Pediatric Nursing

Question 1

Abuse

Answer 1

Nonaccidental physical injury or the nonaccidental act of omission of care by a parent or person responsible for a child; includes neglect and physical, sexual, or emotional maltreatment.

Question 2

Active immunity

Answer 2

A form of long-term acquired antibody protection that develops naturally after an initial infection or exposure to antigens, or artificially after a vaccination.

Question 3

Atresia

Answer 3

Congenital absence or closure of a body orifice.

Question 4

Attenuated vaccines

Answer 4

Vaccines derived from microorganisms or viruses; their virulence has been weakened as a result of passage through another host.

Question 5

Chronological age

Answer 5

Age in years.

Question 6

Crackles

Answer 6

Audible high-pitched crackling or popping sounds heard during lung auscultation; result from fluid in the airways, and are not cleared by coughing.

Question 7

Cyanosis

Answer 7

The bluish color that results in tissues, nail beds, and mucous membranes when tissues are deprived of adequate amounts of oxygen.

Question 8

Developmental age

Answer 8

Age based on child’ maturational progress. It is determined by standardized resources such as body size, physical and psychological functioning, motor skills, and aptitude tests.

Question 9

Functional age

Answer 9

The age equivalent at which a child actually is able to perform specific self-care or related tasks.

Question 10

Growth

Answer 10

Measurable physical and physiological body changes that occur over time.

Question 11

Grunting

Answer 11

The sound made by forced expiration, which is the body’s attempt to improve oxygenation when hypoxemia is present.

Question 12

Hereditary

Answer 12

Refers to the transmission of genetic characteristics from parent to offspring.

Question 13

Inactivated vaccines

Answer 13

Vaccines that contain killed microorganisms.

Question 14

Nasal flaring

Answer 14

A widening of the nares to enable an infant or child to take in more oxygen; a serious indicator of air hunger.

Question 15

Passive immunity

Answer 15

A form of acquired immunity that occurs artificially through injection or is acquired naturally as the result of antibody transfer through the placenta to a fetus or through colostrum to an infant; is no permanent and does not last as long as active immunity.

Question 16

Prodromal

Answer 16

Pertaining to early symptoms that mark the onset of a disease.

Question 17

Puberty

Answer 17

The period of time during which the adolescent experiences a growth spurt, develops secondary sex characteristics, and achieves reproductive maturity.

Question 18

Regurgitation

Answer 18

An abnormal backward flow of body fluid.

Question 19

Retraction

Answer 19

An abnormal movement of the chest wall during inspiration in which the skin appears to be drawn in between the ribs and above and/or below the clavicle, and scapula; indicates respiratory difficulty.

Question 20

Shunt

Answer 20

Movement of blood or body fluid through an abnormal anatomical or surgically created opening.

Question 21

Stenosis

Answer 21

The narrowing or constriction of an opening.

Question 22

Stridor

Answer 22

A shrill harsh sound heard during inspiration, expiration, or both, produced by the flow of air through a narrowed segment of the respiratory tract.

Question 23

Vaccine

Answer 23

A suspension of attenuated or skill microorganisms administered to induce active immunity to infection diseaase.

Question 24

Wheezing

Answer 24

High-pitched musical whistle sounds heard with or without a stethoscope as air is compressed through narrowed or obstructed airways because of swelling, secretion, or tumors.

Question 25

Impetigo

Answer 25

A contagious bacterial infection of the skin caused by B-hemolytic strep or staphylococci, or both. Most common during hot, humid months. Can be caused due to poor hygiene; can be primary or secondary infection. Most common sites of infection are on face, around mouth and hands, neck and extremities. Lesions begins as vesicles or pustules and progress to crusting stage.
Need contact iso; assist with daily bathing w antibacterial soap; allow lesions to air dry; wash clothing separated from household.

Question 26

Pediculosis Capitis

Answer 26

Lice

Question 27

Scabies

Answer 27

A parasitic skin disorder caused by an infestation of Sarcoptes scabiei (itch mite).

Assessment findings: Pruritic papular rash; Burrows into the skin (fine grayish red lines).

Incubation period: female mite burrows into the epidermis lays eggs, dies in burrow after 4-5 wks. The eggs hatch in 3-5 days and mature.

Infectious during the entire course of the infestation. Transmitted by close contact.

Question 28

Scabies Interventions

Answer 28

Topical application of a scabicide; Daily laundry; Non washable things should be sealed in plastic bags for at least 4 days.

Lindane is another treatment but contraindicated for those younger than 2 years due to high absorption and risk of toxicity and seizures.

Question 29

Burn Injuries

Answer 29

Burns involving more than 10% of the total body surface area require some form of fluid resuscitation.

Increased risk for fluid and heat loss, dehydration, metabolic acidosis, protein/calorie deficiency, disturbed body image, delay growth.

Question 30

Extent of burn injury

Answer 30

Rule of nines (used for adults) give an inaccurate estimate in children due to differences in body proportions.

In pediatric, the extent is expressed as a % of the total body surface area, using age-related charts. (pg 419)

Question 31

Sickle Cell Anemia

Answer 31

Hgb A is partly or completely replaced by abnormal sickle hgb S. Caused by inheritance of a gene for a structurally abnormal portion of the hgb chain.

Hgb S is sensitive to changes in the O2 content in RBCs. Insufficient O2 causes cells to assume a sickle shape and clump together obstructing blood flow.

Manifestations: Obstruction and RBCs destruction; Increased need for O2, dehydration, fever

Question 32

Sickle Cell Anemia - Interventions

Answer 32

Adequate hydration and blood flow; electrolyte replacement as needed; Administer O2 and blood transfusions as needed; Pain control; Increase HOB 30 degree (comfortable position); High calorie/protein diet;

Ensure child received pneumococcal and meningococcal vaccines and annual flu vaccine because susceptibility to infection secondary to functional asplenia.

Question 33

Vaso-Occlusive Crisis

Answer 33

Caused by stasis of blood with clumping of cells in the microcirculation, ischemia, and infarction.

S&S: fever, painful swelling of hands, feet, joints; abdominal pain.

Question 34

Splenic Sequestration

Answer 34

Caused by pooling and clumping of blood in the spleen (hypersplenism).
S&S: Profound anemia, hypovolemia, shock.

Question 35

Hyperhemolytic Crisis

Answer 35

An accelerated rate of RBC destruction.

S&S: Anemia, jaundice, reticulocytotic.

Question 36

Aplastic Crisis

Answer 36

Caused by diminished production and increased destruction of RBCs, triggered by viral infection or depletion of folic acid.

S&S: Profound anemia and pallor.

Question 37

Iron Deficiency Anemia

Answer 37

Iron stores are depleted, resulting in a decreased supply of iron for the manufacture of hgb in RBCs. Commonly results from blood loss, increased metabolic demands, syndromes of GI malabsorption, and dietary inadequacy.

Question 38

Iron Deficiency Anemia- Assessment findings

Answer 38

Pallor, Weakness/fatigue, low hgb and hct levels, RBCs that are microcytic and hypochromic.

Question 39

Iron Deficiency Anemia - Interventions

Answer 39

Increase oral intake of iron; high iron foods, iron supplements, IM injections of iron.

Administer iron supplements between meals for max. absorption; Give multivitamin or fruit juice because Vit C increases absorption; Don’t give milk or antacids because it decreases absorption.

Educate side effects: black stools, constipation, foul aftertaste. Liquid iron stains teeth (take through straw and brush teeth after).

Question 40

Iron-Rich Foods

Answer 40

Breads and cereals; dark green, leafy veggies, eggs yolks, dried fruit, kidney beans, legumes, liver, meats molasse, nuts, potatoes, prune juice, raisins, seeds, shellfish, tofu, whole grains.

Question 41

Aplastic Anemia (description, causes, diagnostic, therapeutic management).

Answer 41

A deficiency of circulating erythrocytes and all other formed elements of blood, resulting from the arrested development of cells within the bone marrow. Can be present at birth or acquired.
Causes: viruses, infection, autoimmune disorders, allergic states.
Diagnostic: bone marrow aspiration
Therapeutic management focuses of restoring function of bone marrow and immunosuppressive therapy and bone marrow transplant.

Question 42

Aplastic Anemia (Assessment; Interventions)

Answer 42

Assessment: pancytopenia; petechiae; purpura, bleeding, pallor, weakness, tachycardia, fatigue.

Interventions: prepare for bone marrow transplant; administer immunosuppressive meds; blood transfusion.

Question 43

Hemophilia

Answer 43

a group of bleeding disorders resulting from a deficiency of specific coagulation proteins. Identifying the specific coagulation deficiency is important so that treatment with the specific replacement agent can be given.
Most common types: Factor VIII deficiency (hemophilia A or classic); Factor IX deficiency (hemophilia B or Christmas disease).

Question 44

Hemophilia (Assessment and Treatment)

Answer 44

Assessment: abnormal bleeding in response to trauma or surgery; nosebleeds; joint bleeding causing pain, tenderness, swelling, LROM, bruising, Clotting factor function may be abnormal.

Interventions: Primary Tx is replacement of the missing clotting factor; monitor for bleeding, Pain management, monitor urine of hematuria, caution with activities and wear appropriate padding for sports.

Question 45

von Willebrand’s Disease (description, causes)

Answer 45

A heredity bleeding disorder; characterized by a deficiency of or a defect in a protein termed von Willebrand factor.
Causes platelets to adhere to damaged endothelium; Increased tendency to bleed from mucous membranes

Question 46

von Willebrand’s Disease (Assessment; Interventions)

Answer 46

Assessment: Epistaxis, Gum bleeding, easy bruising, excessive menstrual bleeding.

Interventions: Administer clotting factors; emotional support during episodes of bleeding.

Question 47

A child with a bleeding disorder needs __.

Answer 47

To wear a medic-alert bracelet.

Question 48

B-Thalassemia Major (description)

Answer 48

An autosomal recessive disorder characterized by the reduced production of one of the globin chains in the synthesis of hgb (both parents must be carrier to produce a child with B-thalassemia major).

Question 49

B-Thalassemia Major (Assessment)

Answer 49

Frontal bossing, Maxillary prominence, Wide set eyes with a flattened nose, greenish yellow skin ton, hepatosplenomegaly, severe anemia, microcytic RBCs.

Question 50

B-Thalassemia Major (Interventions)

Answer 50

Blood transfusion, monitor for iron overload, splenectomy may be done, ensure vaccines up to date for children, genetic counseling to parents.