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Rn 2024 > Pediatrics Nursing > Flashcards

Pediatrics Nursing Flashcards

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1
Q

What are the EARLY signs of increased ICP?

A

INFANT: high pitch cry/ Shill cry
CHILD: Aggitation
ADULT: Restlessness
GERIA: Confusion

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2
Q

SIGNS of Increased ICP in Infants:

A

Increased head circumference
Bulging Fontanelles
Headache
Diplopia (double vision)
Pupillary Changes
Sunset Eyes
Anorexia, Nausea, Weight loss
Seizures

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3
Q

When is the time Anterior and Posterior Fontanelles closes?

A

A. Fontanelle: DIAMOND 12-18 mos
P. Fontanelle: TRIANGLE 2-3 mos

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4
Q

INITIAL SIGN of increased ICP?

A

HEADACHE

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5
Q

One pupil is dilated the other is constricted? (O.o)

A

Anisocoria = brain Damage

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6
Q

What may be the cause of both dilated pupils?

A

SHOCK

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7
Q

What may be the cause of both constricted pupils?

A

Narcotic OD

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8
Q

What happens to the eye because of Increased ICP?

A

Sunken Eyes (PUPILS are lower)

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9
Q

Contraindicated meds for pedia’s w/ increased ICP?

A

OPIATES AND SEDATIVES
(Further increases ICP)

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10
Q

Mngt for increased ICP (pedia)?

A

Semi fowlers
Coughing/sneezing avoided
limit fluid intake (1200-1500 a day)

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11
Q

Med Management for increased ICP (pedia)?

A

Diuretics
Steroids(dexamerthasone) - prevent cerebral edema
anticonvulsants
anticoagulants - prevent clumping of blood in the brain
antacids - prevent GI irritation

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12
Q

Med Management for increased ICP (pedia)?

A

Diuretics
Steroids(dexamerthasone) - prevent cerebral edema
anticonvulsants
anticoagulants - prevent clumping of blood in the brain
antacids - prevent GI irritation

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13
Q

Antidote for HEPARIN and WARFARIN?

A

HEPARIN: Protamine Sulfate
WARFARIN: Vit. K

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14
Q

Infection of the Meninges

A

Bacterial Meningitis

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15
Q

Diagnostics for Bacterial Meningitis?

A

Lumbar Puncture
CSF Analysis

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16
Q

what vertebrae is accessed in Lumbar Puncture?

A

L3, L4. L5,

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17
Q

Position for Lumbar Puncture?

A

C- shape, fetal, kneechest/genopectoral

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18
Q

CSF Analynsis:
Normal color of CSF?

A

Clear
CLOUDY = Infection
- Elevated WBC
- Elevated protein

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19
Q

Causative agent of bacterial meningitis?

A

neisseria Meningitides

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20
Q

S/SX
KERNIG’S
BRUZINKI’s

A

KERNIG’S: Knee -> flex -> (+) pain in the hamstring

BRUDZINKI’S: Batok -> flex-> (+) pain in the neck and back

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21
Q

Other S/SX of bacterial meningitis

A

Nuchal Rigidity: body moves as one unit
Opisthotonus: arching of the back

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22
Q

Difference between Concussion and Contusion

A

Concussion: Jarring of the brain (BAGOK)
Contusion: Bruising; structural alteration due to extravasation of blood (BUKOL)

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23
Q

INFANT CAR SEAT

A

<3 y/o = rear facing (Protect the spine)
>3y/o = front/forward facing; booster seat

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24
Q

An erratic transmission of electrical impulse in the brain

A

Seizure

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25
Q

TYPE OF SEIZURE:
Known as generalized seizure

A

Grand Mal

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26
Q

TYPE OF SEIZURE:
“Absent Seizure” ; blank facial expression
- automatism
- lip smaking

A

Petite Mal

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27
Q

Tonic-clonic of a group of muscle which can lead to grand mal

A

Jacksonian

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28
Q

TYPE OF SEIZURE:
- Mental clouding and intoxication
- not common in children

A

Psychomotor

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29
Q

TYPE OF SEIZURE:
- Temperature increasing from 35c to 40c
- common in children

A

Febrile Seizure

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30
Q

TYPE OF SEIZURE:
- brain damage can occur
- can last to up to 30 mins.

A

Status Epilepticus

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31
Q

Management of Seizure

A

1st choice: Medication
2nd Choice: Surgery

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32
Q

Medical Management of Seizure:

A
  • Phenytoin
  • Benzodiazepines
  • Carbamazepines
  • Valporic acid
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33
Q

Phenytoin precautions

A

WOF: Gingival hyperplasia
- use soft bristled toothbrush
- meticulous oral care
- inform patient about pinkish/red urine

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34
Q

Valporic Acid precautions

A
  • use as last resort
  • hepatotoxic
  • never given in pregnancy - can cause neural tube defects
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35
Q

Surgical Management of Seizure

A

Neurectomy - surgical resection of cranial nerve involved in the seizure.

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36
Q

CARDIOVASCULAR DISORDERS (PEDIA)

A
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37
Q

LAYERS of the HEART

A

Endocardium: innermost
Myocardium: Muscle > Contraction; Middle
Pericardium: Outermost

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38
Q
  • Ductus arteriosus is still present after delivery
  • acyanotic
A

Patent Ductus Arteriosus

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39
Q

Pathognomonic Sign of PDA

A

Machine-like murmurs

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40
Q

DOC for PDA

A

Indomethacin - Prostaglandin inhibitor

41
Q

What maintains the patency of ductus arteriosus

A

Prostaglandins

42
Q
  • A congenital disease
  • a hole in the septum of the heart
  • acyanotic
A

Atrial Septal Defect
Ventricular Septal Defect

43
Q

Management of ASD/VSD

A
  • Surgery by suture
  • Dacron Patch
44
Q

2 types of Dacron Patch

A
  • Tissue/Cardiac tissue - low rejection rate (most preferred)
  • Plastic - high rejection rate
45
Q
  • Narrowing of the aorta
  • specifically in the descending aorta
A

Coarctation of the Aorta

46
Q

What are the VS in the L. extremities and U. extremities?

A

UE - high VS
LE - low vs

UE - BP high; Pulse bounding
LE - BP low; Pulse weak/absent

47
Q

Compensation made by the heart cause by the narrowed aorta

A

Rib notching -> rib deformity

48
Q

Management of CoA

A

Balloon angioplasty w/ coronary stenth

49
Q

CoA
type of permanent stent used in this surgery

A

Mesh

50
Q
  • A congenital heart disease caused by 4 defects in the heart?
  • Cyanotic
A

Tetralogy of Fallot

51
Q

the 4 problems of Tof

A
  • Pulmonary Stenosis
  • R. Ventricular hypertrophy
  • overriding of the aorta
  • VSD
52
Q

Primary problem in ToF?

A

Pulmonary Stenosis

53
Q

ToF:
What is the compensatory mechanism in ToF?

A

R. Ventricular Hypertrophy

54
Q

ToF:
What allows the mixing of blood?

A

overriding of the aorta

55
Q

ToF:
What keeps the patient alive in ToF?

A

VSD - relieves the pressure on the Right Ventricle

56
Q

ToF:
A sign in which there is decreased venous -> decreased cardiac output which lead to cardiac rest?

A

Squatting

57
Q

TRIAD of ToF

A

TET SPELLS
- irritability
- pallor
- blackout/convulsions

58
Q

other signs and symptoms of ToF

A
  • cardiomegaly
  • clubbing of nails (naumbok)
  • pan systolic murmurs
  • Boot shaped heart via 2D echo
59
Q

Palliative surgical mngt of ToF

A

Blalock-Taussig Shunt
- relieves s/sx
- goal: oxy>deoxy
- anastamosis (pagdugtungin) of PA and Aorta using subclavian artery

60
Q
  • Aorta is connected in the RV
  • PA is connected in the LV
  • cyanotic
A

Transposition of the Great Arteries (ToGA)

61
Q

S/Sx of ToGA

A
  • Severe Respi depression
  • Failure to thrive
  • no murmurs heard due to weak contractions
62
Q

ToGA:
What is needed to be maintained for the patient to be alive?

A

Patent Ductus Arteriosus

63
Q

ToGA:
Medical Management:

A

Prostaglandin E

64
Q

Surgical Management of ToGA

A

Jatane Switch/ Arterial Switch
- must be done during the 1st week of life of the newborn

65
Q

Surgical Management of ToGA

A

Jatane Switch/ Arterial Switch
- must be done during the 1st week of life of the newborn

66
Q

An autoimmune disease caused by GABHS

A

Rheumatic Fever

67
Q

Rheumatic Fever:
Signs/Symptoms

A

Inflammation of:
- heart
- joints
- blood vessels
- brain

Sore throat which can lead to acute glomerulonephritis

68
Q

Rheumatic Fever:
Criteria used to diagnose RF

A

Jones Criteria
MAJOR:
-Joint pain
- Carditis
- Nodules - Subq
- Erythema Marginatum - trunk
- Sydenham Chorea
MINOR:
- increased TEMP
- 950 - titer - antistreptolysin
- ESR + CRP - inflammatory marker

69
Q

Rheumatic Fever:
JONES CRITERiA

A

2 MAJOR or
1 MAJOR + 2 MINOR

70
Q

Rheumatic Fever:
Medical Management:

A
  • Penicillin
  • Aspirin
  • Steroids/NSAIDs
  • Phenobarbital/Diazepam
71
Q

2 Types of heart failure:

A

RSHF: Systemic Manifestations
LSHF: Pulmonary Manifestations

72
Q

2 Types of heart failure:

A

RSHF: Systemic Manifestations
LSHF: Pulmonary Manifestations

73
Q

HEART FAILURE:
Diagnostics

A
  • Chest X-RAY
  • 2d ECHO
  • Pulse OX
  • PWCP for LSHF
  • CVP for RSHF
74
Q

HEART FAILURE:
Management

A
  • Fowler’s Position
  • O2 Therapy
  • Inotropics: Increases Cardiac Output
    • LANOXIN/DIGOXIN
75
Q

HEART FAILURE:
DIGOXIN WOF

A
  • Nausea
  • Anorexia
  • Visual Disturbance
  • Diarrhea
  • Abdominal cramps
76
Q

HEART FAILURE:
DIGOXIN ANTIDOTE

A

DIGIBIND

77
Q

HEART FAILURE:
Nursing Responsibilities

A
  • Monitor IO
  • Record daily weight > same time, clothes and scale
  • administer diuretics
78
Q

An autoimmune disease that has generalized vasculitis and it is called as acute febrile syndrome

A

KAWASAKI’S DISEASE

79
Q

KAWASAKI:
S/SX

A
  • Fever for 5 days
  • eyes w/o exudates
  • lips > edema; peeling
  • **strawberry tongue
  • lymphadenopathy
  • trunk - rashes
  • palms/soles - red, edema, peeling
  • blood test - increased uric and platelet
80
Q

KAWASAKI:
MANAGEMENT

A
  • IV Ig Stat (w/in 7-10 days)
  • Aspirin for fever and thrombus formation
  • Echocardiogram
  • Vaccine must be delayed
81
Q

inflammation of the stomach and intestine which is caused by an infection that leads to vomiting and diarrhea

A

Acute Gastroenteritis

82
Q

type of infection in AGE

A

Viral Infection (self-limiting)

83
Q

AGE:
SIGNS of Dehydration

A
  • Fontanelle sunken
  • eyes sunken
  • poor skin turgor (< 1 sec; abdomen)
84
Q

AGE:
Management of vomiting (Alkalosis)

A
  • SFF
  • ORS
  • Antiemetic
  • Pedialyte
  • IVF D5NS (if severe)
85
Q

AGE:
Management of Diarrhea (Acidosis)

A
  • ORS
  • IVF D5NS
  • IV Ca
  • IV K (diluted, incorporated, infused slowly)

Ensure if voided

86
Q

Narrowing of the pyloric sphincter valve

A

Pyloric stenosis

87
Q

PYLORIC STENOSIS:
S/SX

A
  • vomiting immediately after feeding
  • projectile vomiting
  • dehydration
  • olive-shaped lump
  • no bile in vomitus
  • sour smelling vomitus
88
Q

PYLORIC STENOSIS:
MANAGEMENT

A

PYLOROMYOTOMY - widen the lumen

89
Q

PYLORIC STENOSIS:
POST OP

A
  1. NPO w/ pacifier
  2. IVF
  3. 4-6 hrs: ORS na
  4. ORS + milk
  5. milk

position: right SL
report: vomiting
normal: diarrhea dumping syndrome

90
Q

An idiopathic disease in which distal part of the ileum invaginated the proximal colon

A

Intussusception

91
Q

INTUSSUSCEPTION:
S/Sx

A
  • severe pain
  • distended abdomen
  • reappearing pain
  • red currant jelly stool/ bloody mucoid stool
92
Q

INTUSSUSCEPTION:
MANAGEMENT

A

Surgical emergency:

  1. Instillation
    - Water Soluble Enema
    - Air Insufflation
    - Barium Enema
  2. Delayed Repeated Enema (24hrs monitor)
  3. Reduction Surgery
93
Q

Characterized as a distended sigmoid colon with the absence of muscle curvatures of the ganglions

A

Hirschsprung Disease

94
Q

Characterized as a distended sigmoid colon with the absence of muscle curvatures of the ganglions

A

Hirschsprung Disease

95
Q

Hirschsprung disease:
S/Sx

A
  • Megacolon
  • aganglionic
  • ribbon- like stools
  • chronic constipation
96
Q

Hirschsprung disease:
Diagnostics

A
  • rectal exam
  • balloon catheter - anorectal
    - manometry
  • barium enema w/ contrast
    w/ caution
  • Biopsy
97
Q

Hirschsprung disease:
Diagnostics

A
  • rectal exam
  • balloon catheter - anorectal
    - manometry
  • barium enema w/ contrast
    w/ caution
  • Biopsy
98
Q

Hirschsprung disease:
Management:

A

Pull through operation
1. temporary colostomy
2. 12-16 months: Bowel repair
3. Permanent Colostomy

Rn 2024 (3 decks)

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