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NPS - patient assessment > NPS- Pediatric Assessment > Flashcards

NPS- Pediatric Assessment Flashcards

1
Q

Explain obtunded

A

drowsy state, may have a decrease gag reflex and cough… patient should be admitted and assessed emergently

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2
Q

What is Euphoria

A

Drug overdose

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3
Q

If a patient is panicked what would you start thinking is wrong with the patient?

A

They cannot breath…. hypoxia, PTX, asthma attack

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4
Q

What are some assessments of daily living?

A

eating, dressing, walking, bathing, grooming, toilet use

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5
Q

Marasmus

A

inadequate energy intake which is normally seen in 6-18 mo

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6
Q

Kwashiorkor

A

lack of protein with normal energy intake, child will also have a protruding belly and edematous face and limbs

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7
Q

What does the Glasgow Coma Scale (GCS) monitor?

A

Eye opening

verbal response

motor response

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8
Q

If a patients GCS is low is that good or bad?

A

bad

13-15 high
9-12 moderate
3-8 is severe

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9
Q

A patients Glasgow coma scale is 5… what does that indicate?

A

Severe ! This isbad

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10
Q

You are trying to get a focused medical history or a patient….Using SAMPLE what is being assessed?

A

S- signs and symptoms
A- Allergies
M-Medications
P-Past medical history
L- Last meal eaten
E- Events leading to current illness or injury

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11
Q

What is subjective symptoms

A

Coming from the patient, their own opinion

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12
Q

Orthopnea

A

Difficulty breathing except when in the upright position

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13
Q

When a patient is feeling run down, nausea, weak, fatigue, headaches

A

General Malaisse

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14
Q

When a patient is feeling neusea, run down, and tired…. what should you consider?

A

electrolyte imbalance

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15
Q

Explain Dysphagia

A

difficulty swallowing and hoarseness

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16
Q

Normal WBC in pediatrics

A

5,000-10,000/mm

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17
Q

Normal Glucose in Peds

A

54-117 mg/dL

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18
Q

What is the gold standard test for cystic fibrosis

A

The Sweat Test or Sweat Chloride Test

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19
Q

Explain the Sweat Test

A
  1. Pilocarpine is injected into the skin to stimulate sweat production
  2. 2 + tests are necessary to dx. CF
  3. Normal value is <30 mmol/L
  4. CF is confirmed when value is >60 mmol/L
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20
Q

When is CF confirmed?

A

When sweat test is >60 mmol/L

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21
Q

What is used in the sweat test to produce sweat?

A

pilocarpine

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22
Q

excessive fluid in the tissue is known as what?

A

Pitting edema- ankles and feet also known as pedal edema

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23
Q

What is peripheral edema caused by?

A

fluid OL, CHF, and renal failure

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24
Q

What med is used to help with pedal edema?

A

Lasix, diuretic therapy

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25
Q

Clubbing of fingers is caused by what?

A

chronic hypoxemia

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26
Q

Venous distention occurs with what?

A

Fluid OL and CHF

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27
Q

Erythema

A

Redness of the skin

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28
Q

Pectus Carinatum

A

Anterior protrusion of the sternum

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29
Q

Pectus Excavatum

A

depression of part or all of the sternum

30
Q

Kyphosis

A

Hunchback or convex spinal curve

31
Q

Scoliosis

A

”s”

Lateral curvature of the spine

32
Q

Kyphoscoliosis

A

combo of both and causes a severe restrictive impairment

33
Q

Barrel chest

A

result of chronic air trapping/hyperinflation

34
Q

What diseases most commonly result in barrel chest?

A

Asthma and CF

35
Q

when would you see unequal movement in chest ?

A

atelectasis

PTX

Flail chest

An intubated patient with an ETT in one lung

36
Q

Normal RR for an infant

A

30-60 bpm

37
Q

Normal RR for toddler 1-3 yo

A

24-40

38
Q

normal RR for a pre-schooler 4-5 yo

A

22-34

39
Q

Eupnea

A

Normal RR, depth, and rhythm

40
Q

What would cause an increase in RR

A

fever
hypoxia
pain
anxiety
metabolic acidosis

41
Q

Oligopnea

A

Decrease in RR

42
Q

What would cause a decrease in RR

A

sleep (normal)
drugs
alcohol
metabolic disorders

43
Q

define apnea

A

cessation of breathing for >20 seconds

44
Q

Explain Cheyne Stokes

A

gradually increasing then decreasing RR lasting from 30-180 seconds with periods of apnea in between

45
Q

Cheyne Stokes and Biot’s breathing most commonly indicates what type of injury?

A

brain injury/CNS problem

46
Q

Kussmaul’s

A

increased RR, usually over 20 bpm, with increased depth, irregular, and breathing sounds labored

47
Q

What is the most common reason for Kussmauls breathing>

A

diabetic, metabolic acidosis

48
Q

Normal HR for 1-2 yo

A

80-130

49
Q

Normal HR for 2-6 yo

A

10-120

50
Q

Normal HR for 6-10 yo

A

70-110

51
Q

Normal HR for 10-16 yo

A

60-100B

52
Q

Bradycardia indicates what?

A

Heart failure, shock, CODE/EMERGENCY

53
Q

What should you do if a patients HR changes more than 20 BPM from BL during a therapy?

A

this is an adverse reaction

STOP therapy, notify RN and MD, document in chart

54
Q

If there is a change in rhythm what should you do?

A

further monitoring

55
Q

Explain paradoxical pulse or pulsus paradoxus

A

pulse/BP varies with respiration and may indicate air trapping such as status asthmaticus

56
Q

Tactile fremitus- what would cause increased transmission

A

consolidation
PNA

57
Q

Tactile fremitus- What would cause decreased transmission?

A

pleural effusion
lung cysts
bullae
PTX

58
Q

If a patient reports tenderness in chest or abdomen, what should you do?

A

further investigation

59
Q

Bronchial breath sounds that are heard over the trachea or bronchi are considered what?

A

normal

60
Q

bronchial breath sounds that are heard over the lung periphery (lower in the lungs) would indicate what?

A

consolidation

61
Q

Adventitious breath sounds means what?

A

abnormal

62
Q

crackles indicate what?

A

fluid

63
Q

unilateral wheeze indicates what?

A

foreign body aspiration

64
Q

stridor- supraglottic swelling is causes by what?

A

epiglottitis

65
Q

Describe tx for stridor

A
  1. topical vasoconstrictor ( rac epi) for swelling and edema
  2. sx’ing and or bronch for secretions and foreign body aspiration
  3. intubation for marked or profound swelling and epiglotisis
66
Q

Pt has marked/severe stridor, what should be done?

A

intubation

67
Q

A 1 yo BP is 70/40… is this normal or abnormal?

A

normal

68
Q

A 7 yo BP is 120/80…is this normal or abnormal?

A

abnormal…this is high

69
Q

Increased BP indicates what?

A

cardiac stress & hypoxemia

70
Q

Decreased BP indicates what?

A

poor perfusion & shock

NPS - patient assessment (9 decks)

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