Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pediatrics > Pediatrics Exam 2 > Flashcards

Pediatrics Exam 2 Flashcards

1
Q

Why are infants at higher risk than adults for dehydration?

A

Higher % of H2O in Extracellular Fluid (ECF)
Immature renal function (Decreased ability to concentrate urine & Decrease GFR)
Higher metabolic rates = Higher H2O consumption
Unable to communicate third
Thirst receptors are underdeveloped

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Do infants have a high or low metabolic rate

A

high

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Can infants tell when they are thirsty

A

no

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is different about infant kidneys

A

cannot concentrate urine well

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what are the sign and symptoms of dehydration in infants (NUMBER 1 thing)

A

WEIGHT LOSS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what else might tell a nurse that an infant is dehydrated?

A

few wet diapers
no tears
irritable
fontanelles
tachycardia
hypotension
skin turgor = decreased

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

how do we manage mild/ moderate dehydration

A

can be managed at home
replace fluids every 4-6
oral rehydration therapy is effective here

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

how do we manage severe dehydration

A

this child will likely need to come to the hospital
IV fluids
isotonic IVF for replacement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what viral pathogen is the most common cause of dehydration in infants in the uS

A

Rotavirus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what advice would you give to parents on feeding a child with GERD

A

avoid foods that execrate acid reflux
feeding maneuvers
positioning can be important
Zantac for pharm management

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is Hirschsprung disease

A

congenital anganglionic megacolon

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what is the nursing care following surgery of Hirschsprung disease

A

⇒ Help parents understand defect
⇒ Foster bonding
⇒ Assist with colostomy care
post procedure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What do you need to explain to the parents of a child who needs surgery for Hirschsprung disease

A

this is a two step procedure !!!
ostomy to relieve distention and then a pull through procedure later

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How should you position a child in pain due to appendicitis

A

in a position of comfort for them

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What measures can be taken to care for a child post surgery for cleft lip

A

post surgery comforting is important
no pacifier

haberman cradle
gavage feeding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the nursing care for a child with trachea-esophageal fistula?

A

we want to make sure we diagnosis this prior to the first feed since it can be super dangerous if not!!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

once you diagnosis a child with trachea-esophageal fistula what nursing considerations are there

A
  • monitor for abdominal distention
  • maintain patent airway!!!
    -usually this is a surgical emergency
  • NPO !!!
    _gastric tube placed
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what is nursing care for a child with omphalocele

A

maintain NPO
IV therapy
moniter infant temp closely
repairing the sac may be staged dependent on how much is outside the body and the infant size
keep the sac moist

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what are the symptoms of pyloric stenosis

A

projectile vommiting !!!!
Lethargy
Fluid/electrolyte disturbances
Upper abdomen distention with visible peristaltic waves
Palpable olive like mass in the upper quadrant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what is the treatment for intussusception

A

Radiologist guided pneumoenema

Ultrasound guided hydrostatic (saline) enema

If not successful surgical intervention may be needed

Nonoperative reductions are successful in 80% of cases

Recurrence of condition post treatment occurs in 1 out of 10 patients

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what is Radiologist guided pneumoenema

A

air given for intussusception

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Other then projectile vommiting, what is another unique feature of pyloric stenosis

A

Upper abdomen distention with visible peristaltic waves

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is the risk of TPN (total parenteral nutrition)?

A

long term can lead to liver failure
overfeeding syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What medications are used for severe inflammatory bowel disease?

A

Aminosalicylates
Corticosteroids
Immunomodulators
Antibiotics
Biologics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

what are aminosalicylates used for

A

prevents leukocytes from entering the bowel in IBD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

corticosteriods are used for IBD because

A

we need to decrease inflammation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

when thinking about IBD which two pharmacological interventions are to modulator the immune system

A

immunomodulators
biologics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

what is the normal age for sexual development to begin in girls

A

Girls between 10 and 14

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

what is the normal age for sexual development to begin in boys

A

Between 12 to 16

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What is the nursing care for children who receive daily injections of biosynthetic growth hormone?

A

Early identification of growth problems
Family support and education === Daily injections & Rotating sites
Child’s body image
Treatment is expensive

31
Q

what is the relationship between exercise to glucose levels in diabetics (children)

A

exercise lowers blood sugar
more risk of hypoglycemia in these cases
brings snacks

32
Q

what are the signs of hypoglycemia

A

Hunger
Dizziness
Anxiety
Shakiness
Sweating

33
Q

what are the symptoms of DKA

A

Hyperglycemia ⇒ Diuresis (frequent urination)
Dehydration ⇒ Shock this will be your priority action
Acidosis ⇒ Lipolysis
Rapid deep respirations ⇒ Electrolyte imbalances
Can lead to coma ⇒ Hyperosmolality

34
Q

in terms of DKA, priority action is …

A

Dehydration ⇒ Shock this will be your priority action

so we want to rehydrate these patients

35
Q

at what age can children start giving their own insulin

A

Around 10 -12

36
Q

What is the treatment for ketones in the urine of a child with diabetes who has been ill?

A

need to know urine ketones and blood ketones to then be able to treat using fast acting insulin

37
Q

negative urine ketones and blood ketones under 0.6 means

A

no extra insulin and recheck blood every 3 hours

38
Q

small amount of urine ketones and blood ketones 0.6 to 1.5 means

A

increase the correction 5% and recheck blood every 3 hours

39
Q

moderate amount of urine ketones and blood ketones 1.5 to 3 means

A

increase the correction 10%

40
Q

large amount of urine ketones and blood ketones over 3 means

A

increase the corrction 20%

41
Q

what is unique about a concussion

A

transient and reversible head trauma that will not show up on a CT scan

42
Q

What are the symptoms of post concussive syndrome?

A

You will see fatigue, poor concentration, dizziness, headache, mood swings after getting the concussion

43
Q

What are the symptoms of brain trauma?

A

When having neurological issues they can be seen having a wide based gait
Pupil may not be appearing PERLA
Skin abrasions

44
Q

what are the characteristics of hydrocephalus in a neonate

A

High pitched cry
Eyes have sunsetting feature
Bulging fontanelle
Fontanels are tense
Scalp veins are distended
Head is bulging

45
Q

What is the difference between the adult and the infant Glasgow Coma scale?

A

age appropriate motor and verbal components

46
Q

what are symptoms of brain trauma

A
  • neurological issues may present in the gait, pupils not appearing PERLA, skin abrasions
47
Q

what actions should be taken when a child is experiencing a seizure

A

stay calm
start the timer
ease the child to the floor
place apillow

48
Q

what does a CT scan tell you

A

direct tissue injury
the actual damage
will not show you a concussion

49
Q

what is a risk factor for reye syndrome

A

aspirin and varicella

50
Q

what are the characteristics of epilepsy

A

seizure disorder syndrome
Stiff muscles. Uncontrollable jerking movements of the arms and legs. Loss of consciousness or awareness. Psychological symptoms such as fear, anxiety or deja vu.

51
Q

what assessments are necessary when a child is admitted with a head injury

A

24 hour observation
hourly neuro checks
oxygen
positioning is important
looking out for fever and seizures

52
Q

how do you assess a child’s LOC

A

dependent on their baseline and developmental abilities
can includee= recognition, cry, verbal ability, feeding, behavior

53
Q

mild disability with the mental age of 8-12 you can plan to observe

A

social and vocational skills, some support and guidance as needed as an adult

54
Q

moderate disability mental age of 3 to 7 you can plan to see

A

needs a more sheltered condition (can live and work with the right treatment) but can learn simple health and safety things

55
Q

severe disability mental age of 1 to 3 you can plan to see

A

usually walks, some language skills, can conform to daily routine and rituals, supervision

56
Q

profound disability mental age of an infant you can plan to see

A

needs complete care, some primitive speech

57
Q

What are the risks of physical activity for children who have Down syndrome?

A

children with down syndrome have more heart defects

58
Q

When should developmental stimulation programs for developmentally delayed children begin?

A

As early as possible

59
Q

What are appropriate activities for children with Down syndrome?

A

Normalization is key
everyone is an individual, so activities should be chosen based on the child’s interests and abilities
Boy and girl scouts might be a good example of social activities that could incorporate children with different abilities. Inclusion in family, school and town activities - most kids enjoy these things and will have individual tolerances for activity, socialization, noise, etc.
Kids with Down syndrome still need exercise so activities that involve walking, bike riding, swimming and the like could be enjoyed.
Craft activities geared toward abilities - such as working with play-doh and all the kinds of modeling clay can strengthen hand muscles and fine motor coordination, and give the satisfaction of having created something. So, the idea is that kids with Down syndrome may have ‘differences’ from the ‘norm’ but still have the same human needs for love, interaction, mastery, physical activity, etc., so choose activities that the individual child likes and can be adapted to their abilities

60
Q

What are the physical characteristics with implications for nursing care of children with Down syndrome?

A

Tracheoesophageal Fistulas
Atlanto-axial Subluxation/Instability
a small chin, slanted eyes, poor muscle tone, a flat nasal bridge, and a single crease of the palm. Flat occiput and a flattened facial appearance

61
Q

What is the parent education for iron administration?

A

give it with OJ (helps the absorption)
expect green tarry stool
if n and v give wihth meals
may stain teeth

62
Q

What are the symptoms of vaso-occlusive crisis in sickle cell disease?

A

Pain in areas of involvement, r/t ischemia of involved areas
Extremities – painful swelling of hands and feet, painful joints
Abdomen – severe pain
Cerebrum – stroke, visual disturbances
Chest – pneumonia, protracted pulmonary disease
Liver – obstructive jaundice
Kidney – hematuria
Genitalia - priapism

63
Q

What is the purpose of daily penicillin for children with sickle cell disease?

A

significantly reduces the risk of pneumococcal infection

64
Q

what are three critical complications of sickle cell disease?

A
  1. Splenic Sequestration
  2. Acute chest syndrome
  3. cerebrovscular accident (stroke)
65
Q

what are some preventative measures that can be taken for children that have sickle cell disease

A
  1. Oral penicillin prophylaxis
  2. hydroxyurea
  3. allogenic hematopoietic stem cell transplantation
  4. avoid precipitant factors
66
Q

what vaccines should be given with caution to children with HIV

A

live virus = MMR, varicella, rotavirus

67
Q

what is mucositis

A

oral ulcers

68
Q

how should we care for a child with mucositis

A

frequent oral care!!

69
Q

what is important not to use with oral ulcers

A

viscious lidocaine
lemon glycerin
hydrogen peroxide
milk of magnesium

70
Q

what are signs of cancer in children

A

Unusual mass or swelling
Unexplained paleness and los of energy
Sudden tendentot bruise = Bruising that is abnormal
Persistent and localized pain
Prolonged fever
Frequent headaches
Sudden eye or vision changes

71
Q

What is advice for parents when children sleepwalk?

A

this will go away!
reintroduce a nap maybe
don’t wake the child
guide back to bed
safey proof

72
Q

What is advice for parents when toddlers engage in negative behavior?

A

Use a firm direct approach
Ignore temper tantrums
Use distraction technique
Restrain adequate
Reduce the opportunity to say no
Good behavior = rewards

73
Q

what is safety advice for parents when toddlers are “into everything”?

A

Supervise the child constantly
Safeguarding the environment

74
Q

What are best practices for reducing communicable disease in children?

A
  • vaccination
    -hand washing

Pediatrics (1 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions