Module 2 Care of Child with Respiratory, Cardiac, and Hematology Disorders Flashcards
What is the difference between an adult epiglottis and a child epiglottis
Child Epiglottis is smaller and may not close properly
Define: Bronchiolitis
inflammation of the bronchioles
What are 7 signs of Respiratory distress in a child
Flared Nostrils Cyanosis Grunting Wheezing Stridor Pallor Change in Respiratory and Cardiac Rate
Flared nostrils are
Quivering nostrils
Grunting in a child sounds like
An Oinking sound
Respiratory distress in a child can lead to (3)
Restlessness and Air hunger
Dyspnea
Circumoral pallor is
Pallor around mouth
Cyanosis is a sign of
Severe Respiratory Distress
What is the best position to put a child in for Respiratory Distress
High fowlers
What are 4 things we can do for a child with Respiratory Distress (other than high fowlers)
Increase Humidity
Chest Physiotherapy (PT)
Increase Hydration
Control Temperature
What should the O2 Sat be on a child and how do we check it
Above 92, on toes
What disorder causes O2 Sat to be low
Cystic Fibrosis
What is the best way to diagnose a Resp disorder in a child under 5
Pulse Ox, and ABG
What are 2 nursing interventions for a child going into resp. tent
Dress kids with least clothes as possible
No Electronic or battery operated toys
What is the preferred Resp tx. to admin Oxygen
Mask
When do we use a Cannula to admin Oxygen
Older kids
What can we use if a child has Bronchodilators
Nebulizer
When performing postural drainage on a child, what position should we place them in
Side lying (across lap)
How often should we perform Postural Drainage / Chest PT
3-4X day, 10-15 min
A mechanical vest is used to help with
Cupping and Clapping
When is the best time to perform postural drainage
In the Morn B4 Breakfast, during tx.
What do we use on kids to perform Nasal Suctioning
Bulb Syringe
How long can we perform suctioning on an infant
No longer than 5-10 seconds
What are some immediate signs of Strep throat
Redness w/ white patches
If there is swelling in the middle of the throat what must we not do
Culture for Strep throat
Define Mononucleosis
Strep infection spread through Saliva
What can Mononucleosis lead to
Extreme lethargy
Strep throat can be tx with
Throat culture and Abx
If a child has more than 3 strep throats in a year what should we advise
Tonsillectomy
Kid snoring happens because of
Enlarged Tonsils
If child has any kind of blood disorder what must we not do
Tonsillectomy
What are 6 Nursing interventions of Post op care for Tonsillectomy
Position Side lying Observe for swallowing (bleeding) Ice collar for bleeding Clear diet No nose blowing No hot fluids / soft foods
What Temp should we call M.D. for
101 +
How do we treat Obstructed airway for a child under 1 year old
Abdominal Thrust
How do we treat Obstructed airway for a child over 1 year old
Back blows
What are 3 common symptoms of Epiglottitis
Acutely ill
Drooling , agitation
Cherry red epiglottis
What are 2 important nursing interventions for a child with Epiglottitis
Trache at bedside
Don’t use tongue blade
What are 3 symptoms of Laryngotracheobronchitis
Stridor
Resp. Distress
“Seal like Bark”
What are 3 nursing interventions for Laryngotracheobronchitis
Cold air
Hot showers
Monitor O2 Sat
What are 3 symptoms of Bronchiolitis
Wheezing
Cyanosis
Dehydration
What are 3 Tx for Bronchiolitis
Abx
IV fluids INCREASE FLUIDS
O2 admin
RSV stand for
Respiratory Syncytial Virus
RSV is known for
Being most frequent hospitalization of children under 1
What is tx for RSV (2)
Increase Humidity
Steroids (for inflammation)
What are 3 nursing interventions for RSV
Increase fluids
Nasal Suction PRN
Take O2
What are 4 S/S of Child Pneumonia
Fever
Anorexia
Shallow Respirations
SOB
What are 3 tx. for Child Pneumonia
Rest
Abx
IV fluids
Asthma is considered a
Dry Resp Disorder
What are 3 symptoms of Asthma
Wheezing
Dyspnea
Resp Distress
What are 4 tx. for Asthma
Bronchodilators
MDI
Nebulizers
Corticosteroids
What should we always have on hand for a child with Asthma
Adrenalin
What are the 3 main food allergies for Children
Peanuts
Dairy
Chocolate
Cystic Fibrosis leads to
Failure to thrive
What are 3 symptoms of Cystic Fibrosis
Failure to Thrive
Salty taste to skin
Meconium ileus
Meconium ileus is
no stool passed within 24 hours
How do we dx. Cystic Fibrosis (2)
Stool Analysis
Sweat test
How might the stool be in a child with Cystic Fibrosis
Steatorrhea Large bulky Fatty Foul Smelling Stool
What are 6 Symptoms of Cystic Fibrosis
COPD Barrel Chest Clubbed Fingers Cor Pulmonale Rectal Prolapse Fat Soluble Vitamin Deficiency
What is Cor Pulmonale
Heart defect from low O2
A child with Cystic Fibrosis is always …. and has ….
Hungry, loose skin
How do we tx. Cystic Fibrosis (4)
Pancrease
Humidity
Bronchodilators
Increased protein, fat, calories, vitamins (3,000 per day)
Epistaxis is
Bleeding from nose
Epistaxis is usually first sign of
Leukemia
If Epistaxis lasts for more than 15 min what should we do
Call doctor
How do we tx Epistaxis (2)
Apply ice
Pinch bridge of nose while leaning forward
How can we “cauterize” the nose
Apply Silver Nitrate
SIDS stands for
Sudden Infant Death Syndrome
SIDS is more common in
Males
Dehydration can lead to
Bad diet, child not eating
What are the 3 Blood disorders that we don’t do Tonsillectomy for
Hemophilia
ITP
Leukemia
Is Rheumatic Fever contagious
yes, but not communicable
Migratory Polyarthritis
Many stiffness in joints, moves around body
Skin eruptions are
Preparer Rash, large flat reddened areas
Sydenham’s Chorea
irritation of nerve cells, twitching and jumping
Tx. for Rheumatic Fever (4)
Rest
Tylenol/ Motrin
Erythromycin
Prednisone
What are the 3 Acyanotic Defects
Patent Ductus Arteriosus
Atrial Septal Defect
Ventricular septal defect
What is Patent Ductus Arteriosus
Artery does not open
In patients with Atrial Septal Defect we can
Hear a loud Murmur
How do we tx. Atrial Septal Defect
Cardiac Catheterization
Ventricular Septal Defect is known for being
Most common
What are 3 Cyanotic Defects
Tetralogy of fallot
Coarctation of the Aorta
Transposition of great vessels
Tetralogy of fallot is
Babies crying leads to cyanosis
Coarctation of the aorta is
Narrow Aorta
Transposition of great vessels is
Pulmonary Artery and Aorta are switched
What are 3 S/S of Congestive Heart Failure
Fatigue during feedings
Weight gain
Sweating
What are 4 tx for CHF
Rest
Lasix
Digoxin
Potassium
Endocarditis is a side effect of
Strep throat
When is the highest incidence of Iron Deficiency Anemia
9 mo - 2 years
What is a common sign of Iron Deficiency Anemia
Pallor
What is Sickle Cell Anemia
Decrease in HgB due to crescent shape of RBC’s
To have Sickle Cell Anemia Disease
You must have gene from both parents
Blood in Sickle Cell patients does not clot it
Clumps
What are 5 S/S of Sickle Cell
Fatigue Tissue Hypoxia Jaundice Pallor Swollen Joints
Priapism is
when clumping occurs in circulatory system leading to long erection
Clumping of cells in Sickle Cell is called
Vaso-Occlusive Crisis
What factors precipitate a crisis (6)
Fever Dehydration High Altitude Emotional Distress Alcohol Pregnancy
Tx for Child with Sickle Cell Disease (4)
Rest
Hydration
analgesics
Blood tranfusions
Hemophilia can be diagnosed by checking
Bleeding and clotting times
S/S of Hemophilia (3)
Easily bruised
Hematuria
Hemarthrosis
What is the tx for Hemophilia
Synthetic Factor VIII
ITP stands for
Idiopathic Thrombocytopenic Purpura
How do we dx ITP (2)
Platelet count less than 20,000
Bone marrow aspiration
What are 3 symptoms of ITP
Petechiae
Purpura
Bleeding gums
What are 2 tx for ITP
IV gamma globulins
Splenectomy
IV gamma globulins help
build immune system
Leukemia is the
uncontrolled growth of immature WBCs
How do we dx Leukemia (2)
Bone Marrow Aspiration
CBC with diff
What are 5 symptoms of Leukemia
Petechiae Pallor Anemia Enlarged Lymph nodes Anorexia
Tx for Leukemia (2)
Chemotherapy
Platelet transfusions
A patient with Leukemia should be on
Reverse isolation
How do we diagnose Hodgkins disease
Bone Marrow Aspiration
How to we treat Hodgkin’s disease (2)
Chemotherapy
Radiation therapy
An early sign of Hodgkin’s disease is
Painless enlarged lymph node
The primary symptom in croup is
Cough
A nurse is caring for a 7-year-old patient immediately following a tonsillectomy. The best position for this patient is
partly on the side and partly on the abdomen
Cystic fibrosis is an _______ system disease
Endocrine
Deoxygenated blood enters the systemic arterial circulation in which disorder
Coarctation of the aorta
The nurse is caring for a child receiving digoxin (Lanoxin) for the diagnosis of heart failure. Which manifestation is a cardinal sign of digoxin toxicity
Extreme bradycardia
Which observation indicates that an infant with CHF is carefully following the prescribed medical regimen
The child exhibits normal weight for age
The most common form of childhood cancer is
leukemia
The nurse is caring for a 5-year-old child with leukemia who was admitted to the hospital with the primary diagnosis of pneumonia. The nurse knows the most likely cause of this child’s pneumonia is
neutropenia
The classic symptom of idiopathic (immunological) thrombocytopenia purpura (ITP) is
bruising
What nerve connects brain for respiratory movement
Vagus Nerve
What is the accepted O2 Sat for a child with cystic fibrosis
88%
During respiratory tx. what kind of restraints will we put on child
Elbow restraints
What is one major thing we must encourage with a child on oxygen
Lots of fluid
If child has neg strep on quick test what should we do
72 hour culture
What is performed in an emergency situation with a child with obstructed airway
Tracheostomy
