Paediatrics Flashcards
<1 year old vital sign normal ranges
HR 110-160
RR 30-40
SBP 70-90
1-2 year old vital sign normal ranges
HR 100-150
RR 25-35
SBP 80-95
2-5 year old vital sign normal ranges
HR 95-140
RR 25-30
SBP 80-100
5-12 year old vital sign normal ranges
HR 80-120
RR 20-25
SBP 90-110
5 types of child abuse
Physical, emotional, sexual, neglect, family violence
Indicators of child abuse
Developmental delay, withdrawn, signs of depression/anxiety, attention seeking behaviours, models adult behaviour
Abnormal bruising (intentional) sites
Back, buttocks, back of thighs and calf muscle
Name 5 medication interventions utilised for broncospasm in the paediatric population
Corticosteroids, beta agonists, aminophyline, lidocaine, epinephrine
What is the FLACC scale?
Face, Legs, Activity, Cry, Consolability - observation tool for assessing pain
What ages is the FLACC scale used?
2 months to 7 years
How does the scoring of the FLACC scale work?
Each section has a score out of 3, 0 being the lowest level of pain.
For total scores
0 = relaxed
1-3 = mild discomfort
4-6 = moderate pain
7-10 = severe discomfort or pain or both
What is the Wong-Baker FACES Pain Scale?
Used for self-reporting of pain between the ages of 3-10. Faces showing expressions of sadness/pain along a number scale 0, 2, 4, 6, 8, 10. Children pick the face that they feel corresponds to their pain
What are three non-pharmacological treatment options for a child in pain?
Positive reinforcement, massage therapy, distraction techniques
Three main factors that predispose a newborn to excessive heat loss
Inability to shiver, large surface area, less subcutaneous fat
Which statement is false?
A) Newborns are at greater risk of hypothermia in hot environments.
B) Newborns are unable to adapt as easily to temperature changes in the environment.
C) Newborns require more layers of clothing to keep warm.
D) Newborns should be dried quickly after a bath.
A) Newborns are at greater risk of hypothermia in hot environments.
Can newborns produce heat through increased metabolism and oxygen consumption?
Yes
Congenital cardiac defects
Cardiomyopathy, coarction of aorta, atrial septal defect, ventricular septal defect, patent ductus arteriosus, tetralogy of fallots, transposition of great arteries
Which statement regarding rheumatic fever is false?
A) All sore throats in Māori and Pacific children, and young people (4-19 years) in some parts of the North Island need to be checked.
B) Rheumatic fever can cause the heart, joints, brain and skin to become inflamed and swollen.
C) Rheumatic fever can develop into rheumatic heart disease, and cause serious heart problems.
D) Rheumatic fever starts with a throat infection (strep throat), caused by the Group A Streptococcus bacteria.
E) Strep throat is unresponsive to antibiotics, and most strep throat infections lead to rheumatic fever.
E) Strep throat is unresponsive to antibiotics, and most strep throat infections lead to rheumatic fever.
What is atopy?
A) A predisposition to developing allergic reactions.
B) An allergic reaction that affects the respiratory tract.
C) An allergic reaction of the skin.
A) A predisposition to developing allergic reactions.
Immediate nursing interventions for a 3yr old child admitted with asthma and marked respiratory distress
Assess respiratory distress, administer oxygen, position patient for maximum ventilation and airway patency, administer prescribed meds, suction airway if needed, comfort, reassurance
Which statement regarding epiglottitis is false?
A) It involves swelling and inflammation of the epiglottis.
B) It is often caused by a bacterial infection.
C) It is more common in adults than in children.
D) It is more likely to develop in individuals with a weakened immune system.
C) It is more common in adults than in children.
Which of these reduce the risk of developing epiglottitis?
A) Up-to-date influenzae type b immunisation
B) Dairy free diet
C) Using an asthma preventer inhaler
A) Up-to-date influenzae type b immunisation
Which of the following statements regarding cystic fibrosis is true?
A) For a child to have CF, both parents must carry the abnormal gene.
B) For a child to have CF, only one parent must carry the abnormal gene.
C) For a child to have CF, the mother must carry the abnormal gene.
A) For a child to have CF, both parents must carry the abnormal gene.
What is genetic counselling?
It provides advice to parents who are concerned about the risks of genetic disorders in a future child.
How does genetic counselling relate to cystic fibrosis?
A genetic counsellor can help show the parents how the CF gene is passed down
Symptoms of cystic fibrosis
Coughing up thick mucus, weight loss or difficulty to gain weight, wheezing and SOB, constipation, stomach pain
Higher risk of development with cystic fibrosis
Pancreatitis, diabetes, liver disease, gall stones, low bone density, sinus infections, bronchitis, pneumonia
Two main productions of cystic fibrosis
Thick, sticky mucus and abnormally salty sweat
Pathophysiology of cystic fibrosis
Salt and chloride ions travel toward to skin surface to produce sweat, little is reabsorbed
What environmental factors can quickly cause an ionic balance for people with CF?
Exercise and hot weather
Symptoms of the ionic balance associated with CF
Fatigue, fever, muscle cramps, weakness, stomach pain, dehydration, vomiting, heat stroke
Main organs affected by thick, sticky mucus in CF
Lungs, pancreas, liver, intestines, kidneys
Is there a cure for cystic fibrosis?
No
Treatment and medication for cystic fibrosis
Massage techniques, antibiotics, anti-inflammatory, vitamin supplements, devices to help block the mucus and unblock airways, medication to facilitate digestion of fats and proteins
Treatment in severe cases of cystic fibrosis
Lung, pancreas, liver transplants
Three endocrine conditions in children
Cushing’s syndrome, hypothyroidism, acute adrenocortical insufficiency
True or false?
Type 2 diabetes generally develops after the age of 40 and is not associated with complete loss of insulin production.
True
Which of these statements about the kidney and urine is not true?
A) Only people who have glucose in their urine consistently can be diagnosed as having diabetes.
B) People can lose so much water in the urine in diabetes that they become clinically dehydrated.
C) Some diabetics never have any glucose in their urine.
D) When there is significant glucose in the urine, the rate of urine production is increased.
A) Only people who have glucose in their urine consistently can be diagnosed as having diabetes.