Ped Review Flashcards
1
Q
What are 3 major causes of death in patients under 1 year of age?
A
Congenital anomalies, Prematurity, SIDS
2
Q
What is the number one cause of death in neonates?
A
Prematurity
3
Q
What should you attain from each visit?
A
Height/ length, weight, head circimference
4
Q
When should you take note of growth measurements?
A
When the patient is under the 5th percentile or over the 95th percentile
5
Q
Weight
A
doubles by 4-7 months, triples by first birthday
6
Q
True or False. Infants gain 5-7 oz. weekly?
A
TRUE
7
Q
True or False. Birth length increases by 50% at 6 months?
A
False, height increases by 50% at 12 months
8
Q
Posterior fontanel
A
Closes by 6-8th week
9
Q
Anterior fontanel
A
Closes by 12-18th month
10
Q
Normal temp.
A
36.5- 37.6
11
Q
Normal HR/ pulse
A
100-160, 180 if crying
12
Q
Normal RR
A
30-60
13
Q
True or False. Birth weight is regained in 3 weeks?
A
False. 2 weeks, depending on feeding method
14
Q
Solitary play
A
one-sided playing, no sharing
15
Q
Parallel play
A
plays alongside, but not with others
16
Q
Associative play
A
group play in similar or identical activities, but without rigid organization or rules
17
Q
Cooperative play
A
shares with and plays with others
18
Q
True or False. During a physical assessment, you should start with BP?
A
False. Start with least invasive procedure such as RR
19
Q
What is the best physical assessment approach for peds patients?
A
Observe then RR, HR, Temp, BP, organ systems assess. Palpate liver last
20
Q
When should you expect to see a social smile?
A
2 months
21
Q
When does head control usually occur?
A
4 months
22
Q
Rolls from abdomen to back?
A
5-6 months
23
Q
Plays peek-a-boo?
A
6 months
24
Q
When do infants transfer objects from one hand to the other?
A
7 months
25
When should children usually sit unsupported?
8 months
26
When would you expect infants to crawl?
9-10 months
27
What age would you expect to see infants wave goodbye?
10 months
28
What age are infants expected to walk with assistance?
10-12 months
29
In addition to MAMA and DADA, when should infants say a few words?
12 months
30
Identify appropriate toys that facilitate G&D for infants under the age of 1
Mobiles, rattles, squeaky toys, picture books, balls, colored blocks, activity boxes
31
Sucking reflex
elicited by placing a nipple or nonlatex gloved finger in the pt's mouth
32
Rooting reflex
elicited by stroking the cheek and noting the infant's response of turning towards the stimulating side and sucking
33
Babinski reflex
Stroking the outer sole of the foot upward from the heel across the ball of the foot, causes the big toe to dorsiflex and other toes to hyperextend
34
What age should infant's coo?
2 months
35
What is FLACC?
A pain assessment tool used to evaluate the child's FACIAL expression, LEG movement, ACTIVITY, CRY, CONSOLABILITY
36
True or False. NPASS is a pain assessment tool specific to preterm infants and babies with anomalies?
True. May be used in neonates as young as 23 weeks and up to infants 100 days old.
37
What does NPASS stand for?
Neonatal Pain, Agitation, and Sedation Scale
38
DDST, DDST-R, Denver II
The most widely used developmental screening test for young children. It determines if child is at the appropriate developmental stage for their age.
39
How is the Denver II interpreted?
Normal, suspect, or untestable
40
How many admissions have medication errors?
4- 17%
41
How many hospitalized patients suffer an adverse event?
4%
42
What are common cause of errors?
Distractions, increased workload, inexperienced staff, insufficient staffing, shift change, staff from agency, emergency situations
43
What are the consequences of medical errors?
Morbidity, mortality, cost
44
In addition to the 5 rights, what other rights should nurses consider in regards to medication?
Right reason, Right documentation
45
Identify 3 other causes for potential errors
Reconsitution error, wrong diluent, incorrect dilution amount, admin. of Rx that is too concentrated, incorrect rate, use of wrong port or IV line
46
For newborns and infants, what is the preferred ROA for IM injections
Vastus lateralis
47
For children 3 years of age and older, what is the preferred ROA for IM injections?
Deltoid
48
True or False. IM medications absorb the fastest?
False, medications adminsitered IV absorb the fastest.
49
Volutrol/ Buretrol
A type of infusion device that holds limited quantities of IV fluids or medications. Designed to prevent free flow of fluids or air once infusion is done.
50
True or False. Infants can handle large fluid influxes like adults?
False. Less able, 80% of body weight is fluid.
51
Schedule of visits during infancy include?
Newborn, 2 weeks, 2 months, 4 months, 6 months, 9 months, 12 months.
52
What 3 components should be addressed during each scheduled visit?
Safety, nutrition, health care
53
What safety issues are most important to discuss?
Car seats, SIDS prevention, smoke detectors, bath water temp., crib safety, sun exposure, walkers
54
What nutritonal issues should be discussed during visit?
Review feeding schedules, solid-food introduction, picky eater concerns
55
In regards to health care, what issues should be discussed during visits?
Vaccines, dental, next visit
56
True or False. The dangers children get into are directly related to their developmental capabilities
TRUE
57
True or False. Age appropriate guidance is only important to give to the baby?
False, nurses should give age appropriate guidance to baby and age appropriate teaching strategies to the parents
58
Name 3 common safety issues for infants and toddlers
Car safety, pets/ allergens, poisoning, toys, medications
59
True or False, 1/2 of injuries occur at home
False, 2/3.
60
Unintentional injuries such as MVAs are the number 1 cause of death in children age 1- 24, T or F.
TRUE
61
Car Safety seats depend on age, T or F?
False, recommendations for car seats depends on weight and age.
62
Who should sit in backward facing bucket seats?
Infants up to 1 year and up to 20lbs.
63
Who should be restrained in forward facing car seats?
Children over 1 year and over 20lbs until they're 6 years of age and/or 60lbs.
64
What other measures are included to reduce SIDS?
Use a firm sleep surface, practice room-sharing without bed- sharing, use a fitted sheet, no loose bedding or soft objects in crib, avoid overheating.
65
True or False. Newborns gain 4-7oz. a week?
TRUE
66
How long should Back to Sleep PLUS measures be followed?
Should be followed for a year
67
Why aren't vitamin D levels checked before 2 months?
Passive immunity, lasts up to 6 months
68
What is HEADSS?
Teen assessment tool/ Psychosocial interview for adolescents
69
What information is gathered during a HEADDS assessment?
Home and environment, Education, Activities, Drugs, Sexuality, Safety/ Suicide/ Depression
70
Morbidity and mortality in teens is commonly caused by disease, True or False?
False, physically damaging behaviors such as depression, suicide, obesity, and substance abuse are the cause, not disease.
71
What important questions should you ask when you see a rash?
Immunization status, traveled outide of the US, Prodrome, When/ Where did it start, Painful or Pruritic, Tx used at home
72
Chickenpox
Child is only contagious 1 day before eruption of lesions and up to 6 days after the lesions crust
73
What precautions should be in place for patient with Chickenpox?
Maintain contact, respiratory, droplet precautions until all lesions are crusted.
74
What supportive treatment should you promote when a child has Chickenpox?
Low dose BENADRYL to decrease itch, good skin care
75
What nursing care could you give a patient with Chickenpox?
Give bath, change clothes and linen daily, keep child cool, low dose benadryl
76
What are the clinical manifestations of Measles/ Rubeola? Hint, 3 C's.
Koplik spots, coryza, photophobia. Coryza, cough, conjuctivitis
77
What type of ISOLATION would you expect for a patient diagnosed with Measles?
Maintain respiratory isolation until 5th day of rash, institute droplet precaution if child is hospitalized.
78
What complications can occurs from Measles/ Rubeola?
Otitis media, pnemonia, encephalitis.
79
As a nurse, what supportive treatments can you provide to patients suffering with Measles/ Rubeola?
Administer antipyretics for fever, eye care, cool mist vaporizer for cough, tepid bath to improve skin care
80
True or False. The prodrome period for Measles/ Rubeola is 7 days?
False. 3- 5 days.
81
Exanthem Subitum/ Roseola
Caused by Herpesvirus type 6, peak at 18 months.
82
Symptoms of Exanthem subitum include
Sudden high fever up to 105F, febrile seizures, pink discrete maculopapular rash
83
What should you discuss with the parents of children diagnosed with Roseola?
Teach measures for lowering temperature with antipyretic Rx, discuss appropriate precautions and possibility of recurrent febrile seizures.
84
Erythema Infectiosum/ Fifth Disease
caused by Human parovirus B19
85
True or False. Isolation is necessary for patient diagnosed with Erythema Infectiosum/ Fifth disease?
False, isolation is not necessary, except hospitalized child suspected of HBV infection is placed on respiratory isolation and standard precaution.
86
Classic slapped-cheek appearance
Erythema Infectiosum, usually disappears with 1-4 days but then spreads to extremities
87
True or False. Blood tests that look for antibodies against parovirus B19 is used for exposed pregnant women?
TRUE
88
Body rash followed by lace-like pattern of erythema that persists up to 2 weeks
Characteristics of Erythema Infectiosum/ Fifth Disease
89
Characteristics of Measles/ Rubeola
Confluent maculopapular rash
90
Charateristics of Chickenpox
No or mild prodrome, superficial vesicles, pruitic, crops in different stages, concentrated on trunk.
91
True or False, CRIES is a pain rating scale that can be used with infants 32 to 60 weeks of gestational age?
TRUE
92
What two viruses are most likely to precipitate Otitis Media (OM)?
RSV and Influenza
93
Otitis Media
May occur because of blocked eustachian tubes from the edema of URIs, allergic rhinitis, or hypertrophic adenoids.
94
True or False. Many cases of bacterial OM are preceded by a viral respiratory infection?
TRUE
95
True or False. Children living in households with many members (especially smokers) are more likely to have OM?
TRUE
96
What is the pathophysiology of OM?
OM is primarily the result of malfunctioning eustachian tubes. Mechanical or functional obstruction of these tubes causes accumulation of secretions in the middle ear. Obstruction results in negative middle ear pressure and produces a transudative middle
