MODULE 6! Flashcards
GERD
s/s
tx
reflux of gastric content into orthopharynx
risk of aspiration and pneumonia
tx: reflux precautions. upright position with eating and 30 minutes after, frequent burping during feedings, thickened formula
pyloric stenosis
s/s
diagnosis
tx
s/s: projectile vomiting during and after feedings, may palpate and olive shaped mass in epigastric area
diagnosis: abdominal ultrasound
tx: hydration/electrolyte replacement, I&O, daily weight, monitor urine output closely, surgery
otitis media
patho
tx
prevention
p: infection of middle ear, bulging bright red TM, preceded by upper respiratory infection
tx: antibiotics if indicated, avoid chewing motion, avoid smoke exposure, PE tubes- wear ear plugs around water
prevention: sit up during feedings, NO bottle propping, gentle nose blowing, avoid smoke exposure
UAP role task person circumstance
role: supportive
task: routine, simple, repetitive
person: stable clients
circumstance: uncomplicated
LPN role
task
person
circumstance
task: 1. no nursing process. can collect data and assist with plan but RN must sign behind. 2. can implement within scope. 3. no creating a teaching plan only reinforce or standard plan
person: stable clients
circumstance: must reassign if client becomes unstable; can care for complex if stable
when does the anterior fontanel close
12-18 months
when does the posterior fontanel close
2-3 months
when giving IM injections, why is the ventrogluteal muscle contraindicated in children who have not been walking for atleast a year
the ventrogluteal muscle is not developed well enough
for babys under 12 months the ear will be pulled
the ear will be pulled down and out
how many cups of milk should a 15 mo old toddler consume daily
2-3 cups
what ages does the best friend stage occur
9-10 years
girls go through puburty how much sooner than boys
1-2 years
car seat safety
car seats go in the back. <20 pounds in the middle of the back seat in a rear facing until 12 months
car seats should be used until at least 30 pounds
boosters 4-8
order of VS
resp
hr
bp
temp
temp
rectal is most reliable. do not use rectal on newborns!
newborn communication
birth - 1 mo
nonverbal
express themselves through crying
encourage parents to touch their infant
infant communication
1 mo - 12 mo
primarily nonverbal
starts with repeating consonants (dada)
communicate through crying and facial expressions
respond to touch
toddlers and preschoolers 1-5 years
verbal skills
ages 3-4 form 3-4 word sentences called telegraphic speech
asking why
concrete and literal thinking so may misinterpret
short attention span
cognitive development: egocentric, magical thinking, animism, object permanence
express themselves through dramatic play and drawing
school age children 6-12
able to use logic begin to understand others point of view begin to understand cause and effect understanding body functions can interpret nonverbal messages expression of thoughts and feelings
adolescents 13-18
abstract thinking without full adult comprehension
strive for independence
need for privacy
nursing: straightforward approach, talk in private area, conduct part of interview without parents
observable signs of resp distress in children
use of accessory muscles
nasal flaring
sternal retractions
grunting with respirations
croup
what is it
tx
aka laryngotracheobronchitis
a viral infection that can result in a slight to severe dyspnea, barking or brassy cough, elevated temp
tx: steam from hot showers. no improvement? nebulized epi or corticosteroids
epiglottitis
what is it
tx
serious obstructive imflammatory process: there is absence of a cough, presence of dysphagia, drooling, and rapid progression to severe resp distress prim organism: H flu prevent: Hib vaccine NEVER USE A TONGUE DEPRESSOR the less noise they make the worse
RSV
what is it
s/s
tx
lower resp tract illness caused by an acute viral infection that affects the bronchioles
s/s: nasal discharge, wheezing, paroxysmal cough, tachypnea with flaring nares
tx: mild: tx symptoms. severe: IV fluids, albuterol, antipyretics, suction, o2
pneumonia
what is it
s/s
tx
inflammation of the lungs.
s/s: fine crackles or ronchi with a cough that is either productive or non productive
chest pain
back or abdominal pain
fever
tx: o2, fluids for hydration, antibiotics for bacterial pneumonia/supportive care for viral
cleft palate and lip
affects the oropharynex and increases the risk of malnutrition and aspiration
pre op: infants must be fed with an elongated nipple or medicine dropper down the side of the mouth to prevent aspiration. burp frequently because they swallow lots of air
post op: protect the sutures. position them supine or side lying. DO NOT PLACE PRONE. soft diet until healed
if a baby is born with both cleft lip and palate, which problem do they correct first
cleft lip to assist with feeding
GERD
what is it
tx
backwash or reflex of gastric contents into the esophagus
tx: use upright position with feeding and for 30 minutes after, frequent burping, thicken formula
pyloric stenosis
projectile vomiting during and after a feeding
s/s: olive shaped mass in the epigastric region which is the enlarged pylorus
tx: hydration and electrolyte replacement, I and o, monitor urine specific gravity, daily weight, surgery
intussusception
what is it
s/s
tx
piece of the bowel telescopes in on itself forming an obstruction
s/s: drawing up the knees, sudden onset, episodes of pain, currant jelly stools
tx: enema or surgery
hirschsprung disease
what is it
s/s
tx
congenital anomaly aka aganglionic mega colon, mechanical obstruction
s/s constipation; there are no nerves=no peristalsis, abdominal distension, ribbon-like stools that have a foul smell
tx:surgery to remove portion of the bowel that is diseased
head lice
itching
spread through direct contact
bag up all toys
tx: antiparasitic meds
pin worms
how is it spread
tx
rectal itching
spread hand to mouth
whole family should be treated- wash all sheets and clean bathrooms
specimen- tape test on rectum to collect eggs
tx: mebendazole, good hand washing, fingernails short
infectious mono
name virus
s/s
tx
s/s: sore throat, swollen lymph nodes, liver or spleen enlargement
epstein barr virus
tx: rest, analgesics, increase fluids, good nutrition
prevent contact sports
tonsillectomy and adenoidectomy
who gets this?
how do you position post op
performed on children with recurrent upper respiratory infections or obstructive sleep issues
post op: place on their side and elevate HOB or prone position to prevent aspiration
complains of sore throat and slight ear pain, low grade temp is normal
what would indicate that hemorrhaging is occuring after tonsillectomy or adenoidectomy
frequent swallowing
cystic fibrosis
involves both GI and respiratory systems.
pancreatic enzymes must be given to help improve digestion
high fat and high calorie diet
s/s: steaorrhea, hyponatremic, thick and sticky secretions
test for cystic fibrosis
sweat chloride test
in newborns what Is the earliest sign of CF
meconium ileus
what type of infections are down syndrome children most prone to developing
respiratory infections because they have a poor immune system
celiac disease
malabsorption due to an intestinal intolerance to gluten
CANNOT HAVE BROW:
barley, rye, oats, wheat
CAN HAVE RCS: rice, corn, soy
sickle cell disease
what is it
s/s
tx
anemia in which the normal hemoglobin is partly or completely replaced by abnormal hemoglobin and sickled shaped RBC
s/s: pain, anorexia, fatigue
tx: bedrest, HYDRATION
duchennes muscular dystrophy
what is it
s/s
specific to male children because it is x linked recessive trait
s/s: lordosis- curvature of lower spine, waddling gait, frequent falls, toe walking, gowers sign
tx of duchennes
maintain muscle function with physical therapy
prevent contractures
steroids may help improve muscle strength and respiratory function
tet spells
hypercyanotic spells are seen in children with the congenital heart defect of tetralogy of fallot
insufficient blood flow to the lungs
tx for tet spells
knee chest position which forces blood to go to lungs to be oxygenated
100% o2, monitor cardiac output, morphine for sedation
quiet play, minimize stress
congenital heart defects
structural defect of the heart or great vessels that is present at birth
UTI
s/s: failure to thrive, feeding problems, if not treated= kidney failure, foul smelling urine
frequency, dysuria, fever, flank pain, hematuria
causes of uti
renal anomalies, constipation, bubble baths, poor hyigene, pin worms, sexual activity
tx for uti
antibiotics
teach prevention: proper wiping technique, no bubble baths, cotton underwear, limit carbonated drinks
hydrocephalus what is it and s/s
disturbance of the ventricular circulation of cerebral spinal fluid. this fluid builds up and caused ICP
s/s: bulging fontanels with head enlargement, depressed or sunken eyes, setting sun sign
diagnosis hydrcephalus
head circumference
myelomeningocele
associated with hydrocephalus. when baby is born with spina bifida- protect the sack and dont let it rupture. sterile moist dressing and baby lies prone
scoliosis tx
3 O’s
observation
orthosis- supports and braces
operation- spinal fusion w rods
chicken pox
primary prevention
same virus causes shingles
infection of the lesions
virus that causes chicken pox
varicella zoster
sets reasonable limits on behavior, encourages growing autonomy of child, open communication
authoritative
no limit setting, lack of affection for the child, focus is on own life
indifferent
5 rights of delegation
right task right circumstances right person right direction right supervision
LPN and meds
can administer IVPB meds but not IV PUSH.
can monitor blood transfusions but cannot initiate it
administer meds in NG tube, G tube/button, J tube
insert and remove urinary catheters
fluid bolus
20 ml/kg