Pediatrics: Body systems Flashcards
Solutions/Actions for Otitis Media
Tx: ABX, Analgesics, Numbing ear drops
Nursing Interventions: Lay on affected ear with warm/Heat compress, Immunization (flu), No smoking near children, stress the need to follow up with PCP due to risk of hearing loss
Write out the concept map for Asthma (Notice, Analyze, Hypothesize, Solutions, Actions, Evaluate Outcomes)
S/S: Cyanosis, work of breathing/SOB, Wheezing, barrel chest, anxiety
Tx: Bronchodilators, inhaled corticosteroids, leukotriene modifiers
Dx: Pulse Ox
Chest radiograph- hyperinflation
ABG: Decreased Co2, hypoxemia
Pulmonary fx tests (Incentive spirometer = decreased)
Allergy testing
Solutions/Actions for burns
Warm fluid resuscitation
100% O2 via non rebreather for severe burns
Wound care- culture
Infection prevention
Keep pt warm/prevent shivering
PT/OT/intubation if necessary
Labs/Dx: Wound culture, pulse ox + cardiac monitoring, chest radiograph for inhalation injury, pain management, CBC + ABG trends
Notice/Analyze/Hypothesize increased pulmonary blood flow disorders (ASD,VSD, PDA)
Notice- S/S mimic heart failure, failure to thrive, cyanosis during stress
Analyze- Echocardiogram to confirm dx, chest radiograph to reveal cardiomegaly
Hypothesize- Prevent stress, indomethacin for PDA if symptomatic to decrease symptoms of heart failure
**For all other defects or if unsuccessful, proceed with surgery & prostaglandin
Evaluate Outcomes for Glomerulonephritis
Decreased edema, decreased work of breathing, decreased s/s of kidney dysfunction, increased urine output, assess need for dialysis education, controlled BP, medication adherence for diuretics, antihypertensives (labetalol + nifedipine), pt stating education regarding med for strep if future instances occur
Hypothesize/Solutions for Submersion Injury
Labs/Dx: ABG to determine respiratory acidosis, ECG to determine cardiac arrhythmias, chest radiograph to view pulmonary edema + infiltrates
Solutions: Assess need for airway interventions, stabilize cervical spine, suction airway, supplemental O2 at 100%, possible intubation, orogastric/nasogastric tube to decompress stomach + prevent aspiration of stomach contents, slowly warm pt with fluids + towels + blankets
When would you begin CPR on a child?
If there is no pulse present or if HR is less than 60 and there are no s/s of perfusion
Actions for Diabetes Mellitus
Hypo- Nervousness, confusion, sweating, tachycardia, slurred speech, ALOC, hunger, seizures
Actions- Admin glucagon, Provide 10-15g simple carbs. Wait 15 min + reassess
Hyper- Dry mouth, increased thirst, Weakness, deep/rapid breaths, headache, blurred vision, frequent urination
Actions- Admin NS, insulin
Notice/Analyze/Hypothesize for Hirschsprung disease
Notice- Down syndrome, failure to pass stool within first 24 hours of life, distended abdomen, palpated stool mass
Analyze- Barium enema: Intestinal narrowing, rectal suction biopsy: absence of ganglion cells + provide definitive dx
Hypothesize- Surgical resection of bowel + reconnection of intestine to restore bowel fx (temporary stoma creation)
**Bowel rest, ABX, and IV fluids if low BP
Evaluate Outcomes for Febrile Seizures
(When they occur, longterm complications)
Occurs in children less than 5 years of age
Longterm complications: status epilepticus, motor coordination deficits, intellectual disability, and behavioral problems
Meds: Benzodiazepines (diazepam, midazolam, lorazepam), acetaminophen to lower fever
** Monitor fever, during seizure decrease stimulation
Actions for Fractures
Immobilize fracture in splint
Assess for compartment syndrome
Cool therapy for first 48 hours
Determine abuse (could fracture realistically occur based on age + location?)
[Femur/Rib/Humerus in children less than 2 years of age = abuse]
Notice/Analyze for Anaphylaxis
Notice- Massive vasodilation (drop in BP due to increased Co2/ resp alkalosis)
Tachycardia, hives, angioedema, SOB, stridor, chest/abdominal pain, vomiting
Analyze- IM Epinephrine, IV diphenhydramine/Benadryl, Albuterol, Supplemental O2 + fluids
Solutions/Actions for Wilms Tumor
Solutions- Nephrectomy (kidney removal), radiation, chemotherapy
Actions- Do not palpate abdomen following surgery to prevent tumor “seeding”, if nephrectomy completed no contact sports to protect remaining kidney
Compare/Contrast: Early vs. Late signs of increased ICP
Early: Bulging fontanel, wide sutures, high-pitched neuro cry, decreased HR/RR, Vomiting, ALOC, increased BP, Sunset eyes, Dizziness/blurred vision, headache
Late: Decreased LOC, Bradycardia, Irregular RR, Fixed/Dilated pupils, Decerebrate/Decorticate positioning, decreased motor/sensory responses, Cheyne-Stokes response.
ICP drain complications
Infection, malfunction, obstruction
EVD- Clamp drain when child is moving + rezero and open when done
**Zero at clavicle
**Document color & volume of CSF every hour
**Routine CSF sent daily
**Prophylactic ABX required
What is the 1st sign of Heart Failure + Tx in children?
1st sign: Tachycardia
Tx: Diuretic, Digoxin(monitor therapeutic levels), Catheterization
What is the therapeutic dose for Digoxin?
0.6 - 2.0
For pediatrics, which medication is not allowed under 6 months?
Ibuprofen & aspirin
Notice/Analyze/Hypothesize Epiglottitis
Notice- High fever, Sitting forward with neck extended (tripod positioning), drooling/dysphagia, refusal to speak/lay down
Analyze- Epiglottis, airway closure risk if lay child down or try to visualize throat [Need to intubate/ventilate]
Hypothesize- Lateral neck radiograph , 100% oxygen admin, IV ABX
How would you administer eardrops to a child less than 3?
Pull the pinna down and back, direct the eardrops towards the wall of the canal
