retractions when sitting
Inaudible breath sounds or crackles (severe obstruction)
Asthma
** Croupy barky cough**, restlessness, difficulty breathing, hoarseness, and nighttime episodes of laryngeal obstruction
Acute spasmodic laryngitis
Expected findings
Drooling, agitation, absence of spontaneous cough
Sitting upright with chin pointing out, mouth opened, and tongue protruding (tripod position)
Dysphonia (thick, muffled voice and froglike croaking sound)
Dysphagia (difficulty swallowing)
Inspiratory stridor (noisy inspirations)
Suprasternal and substernal retractions
Sore throat, high fever, and restlessness
Croup syndromes: Bacterial epiglottitis (acute supraglottitis)
Medical emergency
Usually caused by Haemophilus influenza
Low-grade fever, restlessness, hoarseness, barky cough, dyspnea, inspiratory stridor, and retractions
Infants and Toddlers: nasal flaring, intercostal retractions, tachypnea, and continuous stridor
Acute laryngotracheobronchitis
Infectious mononucleosis/Epstein Barr virus
Fever
Lethargy
Sore throat
Swollen lymph glands
Loss of appetite
Headache
Increased WBC
Atypical lymphocytes
Splenomegaly
Hepatic involvement
Acute (related to dehydration and decreased oxygen)
Severe pain, usually in bones, joints, and abdomen
Swollen joints, hands, and feet
Abdominal pain
Hematuria
Obstructive jaundice
Visual disturbances
Chronic
Increased risk of respiratory infections and osteomyelitis
Retinal detachment and blindness
Systolic murmurs
Renal failure and enuresis
Liver cirrhosis; hepatomegaly
Seizures
Skeletal deformities; shoulder or hip avascular necrosis
Vaso-occlusive crisis (painful episode)
