Pediatrics Flashcards
when does the anterior fontanel close
12-18 mths
when does the posterior fontanel close
2-3 months
why are foods introduced to infants one at a time
worried about allergies
also they have an immature GI track
what is the most common reason for failed toilet training
they are not ready
at what age does the best friend stage occur
9-10
what happens to the growth rate between 6-12 yrs of age
decreases
a school age child reqiuries hos many caloreis per day
2400
how many years earlier to girls go through puberty
1-2
what is the first step in assessing a child
observation
why should you talk to the parents before you talk to a child
to build a trusting relationship with the child
what is the progression of obtaining child VS
resps
HR
BP
temp
why is it important to count RR and HR for a full minute with children
because of irregularities
what should be done if you cant take VS without disturbing the child
record the behaviour with measurements
how should temperature be taken for children younger than 2 years
rectal
what is considered the most reliable form of temperature in children
rectal
when is rectal temperature contraindicated
in immunosuppresed children
when should axillay be done in children? what ages
all ages when an oral route is not possile
when can you start taking oral temps
ages 5-6
what do newborns brith - 1 years old respond to
human voice and presence
touch ash psitive effect
waht should nruses encourage for newborwns birth to 1 month
lots of touch
how do infants 1 month to 12 mths communicate
crying and facial expressions
what are infants age 1 - 12 months attentive to
human voice and presence
no comprehension of words
what do infants 1mth-12 mths respond to
touch through patting, rocking and stroking
what are nursing stategies for infants age 1-12mths
speack in high-pitched voice, cuddle,pat and rub to calm
what age do you start evolving verbal skills
toddlers and precschoolers age 1-5 yrs
do toddlers and preschoolers have greater expressive languate or receptive
receptive
what age group has concrete and literal thinking which may lead to mininterpreation of phrases
1-5 years
what is vocabulary dependent on with toddles and preschoolers age 1-5
development and family use
what age group asks a lot of why questions
preschoolar 1-5
what is the cognivie development of toddlers and preschoolsers
egocentric - world revovles around them
magical thinkiers
animism - think non living things behave like humans
what is the 2 forms of nonverbal communication for toddlers and preschools (1-5)
express themselves through paly and drawing
play is the work of the child
what age group is able to use logic
school-age children (6-12 years)
what age group can begin to undstand others points of view and casue and effect?
6-12
when does a child start to understand how the body functions
6-12
when are children able to interpret non verbal messages
6-12
adolescents age 13-18 can do abstract thinking hovere they cannot
have a full adult comprehension
what age is there a drive for independence and privarcy
13-18
what builds rapport with adolescencts
trust and understanding
what are some nursing strateiges for working with adolscents
straightforward approach
talk in private area
conduct at least part of the interivew without parents present
what is the most common type of croup expereinced by children admitted to the hospital
laryngotracheobronchitis (LTB)
what age group does larygnotracheobronchitis affect
children under 5 –> caused from viral infection
what are the signs and symptoms of larygnotracheobronchitis
slight to severe dyspnea
barkingor brassy cough
increased temp
can children with laryngotracheobronchitis be treated at home
yes
what are 3 ways that laryngoeobronchitis be treated at home
steam such as hot showers
car rides with teh windowns down at night
cool-termpature therapy assists by constricting blood vessels
if symptoms of laryngeobronchitis worsen whant is needed
epinephrine to constrict edematous blood vessls
corticiosteroids to reduce inflammation
what should not be confused with croup
epiglottis
what is epiglottis
serous obstruvtive inflammatory process that occurs in chidlren age 2-5 years old
what is the key difference between epiglottis and croup
epiglottis has no cough
prenece of dysphagia
rapid progression to severe repiratory distress
do epiglottis kids or LTB (laryngeobronchitis) kids sound worse then they look
LTB
do epiglottis kids or LTB kids look worse then they sound
epiglottis kids look worse then they sound
what is an acute viral infecation athat affects the bronchioles
RSV
what does RSV include?
RSV, bronchioligis
RSV pneumonia
what is the leading cause of respiratory tract illness in children less than 2
RSV
what vaccine is givne to children at high risk for RSV
palivizumab
how is asthma differnt from RSV
asthma is inflammation and bronchoconstriction of airways resutling in obstrcution
what is prolonged expiratory wheezing a sign of
ashtma
what happens with cystic firbosis
thick sticky secretions everywhere
what tow body systems are affected by CF
respiratory and GI
what type of enzymes are given to help cysit fibrosis children
pancreatic –> take within 30 mins of eating
what type of diet should a child with cystic firbosis have
well balanced high fat high calorie high protein water soluble vitamins (A, E,D, K)
what type of stools does a patient with CF have
fatty frothy stools
what is the diagnostic test for CF
sweat chloride
what electrolyte imbalance are children with CF at risk for
hyponatremia
in teh newborn what is the earliest sign of CF
meconium ileus
what kind of disease is cystic firbosis
inherited disease –> must get the gene from both paresnts
what types of infecations are children with down syndrome most at risk for
respiroatry becasue they have a poor immune system
what is the most common type of birth defect associted with down syndrome
heart
Hf in children is usually due to what
congenital heart defects
what medications are used to treat HF in children
digoxin
ACE
furosemide
what are the signs of dig toxicity in children
vomiting and bradycardia
when should you hold a dose of dig for infants
if HR <110
when should you hold a dose of digoxin for children
if the pulse is <70
do infants ever get more than 1mL of digoxin
rarely
waht is the normal digoxin level
0.8-1
should you give a dose of digoxin is if ts 4 hours past due
no
what should you do if two doses of digoxin are missed
hold the dose
what is a good feeding schedule for a ehart baby
every 3 hours
what time period should feedings be kept within for heart babies
no longer than 30 mintues
what is the top concern for a client with a cleft palate, cleft lip, or both
nutrition
when a baby is born with a cleft lip and palate which one doyou correct first
lip –> promotes bonding
why do babies with a cleft lip or palate need to be purped frequently
because they swallow a lot of air and are at risk for abd distentions –> N/V
what posisiton should cleft lip repair children be placed in
back or side lining dont want to put them prone because we are protecting the suture line
what should you clean the suture line with for cleft lip pts
NS
what type of restraing would you selfect after a cleft lip repair
elbow
when is the best time for cleft palate repair to be doen
before speech develosp between ages 1-2
waht is the difference between gastrophageal reflux and gastroesophageal reflux disease
GERD is the chronic form of GER - passage of gastric ontents into the esophgagus
which is worse GERD or GER
GERD because its chronic and damages respiratory structures
what type of feedings should be given to a GER GERD pt
small thickened
waht is pyloric stenosis
enlarged pylorus resulting in projectile vomitng afeter feeding
what is associated with an olive shpaed mass in teh epigastric region near the umbilicus
pyloric stenosis –> the enlarged pylorus
how is pyloric stenosis diagnosed
U/S
is sx done for pyloric stenosis
sometimes to open sphinchter
what is it called when a peice of the bowel goes backwards inisde itself forming an obstruction
intussception
what are the S& S of intussception
sudden onset crampingintermittent abd pain drawing up of knees currant jelly stools drawing up of knees
what procedure can soemtimes be doen to fix intussception
barium enema –> pressure of the enema will push the telescoped area back out
what is celiac disease
genetic malabsorption disorder where there is a permanet intestinal intolerance to gluten
what is the acronym for what celiacs cant have in their diet
BROW
Barley, rye, oats, wheat
what is the acronym for what celiac disease patients can have
rice
corn
soy
what is hirschsprung’s disease
congentital disease known as aganglonic megacolon –piece of intestine that has zero nerves —> results in mechanical obstruction
what are the signs and symptoms of hirschprungs disease
constipation
abdominal distension
ribbon like stools that have a foul smell
what is the treatmetn for hirschprungs disease
remove a portionof the bowel that is diseased
what is the most common age of children affected by UTIs
2-24 montsh
do males or females aged 2-24 montsh have a higher cahcne of developing a UTI
it is the same
what pain scale is used for infants 2 montsh to seven years of age
FLACC
Face, Legs, Activity, crying and consolability
what pain scale is used for childresn age 3 and up
wong baker pain rating scale –< facesw
a numerical pain scale can be used for what ages
5 and up
what are depressed eyes a symptom of in children
hydrocephalus
what is a high-pitch cry indicative of
hydrocephalus
what is the setting sun sign and what does it mean
white above the iris
hydrocephalus
how do you collect a specifmen of pinworms for diagnosis
tape test to recutm early monring
does the whole familyneed to be treated for pinworms
yes
what virus causes mono
eb
what is bad breath following a tonsilectomy indicative of
old blood in throat
t or f children with otitis media should avoid chewing
t
