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Peds Flashcards

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1
Q

No small toys for children under what age?

A

Under 4 yo

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2
Q

No metal toys if _________ is in use

A

oxygen

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3
Q

3 things to consider for childhood development toy

A

Is it safe?
Is it age appropriate?
Is it feasible?

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4
Q

0-6 months
Children are __________ so best toy is…

A

Sensory-motor
Musical mobile

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5
Q

6-9 months
Children are working on ____________ so best toy is…

A

Object permeance
Cover-uncover toy

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6
Q

9-12 months
Children are working on ____________ so best toy is…

A

Vocalization
Speaking/talking toys

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7
Q

Toddlers 1-3 yo
Children are working on ____________ so best toy is…

A

Gross-motor skills
Push-pull toys

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8
Q

Preschoolers
Children are working on ____________ and __________ so best toys are…

A

Fine-motor skills = toys that use finger dexterity
Balance = tricycle, tumbling, skating, dance class
Cooperative play
Pretend play

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9
Q

School-aged
Children are working on 3 C’s so best toys are…

A

Creative: Paper and crayons; legos
Collective: beanie babies, Pokemon, barbies
Competitive: games

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10
Q

Piaget: 0-2 yo
Teaching

A

Sensory-motor
Present-oriented
Teach verbally

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11
Q

Piaget: 3-6 yo
Teaching

A

Pre-operations
Fantasy-oriented
Teach future tense and play

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12
Q

Piaget: 7-11 yo
Teaching

A

Concrete operational
Rule-oriented
Teach days ahead: what you’re going to do and skills

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13
Q

What age can a child manage their own care?

A

12

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14
Q

Intussusception patho

A

Ileum telescopes into cecum
Obstruction = pain
Compression of blood vessels
Blood flow decreases
Bowel ischemia
Rectal bleeding

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15
Q

Intussusception S+S

A

Intermittent pain/cramping
Child draws up their legs toward abdomen in severe pain while crying
V + diarrhea
Currant-jelly like stools
Lethargy
Sausage-shaped mass in upper mid-abdomen

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16
Q

Intussusception tx

A

IV fluids
Abx
Decompression via NG tube
Monitor for perforation and shock
May need air or barium enema

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17
Q

Hypertrophic pyloric stenosis patho

A

Hypertrophied pyloric muscle causes narrowing of pyloric canal -> thickness creates a narrow stomach outlet

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18
Q

Hypertrophic pyloric stenosis S+S

A

Projectile vomiting
Non-bilious emesis
Olive-shape mass palpable in RUQ
Infants will be hungry constantly despite regular feedings
Weight loss
Dehydration

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19
Q

Hypertrophic pyloric stenosis tx

A

Obtain daily weights
Pyloromyotomy
Monitor electrolyte: at risk for hypokalemia
Administer IV fluids

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20
Q

Epiglottitis patho

A

Inflammation of epiglottis leading to upper airway obstruction
MED EMERGENCY
Vaxx can prevent (Hib)

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21
Q

Epiglottitis S+S

A

Sudden-onset fever
Sore throat
Toxic appearance: agitated, restless, anxious
Tripod position
4 D’s: drooling, dysphonia, dysphagia, distress

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22
Q

Epiglottitis tx

A

Never leave pt
May need emergency intubation
Calm environment
Don’t place in supine position
NPO

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23
Q

Epiglottitis meds

A

Abx
Antipyretics
Corticosteroids
IV fluids
Avoid supine
Potential endotracheal intubation or tracheostomy

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24
Q

Croup patho

A

Inflammation of larynx, trachea, and bronchi occur as result of viral infx

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25
Q

Croup S+S

A

Stridor
Subglottic swelling
Seal-bark cough

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26
Q

Croup tx
Seek help if…

A

Supportive care
Seek help if: confused, cyanosis, increased RR, retractions, nasal flaring, drooling/can’t swallow

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27
Q

Croup vs epiglottitis

A

Croup: sudden onset, fluctuating fever, cough, viral cause, no emergency usually

Epiglottitis: rapid (w/in hrs), high fever, dysphagia, emergency

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28
Q

Febrile seizures tx

A

Rectal diazepam

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29
Q

Development dysplasia of hips patho

A

Abnormal development of hip joint
Baby’s bones still not ossified -> ability to dislocate and relocate easily

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30
Q

Notable S+S of DDH in infants

A

Asymmetrical or extra gluteal or inguinal folds

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31
Q

Barlow test
Ortolani test
What does it indicate?

A

Barlow: up and in
Ortolani: down and out
+ for clunks felt or heard (DDH)

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32
Q

Tx of DDH

A

Pavlik harness for > 6 months
4 months-2 yrs: closed reduction
> 2 yrs: open surgical reduction

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33
Q

Pavlik harness instructions

A

Must wear at all times
Don’t adjust straps or remove harness until instructed by HCP
Change diaper while baby is harness
Check for redness, irritation, or breakdown 2-3 times per day
Place baby on back to sleep
Place long knee socks and undershirt to prevent rubbing of harness

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34
Q

Tetralogy of Fallot

A

Ventricular septal defect
Pulmonary stenosis
Overriding aorta
Right ventricular hypertrophy

VarieD PictureS Of A RancH

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35
Q

TOF: Oxygenated and deoxygenated blood mix

A

Ventricular septal defect

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36
Q

TOF: pulmonary valve narrows or thickens, preventing normal blood flow from the right ventricle to the pulmonary artery

A

Pulmonary stenosis

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37
Q

TOF: aorta is positioned directly over a ventricular septal defect, instead of over the left ventricle

A

Overriding aorta

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38
Q

TOF: abnormal enlargement of the cardiac muscle surrounding the right ventricle

A

Right ventricular hypertrophy

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39
Q

TOF risk for what? What is the tx?

A

HF
Surgery

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40
Q

S+S of TOF

A

Hypoxemia -> fatigue, dyspnea, cyanosis
Central cyanosis worse w/ exertion
Hypercyanotic episodes
“Tet” spells
Systolic ejection murmur

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41
Q

Nursing interventions for Tet spells

A

Knee-chest position/squatting
Administer oxygen
Soothe newborn
IV fluid bolus
Administer morphine

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42
Q

Refeeding syndrome patho

A

Potentially fatal complication of nutritional rehab in chronically malnourished pts
Lack of oral intake -> decreased insulin production

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43
Q

Refeeding syndrome S+S

A

Electrolyte imbalances: hypokalemia, hypophosphatemia, hypomagnesemia
Hyperglycemia
Can lead to CHF w/o electrolyte replacement

44
Q

Nursing interventions of refeeding syndrome

A

Assess nutritional status
Daily weights
Periodic serum albumin levels
Monitor and replace electrolytes
Continuous EKG monitoring
Collaborate w/ dietitian

45
Q

Tracheoesophageal Fistula and Esophageal Atresia patho

A

Congenital malformation
Esophagus fails to develop as continuous structure -> develops as upper and lower esophagus
Upper esophagus ends up in a blind pouch (atresia)
Lower esophagus connects to primary bronchus or trachea via fistula
Places child at risk for aspiration -> pneumonia

46
Q

S+S of Tracheoesophageal Fistula and Esophageal Atresia

A

Coughing, choking, vomiting w/ feeding
Drooling
Frothy salvia
Abdominal distention
Apnea, cyanosis, coarse breath sounds
Poor weight gain

47
Q

Nursing interventions of Tracheoesophageal Fistula and Esophageal Atresia (what to expect)

A

Feed newborn in semi-upright position
Report increase in drooling or regurgitation during feeds
Anticipate that newborn may initially have difficulty w/ oral feeds
Observe initial oral feeding w/ sterile water
Monitor for signs of tracheomalacia (barking cough)

48
Q

S+S of acute lymphoblastic leukemia

A

Manifestations related to pancytopenia:
Decreased RBCs (anemia)
Decreased platelets (thrombocytopenia)
Decreased mature functioning WBCs (neutropenia): infx

Constitutional S+S:
Weight loss
Bone pain
Lymphadenopathy

49
Q

Neutropenic precautions: avoid

A

Raw fruits/vegetables and uncooked foods
Fresh flowers
Rectal thermometers, enemas, or suppositories
Live vaxx
Large crowds
Those who are ill

50
Q

Difference b/w Acute Lymphoblastic Leukemia
and Acute Myeloid Leukemia

A

ALL: affects production of lymphocytes
AML: affects production of myeloblasts, RBCs, PLTs

51
Q

Mononucleosis patho

A

Acute, self-limiting dz caused by Epstein-Barr virus
Spread via direct contact w/ oral secretions, blood, or transplantation
Typically seen in adolescents

52
Q

S+S of mononucleosis

A

Fever
Significant fatigue
Sore throat
Tonsillar hypertrophy and exudate
Cervical lymphadenopathy
Hepatosplenomegaly
Rash

53
Q

Teaching of mononucleosis

A

Avoid contact sports for 3-4 wks
Increase fluid intake
Antipyretics and analgesics
Salt gargles or anesthetic lozenges
No abx (viral infx)
Schedule rest periods
Fatigue may persist for wks
Avoid sharing drinks and eating utensils to limit spread of illness to others
Report abdominal pain in LUQ or left shoulder pain immediately (splenic rupture)

54
Q

Pertussis AKA

A

Whooping cough

55
Q

Nursing interventions of pertussis

A

Standard and droplet precautions
Abx
Humidified air
Increase fluid intake
S+S of airway obstruction: suction as needed
Complications: apnea, rib fractures, pneumonia

56
Q

Pt teaching of pertussis

A

Avoid triggers that stimulate coughing (exercise, smoke, cold temps)
Abx post-exposure ppx for all household contacts
Vaxx
Mild cough may persist for 6-10 wks
Pts are contagious until they completed 5 full days of abx

57
Q

Cerebral palsy def

A

Non-progressive, permanent motor and postural disorder
Caused by brain injury occurring: perinatally/ postnatally

58
Q

S+S of cerebral palsy

A

Abnormal muscle tone, posture, and coordination
Spasticity
Disturbances in gait
Impairments in speech and swallowing
Difficulty w/ learning and reasoning
Seizures

59
Q

Tx of spasticity

A

ROM exercises regularly
Muscle relaxants (baclofen pump)
Assistive positioning devices

60
Q

Febrile seizure patho

A

Convulsions that occur in children w/ oral temp > 100.4 degrees F
Occur in absence of CNS infx or hx of seizures
Benign in nature
Family hx of febrile seizures is a risk factor

61
Q

S+S of febrile seizures

A

Fever
Seizures

62
Q

Nursing interventions of febrile seizures

A

Antipyretics (acetaminophen)
No tepid sponging
Parental reassurance, education, and emotional support
No long-term behavioral problems
No effect on academic performance
Initiate seizure precautions

63
Q

Substance use effects during pregnancy (alcohol)

A

Fetal alcohol syndrome
Growth deficiency, neuro symptoms (microcephaly), indistinct philtrum, thin upper lip, epicanthal folds, flat midface, and short palpebral fissures

64
Q

Failure to thrive risk factors

A

Poverty
Social/emotional isolation
Cognitive disability or mental health disorder
Lack of nutritional education

65
Q

Substance use effects during pregnancy (cigarette smoking)

A

Perinatal loss, SIDS, low birth weight, prematurity

66
Q

Substance use effects during pregnancy (Valproate)

A

Neural tube defects (spina bifida)

67
Q

Risk factors for SIDS (maternal and infant)

A

Maternal:
Substance use
Maternal age < 20
Inconsistent prenatal care

Infant:
Prematurity or low birth weight
Sleep environment
Bed sharing
Smoke exposure

68
Q

Infant CPR

A

Single: perform 2 mins of CPR before defib (30:2)
2 rescuers: 15:2
Assess brachial pulse for no longer than 10 secs
Chest compressions should be ⅓ of chest’s anterior-posterior diameter depth
Perform compressions using 2 fingers or 2 thumbs

69
Q

Kawasaki dz (S+S and tx)

A

S+S: erythematous polymorphous rash, strawberry tongue, bilateral conjunctivitis w/o drainage
Notify HCP if fever develops
Tx: aspirin, IVIG, echocardiography

70
Q

PKU tx

A

Low phenylalanine diet is required
Dietary tyrosine
Specially prepared infant formula is given
Meat and dairy products shouldn’t be introduced into diet (high phenylalanine foods)

71
Q

Aplastic anemia vs. iron deficiency anemia

A

Aplastic anemia: bone marrow fails to produce new blood cells (pancytopenia)
Interventions: bone marrow biopsy, blood type and crossmatch, monitor for S+S of infx and bleeding

Iron-deficiency anemia: caused by blood loss, malabsorption syndromes, or poor diet of iron
Leukopenia and thrombocytopenia not expected
Interventions: diet recall and monitor stool frequency

72
Q

Acute poststreptococcal glomerulonephritis S+S

A

Gross hematuria
Edema
HTN

73
Q

Acute poststreptococcal glomerulonephritis labs

A

UA: protein, blood, RBC casts
Increased creatinine, BUN
Strep throat culture

74
Q

Tx of acute glomerulonephritis

A

Supportive care
Antihypertensive agents, diuretics, temporary dialysis, abx
Sodium-restricted diet
Report HA to HCP
Seizure precautions

75
Q

Hydrocephalus def and S+S

A

Buildup of CSF in brain
S+S: macrocephaly, prominent scalp veins, full anterior fontanelle, behavioral changes, developmental delay, S+S of increased ICP

76
Q

VP shunt interventions

A

Seizure precautions
Shave hair on head
Mark location where head circumference was measured
Assess for abdominal tenderness
Report temp >100.4
Test surgical site drainage for presence of glucose (leaking CSF contains glucose)

77
Q

Teaching of VP shunt

A

Certain sports should be avoided when the child is older
Shunt requires revision surgeries
Early childhood development programs
Monitor for S+S of increased ICP

78
Q

S+S of RSV/bronchiolitis

A

Initial stage: rhinorrhea, cough, pharyngitis, sneezing, fever, adventitious lung sounds
Days 3-5: hypoxia, retractions, apneic periods

79
Q

Nursing interventions for RSV/bronchiolitis (what precaution?)

A

Contact and droplet precautions
IV fluids, oxygen, acetaminophen
Suction as needed
Saline drops and bulb syringe to suction nares

80
Q

Cystic fibrosis patho

A

Autosomal recessive
Results in thickened, viscous secretions that obstruct:
Small airways
Exocrine ducts
Intestinal tract
Reproductive tract
Dx: positive sweat chloride test
Report that child’s skin tastes “salty”

81
Q

S+S of cystic fibrosis

A

Lung:
Frequent infx
Persistent cough w/ mucus
Barrel chest
GI: meconium ileus; steatorrhea
Failure to grow
Endocrine: DM
Reproductive: infertility (male)

82
Q

Cystic fibrosis interventions

A

To prevent lung dz:
Chest physiotherapy before meals
Aerosolized bronchodilator
Mucolytics (dornase alfa)

Daily exercise and oral fluids
Pancreatic enzyme supplements (w/ meals and snacks)
High protein, high calorie diet w/ unrestricted fat
Vitamin supplements, esp A, D, E, and K
Annual flu and periodic pneumococcal vaxx
Monitor for DM S+S

83
Q

Causes of enuresis

A

Primary:
Maturational delay
Genetic factors
Small bladder

Secondary:
UTI
Constipation
Emotional stress

84
Q

S+S of enuresis

A

Episodes of involuntary daytime/nighttime urination
Psychosocial implications:
Feelings of embarrassment and guilt -> low self-esteem
Social isolation
Dx: voiding diary, UA

85
Q

Nursing interventions of enuresis

A

Primary:
Avoid punishment
Positive reinforcement for dry nights/days
Timed voiding during day
Limit fluids before bed
Awaken child at specified time each time
Enuresis alarm
Meds:
Desmopressin (synthetic antidiuretic hormone)

Secondary: treat underlying cause
Abx for UTI
Laxatives for constipation
Recognize trigger for emotional stress

86
Q

Hemolytic uremic syndrome patho

A

Life-threatening complication of E. coli diarrhea
After diarrheal illness, results in triad of:
Hemolytic anemia
Thrombocytopenia
AKI

87
Q

S+S of hemolytic uremic syndrome

A

Hemolytic anemia: fatigue, irritability, pallor
Thrombocytopenia: bleeding etc
AKI: oliguria, edema

88
Q

Nursing interventions of hemolytic uremic syndrome (what precautions, tx)

A

Contact precautions
Provide fluids
Administer blood products for anemia and thrombocytopenia
Inform caregivers that most pts improve w/in 2-3 wks

Monitor for worsening AKI:
Strict I+O
Antihypertensive meds
Anuria: prepare for dialysis

89
Q

Conjunctivitis S+S (bacterial vs. viral vs. allergic)

A

Bacterial: purulent drainage
Viral: serous drainage
Allergic: intense itching in both eyes

90
Q

Conjunctivitis AKA

A

pink eye

91
Q

Which types of conjunctivitis are contagious?

A

Viral and bacterial

92
Q

Nursing interventions of conjunctivitis

A

Treat underlying cause:
Bacterial -> abx
Viral -> cold compress, saline eye drops
Allergic -> allergen avoidance and antihistamines
Remove accumulated secretions: wipe from inner canthus downward and outward, away from other eye
Separate linens, towels, washcloths
Refrain from rubbing eye
Good hand washing

93
Q

Length of infx for conjunctivitis (bacterial vs. viral)

A

Bacterial: up until 24 hrs after initiation of abx
Viral -> until S+S resolve

94
Q

Acute otitis media

A

Middle ear infx causes inflammation -> obstruction of eustachian tube
Blocked drainage from eustachian tube causes bacterial growth -> bulging and erythema of tympanic membrane

95
Q

Risk factors of acute otitis media

A

Recent upper respiratory infx
Exposure to secondhand smoke
Bottle feeding and use of pacifiers
Attendance at group activities

96
Q

S+S of otitis media

A

Fever
Ear pain and pressure
Refusal to eat or nurse/drink due to increased pain while chewing
Irritability
Pulling on affected ear
Hearing loss
Purulent drainage

97
Q

Nursing interventions of otitis media

A

Abx (amoxicillin)
Analgesic-antipyretic meds
Analgesic ear drops (benzocaine) if no perforation
Apply warm moist cloth over affected ear

98
Q

Congenital heart defects

A

TRouBLe
Needs surgery
Delayed growth
Short life
Apnea monitor
R->L shunting
Cyansosis

R->L shunting
B-> blue

99
Q

All congenital heart defects that start w/ T =

A

Trouble defects

100
Q

All congenital heart defect kids have

A

Murmur
Echocardiogram

101
Q

Exacerbation of cystic fibrosis

A

Greasy, bulky stools (steatorrhea)
Blood-tinged sputum (hemoptysis)
Paroxysmal cough
Hypoxia

102
Q

Drowning first action

A

Rescue breaths

103
Q

Ibuprofen vs acetaminophen SE

A

Ibuprofen: kidney dz (renal)
Acetaminophen: liver dz (hepatitis)

104
Q

Labs of acute postinfectious glomerulonephritis

A

Proteinuria, hypoalbuminemia, hyperlipidemia, edema
Watch for BP

105
Q

Ear drops for children vs. adults

A

Children < 3 yo: pinna down and back
> 3 yo: pinna up and back

106
Q

Iron supplement teaching

A

Iron supplements given on empty stomach between meals for best absorption
Including vitamin C increases absorption
Milk products and antacids decrease absorption
May cause constipation and black/dark tarry stools
Can stain teeth

NCLEX (40 decks)

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