Pediatrics- Emergencies/ Psychosocial Issues Flashcards
1
Q
What are some examples of respiratory emergencies?
A
Respiratory insufficiency
Respiratory failure
Apnea
Respiratory arrest
Airway obstruction
2
Q
What is respiratory insufficiency?
A
Increased work of breathing with mostly had a quick gas exchange or hypoxia with acidosis
3
Q
What is respiratory failure?
A
Inability to maintain adequate oxygenation of the blood
4
Q
What is apnea?
A
Cessation of respirations for more than 20 seconds
5
Q
 What is respiratory arrest?
A
Complete cessation of respirations
6
Q
What is airway obstruction caused by?
A
Can be due to aspiration of foreign body
7
Q
What early indications of respiratory distress
A
Restlessness
Tachypnea
Tachycardia
Diaphoresis
Nasal flaring
Retractions
Grunting
Wheezing
8
Q
What is an expected, finding an advanced hypoxia?( late respiratory distress)
A
Bradypnea
Bradycardia
Cyanosis
Stupor
Coma
9
Q
What are indications of choking?
A
Universal choking sign
Inability to speak
Weak, ineffective, cough
High pitch sound or no sounds
Dyspnea
Cyanosis
10
Q
Nursing care for respiratory emergencies
A
CPR for respiratory in Cardiac arrest
Position to maintain patent airway
Prepare for intubation
Use calm approach
11
Q
Nursing care for obstructed airway
A
For infants, use a combination of pack blues in Chest thrust
Remove any visual obstruction or large debris from the mouth, but do not perform blind finger sweep
12
Q
What is the recovery position for a child who resumes breathing?
A
Side, lying position with legs, bent at knees for stability
13
Q
What is drowning
A
Asphyxiation will a child is submerged in fluid can occur in any standing body of water That is at least 1 inch deep.
14
Q
What is a submersion injury?
A
Near drowning, incidents are those in which children have survive for 24 hours after being submerged in fluid
15
Q
 What are risk factors for drowning?
A
Children ages 0 to 4
Swimming
In adequate supervision or unattended bathtub pools
Not wearing a life jacket
Child abuse
16
Q
Nursing care for a drowning patient
A
Administer oxygen
Provide chest physiotherapy
Monitor for complications that can occur 24 hours after incident (cerebral edema, respiratory distress)
Use calm approach
17
Q
Client education for drowning
A
Lock toilet seats
Do not leave a child unattended in the bathtub
Small amount of water can lead to accidental drowning
Do not leave a child unattended in a swimming pool
Make sure private pools our fence with a lock gate
Provide life jacket
18
Q
What is apparent life-threatening event?
A
Set an event where the infant exhibit apnea change in color, changing muscle tone and choking
19
Q
Respecters for apparent life-threatening event
A
Gerd
Respiratory infection
Seizure
UTI
Sepsis
20
Q
Expected findings during the event of an apparent life-threatening event
A
Apnea can be present
Changing color -pallor redness, cyanosis
Change in muscle tone
Choking, gagging and coughing
21
Q
What should be an expected findings of an apparent life-threatening event?
A
Description of the event by the observer
CPR efforts provided
22
Q
Client teaching for an apparent life-threatening event
A
Use an apnea monitor
Learn CPR
23
Q
What is sudden infant death syndrome?
A
Sudden unpredictable death of an infant without an identified cause
24
Q
What are risk factors for SIDS
A
Maternal smoking
Secondhand smoke
Co sleeping
Nonstandard bed
Prone or sideling sleeping
Low Apgar score
Poverty
25
What is client teaching to reduce the risk of SIDS?
Place the infant on the back for sleep
Avoid exposure to tobacco smoke
Prevent overheating
Use firm, tight fitting mattress
Remove pillows, quilts, stuffed animals
Avoid cosleeping
26
What are risk factors for poisoning?
Children younger than six years of age
Improperly stored medication, household chemicals, and hazardous substances
Lead ingestion from paint 
27
What information do you need to find out about the poisoning?
Name and location
Amount ingestion
Time ingested
28
What is a physical response after 2 to 4 hours of ingestion of acetaminophen poisoning?
Nausea, vomiting, sweating in pallor
29
What is a physical response after 24-36 hours of ingestion of acetaminophen poisoning?
Improvement in condition
30
What is a physical response after 36- 7 days or longer hours of ingestion of acetaminophen poisoning?
Hepatic stage pain in upper right quadrant, confusion, stupor jaundice, and coagulation disturbances
31
What is the final stage of acetaminophen poisoning?
Death or gradual recovery
32
What is a physical response after the acute poisoning of aspirin (aceltylsalictlic acid)
Nausea, vomiting, disorientation, diaphoresis, tachypnea tinnitus ogularia, lightheadedness and seizures
33
What is a physical response after the chronic poisoning of aspirin (aceltylsalictlic acid)
Settle version of acute manifestations
Bleeding tendencies
Dehydration
Severe seizures
34
What is the physical response to the initial period of supplemental iron poisoning?
Initial period ( 30 min- 6 hrafter ingestion)
Vomiting, hematemesis, diarrhea, gastric pain, and bloody stools
35
What is the physical response to the latency period of supplemental iron poisoning?
Latency period (2 to 12 hours after ingestion)
Improvement of condition
36
What is the physical response to the systemic toxicity period of supplemental iron poisoning?
Systemic toxicity period( 4 to 24 hours after ingestion)
Metabolic acidosis, hyperglycemia, bleeding, fever, shock, and possible death
37
What is the physical response to the hepatic injury period of supplemental iron poisoning?
Hepatic injury Period(48-96 hrs. after ingestion)
Seizure or coma
38
What is hydrocarbons
Gasoline, kerosene, lighter fluid paint thinner turpentine
39
What are physical responses to hydrocarbons?
Gagging and choking and coughing, nausea vomiting
Lethargy, weakness, tachypnea cyanosis, grunting, and retractions
40
What are corrosives
Household, cleaners, batteries, denture, cleaners, bleach
41
What are physical responses to corrosives?
Pain and burning in my throat and stomach
Edematous lips tongue and pharynx with white mucus membranes
Violent vomiting with Hemoptysis
Drooling
42
What are physical responses to low dose exposure of lead?
Distractibility, impulsiveness, hyperactivity, hearing impairment, intellectual difficulty
43
What are physical responses to high-dose exposure of lead?
Cognitive delays, bearing and severity, blindness, paralysis, seizure and death
44
Nursing care of a patient who was poison
Assist with gastric decontamination
Activated charcoal
Gastric lavage
Increase bowel motility
Syrup of ipecac is contradicting for routine, poison control treatment
45
Poisoned with aspirin (acetylsalicylic acid) what is the intervention
Activated charcoal
Gastric lavage
Sodium bicarbonate
Oxygen
Vitamin K
46
If a patient is poisoned with supplemental iron what is the intervention?
Emesis or lavage
47
If a patient ingests hydrocarbons, what is the intervention
Do not induce vomiting
Intubation prior to any gastric decontamination
48
If a patient in just a corrosive, what is the intervention?
Aerie maintenance
NPO
Do not attempt to neutralize acid (corrosive)
Do not induce vomiting
49
Client education for poison prevention
Keep Toxic agents out of reach
Lock cabinets
Do not take medication in front of children
Discard unused meds
Do not say meds are candy
Illuminate, lead-based paint
50
Nurse is caring for a child who is experiencing respiratory distress which of the following are early manifestations of respiratory distress(select)
Bradypnea
Peripheral cyanosis
Tachycardia
Diaphoresis
Restlessness
Tachycardia
Diaphoresis
Restlessness
51
A nurse in the emergency department is caring for a child, whose parent reports that the child has swallowed paint thinner. The child is lethargic, gagging and cyanotic which of the following action should the nurse take
Induce vomiting with syrup of ipecac
Insert an NG tube and administer activated charcoal
Prepare for intubation with cuffed endotracheal tube
Administer chelation therapy using deferoxamine mesylate 
Prepare for intubation with a cuffed endotracheal tube
52
A nurse in the emergency department is admitting an infant who experienced a life-threatening event, which of the following prescriptions by the provider should the nurse anticipate(select)
Electroencephalogram
Electrocardio gram
Urine culture
Arterial blood gases
Blood culture
Electroencephalogram
Electrocardio gram
Urine culture
Blood culture
53
A nurse is providing teaching to a caregiver about acetaminophen poisoning, which of the following information should the nurse include in the teaching
Nausea begins 24 hours after ingestion
Pallor appear as early as two hours after ingestion
Jaundice will appear in 12 hours if the child is toxic
Children can have 4 g per day of acetaminophen
Pallor can appear as early as two hours after ingestion
54
A nurse is in a community center in his providing in-service to a group of parents on management of airway, obstruction, and toddlers, which of the following responses by one of the caregivers indicates understanding(select)
I will put on my child abdomen
I Will hyper extend my child’s head to open the airway
I will listen over my child’s mouth for sounds of breathing
I will use my finger to check my child’s mouth or objects
I will place my child in the car and take them to the closest emergency facility
I will push on my child abdomen
I will listen over my child’s mouth for sounds of breathing
55
How do you detect depression?
Difficulty to detect and often overlooked in school age, children, because children have limitations, and expressing their feelings
Findings must be present for one year to diagnose
56
Expected findings and depression
Sad facial expression
Tend to remain alone
Withdrawn from family, friends and activities
Fatigue
Tearful/crying
Ill feeling 
Worthlessness
Weight loss or gain
Alterations in sleep
Lack of interest in school
Low self-esteem
Hopelessness
Suicidal ideations
57
Nursing care for depression
Plant care that is individualized
Assessed for actual or potential risk to self
Encourage peer group discussions 
58
What is a risk factor for PTSD?
Genetic predisposition
Traumatic incident
Repeat a trauma
Psychiatric disorder
Natural disaster
Sexual abuse
Witnessed a homicide or other violent act
59
Expected findings in the initial response of a PTSD patient
Last few minutes to two hours
Increased stress, hormone fight or flight
Psychosis
60
What is the second phase expected findings in a patient with PTSD
Last approximately two weeks
Period of calm (feeling of numbness denial)
Defense mechanisms, decrease
61
What is expected findings in the third phase of PTSD
The coping face extends 2 to 3 months
Client gets worse instead of better
Depression, phobias, anxiety, conversion reactions, repetitive movements, flashbacks, or obsessions occur
62
What is attention deficit hyperactive disorder?
 Inattentiveness, hyperactivity, and impulsiveness usually revealed prior to the age of seven
63
How many findings must a child me in the diagnostic criteria for ADHD in order to diagnose the disorder
Six or more findings from a category are present
Inattention
Or hyper activity impulsivity
64
Expected findings inattention category of ADHD
Failing to pay close attention
Blocking incoming stimuli
Difficulty sustaining attention
Does not seem to listen
Failing to fall through on instructions
Difficulty organizing
avoiding activities that require your mental effort for a period of time
Losing things
Easily distracted
Forgetfulness
65
Expected findings in the hyperactivity
Category of ADHD
Fidgeting
Failing to remain seated
Inappropriate running
Difficulty engaging in quiet play
Seeming to be busy all the time
Talking excessively
66
Expected findings in the impulsivity category of ADHD
Blurting out responses before questions are asked
Difficulty waiting, turns
Interrupting often
Striking out, biting, shouting
67
Nursing care for a patient with ADHD
Use behavioral check list
Use calm, firm, respective approach
Obtain child attention before giving directions
You short and clear explanations
Focus on strengths, not problems
Provide positive feedback
68
How can a nurse assess a family with a child who has ADHD with behavioral strategies?
He was positive reinforcement
Rewards for good behavior
Age-appropriate consequences
You structured environment
You steps when assigning chores
Include regular brakes
69
What is autism spectrum disorder?
Complex neurodevelopmental disorder with spectrum of behaviors, affecting an individuals ability to communicate and interact with others in a social setting
70
Expected findings in a patient with autism
Distressed when routines are changed
Unusual attachment to objects
Inability to start or continue conversation
Using gestures instead of words
Delayed or absent language development
Inability to adjust keys, or look at something else
Lack of empathy
Decrease pain sensation
Spending time alone rather than others
Avoiding eye contact
Repetitive movements
71
Delays in at least one of the following can be expected findings of autism
Social interaction
Social communication
Imaginative play prior to the age of 3
72
Nursing care for a patient with autism
Refer to early intervention
Promote positive reinforcement
Increase social awareness
Teach verbal communication
Decrees unacceptable behaviors
Introduce the child to new situation slowly
73
What is a risk factor for an intellectual disability?
Infections
Fetal alcohol syndrome
Lead ingestion
Trauma to the brain
Gestational disorder
Pre-existing disease
74
Expected findings in a patient with intellectual disability
Delay, developmental, milestones
In ability to reason, or problem solved
75
What are some early manifestations of an intellectual disability?
Abnormal eye contact
Feeding difficulties
Language difficulties
Fine and gross motor delays
Decreased alertness
Reduce response to name
Decrease response to social cues
76
Nursing care for a patient with intellectual disability
Individualized clients needs
Add visual cues with verbal instruction
Give one step instructions
Encourage play
77
What is failure to thrive?
In adequate growth, resulting from the inability to obtain or use calories required for growth
Usually a child who falls below the 5th percentile for weight and has persistent weight loss
78
What are some causes of failure to thrive?
Inadequate, caloric intake
Breast-feeding difficulties
Excessive juice consumption
Inadequate absorption
Increase metabolism
79
What are risk factors of failure to thrive?
Preterm birth, with low birthweight
Parental neglect
Poverty
Family stress
80
Expected findings in failure to thrive
Less than the 5th percentile and growth chart for weight
malnourished appearance
Poor muscle tone
No fear of strangers
Minimal smiling
Decreased activity level with withdrawal
Wide eyed case
81
Nursing care for a patient who has failure to thrive
Obtain baseline, height and weight
Establish a routine for eating and encourage usual times, duration and setting
Use proper positioning latch on a timing
Provide 24 K calorie ounces formula
Administer high calorie milk, supplements
Administer zinc and iron multivitamins
82
What should you encourage the caregiver to do with a patient who is failure to thrive
Maintain eye contact
Talk to the infant
Verb the infant frequently
Remain calm during 10 to 15 minutes of food refusal
Introduce new food slowly
Never force infant to eat
Recognize infant cues of hunger
83
What is mail treatment of infants and children?
Parental child and environmental characteristics across all economic, educational backgrounds in racial ethnic religious groups
Can include physical, sexual, emotional and neglect
84
What is physical nail treatment of a child?
Causing pain or harm to a child
Shaken baby syndrome fractures fictitious disorder, imposed on another
85
What is sexual mailtreatment of a child?j
Occurring when sexual contact takes place without consent, whether or not the victim is able to give consent
Includes any sexual behavior toward of minor and dating violence among adolescents
Employment use persuasion or inducement of a child to engage in any sexual explicit conduct
86
What is emotional mail treatment of a child?
Humiliating, threatening, or intimidating a child
Includes behavior, it that minimizes an individual feeling of self-worth
87
What is neglect a physical care of a child
Failure to provide feeding, clothing, shelter, medical or dental care, safety, and education
88
What is neglect of emotional care of a child
Stimulation to foster normal development: nurturing, affection and attention
89
What is risk factors for maltreatment of a child?
Young age
Having a partner unrelated to the child
Social, isolation
Low income
Lack of education
Low self-esteem
Lack of parenting knowledge
Substance use
History of abuse
90
Who is at the highest risk for male treatment of a child?
One year old or younger, due to the need for constant attention, and increase demands of caregiving
Children who are unwanted, hyper, active, or have physical or mental disabilities due to the increase demands of attention
91
What are warning or indicators of abuse?
Physical evidence of abuse
Vague explanation of injury
Other injuries discovered that are not related to the original concern
Delay in seekin care
Statement of possible abuse
Inconsistencies between stories in injuries
Repeated injuries
92
Warning, indicators of physical neglect
Failure to thrive
Malnutrition
Lack of hygiene,
Frequent injuries,
School absences, 
93
Warning, indicators of physical abuse
 Bruises in Welt in, various stages of healing
Bruising in non-mobile
Multiple fractures, a different stages of feelings
Burns
Fractures
Fear of parents
Withdrawal
Aggressiveness
94
Warning, indicators of emotional neglect, and abuse
Eating disorders
Sleep disturbances
Lack of social smile
Delay development
Attempt suicide
95
Caregivers behaviors and emotional neglect and abuse
Rejecting isolating, terrorizing, ignoring, verbally, assaulting, or overpressuring the child
96
Warning, indicators for sexual abuse
Bruises
Bleeding of genitalia anus mouth
STI
Difficulty, walking or standing
Personality changes
Bloody Torn stained underwear
Unusual body odor
97
What can cause a parent to shake their baby?
Frustrations with persistent, crying
98
Warning, indicators of shaken baby syndrome
Vomiting poor feeding
Bulging fontanelles
Retinal hemorrhage is
Seizure
Altered Loc
Blindness
99
What should suspicious of an infant before six months of age
Bruising
100
Nursing care for abuse
Identify abuse as soon as possible
Remove child from situation
Photograph in detail all visible injuries
 Mandatory reporting is required
Use open ended questions that require descriptive response
Avoid asking the child probing questions
101
Birds that appear glove or stocking, like on hands, or feet, can indicate what in children
Forrest immersion into boiling water
102
Small round burns in children can be caused by what
Cigarettes
103
The nurse is teaching a group of parents about characteristics of infants, who have failure to thrive which of the following characteristic should the nurse include in the teaching
Intense fear of strangers
Increased risk for childhood obesity
 Inability to form close relationships with siblings
Developmental delays
Developmental delays
104
A nurse is providing instructions to the teacher of a child who has ADHD, which of the following classroom strategies to the nurse, include in the teaching (select)
Eliminate testing
Allow for regular breaks
Confine verbal instructions with visual cues
Establish constant classroom rules
Increased stimuli in the environment
Allow for regular breaks
Combine verbal instructions with visible cues
Establish consistent classroom rules
105
A nurse is teaching a parent about PTSD which of the following information should the nurse include in the(select)
Children who have PTSD can benefit from psycho therapy
A manifestation of PTSD is phobias
Personality disorders are a complication of PTSD
PTSD develops following a traumatic event
There are six stages of PTSD
Children who have PTSD can benefit from psychotherapy
A manifestation of PTSD is phobia
PTSD develops following a traumatic event
106
A nurse is teaching the parent of a child about risk factors for ADHD, which of the following should the nurse include in the teaching
Formula feeding as an infant
History of head trauma
History of postterm birth
Child of a single parent
History of head trauma
107
A nurse is caring for a child who has depression which of the following findings should the nurse expect(select)
Preferring being with peers
Weight loss or gain
Report of low self-esteem
Sleeping more than usual
Hyperactivity
Weight loss or gain
Report of low self-esteem
Sleeping more than usual
108
What are symptoms of the new Nate is going to heroin withdrawal?
Low birthweight small for gestational age decreased Moro reflex is jittery sheill persistent cry
109
What are symptoms of a neonate is going through methadone withdrawal
Increased incidence of seizures
Sleep disturbances
How your birth weight
High risk of SIDS
110
What symptoms does a neonate go through during cocaine exposure?
High-pitched cry
Abnormal sleep patterns
Excessive, sucking
Inability to consol
Poor tolerance to change an in routine
111
What symptoms does a neonate go through with meth withdrawal?
Small head circumference
Vomiting
Rapid, respiration rate
Emotional disturbances
Delayed growth and development
112
What symptoms does a patient with fetal applesauce syndrome have?
Small eyes, then upper lip, flat, mad face, lack of stranger, anxiety, developmental, delays diminished fine motor skills
113
A nurse is reviewing the medical record of a newborn who is necrotizing enterocolitis, which of the following findings as a risk factor for an NEC
Macrosomia
Transient tachypnea of the newborn
Maternal, gestational, hypertension
Gestational age 36 weeks
Gestational age 36 weeks
114
The nurse is assessing a newborn who has congenital hypothyroidism which of the following findings should the nurse expect(select)
I
Hypertonicity
Cool extremities
Short neck
Tachycardia
Hyperreflexia
Cool extremities, short neck
115
A nurse is teaching a parent of a newborn how to treat a newborns plagiocephaly, which of the following statements by the parent, indicates an understanding of the teaching
I should put my baby to sleep on their belly during the afternoon nap
I should ensure my baby’s head is in the same position whenever sleeping
I should have my baby where the prescribed helmet 23 hours a day
I should allow my baby to sleep in an infant swing
I should have my baby wear the prescribed helmet at 23 hours a day
116
Are nurses developing a plan of care for a newborn who has hyper bilirubinemia it is to undergo phototherapy, which of the following action should the nurse include in the plan of care
Reposition the new weren’t every four hours
Lotion the newborn skin twice per day
Check the newborns temperature every eight hours
Remove the newborns eye mask during feedings
Remove the newborns eye mask during feedings
117
A nurse is providing preconception, teaching with a patient who has PKU, which of the following information should the nurse include in the teaching
Follow a low phenylaline Diet once pregnancy is confirmed
The client will undergo testing of phenolphthalein levels, one or two times per week throughout pregnancy
Increase intake of dietary proteins prior to conception
The client will require a cesarean section birth, due to the likelihood of having fetus with macrosomia
The client will undergo testing of phenylaline levels 1 to 2 times per week throughout pregnancy
