Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pediatrics > Pediatric Growth and Development > Flashcards

Pediatric Growth and Development Flashcards

1
Q

gross motor: 0-4 months

A

start to gain control of head by 2 months; able to turn from abdomen to back by 4 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

physical growth: 0-4 months

A

gain 5-4oz/week for first 6 months; grow 2.5cm/1in per week in first 6 months; head circumference increases by 1.5cm/0.5in per week for first 6 months; posterior fontanelle closes by 2 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

fine motor: 0-4 months

A

grasp reflex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Erikson stage: 0-4 months

A

trust vs. mistrust; needs nourishment, attachment, and attention; learn whether people are reliable or not

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Health promotion: 0-4 months

A

APGAR scoring, eye care (erythromycin), vitamin K shot, hep b vaccine, newborn screening, bathing and umbilical care, circumcision, feeding, bonding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

physical growth: 5-8 months

A

first tooth may form (not reliable); gain 5-7 oz/week for first 6 months; grow 2.5cm/1in per week for first 6 months; birth weight doubles 5-6 months; responds to own name by 7 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

gross motor: 5-8 months

A

turns from back to abdomen by 6 months; lift head up by 6 months; sits unattended by 7 months; locomotion, crawling, creeping by 8 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

erikson stage: 5-8 months

A

trust vs. mistrust; infants learn to trust that caregivers will meet basic needs (nourishment, attention, attachment), if needs not consistently met then mistrust, suspicion, and anxiety develop; age birth until 1 year

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

fine motor: 5-8 months

A

transferring objects from hand to hand by 6-8 months; grasp reflex progresses to pincer grasp from 8-9 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

health promotion: 5-8 months

A

introduction of solid food from 6-12 months; keeping up with vaccine schedule (diptheria, tetanus, whooping cough, polio, hep B, hib (dose 3/3))

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

physical growth: 9-12 months

A

birth length increased by 50% and anterior fontanelle almost closed by 12 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

fine motor: 9-12 months

A

begins to use pincer grasp to pick up small objects; able to stack two blocks; may show dominance of one hand over another

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

gross motor: 9-12 months

A

cruising and deliberate steps by 10 months; walking by 12 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

erikson stage: 9-12 months

A

trust and mistrust

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

health promotion: 9-12 months

A

vaccination compliance; injury prevention

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

physical growth: 12-36 months (toddler)

A

height and weight trends; head circumference

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

fine motor: 12-36 months (toddler)

A

can hold crayon by 1 year; can draw simple shapes by 2-3 years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

gross motor: 12-36 months (toddler)

A

jump, kick ball, pedal tricycle all by 3 years; take 2-3 steps independently by 1 year; pulls self up to stand

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

erikson stage: 12-36 months (toddler)

A

autonomy vs. doubt and shame; learning to do things on own; become more independent; going to bathroom on own and learn to dress self on own; use words like “no, me, do” and develop sense of control

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

health promotion: 12-36 months (toddler)

A

interest in toilet training, parallel play, temper trantrums are common, transitional objects for safety, need 11-2 hours sleep at night, remain in backward facing car seat (5 point restraint), can transition to forward facing car seat at 2 years, ritualism- setting routines and expectations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

physical growth: 3-5yo (preschool)

A

gain 4-5lbs per year, grow 2-3 in per year

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

gross motor: 3-5yo (preschool)

A

develop running, jumping, kicking skills; develop swimming and biking; able to hop on one foot at 4-5yo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

erikson stage: 3-5yo (preschool)

A

initiative vs. guilt, magical thinking

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

fine motor: 3-5yo (preschool)

A

dominant hand development; cutting, drawing straight and curved lines, discernible pictures at 4-5yo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

health promotion: 3-5yo (preschool)

A

immunizations, motor vehicle safety, sleep 10-12 hours with possible nap, school readiness, dental health; pedestrian, drowning, fire, firearm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

physical growth: 5-12yo (school age)

A

slow and steady pace of height and weight growth, in beginning growth boys height/weight > girls, end growth girls height/weight > boys; pre-adolescence (8-12) body issues begin; puberty onset 9-10 for girls and 9.5-14 in boys (consists of breast buds and testicular enlargement)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

erikson stage: 5-12 yo (school age)

A

industry vs. inferiority; industry- stage of accomplishment, seeking to gain competence, acquisition of new skills, assume new responsibilities, develop sense of confidence in new skills

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

social: 5-12yo (school age)

A

strong identification with peers, associate with same sex, group activities, conformity and rules to be “in” or “out”, social relationships are important, peer pressure is present, bullying can be an issue during this time

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

health promotion: 5-12yo (school age)

A

encourage persona responsibility for hygiene, nutrition, exercises, sleep, and safety; injury prevention like helmets, sports equipment, protective wear

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

physical growth: 13-18yo (adolescent)

A

puberty- girls grow 2-8 in height and gain 15-55lbs, boys grow 4.5-12 in height and gain 15-65lbs, increase in sex hormones causing secondary sex characteristics such as growth in breast tissues, scrotum, and body hair

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

social: 13-18yo (adolescent)

A

employment and education, eating, sexuality, activities, suicide/depression, home, safety, drugser

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

erikson: 13-18yo (adolescent)

A

identity vs. role confusion; search for sense of self and personal identity through intense exploration of personal value, beliefs, and goals

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

health promotion: 13-18yo (adolescent)

A

nutrition, sleep 8-10 hours, STD prevention, sex education, exercise, screen for substance use, screen for depression, screen for suicidal ideation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

atraumatic care

A

providing therapeutic care through use of interventions that eliminate/minimize psychological and physical distress experienced by children and their families

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

overriding goal of atraumatic care

A

do no harm; prevent/minimize child separation from family, promote sense of control (ask which arm they prefer for injection), prevent/minimize bodily injury and pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

3 major factors of family centered care

A

recognize family as constant in childs life, considers needs of all family members in relation to care of the child, philosophy acknowledges diversity amongst family structures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

9 elements of family centered care

A
  1. incorporate into policy/practice recognition of family as a constant; 2. facilitate family-professional collaborations at all levels of care; 3. exchange information between family and professionals (fam knows pt best); 4. incorporate recognition and honor of cultural diversity, strengths and individuality within/across all families; 5. recognize/respect different methods of coping; 6. encourage family to family support and networking; 7. ensure home, hospital, and community support systems for child with specialized health and developmental care; 8. appreciate families as families and children as children
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

nursing care of the hospitalized child

A

preparation for admission, admission; introduction (parent first then pt), orientation (to the unit and answer questions), set expectations, history and assessment (want to know baseline of pt at home), patient and family support; prepare for discharge (begins on admission)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

nursing interventions for hospitalized child

A

promote freedom of movement when applicable, maintain routine, encourage independence, promote understanding, provide developmentally appropriate activities, provide opportunities to play, provide socialization, foster parent-child relationships, provide educational opportunities

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

first vaccine given after birth

A

hepatitis B due to the transmission of the virus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

treatment of reactions to vaccines

A

encourage fluids to stay hydrated; cool damp cloth to reduce redness, soreness, and swelling; reduce fever with cool sponge bath; ask about giving non-steroidal anti-inflammatory drug

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

eriksons stages of psychosocial development

A

infant to 18 months- trust vs. mistrust; 18 mo to 3 years- autonomy vs. shame and doubt; 3 to 5 years- initiative vs. guilt; 5-13 years- industry vs. inferiority; 13 to 21 years- identity vs. role confusion; 21 to 39- intimacy vs. isolation; 40 to 65- generativity vs. stagnation; 65 and older- ego integrity vs. despair

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

pediatric morphine dose

A

IV- 0.05-2 mg/kg q 2-4h; PO- 0.2-0.5 mg/kg q 4-6h

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

true or false: newborns do not feel pain

A

FALSE; newborns do feel pain; the neurologic and hormonal systems are sufficiently developed for transmission of pain stimuli

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

True or False: exposure to pain at an early age has little to no effect on the child

A

FALSE; prolonged or severe pain can lead to increased newborn morbidity; newborns who experienced pain during neonatal period respond differently to subsequent pain; repeated exposure to pain can have long-term consequences

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

True or False: infants and small children have little memory of pain

A

FALSE; memories of pain may be stored in childs nervous system influencing later reactions to painful stimulil

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

True or False: the intensity of a childs behavioral reaction indicates the intensity of the childs pain

A

FALSE; numerous factors affect a childs response to pain; each child is different

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

True or False: a child that is sleeping is not in pain

A

False; sleep may be a coping mechanism for a child in pain or it may reflect exhaustion from dealing with pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

True or false: children are truthful when they are asked if they are experiencing pain

A

False; often children deny pain to avoid painful stimulation, embarassment, procedures, or loss of control

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

true or false: children learn to adapt to pain and painful procedures

A

false; repeated exposure to pain or painful procedure can result in increase in behavioral manifestations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

true or false: children experience more adverse effects of narcotics and analgesics then adults

A

False; risk of adverse effects of narcotics/analgesics is the same for children as adults

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

true or false: children are more prone to addiction to narcotics/analgesics

A

false; addiction to narcotics when used in children is very rare

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

observational pain measurements are…

A

assessing body expressions with validated tools; more reliable for short sharp pain; less reliable for recurrent/chronic pain; reliable for infants and young children; may not correlate with childs self-reported pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

when to use observational pain scales

A

neonates and children around age 4 or for children who are unable to report pain due to issue effecting communication

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

observational pain scale tools

A

FLACC, PIPP, NCCPC, COMFORT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

FLACC pain scale

A

face, legs, activity, cry, consolability; used for ages 2 months - 7 years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

PIPP pain scale

A

premature infant pain profile; used to determine pain in premature infants but depends on gestational age

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

NCCPC pain scale

A

non-communicating childrens pain checklist; need to know childs baseline (caretaker knows best)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

COMFORT pain scale

A

behavioral and unobtrusive method of measuring distress in unconscious and vented infants/children/adolescents; consist of 8 indicators: alertness, calmness/agitation, respiratory response, physical movement, blood pressure, heart rate, muscle tone, facial tension; scored 1-5 for each category and is ranked from 8-40

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

self reporting pain scales

A

use faces chart for 3-7 years old; use NRS for 8 years and older

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

Wong-baker FACES pain scale

A

smiling face is no pain, tearful is worst pain; widely used in US; used for ages 3-7yr

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

NRS pain scale

A

numeric pain scale from 0-10; used for children 8+ years; widely used and easy to use

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

pediatric pain questionairre

A

assesses patient and parental perception of pain experienced in manner appropriate for cognitive development level of child/adolescent; consists of information about 8 areas: pain HX, pain language, colors children associate with pain, emotions children experience, worst pain experiences, ways which child copes with pain, positive aspects of pain, location of current pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

pain prevention with needles

A

DO NOT LIE TO CHILDREN, PROVIDE DISTRACTION, GIVE CONTROL OPTIONS, REWARD OPTIONS; if its going to hurt let them know; infants- breast feeding, sucrose, skin to skin, pacifier; toddlers/small children- comfort holds; older children- deep breathing, distraction, hypnosis, virtual reality

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

pharmacologic methods for pain management in children

A

anesthetic creams like EMLA or LMX which is topical analgesia for short term procedures (takes 1 hour for effect); needle-free jet injection with buffered lidocaine is j tip (10-30 second onset)

65
Q

biobehavioral interventions for pain management in children

A

meditation, distraction, play therapy, relaxation, music

66
Q

types of pharmacological pain management

A

non-opioid for mild to moderate pain; opioids for moderate to severe pain; epidural at any vertebral level; PCA/NCA where patient or nurse controls amount and frequency of administration; topicals like lidocaine

67
Q

2 step process for pharmacological pain management in pediatrics

A

step 1- non-opioid analgesics for pt > 3 months and biobehavioral methods (acetaminophen and ibuprofen/motrin); step 2- opioids but used as step 1 if severe pain and step 2 if pain unrelieved by non-opioids and biobehavioral

68
Q

acetaminophen/tylenol dosing for pediatrics

A

10-15 mg/kg q 4-6h

69
Q

ibuprofen/motrin dosing for pediatrics

A

5-10 mg/kg q 6-8h (can be used for infants > 6mo

70
Q

if giving tylenol and motrin together…

A

stagger every 2 hours

71
Q

most common pediatric opioid

A

morphine

72
Q

airway resistance

A

the effort of force required to move air into the lungs; depends on diameter of airway; narrowing of airway increases resistance and increases work off breathing

73
Q

respiratory assessment criteria

A

movement- symmetrical, coordinated, retractions; rate- bpm; rhythm- regular, irregular, periodic; depth- deep or shallow; quality- effortless and automatic or difficult and labored; breath sounds- noisy, grunting, snoring, heavy

74
Q

breath sounds assessment criteria

A

normal breath sounds- inspiration is longer, louder, higher pitched; infants are obligatory nose breathers until ~4 weeks

75
Q

tachypnea

A

> 60 in infants under 2 months; > 50 in infants 2-12 months; > 40 in children 1 year and older

76
Q

signs of respiratory distress in pediatrics

A

retractions, nasal flaring, head bobbing, grunting, cough, color changes, adventitious breath sounds

77
Q

retractions locations

A

intercostal- in between ribs, suprasternal- right above sternal notch, supraclavicular- right above each collar bone, subcostal- below the rib cages on insides, substernal- below xiphoid process

78
Q

meds for aerosol/nebulizer therapy

A

bronchodilators like albuterol, steroids and anticholinergics, antibiotic nebulizers

79
Q

acute laryngo-tracheobrochitis (LTB)

A

aka croup; relatively minor and self-limiting upper airway obstruction; inflammation and obstruction of upper airway (larynx and trachea) d/t viral infection; preceded by URI like RSV, parainfluenza virus, influenza A and B

80
Q

manifestations of LTB or croup

A

barking cough and stridor that worsens at night; can cause respiratory distress, low grade fever; anxiety and restlessness; can see hypoxemia, respiratory exhaustion, CO2 accumulation (acidosis)

81
Q

management and nursing care of LTB/croup

A

maintain airway, adequate respiratory exchange; interventions are cool mist or humidified air, cool air, ice cream, sleep upright, racemic epi, oral steroids like dexamethasone

82
Q

acute epiglottitis

A

serious obstructive inflammatory process of epiglottits which has potential for complete respiratory obstruction; usually affects ages 2-5yr; not very common

83
Q

manifestations of acute epiglottitis

A

4 D’s- dyspnea, dysphagia, dysphonia, drooling; abrupt onset, sore throat, fever, elevated WBC, tripod position to breath, apprehension

84
Q

definitive diagnosis of acute epiglottitis

A

cherry red, swollen epiglottis is visualized; examining back of throat can cause total trachea occlusion; NEVER assess throat if suspecting epiglottitis; have intubation and tracheostomy set available if physician examining throat

85
Q

epiglottitis nursing considerations

A

assist with intubation (can be very difficult); admin meds like epi to reverse inflammation, IV antibiotics to treat infection, anti-pyretics as ordered, admin oxygen as needed, suctions as needed, monitor for respiratory distress; anxiety/fear/copin- allow for positional comfort and use biobehavioral interventions

86
Q

pharyngitis/tonsillitis

A

inflammation of pharynx and tosils (pharyngeal tonsils); caused by viruses and group A beta hemolytic strep (streptococcus pyogenes)

87
Q

clinical manifestations of pharyngitis/tonsillitis

A

marked enlargement of “palatine” tonsils often known as “kissing tonsils”; risk for airway occlusion; can still swallow but causes pain

88
Q

treatment of acute pharyngitis/tonsillitis

A

throat culture and group A strep- panicillin is antibiotic of choice (10 day course); macrolide or cephalosporin if allergies; kept isolate for 24 hours then return to school; if compliance issue then may be given IM penicillin G

89
Q

if pharyngitis/tonsillitis not treated for GABHS…

A

risk scarlett fever or peritonsillar abscess

90
Q

nursing care for acute pharyngitis/tonsillitis

A

collect throat culture, educate need to complete entire medication course, explain infection control measures, promote comfort measures, prep for surgery if needed

91
Q

care of tonsillectomy and adenoidectomy

A

rarely performed under 3 yrs for d/t risk of bleeding and tonsillar regrowth, maintain airway with position, observe for bleeding and prevent recurrent bleeding, maintain quiet environment to minimize agitation/crying, soft cold food diet, manage pain, observe for post op hemorrhage (rare but serious)

92
Q

acute otitis media

A

inflammation of ear/ear infection; presence of fluid in middle ear with acute signs of illness and symptoms of middle ear infection; can be bacterial or viral

93
Q

reasons for children developing acute otitis media

A

short horizontal eustachian tube, enlarged lymphoid tissue, mechanical or functional obstruction of eustachian tube, immature humoral defenses

94
Q

otitis media manifestations

A

irritability- pulling or tugging on ear, ear pain, purulent drainage from ear, fever, red bulging tympanic membrane, may have respiratory infection like rhinorrhea and cough; complications can be perforated ear drum or hearing loss

95
Q

diagnosing otitis media

A

HX of OM, inspection with otoscope shows red bulging tympanic membrane

96
Q

therapeutic management of otitis media

A

watcha dn wait for 48-72 hours for immune system to fight infection, pain control with analgesic (acet. and ibuprofen if > 6 mo), antipyretic; antibiotics if needed (amoxicillin for 5-7 days); surgical myringotomy if necessary

97
Q

myringotomy

A

surgical opening in ear to remove trapped fluid and then insertion of myringotomy tubes to allow air and prevent fluid build up

98
Q

nursing considerations for otitis media

A

pain and fever control, facilitate drainage, antibiotic adherence, reduce OM occurrence, promote immunization of Hib and prevnar 13 to reduce incidence of acute otitis media, educate feeding and positioning and avoiding cigarette smoke

99
Q

otitis externa

A

aka swimmers ear; inflammation of ear canal; tenderness when touching outside of ear, canal filled with purulent discharge; rapid onset and treated with drops; usually bacterial

100
Q

bronchiolitis

A

inflammation and obstruction of small airways; swelling and irritation of bronchioles; mucus settles and irritates; usually occurs after upper respiratory infection; caused by RSV or other viruses

101
Q

patho of bronchiolitis

A

virus or other causes mucosal cells lining bronchi and bronchioles to die creating debris that clogs and obstructs bronchioles causing partial obstruction and bronchospasm; can cause wheezing and crackles

102
Q

transmission of bronchiolitis

A

contact with respiratory secretions

103
Q

DX of broncioloitis

A

symptoms, nasopharyngeal swab for RSV, chest xray shows hyperinflation of lungs that develop from trapped air

104
Q

s/s of bronchiolitis

A

initial is rhinorrhea, pharyngitis (sore throat), coughing, sneezing, wheezing, ear or eye drainage possible, intermittent fever; progressing is increased coughing and wheezing, fever, tachypnea, retractions refusing to nurse/bottle feed, copious secretion

105
Q

severe illness with bronchilitis

A

tachypnea greater than 70 bpm, listlessness, apneic spells, altered air exchange, diminished breath sounds

106
Q

therapeutic management for bronchilitis

A

supportive measures, contact/droplet precautions, prevent RSV with vaccine that is available for high risk infants only (high risk is preterm under 6 mo born at less than 36 weeks and acute/chronically ill infants)

107
Q

bronchiolitis nursing care

A

monitor oxygenation as ordered with pulse ox, monitor IV or NG fluids, monitor for fever, admin prescribed meds, family support and education

108
Q

asthma

A

chronic reversible inflammatory disorder causing periodic airway obstruction and hyperresponsiveness; results from triggers; bronchoconstriction and inflammation; expiratory airflow decreases and traps gas causing alveolar hyperinflation

109
Q

asthma manifestations

A

coughing, wheezing, mild SOB. yellow zone on peak flow; progressive symptoms are marked respiratory distress, changes in position, red zone on peak flow; emergent- status asthmaticus which is resistant to treatment

110
Q

DX of asthma

A

clinical signs and history; peak expiratory flow, blood gases, pulse ox, RAST testing for allergens/triggers

111
Q

RAST test

A

radio-allegro-sorbent test

112
Q

asthma therapeutic management

A

want to maintain normal activity levels, maintain normal pulmonary function, prevent chronic symptoms and recurrent exacerbations, assist child to live normal happy life

113
Q

long term control meds for astha

A

inhaled corticosteroids- fluticasone and pulmicort; long acting beta 2 agonists- severent via MDI; leukotriene modifiers- singulair PO

114
Q

quick relief aka rescue meds for asthma

A

short acting beta 2 agonists- albuterol or xopenex; anticholinergics- atrovent (given with short acting beta 2 agonists); systemic corticosteroids given orally for 3-5 days and are fast acting but take 3-8 hours for effect

115
Q

during acute asthma attack

A

check peak flow and if in yellow admin short acting beta 2 agonist; if in red go to ER

116
Q

asthma nursing considerations

A

educate if deficient knowledge, assist with fear and anxiety, educate what happens during an attack like ineffective airway clearance or impaired gas exchange or fatigue or activity intolerance

117
Q

cystic fibrosis

A

chronic autosomal recessive inherited disorder of exocrine glands that affects multiple organ systems; cystic fibrosis transmembrane conductacne regulator gene mutation; creates abnormality in sodium and water transport

118
Q

patho of CF

A

mechanical obstruction caused by increased viscosity of mucous gland secretion; mucous gland produces thick mucoprotein that accumulates and dilates

119
Q

altered functioning of bronchi, small intestine, pancreatic ducts, salivary/sweat glands, and reproductive system from CF

A

bronchi- chronic bronchitis, bacterial pneumonia, obstructive emphysema; small intestine- intestinal obstruction and failure of neonate to pass meconium; pancreatic ducts- malabsorption syndromes; salivary/sweat glands- increased sodium and chloride excretion; reproductive system- most patients infertile d/t increased viscosity of cervical mucous in females and blockage of vas deferens in men

120
Q

diagnosing CF

A

family HX, prenatal DNA testing, newborn screening, sweat chloride test (most reliable) where sodium and chloride levels will be 2-5x higher d/t inability to reabsorb

121
Q

respiratory manifestations of CF

A

dyspnea, dry nonproductive cough, wheezing, atelectasis, generalized obstructive emphysema d/t mucoid obstruction, chronic sinusitis, bronchitis, bronchopneumonia (inflamed alveoli), hemoptysis (potentially life-threatening)

122
Q

progressed respiratory manifestations in CF

A

signs of chronic CO2 retention, barrel chest, finger clubbing, cyanosis, decreased CO2 and O2 exchange causing hypoxia hypercapnia and acidosis, compression of pulmonary blood vessels, progressive lung dysfunction causing pulmonary HTN and cor pulmonale and respiratory failure and potentially death

123
Q

respiratory management for CF

A

want pulmonary hygiene with daily routine of chest PT usually 2x per day, airway clearance therapies (CPT and postural drainage), promote physical exercise, medications like pulmozyne, aggressive treatment of pulmonary infections

124
Q

CF GI manifestations

A

need to take pancreatic enzymes with every meal; meconium ileus at birth, weight loss despite increased appetite, malnourishment and vitamin deficiency, malabsorptive syndrome with chronic diarrhea and large frothy smelling stools, long term GI complications

125
Q

long term GI complications with CF

A

G-tube, liver disease from blocked bile duct, can develop diabetes, etc.

126
Q

CF GI management

A

pancreatic enzymes with meals, high protein high calorie diet (150% or recommended amount), prevention/early management of intestinal obstruction, reduction of rectal prolapse, regular nutritional monitoring

127
Q

CF nursing care management

A

assessment of all affected systems, primarily focused on respiratory and GI systems, interventions focused on hospital care home car family support and transition to adulthood

128
Q

foreign body aspiration

A

partial or complete obstruction of upper airway: cough, cyanosis, wheeze, stridor, dyspnea, retractions, voice changes; obstruction of lower airway: 1-sided wheezing, diminished sounds on one side, asymmetry of chest

129
Q

treatment and nursing care of foreign body aspiration

A

heimlich in emergency situation, bronchoscopy to remove object

130
Q

pneumonia

A

inflammation of lung parenchyma; can be bacterial, viral, or from aspirate

131
Q

pneumonia manifestations

A

low to high fever, cough, headache, malaise, infiltrates on xray, WBC > 20000, pt favors leaning on one side d/t pain on inspiration

132
Q

treatment of pneumonia

A

antibiotics if bacterial, increase in fluids, antipyretics, cool mist humidifiers, avoid smoke exposure, decrease anxiety, promote rest

133
Q

indications for artificial ventilation

A

progressive hypoxia, inadequate ventilation, excessive work of breathing, inadequate respiratory effort; BVM at bed side; respiratory assessment; mouth care

134
Q

tracheostomy tube

A

surgical opening below 2 and 4 tracheal ring; indications are deformities from birth or trauma; always keep same size and smaller size trach next to bed; keep suction next to bed

135
Q

upper airway consists of

A

nose, mouth, larynx, pharynx, oropharynx, epiglottis (trachea sometimes)

136
Q

lower airway consist of

A

trachea, bronchi, bronchioles, alveoli

137
Q

risk factors for respiratory distress

A

infectious agents like covid or RSV or flu, age d/t size, resistance in lungs, seasonal variations, excessive/thick secretions, stasis of secretions, CNS depression or immobility, extreme high or low humidity, sleeping positions in infants

138
Q

differences in pediatric upper respiratory system

A

upper- smaller nares and nasal passages that are more prone to obstruction, small oral cavity and large tongue causing prone to blockages, tonsils and adenoid can obstruct if inflamed, larynx has epiglottis that is large and floppy in children; children have lower respiratory reserve

139
Q

differences in upper respiratory system in children

A

tracheal cartilage is less developed and more prone to collapse; bronchioles are not as formed causing less surface area; alveoli where gas exchange occurs is less d/t less developed

140
Q

side effects of morphine

A

nausea, vomiting, diarrhea, dry mouth, drowsiness, decreased respiratory

141
Q

newborn and young infant responses to pain

A

crying, grimace, rigid/arching back, eyes closed mouth opened crying

142
Q

older infant pain response

A

crying, more restless

143
Q

young child pain response

A

verbalizing ow or ouch, may beg for procedure to end, may cry, may be clingy

144
Q

school age child pain response

A

bargaining to waste time is common

145
Q

adolescent pain response

A

less vocal, hide crying, may internalize pain by tensing body, less physical, more direct in statements

146
Q

acute pain

A

less than 6 months; unexpected, more severe

147
Q

chronic pain

A

over 6 months; pt is usually more adapted

148
Q

recurrent pain

A

happens over and over again usually every 3 months

149
Q

vaccines during pregnancy

A

Tdap for whooping cough, flu vaccines, covid-19, RSV, maybe hepatitis B

150
Q

vaccines for newborns

A

Hep B to prevent liver damage and cancer (within first 24 hours of birth or within first 12 hours if mom has hep B), hep B immunoglobin if mom has hep B, RSV

151
Q

vaccines for 1-2 months

A

DTaP (diptheria, tetanus, and pertussis), haemophilus influenzae type b disease (Hib), HepB, pneumococcal disease, Polio (IPV), rotavirus (RV)

152
Q

vaccines for 3-4 months

A

DTaP, Hib, pneumococcal, polio (IPV), rotavirus (RV), RSV if in season

153
Q

vaccines for 5-6 months

A

DTaP, Hib, Flu, pneumococcal disease, polio (IPV), Rotavirus (RV)

154
Q

vaccines for 7-11 months

A

flu yearly

155
Q

vaccines for 12-23 months

A

chickenpox (varicella), DTaP (4/5), Hib dose 3/3 or 4/4, Hep A, Hep B dose 3/3, flue, measle mumps and rubella (MMR), pneumococcal disease dose 4/4, Polio (IPV) dose 3/4

156
Q

vaccines for 2-3 years

A

flue yearly,

157
Q

vaccines for 4-6 years

A

chickenpox (varicella) dose 2/2, DTaP 5/5, flu, MMR dose 2/2, Polio (IPV) dose 4/4

158
Q

vaccines for 7-10 years

A

human papillomavirus (HPV) 2 doses 6-12 months apart, flu yearly

159
Q

vaccines for 11-12 years

A

HPV, flu, meningococcal disease (MenACWY) dose 1/2, TDaP booster

160
Q
A

Pediatrics (4 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions