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NCLEX > Peds > Flashcards

Peds Flashcards

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1
Q

Sensorimotor Stage
age, understands, and teach

A

0-2 y/o
-Understands world through senses and actions
-Only understand the present tense - teach as you do procedure
don’t understand play

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2
Q

Pre operational stage
age, understands, teach

A

3-6years
-understand world through language and mental images
- fantasy oriented, imaginative, understand future and past
- think injuries are punishment
- teach in the future tense, 2 hours before, or morning or day of procedure ( don’t give too much time to imagine)
- learn by play, teach on stuffed animal

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3
Q

Concrete operational
age, understands, teach

A

7-11 y/o
-understands world through logical thinking and categories
- Live and die by the rules, cannot think abstract, one way to do things, everything else is wrong
*7/11 grocery stores are surrounded by concrete - no trees, no flowers
- teach a day or two ahead of time, what and how do do skills and use age appropriate reading and demonstration

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4
Q

Formal operational
age, understanding, teaching

A

12-15
- Understands world through hypothetical thinking and scientific reasoning
- can abstract thing and use cause and effect
- when they turn 12 teach like and adult, regular med surge

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5
Q

At what age can a child manage their care and what is required to do this?

A

12 and they must think abstract
manage= 12
skill= 7

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6
Q

Safety measures regarding toys

A
  • no small toys under 4
  • no metal around oxygen
  • fomites on toys can make immunosuppressed sick (give hard plastic)
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7
Q

Toys for 0-6 months

A
  • best toy is musical mobile
  • toys should be large and soft
  • worst toy after 6 months is musical mobile because they can stand up and cause strangulation
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8
Q

Toys for 6-9 months

A
  • Toys teach object permanence
  • jack in box/ peak a boo
  • toys should be large and firm
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9
Q

Toys 9-12 months

A
  • Teach vocalization
  • tickle me elmo, woody cowboy, talking books
  • purposeful play= 9 months old: build, sort, stack, make
  • in womb for 9 months, another 9 for purposeful play
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10
Q

Toys for 1-3 y/o

A
  • teach gross motor skills, running jumping
  • best toys are push/pull, lawn mowers, wagon, dog with flappy feet
  • can paint with hand
    -parallel play- play next to but not with each other, think terrible twos
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11
Q

Toys for 3-6 y/o

A
  • teach fine motor skills
  • finger dexterity= write, draw, use colored pencils, scissors
  • work on balance- dance, ice skate, tricycles, tumbling,
  • cooperative play- work together to again a common goal, no winner
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12
Q

Toys for 3-6 y/o

A
  • teach fine motor skills
  • finger dexterity= write, draw, use colored pencils, scissors
  • work on balance- dance, ice skate, tricycles, tumbling,
  • cooperative play- work together to again a common goal, no winner
  • highly imaginative
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13
Q

Toys for 7-11

A
  • concrete
  • 3 C’s
    1. Creative- give paper to draw
    2. Collective- barbies, cards, Webkinz
    3. Competitive- winners and losers
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14
Q

12-18 y/o

A

Need peer association
-allow to be in each other’s rooms unless one is post op less than 12 hrs, immunocompromised, contagious

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15
Q

When does toilet training take place?

A

1 1/2- 2 years

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16
Q

Does bladder or bowel control develop first?

A

Bowel control first

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17
Q

2- 3 month developmental milestones

A

Coo, smile, kick legs, raise head in prone position

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18
Q

4-5 month developmental milestones

A

Head lag should be gone (report if present), grabs obejects, diminished rooting and moro reflex

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19
Q

6- 9 months

A

birth weight doubles
- roll from front to back, sit themselves up unsupported, push themselves up, babble few words, hold bottle at 7 months, transfer objects in hand, respond to name, separation anxiety begins

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20
Q

6- 9 months

A

birth weight doubles
- roll from front to back, sit themselves up unsupported, push themselves up, babble few words, hold bottle at 7 months, transfer objects in hand, respond to name, separation anxiety begins

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21
Q

10-12 months

A

Use pincher grasp, learn how to speak, birth weight triples at 12 months, take steps while holding hand, build blocks, turn pages, 3-5 words

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22
Q

10-12 months

A

Use pincher grasp, learn how to speak, birth weight triples at 12 months, take steps while holding hand, build blocks, turn pages, 3-5 words

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23
Q

18 months

A

walk up and down stops, throw a ball, turn pages, build tower with 4 blocks, scribble, ten words, follow commands

24
Q

18 months

A

walk up and down stops, throw a ball, turn pages, build tower with 4 blocks, scribble, ten words, follow commands

25
Q

2 years

A

walk on own independently, know first and last name, form 2-3 word sentences, potty trained

26
Q

2 years

A

walk on own independently, know first and last name, form 2-3 word sentences, potty trained

27
Q

4 years

A

draw a shape with 4 sides , skip on 1 foot, catch a ball

28
Q

4-6 months

A

begin solid food one at a time and 1 food per week

29
Q

fontanels

A

anterior- closes 12-18 months
posterior- 2-3 months

bulging at rest means infection or increased ice

30
Q

0-4 months reflexes

A

rooting reflex and tonic neck reflex

31
Q

Blood in newborn diaper

A

normal

32
Q

18 months

A

walk up and down stops, throw a ball, turn pages, build tower with 4 blocks, scribble, ten words, follow commands

33
Q

stool on third day

A

yellow brown

33
Q

2 years

A

walk on own independently, know first and last name, form 2-3 word sentences, potty trained

33
Q

10-12 months

A

Use pincher grasp, learn how to speak, birth weight triples at 12 months, take steps while holding hand, build blocks, turn pages, 3-5 words

34
Q

Intussusception

A

bowel within a bowel
s/s: currant jelly stools (bloody)
sausage shaped abdominal mass
n/v
green emesis
treatment: enema to attempt to push intestine

35
Q

Epiglottitis

A

caused by HIB
s/s: fever, cherry red epiglottis, drooling, dysphagia, tripod, stridor, no cough, dysphonia
treatment: IV antibiotics
Oxygen
intubate and mechanical vent

36
Q

A child with HIV should receive what vaccine

A

IPV

37
Q

Hirschsprung’s disease

A

absence of enteric neurons= no peristalsis
stool builds up and becomes a megacolon
s/s: delayed passage of meconium
ribbon like stool
swollen belly, vomit withe green/brown substance constipation, gas
treat: surgery

38
Q

Pyloric stenosis

A

hypertrophy of the pylorus, causing narrowed lumen
s/s: olive shaped mass, projectile non- bilious emesis
treat: dehydration, malnutrition, pyloromyotomy

39
Q

Omphalocele

A

Congenital abnormality where the abdominal contents protrude through the umbilicus while remaining in the peritoneal sac.
● Occurs during weeks 9-10 of gestation.
complication: dehydration, sepsis, hypothermia
treatment: Keep exposed intestines moist
● Cover with sterile gauze soaked
in saline
● IV fluids
● IV antibiotics
● Thermoregulation

40
Q

Hydrocephalus

A

Increased accumulation of cerebrospinal fluid
● Increases ICP
treat: VP shunt- drains out as urine
or EVD

41
Q

Spina Bifida

A

○ Failure of the vertebrae to close with protrusion of neural tube contents
○ Meningocele (closed spina bifida)
■ Protrusion of spinal fluid–filled meninges through a vertebral defect
○ Myelomeningocele (open spina bifida)
■ Protrusion of spinal fluid–filled meninges AND the spinal cord
through a vertebral defect

S/s: tuft of hair or sacral dimple, Paralysis possible
○ More likely the higher the defect is located on the spine
● Developmental delay
● Speech delay
● Intellectual disability
● Impaired coordination

● Pre-op
○ Cover the sac with a moist, warm, sterile dressing
○ No diapering if defect is low- keep the sac clean with a protective barrier
○ Prophylactic antibiotics
○ Prone positioning
● Post-op
○ Remain prone until surgical site is healed

42
Q

Microcephaly

A

Head circumference is smaller than normal ○ Brain did not develop properly or stopped growing.

43
Q

Microcephaly

A

Head circumference is smaller than normal ○ Brain did not develop properly or stopped growing.

cause: Genetic abnormalities
○ Drug or alcohol use during pregnancy
○ Virus during pregnancy
Impaired cognitive development

● Delayed motor function
● Delayed speech development
● Facial distortion
● Dwarfism
● Hyperactivity
● Seizures

44
Q

cleft lip/ palate

A

Surgically corrected
○ Cleft lip first at 3-6 months of age
○ Cleft palate second at 6-24 months of age
● Pre-operative care
○ Monitor for aspiration
○ Assess airway patency frequently
● Post-operative care
○ Positioning:
■ Position upright for feedings
■ Cleft palate - can be prone post op to help drain secretions
■ Cleft lip should NOT be prone as this could disturb the suture line
○ Protect suture line
○ Elbow restraints to avoid toddler putting things in the mouth that would compromise the sutures
○ No hard foods, straws, pacifiers, etc.
○ No oral or nasal suctioning

Specialized bottle to facilitate a good suction/latch
● Small, frequent feedings
● Upright position
● Burp frequently - will swallow a lot of air
● May take longer to feed than other children
● Monitor for aspiration

45
Q

Sickle cell anemia

A

The sickled cells are not able to carry oxygen like they should
○ Decreased perfusion
● Due to their shape, they can get caught in vessels and cause obstruction

46
Q

Sickle cell crisis

A

The decreased blood flow to the tissues leads to hypoxia, ischemia, and infarction.
● There is severe joint pain
● Sequestration
○ Blood pools
○ Often in the spleen
○ Splenomegaly and tenderness
● Acute exacerbation can be caused by hypoxia, exercise, high altitude (due to low oxygen), and fever.

treatment: IV Fluids
○ This helps dilute the blood so that the sickled cells are not so concentrated
○ Provides hydration
● Blood transfusion
○ Provides normal RBCs
○ Helps optimize oxygenation and better perfusion
● Oxygen
○ Increase oxygen to the tissues if the client is hypoxic
● Medications
○ Pain management - Analgesics often necessary ○ Hydroxyurea
■ Increases production of fetal hemoglobin to reduce crises

47
Q

Kawasaki Disease

A

Strawberry tongue - red and swollen
● Rash
● Bilateral conjunctivitis
● Red cracked lips/mucous membranes
● Red, swollen hands and feet
● Lymphadenopathy
● Arthralgia
● High fever
● Abdominal pain/Diarrhea/Vomiting
●Innflammation!! Elevated: ○ CRP
○ ESR
○ WBC:
treatment:Aspirin
○ Reduces the fever, swelling, pain and rash
○ Prevents blood clots
● IVIG

48
Q

Reye syndrome

A

Acute encephalopathy following viral illness
● Diagnosed by liver biopsy
● Characterized by cerebral edema and fatty changes in liver
● Most commonly follows influenza or varicella
● Associated with aspirin use in pediatrics during viral illness!
s/s: Viral illness
● Nausea, vomiting
● Fever
● Signs of liver dysfunction: lethargy, jaundice
● High ammonia levels in blood
● Altered mental status
treatment: ● Monitor neuro status and signs of increased ICP!!
● Monitor liver function
● Monitor I&O
● Monitor for impaired coagulopathy
● Rest and low stimulation
** Acetaminophen and ibuprofen are the medications of choice for fever in viral illness due to risk of Reye Syndrome!**

49
Q

Developmental dysplasia of the hip

A

An abnormality in the development of the femoral head, acetabulum, or both.
● Causes the femur to become displaced from the hip.
● Can occur in one or both hips
● Catching it early is key to treatment!
Infant
○ Ortolani & Barlow Tests
● Toddler
○ Limb length inequality (legs with
different lengths)
○ Abnormal walking or gait
Brace
○ Pavlik harness
● Cast
○ Spica body bast
● Surgery
○ Usually followed by a cast!

50
Q

Impetigo

A

Contagious bacterial disease
● Cause
○ Staphylococcus aureus
● Toxins from this bacteria produce a weeping lesion with a ‘honey colored crust”
● Treatment
○ Topical antibiotics
○ Oral antibiotics

51
Q

Assessment to determine if meconium has been passed in utero:

A

Visible meconium in fluid/on infant
● Discolored or foul smelling amniotic fluid
● Discoloration of the cord
● Discoloration of the nails/tonge on the infant
treat: Suction immediately after birth - before they take their first breath.
● Intubation
● IV antibiotics
● IV fluids

52
Q

Croup

A

viral respiratory tract illness
○ Results in inflammation and edema of the larynx and/or trachea

s/s: Hoarse, “bark-like” (or seal-like) cough
● Stridor
● Chest wall retractions
● Runny nose, fever
● Symptoms often worsen at night

treat: ● Corticosteroids
● Epinephrine via nebulizer ○ “Racemic epi”
● Keep patient calm and decrease anxiety levels ○ Agitation can lead to respiratory distress

52
Q

Cystic Fibrosis

A

Respiratory
○ Excessive mucus
○ Frequent respiratory infections
○ Hypoxemia
■ Clubbing
■ Cyanosis
■ Barrel chest
● Gastrointestinal
○ Intestinal obstruction
○ Meconium ileus
○ Large, bulky, frothy, foul smelling stool
○ Fat soluble vitamin deficiency
■ ADEK
■ Malnutrition
elevated chloride in sweat

NCLEX (20 decks)

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