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Pediatrics Flashcards

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1
Q

Growth and Development
• Growth - ↑ in ____ and development is ↑ in capability or _____
• Development does not always follow growth and ______
• Cephalocaudal development - development that moves from ______ downward thru ____ and towards the _____
• Proximodistal development - development that moves from the ____ of body outward to the _____

A
  • physical size; function
  • chronological age
  • head downward thru body and towards the feet
  • center of body outward to the extremities
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2
Q

Play and Toys
• Play is the ____ of children, it’s how they ____ new things, ____, and learn to use ____ skills
• for a child w/ a heart defect, would you give them something to do that will get them excited and ↑ their HR?

A
  • work; learn new things, socialize, use coping skills

* No, b/c that would ↑ workload on the heart, and we NEVER want to ↑ the workload on heart of a client w/ heart disease

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3
Q

5 months old baby–most appropriate toy?

  1. rattle
  2. stuffed animal they can grasp
  3. puzzle w/ big pieces
  4. nursery rhyme CD
A

RATTLE – for grasp reflex and hold on to things

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4
Q

11 yo boy in hospital–approrpiate activity? (SATA)

  1. frequent visits from friends
  2. playing video games in the room
  3. coin collecting
  4. watching TV
  5. reading his favorite book
A

2, 3,4, 5

  1. playing video games in the room; 3. coin collecting;
  2. watching TV; 5. reading his favorite book
    - -pick the nerdiest adn most -un-fun activity for school-age children!!!
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5
Q

General Peds Info
• When does the anterior fontanel close?
• and posterior fontanel?

A
  • anterior close at 12 - 18 months

* posterior close at 2 - 3 months

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6
Q

General Peds Info

Why are new foods introduced to infants one at a time?

A

Allergies and immature GI tract

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7
Q

General Peds Info

Teaching for introducing new food to babies

A
  • one food per week
  • cut food into little bites
  • watch them eat and sit them up in a high chair
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8
Q

General Peds Info

Why are peanuts so dangerous when aspirated?

A

when peanuts are wet, they swell and crumble – DANGEROUS FOR AIRWAYS!!!

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9
Q

General Peds Info

FOODS TO AVOID for children <4

A 
hot dogs
carrots
apples
grapes
peanut butter
marshmallows
nuts and seeds
popcorn
hard candy 
chewing gum
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10
Q

General Peds Info
When giving IM injections, which muscle is contraindicated in children who have not been walking for at least a year? why?

A

ventrogluteal muscle; muscle not developed well enough

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11
Q

General Peds Info

When viewing the auditory can in the young child, how is the earlobe positioned?

A

down and back

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12
Q

General Peds Info

What is the most common reason for failed toilet training?

A

they’re not ready

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13
Q

General Peds Info

How many cups of milk should 15-month old toddler consume daily?

A

2 - 3 cups

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14
Q

General Peds Info
At what age does the best friend stage occur?
imaginary friends?

A

9 - 10 years;

3 yo may have imaginary friends

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15
Q

General Peds Info

What are the leading causes of death from accidental injury in infants up to 1 yo?

A

Suffocation, Motor vehicle-related injuries, drowning

–also falls, aspiration, burns, poisoning

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16
Q

General Peds Info

Between ages 6 and 12, what’s the major cause of severe accidental injury?

A

MVAs

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17
Q

General Peds Info

What to teach children?

A

Stranger safety – not talking/texting anyone they don’t know on the internet, social media sites, or phone

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18
Q

General Peds Info

What happens to the growth rate between 6 and 12 yo?

A

decreases

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19
Q

General Peds Info

A school-age child requires, on average, how many calories per day?

A

2,400 calories/day

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20
Q

General Peds Info

How much earlier do girls experience onset of adolescence than boys?

A

1 - 2 years
–girls start checking out boys in their trendy outfits whil boys don’t care about anything but food, video games, sports

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21
Q

Car Seat Safety

  1. Do not place car seats where? why?
  2. Place infant <20 lbs (9kg) where? what car seat position? why?
  3. In children 12-23 months, what car seat is recommended? which position is it facing?
  4. Car seats should be used no matter what age until child weighs how much?
  5. Never place ____ under or behind infant/child. Why?
  6. Booster seats can be used for children ages _____
A
  1. in front passenger seat b/c of airbags
  2. middle of the back seat in a rear-facing, semi-reclined car seat; provides best protection for heavy head and weak neck
  3. a convertible car seat; positioned facing forward
  4. car seats until child weighs 30 POUNDS (13.6 kg)
  5. padding–become compressed and create slackness in the harness = child ejected from car seat
  6. booster seat – 4 - 8 years (below 4’9 and weigh 35-80 lbs)
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22
Q

Hyperthermia and Car Seat Safety

  1. Can occur from what?
  2. Develops rapidly why?
  3. This has been r/t what?
A
  1. being left in a vehicle in hot weather (>80 F / 26.4 C)
  2. b/c infants are NOT ABLE to regulate their body temp
  3. busy schedules, distractions (cell phones, mental preoccupations)
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23
Q

VS/Assessment
• Observation
• Distraction techniques

Order to obtain VS
• what first?
• ____ before touching/talking to them
• order of VS
• always count RR and HR for how long in infants? why?
• if VS cannot be taken w/o disturbing child, what to do?

A
  • always begin with observation
  • cartoon/cute ID badges/pen; talk to the parents before talking to the child
Order to obtain VS
• LEAST INVASIVE
• observe first
• b/c of irregularities d/t immature nervous system regulation
• record behavior w/ measurements
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24
Q 
VS/Assessment: TEMPERATURE
--Rectal
• considered as most what?
• contraindicated in infants why?
• contraindicated in any child who has what?
  • -Axillary: done when?
  • -Oral: what ages?
  • -Tympanic: for what ages?
A

-Rectal
• most accurate
• TOO RISKY, may perforate the anus
• diarrhea, rectal lesions, receiving chemo, immunosuppressed, or has no rectum (Imperforate Anus/Anorectal Malformation)

Axillary - done when oral route is impossible
Oral - 5-6 yo (cooperative age)
Tympanic - for ALL ages

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25
Q 
VS/Assessment: Oxygen Saturation
• use for?
• check what to determine best location for sensor probe? consider child's \_\_\_\_ too
• common sites?
• should correlate with child's what?
A
  • obtain a “picture” of blood oxygen level thru skin
  • perfusion, skin temp, edema; child’s activity
  • fingers, toes
  • radial pulse
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26
Q 
Communication: Newborn (birth-1 month)
• mode of communication?
• express themselves thru what?
• they respond to what?
• what has a positive effect
• nursing strategy?
A
  • nonverbal
  • crying
  • human voice and presence
  • touch = + effect
  • encourage parent to touch infant
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27
Q

Communication: Infants (1 month - 12 months)
• mode of communication?
• begin verbal communication with? starting with?
• communicate thru?
• attentive to what?
• responds to? thru what?
• nursing strategies?

A
  • still nonverbal
  • vocalizations; repeating consonants “da da”
  • crying, facial expressions
  • human voice and presence (can’t comprehend words)
  • touch thru patting/rocking/stroking
  • speak in gentle-toned voice, cuddle, pat, rub to calm, encourage presence of parents
28
Q

Communication: Toddlers and Preschoolers (1 - 5 years)
• evolving skills of what?

--use of language to express thoughts:
• children 3-4 years old form what? called what?
• concrete and literal thinking?
• vocabulary depends on?
• who may ask a lot of questions?
  • ____ attention span
  • ____ memory
--Cognitive development
• egocentric?
• magical thinking?
• animism?
• object permanence?

Nonverbal communication
• express themselves thru what?
• play is the ____ of the child

A

• evolving verbal skills

  • 3-4 word sentences, telegraphic speech
  • may interpret phrases
  • development, family’s use
  • preschooler ask a lot of “why” questions to everything
  • short attention span
  • limited memory
  • think the world revolves around them
  • believe that their thoughts can cause events to actually happen
  • think nonliving things behave just like humans
  • an awareness that an object still exists even when it’s not in front of them
  • dramatic play and drawing
  • work
29
Q 
Communication: School-Age Children (6 - 12 years)
--Cognitive development
• able to use what?
• begin to understand \_\_\_\_ and \_\_\_\_\_\_
• developing an understanding of?

–Verbal communication
• ____ vocabulary
• ____ and ____ language is more balanced
• Misinterpretation of phrases is _________

–Nonverbal communication
• can interpret what?
• expression of?

A
  • use logic
  • others point of view; cause and effect
  • body functions
  • big vocabulary
  • receptive and expressive language
  • still common
  • nonverbal messages
  • thoughts and feelings
30
Q

Communication: Adolescents (13 - 18 years)
• abstract thinking but without what?
• interpretation of medical terminology is ____
• strive for _____
• what 2 things build rapport?
• need for ____
• nursing strategies?

A
  • without adult comprehension
  • limited
  • strive INDEPENDENCE
  • Trust and Understanding
  • need PRIVACY
  • straightforward approach; talk in private area; have a part of interview w/o parent present
31
Q

Communication: Children w/ Physical and/or Developmental Disabilities
• if unable to communicate, they may feel what?
• who else may feel this way?
• Nursing strategies?

A
  • may feel helplessness, fear, anxiety
  • family may feel fear and anxiety
  • use gestures, picture boards, writing tablets; use ehad nods, eye blinks
32
Q

Respiratory Distress
• what are observable signs of respiratory distress in children?
• what causes it?
• what illnesses causes it?
• the amount of resp distress depends on what?

A
  • Signs - Use of accessory muscles, Nasal flaring, Sternal retractions, Grunting w/ respirations
  • any illness that affects the lungs ability to get O2 in and CO2 out
  • pneumonia, atelectasis, pneumothorax, pleural effusion
  • depends on degree of airway disease
33
Q

Pneumonia

A

infection that inflames the air sacs in one or both lungs

34
Q

Atelectasis

A

partial or complete collapse of a lung

35
Q

Pneumothorax

A

air enters chest and lung collapses

36
Q

Pleural effusion

A

fluid buildup between the lungs and chest

37
Q
  • What’s Laryngotracheobronchitis/Croup? aka?
  • s/sx?
  • viral organisms that causes it?
  • they sound like what?
A
  • viral infection
    • slight to severe dyspnea, barking/brassy cough, ↑ temp
  • Parainfluenza, Adneovirus, RSV
  • barking seal!
38
Q

Laryngotracheobronchitis/Croup Treatment
• if mild:
• if sx worsens or no improvement?

A
  • (at home) – steam from hot showers; cool temp therapy (constrict swollen blood vessels in trachea that are causing swelling)
  • Nebulized epinephrine or corticosteroids
39
Q 
Laryngotracheobronchitis/Croup Treatment:
Nebulized epinephrine
• onset?
• improvement?
• always watch for a
A
  • has rapid onset
  • improvement in 10-15 mins
  • relapse and return of sx when epi wears off
40
Q

Epiglottitis
• what is it? s/sx?
• primary organism cause?
• prevention?

  • can lead to what?
  • considered as?
  • the less noise they make = the _____ the airway obstructive
  • never try to visualize throat/tongue with what?
A
  • serious obstructive inflammatory process – absence of a cough, presence of DYSPHAGIA, DROOLING, rapid progression to severe respiratory distress
  • H-Flu
  • Hib vaccine
  • partial/full occlusion of airway
  • MEDICAL EMERGENCY
  • the WORSE the airway obstructive
  • tongue depressor
41
Q

RSV
• what is it? caused by?
• can be _____ in infants

• Risk factors?
–how to prevent RSV?

• S/Sx?
–know the onset of s/sx b/c RSV become worse at days ____ and can progress to life-threatening resp distress

• Treatment

  • -mild?
  • -severe?
A
  • Respiratory Syncytial Virus; leading cause of lower resp tract illness in children <2yo; caused by acute viral infection that affects bronchioles
  • life-threatening!

• prematurity; congenital disorders (like heart defects); smoke
—avoiding sick contacts and RSV immunizations (Synagis, RespiGam)

• simple URI; nasal discharge, mild fever, wheezing, nonproductive paroxysmal cough (violent attack), tachypnea w/ flaring nares; dyspnea and retractions
—worse at 2-3 days

  • mild – supportive care (hydration, antipyretics, nebulizers)
  • severe – IVFs, Albuterol sulfate (Proventil), antipyretics, suction, O2 (may need intubation and mechanical ventilation)
42
Q 
Pneumonia
• what is it? causes?
• s/sx
• treatment
• teaching
A

• inflammation of lungs; causes – bacterial, viral, fungal, aspiration of foreign substance

s/sx
• FINE CRACKLES or RHONCHI w/ COUGH (productive/nonproductive); ↓/absent breath sounds over affected lung fields; chest pain; back/abdominal pain; HIGH fever

tx
• ABCs, O2, fluids, abx if bacterial, supportive care for viral (hydration, antipyretics, nebulizers)

teaching
• have children vaccinated!!!!

43
Q

Cleft Lip/Cleft Palate
• defects occur when?
• what is it?

Treatment
–Pre-op
• to prevent aspiration: infants fed with? where in mouth?
• what to do frequently because they swallow lots of air? because lots of air causes what? be at risk for what?
• if born with both, which one is corrected first? why?

–Post-op
• goal?
• position after cleft lip repair?
• w/ cleft palate: what to avoid? why? what diet until well healed?
• when is the best time for a cleft palate repair to be done?

A
  • during fetal development
  • orofacial defect that affects the oropharynx and ↑ risk of malnutrition and aspiration

tx
–Pre-op
• elongated nipple, medicine dropper – down the side of mouth
• BURP frequently; causes abdominal distention; at risk for vomiting and aspiration
• CLEFT LIP; assists w/ feeding and promotes parental bonding

–Post-op
• protect suture line
• SUPINE or SIDE-LYING — DO NOT put in PRONE POSITION!!!!
• avoid putting hard/rough foods or utensils in child’s mouth; disrupts suture line — SOFT DIET
• before speech develops (between 1-2 years old)

44
Q

Gastroesophageal Reflux (GERD)
• what is it?
• at risk of? lead to?

tx/positioning
• position?
• reflux precautions?
• can we alter feeding to help w/ reflux? what’s better tolerated?

A
  • backwash or reflux of gastric contents into esophagus
  • aspiration of gastric contents into lungs = lead to PNEUMONIA
  • UPRIGHT position during feeding and 30 mins after
  • UPRIGHT position w/ frequent burping during feedings
  • YES — thickened formula ( 1 tbsp of rice per 1 oz of formula/breast milk)
45
Q 
Pyloric Stenosis
• what is it?
• s/sx
• diagnosis
• treatment
A

• disorder results in PROJECTILE VOMITING during/after a feeding

s/sx
• feel OLIVE-shaped mass in epigastric region near umbilicus (enlarged pylorus; PROJECTILE VOMITING b/c of pressure behind the vomitus

dx
• abdominal ultrasound

tx
• hydration and electrolyte replacement; 
I and O; 
Monitor urine specific gravity;
Daily weights
Surgery
46
Q

Intussusception
• what is it?
• s/sx

  • what can be done to push out the telescoped area?
  • what should you be monitoring closely?
  • after an enema or surgery, they still keep them in the hospital for several days, why?
A

• a piece of bowel telescopes in on itself forming an obstruction

• s/sx
sudden onset (smiling → suddenly scream in pain)
cramping and abdominal pain
drawing up of knees
inconsolability
episodes of pain (HURT then becomes okay)
CURRANT JELLY STOOLS (maroon color)

• air-contrast, barium, ultrasound-guided saline enema
—the pressure of enema push out the telescoped area

  • monitor STOOLS
  • it might reoccur
47
Q 
Hirschsprung's Disease
• what is it?
• usually affects what colon?
• s/sx
• treatment
A
  • a congenital anomaly; aka aganglionic mega colon, results in MECHANICAL OBSTRUCTION
  • sigmoid colon (swollen/enlarged w/ narrowed rectum)

s/sx
• CONSTIPATION
• abdominal distention
• RIBBON-like stools w/ FOUL smell

tx
• surgery – remove portion of bowel that’s diseased

48
Q 
Head Lice
• what is it? 
• can lice spread to other parts of body beside the head?
• spread how?
• treatment
A
  • scalp itching
  • yes, can go anywhere in the body
  • DIRECT CONTACT
  • antiparasitic meds – often need re-treatment
49
Q 
Pin Worms
• sx? manifested by?
• how are they spread?
• whole family should be \_\_\_\_
• how do you collect a specimen for dx?
• Treatment
• teaching
A
  • INTENSE RECTAL ITCHING — general irritability, restlessness, poor sleep, bedwetting, distractibility, short attention span
  • hand to mouth
  • treated
  • TAPE TEST – clear tape in rectum early AM before bm
  • mebendazole (Vermox)
  • good handwashing; keep fingernails SHORT; wash sheets and clean bathroom
50
Q 
Infectious Mononucleosis
• commonly known as?
• s/sx
• virus that causes it?
• how is it spread?
• treatment
--if spleen's enlarged, limit what? why?
A
  • “the kissing disease”
  • sore throat, fatigue, SWOLLEN LYMPH NODES, LIVER and/or SPLEEN ENLARGEMENT
  • Eipstein-Barr virus
  • Direct intimate contact — kids can get it from drinking from water fountain

tx
• rest, analgesics, ↑ fluids, good nutrition
• limit participation in CONTACT SPORTS to prevent injury

51
Q

Tonsillectomy and Adenoidectomy
• surgical procedure for children w/ recurrent what?
• position after tonsillectomy? prevent what?
• why are brown and red fluids not given post-op?

  • what would indicate hemorrhaging is occurring?
  • how may days postop is the client at risk for hemorrhage? why? avoid what?
  • common complaints postop?
  • low grade temp is ____
  • bad breath is sign of? caused by? tx?
A
  • upper resp infections or obstructive sleep issues
  • place on side w/ elevated HOB or Prone position; prevent ASPIRATION
  • be confused with BLOOD
  • frequent SWALLOWING
  • 10 days — scabs on surgical sites will begin to slough off 7-10 days — no chips or rough foods for several days!
  • sore throat, slight ear pain
  • normal (↑ = infection)
  • foreign body in nose — caused from infection in the area — remove foreign body
52
Q

Otitis Media
• what is it? preceded by?

treatment
• use 
• avoid \_\_\_; need \_\_\_\_ foods
• teach parent that?
• avoid \_\_\_\_ of any kind
• may require what? uses? if they have it in ears, what to wear when in bathtub or swimming?
prevention
• position for feedings
• no \_\_\_\_ propping
• gentle nose \_\_\_\_
• play \_\_\_\_\_ games
• avoid \_\_\_\_ of any kind
A

• middle ear infection; BULGING, BRIGHT RED, TYMPANIC MEMBRANE; upper resp infection

treatment
• use ANTIBIOTICS
• avoid CHEWING; need SOFT foods
• teach parent – child may not be able to hear them well
• avoid SMOKE of any kind
• TYMPANOSTOMY TUBES or PE (pressure equalizing) TUBES – keep middle ear drained (temporary and it’s ok when it falls out) — wear earplugs when in bathtub or swimming

prevention
• SITTING UP
• no BOTTLE propping
• gentle nose BLOWING
• play "BLOWING" games (blow balloon, pinwheel)
• avoid SMOKE of any kind
53
Q

Cystic Fibrosis (CF)
• what is it? involves what?
• what’s given to help improve digestion w/ every meal and snack? take within how many mins of eating? beads should not be ____
• diet? why?

s/sx
• what’s commonly seen?
• have trouble absorbing what? what to take?
• diagnostic test for CF?
• earliest sign in newborn?
• w/ CF, mucous secretion are ____ and ____

• what kind of disorder is this?

A
  • genetic/inherited disease involves sx r/t exocrine glands – involves GI system and Respiratory system
  • PANCREATIC ENZYMES; take within 30 MINUTES of eating; NOT CRUSHED/CHEWED
  • HIGH FAT, HIGH CALORIE — usually underweight
s/sx
• STEATORRHEA (fatty, frothy stools)
• fat-soluble vitamins---do not absorb fat well; take Water-miscible forms of fat-soluble vitamins (in multi-vitamin form) to improve absorption "ADEKs"
• Sweat Chloride test
• meconium ileus (cannot pass meconium)
• THICK and STICKY

• Autosomal Recessive Disorder –MUST get the gene from both parents

54
Q

Fat-Soluble Vitamins

A

A, D, E, K

55
Q

Down Syndrome
• most common what? a.k.a.?
• what type of infections are they most prone to? why?
• most common type of physical defect associated with DS?
• Risk factor? Genetic counseling is use for?

A
  • birth defect; Trisomy 21
  • Respiratory infections d/t POOR IMMUNE SYSTEM
  • Congenital heart defects
  • Advanced maternal age; To inform parents of their RISK
56
Q

Celiac Disease
• what is it?

treatment
• teach?
• cannot have BROW?
• can have RCS?

A

• genetic disorder causing malabsorption d/t intestinal INTOLERANCE TO GLUTEN

  • teach it’s a lifelong disorder so NO FOOD W/ GLUTEN (vegetable proteins)
  • Barley, Rye, Oats, Wheat
  • Rice, Corn, Soy
57
Q 
Sickle Cell Disease
• what is it?
• s/sx
• \_\_\_\_ Blood Flow → \_\_\_\_ Oxygen → PAIN
• treatment
A

• hereditary form of anemia — normal Hgb is partly/completely replaced by abnormal Hgb and sickle-shaped RBCs

s/sx
• PAIN in areas of involvement; Anorexia (loss of apetite); Exercise intolerance; Fatigue, malaise
• ↓ Blood Flow → ↓ Oxygen → PAIN

treatment
• bed rest, HYDRATION, analgesics, abx, blood transfusion or packed RBCs (temporary fix), O2 (if hypoxic), Hydroxyurea (chemo med–reduce painful episodes)

58
Q

Duchenne’s Muscular Dystrophy
• what is it?
• common in what gender? why? onset? ages what?
• s/sx
• treatment
–how to maintain optimum muscle function?
–prevent what?
–what help improve muscle strength and respiratory function?
–as disease progresses?

A
  • most common and severe muscular dystrophy; inherited as X-linked recessive trait
  • Male children; it’s a X-linked recessive trait; early childhood 3-5 yo
s/sx
• LORDOSIS (curvature of lower spine)
• WADDLING gait
• frequent falls: muscle weakness
• TOE WALKING
• GOWER'S SIGN (classic sign of DMD) -- climbing or walking up oneself in an effort to standing up position
tx
• physical therapy
• prevent contractures
• Steroids
• support groups and palliative care
59
Q

Tet Spells
• what is it? seen in children with what?
• caused by?

treatment?
• position?
• monitor what?

prevention
• \_\_\_\_ play
• minimize \_\_\_\_
• respond to \_\_\_\_ quickly
• \_\_\_\_\_ in infants and small children is usually d/t Congenital heart defects

• What’s Congenital heart defects?

A
  • “hypercyanotic” spells; childrent w/ congenital heart defect of TETRALOGY OF FALLOT
  • insufficient blood flow to lungs

tx
• 100% O2, Morphine for sedation
• position – KNEE-CHEST POSITION — ↓ venous return from lower extremities and ↑ systemic resistance = diverts blood to pulmonary artery for oxygenation

prevention
• QUIET play
• minimize STRESS
• respond to CRYING quickly
• heart failure

• Structural defect of heart or great vessels that’s present at birth

60
Q

Urinary Tract Infections (UTIs)
• what is it? occurs most often in children ages what? greater risk in?

s/sx <2 yo
• if left untreated?
• tendency for infections to ____

causes?
• ____ anomalies
• why are girls more prone to UTIs than boys?

s/sx over 2 yo
• classic s/sx

diagnosis
• requires?
• most accurate method?

treatment?

prevention?
• proper wiping technique
• no \_\_\_\_\_
• what type of underwear?
• limit what kind of drink?
A

• very common but potentially serious infection in urinary tract — 2-6 yo —- females

s/sx <2 yo
• failure to thrive; Feeding problems, V/D
• if left untreated = DESTROYED RENAL TISSUE AND SCARRING = KIDNEY FAILURE
• re-occur — family teaching is important!

causes?
• RENAL anomalies;
• Constipation, Bubble baths, Poor hygiene, Pin worms, Sexual activity (sexual abuse)
• female urethra is 1 ½ in (maturity), ¾ in young females – ready pathway for microorganisms to invade

s/sx over 2 yo
• frequency, dysuria, fever, FLANK pain, hematuria, foul smelling urine

diagnosis
• properly collected urine specimen
• CATHETERIZATION

treatment
• abx PO or IV

prevention
• FRONT to BACK wiping technique
• no BUBBLE BATHS
• wear COTTON undies
• limit CARBONATED DRINKS -- reduces acidity of urine and bacteria like ALKALINE in urinary tract
61
Q

Hydrocephalus
• what is it? what builds up? causes what?

s/sx
• bulging \_\_\_\_ w/ \_\_\_\_\_ enlargement
• \_\_\_\_ scalp veins
• eyes?
• LOC?
• cry?
• \_\_\_\_\_ \_\_\_\_\_ Sign? what is it?

Diagnosis
Head circumference measure how often?

Surgical treatment
• insertion of?
–postop care
measure what? assess for? monitor? what position?

Hydrocephalus is frequently associated with a ______
• when infant is born w/ this type of spina bifida, protect what? and do not let it _____
• position?
• cover sack with a what? why?
• need special services and referrals for?

A

• disturbance of ventricular circulation of CSF; CSF builds up = ↑ ICP

s/sx
• bulging FONTANELS w/ HEAD enlargement
• DILATED scalp veins
• DEPRESSED/SUNKEN eyes
• IRRITABILITY and changes in LOC
• HIGH-PITCHED cry
• SETTING SUN Sign ---- can see the white all around the iris

Diagnosis
Head circumference measure every well-child check-ups until 3 YEARS OLD

Surgical treatment
• insertion of VP SHUNT (ventriculoperitoneal shunt)
–postop care
• measure HEAD CIRCUMFERENCE
• assess BULGING FONTANELS and widening cranial suture lines
• monitor TEMP
• SUPINE position

Hydrocephalus is frequently associated with a MYELOMENINGOCELE
• when infant is born w/ this type of spina bifida, protect SAC and do not let it RUPTURE
• position PRONE
• cover sack with a STERILE MOISTENED DRESSING —- so it won’t DRY OUT while waiting for surgery
• mobility and developmental delays

62
Q 
Scoliosis
• what is it?
• can be \_\_\_\_ or \_\_\_\_\_
• contributing factors?
• Treatment (3 O's)?
A
  • musculoskeletal disorder — lateral curvature and rotation of spine
  • idiopathic (no cause) or congenital
  • heavy backpacks/suitcases; Bags; Carrying children on hips

tx
• Observation
• Orthosis (supports and braces)
• Operation (spinal fusion w/ rods)

63
Q 
Chicken Pox
• what is it?
• how to not get it?
• primary focus is to prevent what? 
• home remedies to relieve itching?
• is it contagious?
• what virus causes chicken pox?
A
  • childhood communicable disease; the same virus that causes Shingles as a person gets older
  • vaccines recommended by CDC
  • prevent infection of lesions
  • oatmeal bath and baking soda w/ water
  • YES! VERY CONTAGIOUS
  • Varicella zoster
64
Q

Parenting Style: Authoritarian

A

highly controlling, expects to be obeyed, inflexible rules

65
Q

Parenting Style: Authoritative

A

the GOOD ONE!

sets reasonable limits on behavior, encourages growing autonomy of child, open communication

66
Q

Parenting Style: Permissive

A

few/no restraints, unconditional love, much freedom, little guidance, no limit setting

67
Q

Parenting Style: Indifferent

A

no limit setting, lacks affection for the child, focused on own life

NCLEX (24 decks)

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