Newborn And Pediatric Final Flashcards
1
Q
What is the most common form of croup found in children
A
Viral
2
Q
What age group does croup affect
A
Ages 6 months to 5 years
3
Q
What are the most common causes of croup
A
Parainfluenza and RSV
4
Q
What are symptoms of croup
A
Rhinorrhea Sore throat LOW GRADE FEVER BARKY COUGH INSPIRATORY STRIDOR
5
Q
What is treatment for croup
A
It depends on the severity.
IV
IM
ORAL CORTICOSTEROIDS and nebulized epinephrine
These meds open airways. Never give oral meds to to a kid in severe respiratory distress who has STRIDOR
6
Q
Acute epiglottis
A
UPPER AIRWAY OBSTRUCTION
LIFE THRESTENING EMERGENCY
RARLEY SEEN DUE TO VACCINATIONS ( current cases due to u immunized kids)
H. Influenza is the causative agent
7
Q
What are the signs and symptoms of acute epiglottis
A
HIGH FEVER irritability Sore throat Hot potato voice INSPIRATORY STRIDOR Open mouth with protruding tongue Excessive drooling Respiratory distress ( tripod position)
8
Q
What is important to keep in mind while treating a kid with acute epiglottis
A
KEEP THE CHILD CALM. you do not want to obstruct the airway any further. Perform elective intubation by anesthesia and IV antibiotics and corticosteroids
- have a tracheostomy kit at bedside in case intubation fails
9
Q
How is acute epiglottis diagnosed
A
X Ray
10
Q
What is bronchiolitis caused by
A
A virus
11
Q
What is bronchiolitis most commonly caused by
A
RSV virus
Respiratory syncytial virus
12
Q
What does bronchiolitis cause
A
Edema, inflammation, and damage to the bronchiolar epithelium
13
Q
RSV antibodies are available for who
A
They are available via injection for the infants considered at high risk. ( low birth weight, preterm
14
Q
What are clinical manifestations of bronchiolitis
A
Wheezing Rhinorhea Tachypnea Retractions Coughing Intermittent fever Apneic spells Cyanosis
15
Q
How long is alveoli formed
A
It continues to grow for 5-8 yrs after birth
16
Q
What are meds for bronchiolitis
A
Synagis ( IM INJECTION) given to premature infants to prevent RSV
Ribavirin ( antiviral) given to children who are hospitalized
17
Q
What is therapeutic management for bronchiolitis
A
Humidifier oxygen
Adequate oral intake
Airway maintenance
BULB SYRINGE
18
Q
What are clinical manifestations of pneumonia
A
Cough Tachypnea Crackles Decreased breath sounds Chest pain Retractions Nasal flaring Pallor to cyanosis
19
Q
What are the types of pneumonia
A
Viral and bacterial
Only give bacterial pneumonia antibiotics. Treat the symptoms of viral pneumonia only do not give antibiotics. Viral pneumonia doesn’t show up in chest X-ray
20
Q
What is asthma
A
Chronic inflammatory disorder of the airways characterized by recurrent symptoms, airway obstruction, bronchial hyper responsiveness.
Inflammation causes recurrent episodes of wheezing, breathlessness, chest tightness, and cough.
21
Q
What 4 categories are asthma classified in
A
Intermittent
Mild persistent
Moderate persistent
Severe persistent
22
Q
What are triggers to asthma
A
Allergens Irritants Exposure to chemicals Exercise, cold air, changes in weather Colds or infections Animals Meds, strong emotions, food additives, foods, Endocrine factors
23
Q
What is the most chronic condition in children
A
Asthma
24
Q
When do children usually experience symptoms of asthma
A
Before age 5
25
What are the clinical manifestations of asthma that may develop gradually or abruptly
Dyspnea
Wheezing
Coughing
26
What meds are used for asthma
Corticosteroids ( anti inflammatory) are used to reverse airway obstruction, control symptoms, and reduce bronchial hyper responsiveness in chronic asthma. Administered orally, IV, and inhaled
Prednisone and prednisolone
B adrenergic agonists ( short acting) albuterol, xopenex, terbutaline. They are used in acute exasberations.
Anticholinergics atropine and strove to. It treats acute bronchospasm
27
What is true of albuterol
Always use a spacer
| It is a Rescue inhaler not to be given everyday
28
What is xopenex
Used if allergic to albuterol in asthma attacks
29
What is terbutaline
Used in asthmatic patients
| Comes in IV form must be on a monitor it is for very sick kids
30
What is a metered dose inhaler
It is used to deliver inhaled medication
| It must always be attached to a spacer to ensure all medication is delivered to the patient
31
What is needed for hydrocephalus
A shunt, to shunt the fluid away from the brain
32
What is cystic fibrosis
Inherited autosomal recessive trait characterized by increased viscosity of the mucous gland secretions, striking elevations of sweat electrolytes, increased in several organic enzymatic constituents of saliva, abnormalities in autonomic nervous system
33
What is the earliest postnatal manifestation of cystic fibrosis
- Meconium ileus ( failure to pass mecomium)
- Thick secretions block the bile ducts causing PANCREATIC FIBROSIS
- Steatorrhea
34
How is prolapse of the rectum caused
It is a GI complication of CYSTIC FIBROSIS caused by large, bulky, greasy stool, malnutrition, increased intra abdominal pressure secondary to cough.
35
What are Pulmonary complications of cystic fibrosis
- Produced by stagnation of mucous in the airways
- Eventual bacterial colonization leading to destruction of lung tissue.
- abnormal viscous and tenacious secretions are difficult to expectorate and gradually obstruct the bronchi and bronchioles amusing scattered areas of atelectasis and hyperinflation
36
What are reproductive system complications of cystic fibrosis
Infertility
37
What are growth and development complications of cystic fibrosis
Physical growth may be stunted due to decreased absorption of nutrients vitamins and fats
38
What is therapeutic management for cystic fibrosis
Prevent or minimize pulmonary complication
Eat well balanced HIGH PROTEIN, HIGH CALORIE DIET
ENCOURAGE APPROPRIATE PHYSICAL ACTIVITY
39
What is airway management for cystic fibrosis
Percuss for postural drainage
Bronchodilator to open bronchi for easier expectoration
DNase to decrease viscosity of the mucus
Nebulizer
40
What is therapeutic management for cystic fibrosis
Pancreatic enzymes ( can't live without them)
MUST BE TAKEN WOTH FOOD to ensure that it is mixed with food in the duodenum/it replaces the insufficiency
Enteric coated capsules
Swallowed whole or taken apart and sprinkled in food
41
What is the most prevalent disease in early childhood and has a higher incidence in winter months
Otitis media
42
What is otitis media mostly caused by
Bacteria
43
What is true of otitis media
It usually follows a viral respiratory infection
RSV
INFLUENZA
44
When does otitis media typically occur
Within the 1st 24 months
45
What are risk factors for otitis media
Genetic predisposition
| Living in a household that smokes
46
What are predisposing factors of otitis media
```
URI
ALLERGIES
DOWN SYNDROME
CLEFT PALATE
DAY CARE ATTENDANCE
SECOND HAND SMOKE
BOTTLE PROPPING DURING FEEDING
```
* breastfed babies have a lower incidence
47
What are clinical manifestations of otitis media
Follows a URI
EARACHE
FEVER
PURULENT DISCHARGE
48
What are symptoms of otitis media in infants and children
```
Crying
Restlessness/ irritability/ fussiness
Rub, hold, pull on affected ear
Rolling head from side to side
Difficulty comforting child
Loss of appetite,refusal to eat
```
49
What are clinical manifestations for chronic otitis media
Hearing loss
Difficulty communicating
Feeling of fullness, tinnitus, vertigo
50
What is true of a ruptured tympanic membrane
The child will no longer have pain
51
What is therapeutic management of otitis media
```
antibiotics
Myringotomy ( drain the ear)
Tympanostomy tube placement
Pain control
Antipyretics
```
52
How would one know the tympanic membrane has ruptured
Otoscope
53
Differentiate between asthma and croup,
Asthmatic patients experience wheezes and croup kids experience STRIDOR
54
Acute glomerular nephritis
Is an inflammation of the kidneys filtering mechanism - glomeruli
Frequently seen with kids with strep throat, can get it through toxins inhaled and excreted thru the urine
The antigen antibody complex attacks the body
55
Acute glomerular nephritis is commonly seen in children of what age
2-12 yrs old
| It's more frequent in boys
56
What are assessment findings of acute glomerular nephritis
Flu like symptoms
| Fatigue, N/V , loss of appetite, abdominal pain, joint pain, irritability, anemia.
57
What are characteristics of glomerular nephritis
```
Hematuria
Cola colored urine
Decreased urine output
Increased ESR- indicates inflammation
Increased antistreptolysin o (ASO)- indicates a recent streptococcus infection
Increased BP
```
58
What is treatment of glomerular nephritis
Antibiotics
Antihpertensives
Clear diet
Bed rest avoid carbonated beverages and dark drinks
59
What does billiary intresia affect
The liver
60
When is it important to give iron and why
Fetal iron stores are depleted between 4-6 months
| Intake of iron becomes essential
61
What is reye syndrome
A disorder defined as toxic encephalopathy, assoc with damage to the brain, kidneys, and liver
ASSOC WITH VIRAL INFECTIONS IN CHILDREN WHO TAKE ASPIRIN DO NOT GIVE ASPIRIN
62
What age group does reye syndrome generally affect
Ages 4-12
63
Why viral infections are Reye's typically seen with
Respiratory infection
Chicken pox
Diarrhea
64
What are nursing assessment of Reye's syndrome
Neuro-Assess signs of ICP. AssessLOC
Assess vital signs frequently- fever
Monitor LFT because fats build up,in the liver
Prepare for CT SCAN
65
What are interventions for reye syndrome
Initiate seizure precautions even if they don't have seizures
Monitor I&O closely 2/3 IV maintenance fluid
66
How would,you know someone has lead poisoning
```
N/V
Anorexia
Abdominal pain
Constipation
Pallor
Fatigue
Tachycardia
Stunted growth
History of pica
Behavior changes
Distractibility
Learning disabilities
```
67
What are classifications of heart disease
Class 1- asymptomatic no limitation of activity no signs of insufficiency
Class 2- symptomatic with slight limitations of activity
Class3- symptomatic marked limitation of activity
Class 4- symptomatic inability to carry out any physical activity without symptoms
68
What tests can be done during pregnancy to determine the extent of cardiac disease
EKG
PULSE OX
Chest x Ray ( late pregnancy 3rd trimester only)
69
How much does blood volume increase during pregnancy
By 40%
70
List common symptoms of cardiac de compensation in the pregnant woman
```
Dyspnea, SOB, edema
Increased fatigue, palpitations
Increased respiratory rate
Feeling of being smothered (air hunger)
Frequent cough with or without blood
Crackles over lungs
```
71
Which classification of drugs is commonly used prophylactically for pregnant woman diagnosed with valvular or congenital cardiac disease
Antibiotic
72
Types of abortion
Threatened/ some cramping, some backache, some bleeding CERVIX IS CLOSED
imminent/ cervix starts to dilate
Incomplete/ part of the products of conception are retained CERVIX IS DILATED
73
Identify the condition that is performed to treat the condition of incompetent cervix ( recurrent premature dilation of the cervix)
Cerclage/ stitch placed in internal os in cervix to prevent spontaneous abortion or premature birth/dilation
74
Characteristics of contractions
Frequency/ recorded in minutes
Duration/ recorded in seconds
Intensity/ how strong are the contractions
75
What is a oxytocin given for
It is given after delivery to contract the uterus to prevent bleeding
76
At 12 hr, where is the level of the fundus
At the level,of the umbilicus
77
Failure of the uterus to contract is called what
Uterine atony
78
Stage 1 of labor
The longest stage. There are 3 subphases.
1. Latent
2. Active
3. Transition
79
Describe the latent phase of the the first stage of labor
Begins with onset of regular contractions usually mild.
Little or no fetal descent is evident
Cervical dilation 0 to 3 cm
Averages 8.6 hours for 1st time moms not to exceed 20 hrs
Averages 5.3 hrs not to exceed 14 hrs
Contractions Q 3-30 min duration 30-40 sec
80
Described the active phase of labor
```
Intensification of contractions
Fetal descent is progressive
Cervix dilates 4 to 7 cm
Contractions Q 2-5 min duration 40-60 seconds
Contractions progress to strong
```
81
Describe Transition phase of the first stage of labor
Last part of 1st stage of labor
Cervical dilation slows as it progresses to 8-10 cm
Should be no longer than 3 hrs for 1st time moms and 1 hr for multi paras
82
2nd stage of labor
Begins when the cervix is fully dilated and ends with the birth of the infant
It usually occurs within 2 hrs after cervix is fully for primiparas and 15 min for multiparas.
83
3rd stage of labor
Period of time from birth of infant until the completed delivery of the placenta
84
4th stage of labor
The period of time from 1-4 hrs after birth in which psychological adjustment of the mothers body begins
85
What are the 2 most common forms of domestic violence
Intimate partner violence
| Sexual assault
86
Identify the 3 phase in the cycle of violence
Tension building phase
Acute battering incident
Tranquil phase
87
Identify the 4 rape trauma syndrome phases and list them in order
Acute phase or disorganization
Outward adjustment or denial phase
Reorganization phase
Integration phase
