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Health And Healing > PAEDS FINAL Extras > Flashcards

PAEDS FINAL Extras Flashcards

1
Q

What is asthma?

A

Chronic airway disorder marked by:

Bronchoconstriction and Airway hyper-responsiveness to stimuli

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2
Q

What are common symptoms of asthma?

A 
Dyspnea
Wheezing
Cough
Sputum production
Chest tightness
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3
Q

What is status asthmaticus?

A

SEVERE bronchospasm that is NOT reversible by normal means.

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4
Q

What happens if status asthmaticus continues without treatment?

A

Hypoxemia -> decreased expiration -> increased acidosis

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5
Q 
A 11 year old is having an asthma attack. Which inhaler should they use?
A/ Ventolin
B/ Advair
C/ Singulair
D/ Flovent
A

A/ Ventolin

  • It is a short-acting bronchodilator, all others are long acting.
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6
Q

What is Sickle Cell Anemia?

A

Inherited blood disorder that leads to chronic hemolytic anemia and vaso-occlusive episodes. Defective hemoglobin molecule that causes RBCs to become sickle-shaped in hypoxic states that leads to the destruction of RBCs -> imparied circulation, pain, poor O2

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7
Q

What is Sickle Cell Crisis? How would the patient be presenting?

A

Acute exacerbation of the disorder. Patient has swollen extremities, pain, enlarged spleen -> can lead to hypovolemic shock/ decreased oxygenation/and or ventilation

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8
Q 
Which of the following is NOT a sign and symptom of Sickle Cell anemia?
A/ Redness of tissue
B/ Jaundice
C/ Swollen extremities
D/ Anemia
A

A/ Redness of tissues

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9
Q

What are some therapeutic management techniques of Sickle Cell disease?

A
  • Hydration
  • Antibiotics/Medications
  • Pain Management
  • Frequent rest periods to lessen chance of sickling
  • Bone marrow/stem cell transplant
  • Splenectomy
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10
Q

What is Cystic Fibrosis?

A

Genetic disease that affect the respiratory and digestive system and sweat glands. Characterized by Excessive and thick Mucous production

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11
Q

What are some signs and symptoms of Cystic Fibrosis?

A
  • Repeated lung infections
  • Cough with thick mucous
  • Breathing difficulties
  • Poor weight gain
  • Bulky-greasy stool
  • Salty skin
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12
Q 
Which of the following is NOT a therapeutic management of Cystic Fibrosis?
A/ Vitamins
B/ Oxygen therapy
C/ Antibiotics
D/ Bronchodilators
E/ Decreased physical activity
F/ Lung transplantation
A

E/ Decreased activity

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13
Q 
Which of the following is NOT a complication of Cystic Fibrosis?
A/ Diabeetus
B/ Respiratory failure
C/ Infertility
D/ Anemia
E/ Pneumonia
F/ Distal intestinal Obstruction syndrome
G/ Atelectasis
A

D/ Anemia

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14
Q

Gertrude is a 16 year-old slut who is admitted to hospital with acute chest infection and moderate weight loss. your nursing care involves?

A
  • Encourage fluid intake
  • Suctioning PRN
  • Antibiotics
  • Respiratory assessment and O2
  • Elevate head of Bed
  • Ensure they are taking enzymes and eating well (High fat/protein and calorie diet)
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15
Q

A 10 year old narcissistic prick comes into the ER presenting Abdominal pain, poor appetite, Nausea, fever, vomiting, rashes, and bloody diarrhea. What is their diagnosis and what treatment should you provide?

A

Either Crohn’s/Ulcerative colitis.

TX: 
NSAIDS
Enteral/parenteral nutrition
Fluid and electrolyte balance
Monitor weight
Rest
Low-fibre, high protein/calorie diet
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16
Q

What does the FLACC pain assessment tool look at to identify pain?

A 
F - Facial expression
L - Leg position/movement
A - Activity (Position, movements)
C - Cry
C - Consolability
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17
Q

WHat are some complications of giving Opioids to little tatter-tots?

A
  • HR/BP changes
  • Nausea Vomiting
  • Constipation
  • Urinary retention
  • Pruritus (Histamine release)
  • Sedation
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18
Q 
Hans is a 4 year old on morphine for pain management. Which of the following is an  abnormal sign of Morphine use in children?
A/ Hans is itchy
B/ Hans Is Sleepy
C/ Hans is hypotensive
D/ Hans is Dead
E/ Hans is sleepy
A

D/ Dead… Hans is Dead.

That is not okay with Hans’ family. You Killed Hans.

You
Killed
Hans

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19
Q

What should you monitor for when you pediatric patient in on opioids?

A 
LOC
SA02
Respirations
In and out
Allergies
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20
Q

What is Leukemia?

A

Cancer of lymphoid and hematopoietic tissue (Blood)

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21
Q

Elka is a 14 year old with ____lymphoma. Her symptoms include:
Involvement of the lymph node and metastasis to her liver, anorexia, and fatigue with Reed-Sternberg cells.

A

Hodgkin Lympoma

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22
Q

What are common side effects of chemo/radiation?

A
  • Infections/neutropenia
  • Hemorrhage
  • Anemia
  • Nausea and Emesis
  • Altered Nutrition
  • Mucosal ulceration
  • Fatigue
  • Neurologic problems
  • Alopecia
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23
Q

What are the three stages of adaptation + coping in children with Chronic Illness?

S.A.A.

A

Shock/Denial - Is a normal stage of the process but can become an issue if not moved through, and overcome.

Adjustment - Guilt/anger/overprotection that eventually leads to the acceptance of the condition.

Acknowledgement - Realism with realistic expectations. Family becomes an expert on the illness and how to manage it, and they begin to continue on with their life.

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24
Q

WHat are some common nursing interventions for families who have a child with a chronic illness?

A
  • Provide support
  • Therapeutic communication
  • Education
  • Giving them community-based resources
  • Promote independence
  • Teaching self-care practices
  • Realistic goal setting
25
Q

If Status Asthmaticus is left untreated, what occurs?

A

Hypoxia worsens -> Ventilation decreases -> reduced expiration -> ACIDOSIS

26
Q

What are some therapeutic management techniques for Asthma?

A
  • Bronchodilators (short and long acting)
  • Corticosteroids to reduce inflammation
  • Relaxation techniques
  • Management of triggers (Allergies, activities, environment)
  • Exercise
  • Chest physiotherapy
  • Health teaching/medication adherence
27
Q 
Which of the following would you take daily to prevent asthma? Select all that apply.
Ventolin
Serevent
Advair
Prednisone
Flovent
A

Serevent
Advair
Flovent

All of these are long-acting inhaled meds that prevent asthma. NOT TO BE USED IN ACUTE ATTACK

28
Q 
Which of the following is a combination of long-acting and an inhaled steroid?
A/ Flovent
B/ Advair
C/ Singulair
D/ Serevent
A

B/ Advair

29
Q

What are the goals of asthma therapy?

C.M.P.A

A

Control - symptoms

Maintain - normal activities

Prevent - acute episodes

Avoid - adverse effects of medications

30
Q

As a nurse, what do you do in the situation of an acute Asthmatic episode?

A
  • Ensure patent airway
  • Assessment (Resp. cardio, other)
  • Interventions (O2, meds, IV access, hydration)
  • History: What were you doing? What triggered attack? Interventions used?
  • Evaluation/Reassessment: Improvement?
  • Education
31
Q

WHat are some signs and symptoms of Sickle Cell crisis?

A

PAIN

Swollen limbs
Splenic enlargement
Hypovolemic shock
Chest pain due to sickling in chest -> resp issues

32
Q

What are some therapeutic management techniques for Sickle Cell anemia?

A 
Hydration -> increase BV
Penicillin -> prevent infections that arise during splenic issues
Meds -> promote RBC synthesis
Pain + fever management
Rest periods during strenuous activity
Bone Marrow Transplantation
Splenectomy
33
Q

What are some therapeutic management techniques for Cystic fibrosis?

A
  • Antibiotics (Prophylaxis)
  • Bronchodilators (Ventolin)
  • Mucolytics (Aid in mucous clearance)
  • Pancreatic enzymes (Breakdown mucous)
  • Vitamins
  • Chest Physiotherapy
  • O2 therapy
  • Diet modification (High calorie, protein & fat)
  • Physical Activity
  • Immunizations
  • Lung/liver transplant
34
Q

What are possible complications of Cystic Fibrosis?

A
  • Diabeetus
  • Pneumonia
  • Atelectasis
  • Bronchiectasis (Widening of Bronchus)
  • Hemoptysis (Coughing blood)
  • Respiratory Failure
  • Infertility
35
Q

DIfferentiate between Type I and Type II diabeetus.

A

Type I :

  • Genetic Disposition
  • Environmental Trigger (Sometimes occurs post viral)
  • Caused by destruction of B cells which secrete insulin.

Type II :

  • Genetic Disposition
  • Environmental Factors
  • Sedimentary lifestyle
36
Q

Differentiate between Hypoglycemia and Hyperglycemia.

A

Hypoglycemia - Insulin Overdose/decreased sugar
Caused by: Missed meals, overexertion, too much insulin

Hyperglycemia - Not Enough Insulin
Caused by: Failure to take insulin, Insulin pump failure, Acute stress, Febrile, Virus

37
Q

What is Diabetic Ketoacidosis? Symptoms?

A

A severely low amount of insulin in the body that can be life-threatening. Most common in Type I diabeetus.

Serum Glucose > 11 mmol/L
pH

38
Q

How do we treat Diabetic Ketoacidosis?

A

Administer Insulin
Assess
Give fluids to counteract dehydration + electrolyte imbalance (Dextrose solution to IV bag when glucose is

39
Q

Which type of inflammatory bowel disease can receive a blood transfusion?

A

Ulcerative colitis.

40
Q

How would we see pain in a child or infant if they are unable to state the presence of pain?

A
  • Changes in HR, Respirations, BP, O2
  • Shallow Respirations
  • Palmar Sweating
  • Transcutaneous Oxygen
  • Increased Muscle tone
41
Q

How does a child rate their pain on a Word scale or Verbal Analog Scale?

A

None
a Little
Medium
A lot

42
Q

What paediatric effects do Opioids have on the CNS?

A
  • Pain Suppression
  • Drowsiness/sedation
  • Miosis (Constricted pupils)
  • Euphoria/Dysphoria
  • Seizures
43
Q

What paediatric effects do Opioids have on the Cardiovascular and respiratory systems?

A

Cardiovascular

  • Hypotension (Morphine)
  • Bradycardia (Fentanyl, morphine)
  • tachycardia (Meperidine)

Respiratory

  • Decreased respiratory rate and volume
  • Decreased Sats
44
Q

What paediatric effects do Opioids have on the Gastrointestinal and Urinary Systems?

A

GI - Decreased peristalsis - constipation, nausea and vomiting

Genitourinary - Urine retention

45
Q

What are some non-pharmacological tx options for pain?

A
  • Distraction
  • Heat/cold
  • Relaxation
  • Guided imagery
  • Touch
  • Containment (Bundling)
  • Positioning
  • Non-nutritive sucking (Whip-out-the-nip)
  • Kangaroo holding
46
Q

How does the Bromage Sedation scale measure sedation?

A 
0 - Alert
1 - occasionally drowsy, easy to arouse
2 - Frequently drowsy, easy to arouse
3 - Somnolent, hard to arouse (That's what she said)
S - Normal sleep, easy to arouse
47
Q

What is the most common childhood cancer?

A

A.L.L.

Acute Lymphoblastic Leukemia

48
Q

What are common symptoms of leukemia in children due to bone marrow failure?

A

Anemia, Pallor
Fever
Bruising, petechiae
Bone pain

49
Q

What is the difference between a leukemia and a lymphoma?

A

Leukemias originate in stem cells of bone marrow

Lymphomas originate in lymphoid and hematopoietic systems.

50
Q

Differentiate between Hodgkin’s and non-Hodgkin’s Lymphoma in children

A

Hodgkin’s -

  • Older kids
  • REED-STERNBERG cells
  • Primarily involves lymph nodes
  • Usually metastisizes to other lymphatic tissues (Spleen, liver, bone marrow)

non-Hodgkin’s -

  • B-cell, T-cell, NK-cell lymphoma
  • Usually diffuse disease rather than nodular (All over)
  • HIGHLY AGGRESSIVE
51
Q

How might a lymphoma present in a child?

A

Painless enlargement of lymph node and Low fever, night sweats, anorexia, weight loss, fatigue

52
Q

What are common side effects of chemo/radiation?

A
  • Infection/neutropenia
  • Anemia
  • Hemorrhage
  • Nausea/emesis
  • Altered nutrition
  • Mucosal ulceration
  • Fatigue
  • Neurological problem
  • Alopecia/skin changes
53
Q

What are some goals of palliative care for children?

A
  • Support child/fam
  • Advocate for wishes and empower decisions
  • Educate
  • Assess child awareness of death and dying
54
Q

A nurse is with the parents of a 3-year-old child (Hans) who has just died. The most therapeutic question for the nurse to ask the parents is:
A/ “Do you feel ready to consent to an autopsy?”
B/ “Have you made a decision made about organ donation?”
C/ “Sweet holy Hell, it stinks in here…. no seriously who died?”
D/ “Can I be of any help with traditional practices that are important to you?”

A

D/

The nurse should be sensitive to any cultural or religious beliefs that may help the parents cope with their grief. Immediately discussing the topic of autopsy or organ donation is insensitive to the parents’ grief at this time.

55
Q 
A 30-month-old boy with cystic fibrosis is admitted to the pediatric unit with a severe upper respiratory infection. The toddler is small for his age. What pathologic process does the nurse know is the cause of his small stature?
A/ Increased salt retention
B/ An atrioventricular defect
C/ Retention of carbon dioxide
D/ An absence of pancreatic enzymes
A

D/

Fats, proteins, and carbohydrates are not digested because of a deficiency of pancreatic enzymes and therefore physical growth is hampered

56
Q

An adolescent who was admitted to the hospital with ketoacidosis is stable and receiving Novolin R subcutaneously. One hour after its administration the nurse enters the room and notes that the adolescent is diaphoretic and irritable. What is the nurse’s priority intervention?
A/ Delaying the client’s lunch tray
B/ Providing a glass of low-fat milk
C/ Obtaining a blood glucose reading
D/ Covering the client with a light blanket

A

C/

The adolescent is exhibiting signs of hypoglycemia; the blood glucose level should be determined so that the client’s status may be documented and appropriate treatment instituted. It may be necessary to offer food rather than withhold it if the client is having a hypoglycemic reaction.

57
Q

A 5-year-old kindergartener asks to go to the bathroom almost every hour. What is the most important question to ask when the school nurse calls the mother to inquire about this problem?
A/ “Has your child had a physical lately?”
B/ “Does your child wet the bed at night?”
C/ “Does your child have a short attention span?”
D/ “Has your child been going to the bathroom often at home?”

A

D/

If this behavior persists outside school as well, the nurse may pursue a physical examination to test for possible problems such as a urinary tract infection or diabetes.

58
Q 
When assessing the reflexes of a 4-month old, the nurse observes that the child is extending an arm to the side while the head is turned. Which reflex does the nurse observe?
A/ Extrusion reflex
B/ Trunk incurvation
C/ Tonic neck reflex
D/ Ankle clonus reflex
A

C/

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