Pediatrics Flashcards
Anterior fontenel closes when?
Posterior?
Anterior: 12-18 months
Posterior: 2-3 months
How to introduce foods to infants? Why?
One at a time because of allergies
Have an immature GI tract causing vomiting…. What caused the vomiting?
Most common reason for failed potty training How much milk should a 15mo drink/day? When is the best friend stage Major accident causes up to age 1? Accidents between 6-12?
Not ready
2-3 cups - BALANCED diet and not just milk
9-10
Falls, poison, burns
MVA - biks, 4 wheelers, increased kidnapping risk
How is the growth rate between 6-12?
Calories for a school-age kid?
How much sooner is girl puberty?
DEC - getting ready for a spurt
2400 calories
1-2 years
Vitals/assessment
Start with what? Best way to get VS? Talk to who first? What if you can't get them? Order of VS? How long to mx RR and HR When we can't do rectal T? When is rectal T recommended? Who can we do axillary T? Temporal? When to start oral T? Do we add a degree ever?
Observation Distraction Parents Record that you couldn't RR, HR, BP, T 1 full minutes - bc of abnormalities When immunosuppressed Recommended for kids younger than 2 All ages; All ages Age 5-6; can be cooperative NO!! always note where recorded
Common site for O2?
How to record O2?
Make sure monitor matches what?
Fingers, toes
Record what is going on when recording
Monitor matches radial pulse
Communication: NEWBORN
Age? Primary mode of communication? How do they express themselves? What do they respond to? What has a positive effect? Encourage parents to what?
Birth - 1 month
Nonverbal Express though crying Respond to voice end presence Touching = positive encourage touching
Communication: INFANT
Age? Primary mode of communicant? Being doing what? How do they express themselves? Do they comprehend words? Respond to what? Nursing strategies?
1 month - 12 months
Primarily nonverbal Begin vocalizations Express through crying, facial expressions NO COMPREHENSION of words Respond to patting, rocking, stroking
Nurse: high-pitch voice, cuddle, pat, rub to calm
Communication: TODDLER
Age? Evolving what? What kind of language is greater? How do they think? What is their vocal like? Primary question? Attention span? What is there memory like?
1-5 years
Evolving verbal skills Greater receptive than expressive CONCRETE thinkers Vocal depends on development & family use WHY WHY WHY Short attention span Limited memory
Toddler - Cognitive development
How to they like to express themselves?
How does play help development?
Egocentric
Magical thinkers
Animism
Through dramatic play and drawing
Play is the work of the child
School - Age: Cognitive development
Age?
They can now use what?
They can understand what?
What is there vocab like? Expressive vs/ receptive? Do they misinterpret things? Can they interpret nonverbal stuff? How do they express themselves?
6-12
Use logic
Understand POV, cause/effect, body functions
Big vocab Good balance of express/receptive Commonly misinterpret things Can interpret non-verbal stuff Express through thoughts and feelings
Adolescent
Age? What kind of thinking? Do they understand medical terminology? Drive for what? What are they building? Need what?
Nursing strategies?
13-18 Abstract without full adult comprehension Med is limited Drive for independence Building trust and understanding Need PRIVACY
Private area talking, straightforward, bye bye parents for part of interview
How might a child with disability feel if they can’t communicate?
Nursing strategies
Helpless, fearful, anxious
Gestures, picture boards, writing tablets
System of head knows or eye blinks
What is circumoral pallor?
Other S/S RR distress?
Blueness/pallor around the mouth
S/S RR distress
Accessory muscle use, nasal flare, sternal retractions, cap refill
LTB (Laryngotracheobronchitis)
What is it?
Primarily affects who?
Caused from what? - Ex?
S/S
CROUP
Viral upper airway infection
Kids under 5
RSV, parainfluenza, adenovirus
SOB, barking cough, increased T
Treatment of LTB (Croup)
Mild croup @ home?
More severe?
Meds?
Mild: steam, fresh air, cool temp therapy
Severe
Meds: Neb Epi; observe for relapse w/in 2 hr
CS to decrease airway inflammation
Epiglotitis - DON’T CONFUSE W CROUP
Key differences? - S/S; sound vs look?
Severe and obstructive inflammation
No cough, dysphagia, RAPID progression to severe RR distress
Epiglotitis: Worse than they sound
LTB: Worse than they look
Also remember that asthma is not a virus and also leads to obstruction
RSV
What is it?
Leading cause of what?
Risk Factors?
How to we PREVENT is?
Acute VIRAL infection affecting the bronchioles - includes RSV pneumonia, bronchiolitis, RSV
Leading cause of lower R illness in kids
RF: premie, congenital, smoke
Prevention: Palivizumab
RSV
S/S
How fast does it progress?
How to treat? mild vs severe
S/S: UR infection, nasal discharge, fever, SOB, NP cough, ^RR, nasal flaring, retraction
Worse in 2-3 days!! CAN PROGRESS FAST!
Treatment
Mild: anti-paretics
Severe
Suction, O2 and possible MV
IV fluids
Albuterol, anti-paretics
Pneumonia
Causes -- Viral Bacterial Mycotic Aspiration
S/S
Tx
Inflammation of the lungs
Viral - RSV, Adenovirus
Bacterial - Strep, kids
Mycotic - walking, adolescent
Aspiration
S/S: RR distress symptoms
Tx: Depends on type
ABC, O2, fluids, antibiotics, hydrate, nebulizer
Good pet for asthma?
Important to teach?
FISH
triggers
CF
2 body systems affects?
What do they need with food?
Diet?
Vitamins?
RR and GI
Pancreatic enzymes within 30 min of eating - DONT crush/chew or will burn mouth
High fat, calories, protein (Don’t absorb fat well, malnourished)
Water-soluble bc don’t absorb fat well (ADEK)
