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NCLEX > Pediatric > Flashcards

Pediatric Flashcards

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1
Q

Explain the difference between growth and development

A

Growth is increase in physical size

Development is increase in function

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2
Q

Does development follow chronological age

A

No

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3
Q

What is cephalocaudal development

A

It’s development that moves from head downward through the body toward feet

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4
Q

What is Proximodistal development

A

Development from center of the body to outward extremity

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5
Q

What kind of grasp reflex does a newborn have

A

Involuntary

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6
Q

Which fontanel closes first

A

Posterior

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7
Q

Around what month do the anterior fontanel close

A

12-18 months

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8
Q

Around what month do the posterior fontanel close

A

2-3 months

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9
Q

How do you position an earlobe to view the auditory canal in a child

A

down and back

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10
Q

How many cups should a 15 month toddler consume daily

A

2-3 cups

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11
Q

What age is the best friend stage

A

9-10

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12
Q

What are the major causes of accidents in children up to 1 year of age

A

Falls
Poisoning
Burns

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13
Q

What is the major cause of accidents in a 6-12 years

A

MVA

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14
Q

Does the growth rate of a 6-12 year of age increase or decrease

A

decreases

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15
Q

A school age child requires how many calories

A

2400 calories

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16
Q

Who develops earlier, girls or boys and about how many year difference

A

girls and 1-2 years

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17
Q

What is the order to obtain vital signs

A
  1. Respiration
  2. Heartbeats
  3. BP
  4. Temperature
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18
Q

With temperature when should you do a rectal temperature and when should you not

A

Children younger than 2

contraindicated for immunocomppresed or no rectum

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19
Q

With temperature when should you do an axillary

A

All ages if oral is not possible

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20
Q

With temperature when should you do an oral temp

A

start at 5-6 years

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21
Q

With temperature when should you do a tympanic temp

A

All ages

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22
Q

What age group uses non-verbal as their primary mode of communication

A

Newborn(birth-1month) and infants (1month -12 months)

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23
Q

What age group uses crying as a way to express themselves

A

Newborn(birth-1month) and infants (1month -12 months)

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24
Q

What age group responds to human voice and presence

A

Newborn(birth-1month) and infants (1month -12 months)

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25
Q

What age group allows the nurse to speak in high-pitched voice and cuddle and pat and rub to calm them

A

infants (1month -12 months)

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26
Q

What age group is mroe receptive to language than expressive

A

Toddler and preschooler (1-5 years)

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27
Q

What age group uses concrete thinking and may misinterpret phrases

A

Toddler and preschooler (1-5 years)

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28
Q

What age group may ask a lot of questions, has a short attention spam, limited memory

A

Toddler and preschooler (1-5 years)

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29
Q

What age group uses egocentric, magical thinkers animism and expresess themselves with playing and drawing

A

Toddler and preschooler (1-5 years)

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30
Q

What age group uses logic, understands points of view, understands cause and effect and body functioning

A

School age (6-12 years)

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31
Q

What age group uses big vocal, has both receptive and expressive language and still has misinterpretation of phases

A

School age (6-12 years)

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32
Q

What age group can interpret nonverbal messages, express thoughts and feelings

A

School age (6-12 years)

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33
Q

What age group uses abstract thinking, has limited interpretation of medical terminology,longs for independence, needs privacy

A

Adolescent 13-18 years

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34
Q

What nursing strategy must be used for adolescents 13-18 years

A

Straightforward approach, talk in private

Conduct some interview without parent presence

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35
Q

What are some signs of respiratory dysfunction

A
  • Accessory muscle use
  • Nasal flaring
  • Circumoral Pallor
  • Sternal retractions
  • Capillary refill>3 seconds
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36
Q

Laryngotracheobronchitis, an upper respiratory disease, common type is? who does it primarily affect and what is it caused by

A

Croup and affects children under 5 years. caused from viral infection

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37
Q

What are the S/S of Croup

A

Slight to severe dyspnea
Barking or brassy cough
Increased Temp

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38
Q

Treatment for Laryngotracheobronchitis(LTB)

A
  • Manage mild Croup at home: Steam, hot showers, car rides cool wind, cool temps.
  • Hospitalization: Nebulized Epinephrine (constrict edematous vessels)
  • Corticosteroids to decrease inflammation
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39
Q

What is the difference between epiglottitis and croup

A

Epiglottitis is serous obstructive inflammation
Absent of cough
Presence of Dysphagia and rapid progression to severe respiratory distress

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40
Q

What is RSV

A

RSV is respiratory syncytial Virus that is an acute viral infection that affects the bronchioles, which includes RSV bronchiolitis or RSV pneumonia

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41
Q

Who is at more danger for RSV

A

the very young, leading cause of illness in children less than 2 years

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42
Q

What are some risk factors related to RSV

A
  • Prematurity
  • Congenital disorders
  • Smoke
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43
Q

What can we do to prevent RSV

A

Immunize Palivizumab (Synagis) and RespiGam

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44
Q

If a person has

  • URI
  • Nasal discharge
  • mild fever
  • dyspnea
  • Nonproductive cough
  • tachypnea with flaring nares
  • Retraction and possible wheeze what are these s/s common for
A

RSV

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45
Q

When can you notice worsening of symptoms of RSV if not treated

A

Days 2 or 3

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46
Q

How do we treat Mild RSV

A

Supportive Care: antipyretics

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47
Q

How do we treat Severe RSV

A 
Suction
Oxygen (may need mechanical vent)
IV fluids
Albuterol (Proventil)
Antipyretics
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48
Q

What is pneumonia and how is it caused

A

Inflammation of lung

  • viral- RSV, parainfluenza, Adenovirus
  • Bacterial, Strep
  • Mycotic (walking pneumonia)
  • Aspiration pneumonia
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49
Q

What are some s/s of pneumonia

A
  • Fine crackles or rhonchi, productive or non-productive cough
  • Decreased or absent breath sounds
  • Abdominal distention
  • Back Pain
  • Fever high
  • Chest pain
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50
Q

How do we treat pneumonia

A

Depending on type

1) ABC
2) Oxygen
3) Fluids
4) Abx
5) Supportive care: hydration, antipyretics and nebs

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51
Q

What is Asthma

A

Inflammation and constriction of airways resulting in obstruction

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52
Q

What are some s/s of asthma

A
  • cough
  • SOB
  • Audible wheeze
  • prolonged expiratory wheeze
  • restlessness and cyanosis
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53
Q

What is important thing to note with asthma education

A

avoid triggers

Pets, food, environmental condition and emotions

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54
Q

What two body systems are affected with cystic fibrosis

A

Resp and Gi

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55
Q

What type of enzymes can be given to help improve digestion and what is important to mention

A

Pancreatic enzymes, do not crush or chew the enzymes

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56
Q

What kind of diet do you want a person with cystic fibrosis to be on

A

Well balance
low fat
high calories
high protein

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57
Q

What kind of vitamins does a person with cystic fibrosis need

A

Water soluble, including A, D, E and K

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58
Q

What kind of stool does a person with Cystic fibrosis have

A

Steahorrhea, fatty frothy stool

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59
Q

What test is used to dx cystic fibrosis

A

Sweat Chloride

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60
Q

What electrolyte imbalance does a child with Cystic fibrosis have

A

Hyponatremia

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61
Q

What is the earliest sign of cystic fibrosis in achild

A

Meconium ileus

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62
Q

What are the mucous secretions in a person with cystic fibrosis

A

thick and sticky

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63
Q

Is cystic fibrosis an inherited disease from only one parent

A

No from both

AUTOSOMAL RECESSIVE

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64
Q

What type of infection are Down Syndrome children most prone to develop

A

Respiratory, because of poor immune system

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65
Q

What is the most common defect in a person with down syndrome

A

Heart

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66
Q

What is the main reason for heart failure in children

A

Congenital heart defects

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67
Q

What are some early s/s of heart failure

A
  • increased pulse at rest and with slight exertion
  • increased resp rate
  • scalp sweating
  • fatigue
  • sudden weight gain
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68
Q

What do you think of with fluid retention

A

Heart problem

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69
Q

What treatments should you be doing for a child with heart failure

A
  • ongoing assessment
  • listen to lungs
  • control room temp
  • sit them up
  • rest
  • decrease stimuli
  • cool humidified oxygen
  • uninterrupted sleep
  • medications
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70
Q

What are some medications used to treat heart failure

A
  • Digoxin
  • Aceinhibitors
  • furosemides
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71
Q

What should we worry about in terms of weight in children

A

more than 1lb or more a day

72
Q

What is the main sign of dig toxicity

A

Bradycardia and vomitting

73
Q

When should you hold digoxin for infants

A

When pulse is less than 110

74
Q

When should you hold digoxin for children

A

When pulse is less than 70

75
Q

What is the normal dig level

A

0.8-2.0 ng/mL

76
Q

When is it safe to give digoxin

A

Either 1 hour before feeds or 2 hours after feedings

77
Q

Should you give digoxin with food, or give more if baby throws up, or if it’s past due it’s scheduled time, or more than 1 ml

A

NO

78
Q

Giving digoxin to children you should always check what?

A

Check the dose with another nurse

79
Q

What do you watch for with Ace Inhibitors

A

1) Decreased Bp
2) Kidney Problems
3) Dry Cough

80
Q

How does Ace inhibitors work

A

They block aldosterone and can cause hyperkalemia

81
Q

Why give furosemide with heart failures

A

To decrease volume

82
Q

What is a good scheduling for meals for a HF ped patient

A

every 3 hours, they should be well rested prior to eating and small frequent feeds

83
Q

What can you do to help the ped patient receive adequate nutrition when facing HF

A

Increase calories
Don’t prolong feeds longer than 30 mins
Use soft nipple with large opening so baby wont work so hard to get meals

84
Q

Do breastfeeding babies require more or less supplements for calories

A

More and do not restrict sodium/fluids

85
Q

What is a hypercyanotic spell

A

It’s a blue spells or “tet” spells and seen in infants with Tetralogy of Fallot

86
Q

Why would you give lavage feedings

A

If the patient is having respiratory distress

87
Q

What is tetralogy of fallot

A

4 defects

1) Ventricular Septal Defect
2) Stenosis of Pulmonary Artery
3) Overriding Aorta
4) Right Ventricular hypertrophy

88
Q

What’s the treatment for a hypercyanotic spell

A
  • put patient in knee chest position
  • give them 100% oxygen
  • Morphine for Sedation
  • Loose Clothes
  • Quiet play
  • No stress
  • Respond to crying quickly
  • Infections must be treated promptly
89
Q

Why put a patient in knee chest position

A

This position decreases venous return and increases systemic resistance

90
Q

What are some effects of Chronic Hypoxia

A
  • Polycthemia (increased RBC)
  • Clubbing (late sign of chronic hypoxia)
  • Poor growth and development
  • Squatting
91
Q

What is a congenital heart defect

A

It’s a structural or functional defect of the heart or greater vessel and is present at birth

92
Q

In children what are cardiac defects classified as

A

Blood flow patterns

  • increased pulmonary blood flow
  • obstructive defect
  • defect with decreased pulmonary blood flow
93
Q

For someone with a cleft palate or cleft lip what are we concerned about

A

nutrition

94
Q

Which do you correct first, cleft palate or cleft lip

A

Cleft lip

95
Q

What should you do frequently with a client that has a cleft palate and or lip

A

burp them

96
Q

After a cleft lip repair what position do you put the client and what do you place on the patient

A

Put them on their back, or side lying and use elbow restraints

97
Q

What do you clean the suture line post-op a cleft lip

A

Saline

98
Q

When is the best time to repair a cleft palate

A

Before speech develops around ages 1-2 years

99
Q

What should you avoid with a cleft palate repair

A

Avoid putting anything in the mouth

100
Q

What kind of diet do you have a patient that has a cleft palate repair

A

Soft diet

101
Q

Are speech defects common after a cleft palate repair

A

yes

102
Q

What is the difference between Gastroesophageal reflux and gastroesophageal reflux disease

A

GERD is the chronic form of GER
and its passage of gastric contents into esophagus
GERD tissue damage of resp structures and is worse

103
Q

A patient with GERD what position do you put them in for feeding and at night

A

upright position

104
Q

What position do you put a GERD patient in if you want to decrease reflux and improve emptying and decrease chance of aspiration

A

Elevated Prone position (30 degrees)

105
Q

What are some s/s of pyloric stenosis

A

projectile vomitting after feeds and they are always hungry after vomitting
olive shaped mass in epigastric region near umbilicus

106
Q

what is the dx for pyloric stenosis

A

Pyloric u/s

107
Q

What are the tx for pyloric stenosis

A

Hydration
I/O
Daily weights
Monitor specific gravity

108
Q

What is intussusception (interceptive bowel)

A

It is when a piece of bowel goes backward inside itself forming an obstruction

109
Q

When someone has a sudden onset, cramps, abdomnial pain intermittent, inconsolability, drawing up of knees, currant jelly stool (blood and mucous)
what are these s/s related to

A

Interceptive Bowel

110
Q

What should you be monitoring a client with interceptive bowel

A

The stool to see if it fixed itself

111
Q

What could tx an interceptive bowel

A

-enema
-surgery
and after resolved they keep patient in hospital for 3 days to make sure it doesn’t return

112
Q

What is celiac disease

A

It is a genetic malabsorption disorder where there is a permanent intestinal intolerance to gluten

113
Q

What is the treatment for celiac disease

A

No food with glutten
They cannot have BROW
Can have RCs

114
Q

What is BROW that celiac patients cannot have

A

Barley
Rye
Oats
Wheat

115
Q

What is RCS that the celiac patient can have

A

Rice

Corn and Soy

116
Q

What is Hirschsprung’s disease

A

It is a congenital anomaly aka aganglionic (part of the intestine not having any nerves) megacolon that results in mechanical obstruction, usually afffects sigmoid colon

117
Q

The s/s of a hirschsprung’s disease

A

Constipation
abodminal distention
ribbon like stool with foul smells

118
Q

The tx for hirschusprung’s disease

A

Remove portion of bowel that is diseased

May require 2 surgeries to give healing time

119
Q

What is a common infection in children more so young females affecting most commonly 2-24 months

A

UTI

120
Q

if a child has failure to thrive, feeding problems, has vomitting and diarrhea what could this show

A

UTI

121
Q

if UTI is untreated what could happen

A

Tissue could be destroyed and scarring occurs and this could lead to kidney failure

122
Q

What is important to teach families regarding UTI

A

That it could re-occur and hygeine

S/s anything fishy

123
Q

What are some pre-disposing factors related to UTI

A
  • Renal anomalies
  • Constipation
  • Displaced bladder
  • Poor hygeine
  • Pin worms
  • Sexual activity
124
Q

When are classic signs of UTI’s seen and what are they

A

Children greater than 2 years and

  • frequency
  • dysuria
  • Fever
  • Flank pain
  • Hematuria
125
Q

After 24 months do UTI’s incline or decline in males

A

Decline

126
Q

What is used to dx uti

A

urine samle through catherization is most accurate

127
Q

What are tx for UTI

A

Antibiotic therapy: PO or IV

128
Q

What do you include in a client with hematological disorders

A

Protective Isolation in their plan of care

129
Q

What is high risk for a patient with hematologic issues and what should be encouraged

A

Infection, good hand hygeine sterile technique

130
Q

What is sickle cell disease

A

Hereditary disorder in which hemoglobin is partly or completely replaced with a sickle cell hemoglobin

131
Q

What can occur with sickle cell crisis

A

decreased blood flow and decreased oxygen leads to pain

132
Q

What are some s/s related to sickle cell disease

A

Pain in areas of involvement (all sickle cell shaped floating and get tangled and form clot and impede blood flow causing pain)
Anorexia
Exercise intolerance

133
Q

What are some treatment options for someone with sickle cell disease

A 
Bed rest
hydration
analgesics
antibiotics
blood transfusion
oxygen
134
Q

What pain scale do you use for infants 2 months to 7 years of age

A

FLACC Scale

face, legs, activity, crying consolability

135
Q

What do you sue for children 3 years and older

A

Wong-Baker Pain rating scale (faces scale)

136
Q

What scale do you use for children 5 years and older

A

Numeric scale

137
Q

What is hydrocephalus

A

Disturbance of ventricular circulation of cerebral fluid in brain and causes increase cranial pressure

138
Q

What are the s/s of hydrocephalus

A
  • Bulding with palpatation of anterior fontanel
  • dilated scalp vein
  • depressed eyes
  • irritability and change in loc
  • high-pitched cry
  • setting sun sign
139
Q

What is the treatment for hydrocephalus

A

Insertion of VP (ventriculoperitoneal shunt)

140
Q

After inserting a VP shunt what kind of care do you provide

A
  • measure frontal occipital circumference
  • fontanel and cranial suture assessment
  • monitor temp
  • put them in supine position
141
Q

What is hydrocephalus associated with

A

Myelomeningocele which is a sac on the back that the baby born with spina bifida has

142
Q

What do you do with a patient that has a sac on the back (myelomeningocele)

A

Put the patient in prone position

cover sac with moist sterile normal saline dressing so it wont dry out

143
Q

What is scoliosis and when is it apparent

A

It is the lateral curvature and rotation of spine and is apparent before age 10 and can be genetic

144
Q

What contributes to scoliosis

A

heavy back pack
bags
carrying children on hips

145
Q

What is the treatment for scoliosis think 3 o’s

A

Observation
Orthosis (supports and braces)
Operation

146
Q

What is a common symptom related to lice and how can it be spread

A

itching through personal contact

147
Q

How are pin worms spread

A

Hand to mouth

148
Q

How do you collect a specimen to diagnose pin worm

A

Tape to rectum early in the morning

149
Q

Should the whole family be treated for pin worms

A

yes

150
Q

What are some s/s of pin worm

A
  • itching
  • general irritability
  • restlessness
  • poor sleep
  • bed wetting
  • distractibility
  • short attention spam
151
Q

What is mebendazole used to treat

A

Pin worms, also good hygeine and keeping fingernails short is good

152
Q

What causes chicken pox

A

Varicella zoster virus

153
Q

What are some home remedies that help with chicken pox

A

oatmeal baths

baking soda paste

154
Q

What does the varicella zoster cause in adults

A

Shingles

155
Q

What is the name of the virus that causes mononucleosis

A

Epstein Barr

156
Q

How is it spread

A

Through direct intimate contact (kissing disease)

157
Q

How should Mono be treated

A

Rest, analgesics and fluid

158
Q

What organ can be enlarged with Mono

A

Spleen therefore no contact sports

159
Q

After a tonsillectomy how should a client be positioned

A

Place on side and elevate HOB or Prone to prevent aspiration

160
Q

Do we give brown or red fluids post op a tonsillectomy

A

No

161
Q

What can indicate to the nurse of a hemorrhage after a tonsillectomy

A

Constant swallowing

162
Q

How many days post op is a client at risk for hemorrhage

A

up to 10 days

163
Q

What are some common complaints post op tonsillectomy

A

Sore throat and slight ear pain

Low grade temp and bad breath

164
Q

What part of the ear is affected with otitis media and what is blocked

A

middle and the eustachian tube is blocked

165
Q

What does an otitis media follow from

A

Upper respiratory infection

166
Q

What are some s/s related to otitis media

A

Tympanic membrane bulgy and bright red

167
Q

What are some treatments for Otitis media

A
  • heating pad
  • lie on affected side
  • avoid smoke
  • tympanostomy tube
168
Q

Should a client who has otitis media be chewing

A

No give soft foods

169
Q

What is a tympanostomy tube

A

It’s a tube used to drain fluid from middle ear

170
Q

Is it ok if tubes fall out, PE tubes or grommet tubes

A

Yes it’s ok

171
Q

How can we prevent otitis media

A
  • sit up baby for feeds
  • no bottle propping
  • No hard nose blowing
  • play blowing games
  • avoid smoke
172
Q

What should you do if tubes are in and you need to bath baby

A

wear ear plugs

173
Q

Why are peanuts dangerous when aspirated

A

They swell and crumble

174
Q

Why does a mentally challenged child often deliberately do things to displease

A

for attention

175
Q

Why don’t you give IM medications to the ventrogluteal muscle for children who have not been walking for at least a year

A

Because that muscle hasn’t developed yet

176
Q

After a perineal surgery what position do you put your client in post-op

A

Never PRONE

On the other side to decrease stress on suture line

177
Q

What do you give an infant if you want to make them vomit because it irritates their stomach

A

Syrup of Ipecac

NCLEX (21 decks)

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