peds Flashcards
impetigo
bacterial infection of skin
causes of impetigo
poor hygiene, infected bite, hot weather
s/s of impetigo
itchy, burning, honey-coloured crusted lesion, pus
nursing for impetigo
contact precautions, keep lesion open to air, daily clean, warm compress with saline to area, meds (antibiotics), hand hygiene
s/s of lice
itchy scalp
nursing for lice
meds (Pediculicide), fine tooth comb, daily clean, no sharing of items
s/s of anemia
pale, weak
hypochromic (less red than normal) and microcytic (smaller than normal) RBC, low hemoglobin + hemocrit
nursing for anemia
iron supplement
what education for iron supplements?
side effects: constipation, dark stools
give with fruit juice for max absorption, avoid giving with milk or antacids as decreases absorption
hemophilia
X linked recessive disorder that causes bleeding due to problems with factor involved in coagulation
types of hemophilia
A and B
hemophilia A
no Factor 8
hemophilia B
no Factor 9
s/s of hemophilia
bleeding, epistaxis/nosebleed, easy bruising
nursing for hemophilia
monitor for bleeding, replace factor, assess LOC due to increased risk of of cranial hemorrhage, avoid contact sports
Von Willebrand’s Disease
no von Willebrand factor causing bleeding of mucous membranes
s/s of Von Willebrand’s Disease
nosebleed, bleeding and bruising of gums, more menstrual bleeding
risks of vomiting
dehydration, electrolyte imbalance, metabolic alkalosis, aspiration pneumonia
nursing for vomiting
NPO, IV fluids
risks of diarrhea
dehydration, electrolyte imbalance, metabolic alkalosis
nursing for constipation
high fiber, more fluids, meds (enema, stool softeners, laxatives)
cleft lip/palate
due to failure of fusing of tissue or bone
complications of cleft lip/palate
speech impairment, otitis media
cleft lip repair
3-6 months
cleft palate repair
6-24 months
nursing for cleft lip/palate
assess ability to breathe, monitor I/O, daily weigh, milk should be directed to side/back of mouth, feed should be ESSR + small amounts, suction
ESSR
enlarge nipple, simulate sucking reflex, swallow, rest
esophageal atresia
food enters lungs due to problems with esophagus
s/s of esophageal atresia
3 C’s (coughing, choking, cyanosis)
frothy saliva, high RR
nursing for esophageal atresia
NPO, IV fluids, suction, supine, meds (antibiotics) as aspiration pneumonia possible
Hirschsprung’s disease
no ganglion cells in rectum which means that muscles in rectum cannot move stool out
s/s of Hirschsprung’s disease
abdominal distention, constipation
s/s of Hirschsprung’s disease
monitor for enterocolitis, low fiber/high cal/high protein diet, meds (stool softeners), rectal irrigation, NPO, daily weights
enterocolitis
inflammation of GI tract
intussusception
block in GI tract
s/s of intussusception
bile stained vomit, jelly-like stool, distended abdomen, sausage shaped mass in RUQ
nursing for intussusception
monitor for perforation, NGT, meds (antibiotics), IV fluids
when intussusception cured?
pass normal stool
umbilical hernia
bowel protrudes through opening in abdominal wall
incarcerated hernia
*MEDICAL EMERGENCY, intestine trapped and stops blood supply
conjunctivitis
eye infection
causes of conjunctivitis
bacterial, viral
*BOTH VERY CONTAGIOUS
s/s of conjunctivitis
redness, edema, discharge, burning
nursing for conjunctivitis
hang hygiene, meds (antibiotics, eye drops), no sharing of items, no school until 24 hrs post antibiotics administration, no eye makeup
otitis media
infection in middle ear
causes of otitis media
after resp infection, children
how to prevent otitis media
feed infant upright, breast feed for 6 months, avoid smoking, immunizations
s/s of otitis media
fever, ear pain, crying, no appetite, head rolling side to side, pulling on ear, ear drainage, red tympanic membrane
pinna when giving meds for otitis media
under 3 years: pinna down
over 3 years: pinna up
epistaxis
nosebleed
nursing for epistaxis
do not lie pt down as risk of aspiration
epiglottitis
bacterial infection of epiglottis
*EMERGENCY as affects ability to breathe
s/s of epiglottitis
fever, red throat, painful swallowing, no cough, stridor, drooling, tripod position
nursing for epiglottis
patent airway, do not measure oral temp, NPO, do not leave child unattended, avoid supine position, meds (antibiotics, antipyretics), cool mist, *DO NOT TRY TO LOOK AT THROAT OR TAKE CULTURE AS CAN CAUSE SPASM THAT BLOCKS AIRWAY
tripod position
hunched over in chair
respiratory syncytial virus/RSV causes
affects ciliated cells so increased mucus production and causes respiratory infections
s/s of RSV
flu-like symptoms
nursing for RSV
contact precautions, patent airway, cool O2, suction, meds (antivirals, antipyretics), IV fluids
CF
no cure, autosomal recessive trait that causes thick secretions in lungs
s/s of CF
frothy stools, very high concentration of salt in sweat, SOB
nursing for CF
meds (antibiotics), chest physiotherapy, huff cough, bronchodilators, O2, high cal/protein/fat, monitor stools, pancreatic enzyme replacement within 30 min of eating, salt replacement
when can chest physiotherapy not be done?
after eating
risk of SIDS
prone sleep position, overheating, co-sleeping, mother who abused substances while pregnant, excessive sheets in bed, baby exposure to smoke
incidence of SIDS lower in
breastfed babies
atrial septal defect
opening between atria so oxygenated blood goes to right side of heart
s/s of atrial septal defect
low BP, high HR, pale
atrioventricular
canal defect
seen in Down syndrome, incomplete fusion of endocarditis
s/s of atrioventricular
canal defect
murmur,
decreased CO
patent ductus
arteriosus
shunt connecting aorta + pulmonary
artery does not close
s/s of patent ductus
arteriosus
murmur, decreased CO
prone position
how i sleep LOL
ventricular septal defect
open between left and right ventricles
s/s of ventricular septal defect
murmur
aortic stenosis
narrowing of aortic value affecting flow of blood from left ventricle to aorta causing LEFT VENTRICULAR HYPERTROPHY
s/s of aortic stenosis
murmur, decreased CO, chest pain
coarction of aorta
narrowing near ductus arteriosus
s/s of coarction of aorta
bp higher systolic than diastolic, cool lower extremities, decreased CO,
pulmonary stenosis
narrowing at pulmonary artery causing RIGHT VENTRICULAR HYPERTROPHY
s/s of pulmonary stenosis
murmur, decreased CO, cyanosis at birth
complication of pulmonary stenosis
pulmonary atresia
Tetralogy of Fallot
baby’s heart doesn’t form correctly
s/s of Tetralogy of Fallot
murmur, clubbing, cyanosis at birth
tricuspid atresia
tricuspid valve does not develop causing unoxygenated and oxygenated blood
s/s of tricuspid atresia
clubbing, SOB
transposition of
great arteries
two main arteries leaving the heart are reversed (pulmonary artery and aorta)
s/s of transposition of
great arteries
cyanosis at birth, cardiomegaly
rheumatic fever
autoimmune disease affecting connective tissue of heart, CNS, etc.
s/s of rheumatic fever
chorea/involuntary movement of face, fever, carditis/inflammation of mitral valve, red lesions on trunk
nursing for rheumatic fever
meds (antibiotics, pain, anti-inflammatories), seizure precautions if chorea, ask about recent sore throat
complication of rheumatic fever
rheumatic heart disease
cause of rheumatic fever
untreated strep or scarlet fever
Kawasaki Disease
immune disease
complication of Kawasaki Disease
aneurysms
s/s of Kawasaki Disease
fever, red throat, cracked lips, peeling skin
nursing for Kawasaki Disease
monitor for fever, assess skin due to peeling, soft food diet, ROM exercises, meds (aspirin)
s/s of nephrotic syndrome
weight gain, edema, low urine output, hypertension
protein in the urine, low blood albumin levels
enuresis
pt cannot control bladder
crytorchidism
testes fail to descend into scrotum
epispadias + hypospadias
defect of the urethra where the tube not fully formed and urine comes out of a different location in boys
cerebral palsy
impaired movement due to problems in extrapyramidal system
s/s of cerebral palsy
stiff muscles, delayed milestones, affects posture, seizures
nursing for cerebral palsy
PT/OT, speech therapy, mobility devices, *interact with child based on developmental level , safe environment with seizure precautions, upright after meals
increased ICP
Macewen’s sign: cracked pot sound on head, setting sun sign: sclera shows above iris, increased head circumference, bump on fontanel
nursing for increased ICP
patent airway, O2, no stress environment, seizure precautions, NPO, meds (Tylenol, anticonvulsants, osmotic diuretic, antibiotics), monitor for any drainage
s/s of brainstem injury
high RR, high HR, unequal pupils
nursing for autism
safe, consistent routine
neural tube defects
neural tubes fail to close
examples of neural tube defects
spina bifida, meningocele, myelomeningocele
nursing for neural tube defects
dressing changes, neuro status, monitor ICP, monitor for infections, meds (antibiotics), prone position, prep for surgery
hydrocephalus
increased CSF due to tumour
s/s of hydrocephalus
same as increased ICP
Macewen’s sign: cracked pot sound on head, setting sun sign: sclera shows above iris, increased head circumference, bump on fontanel
nursing for hydrocephalus
shunt to drain CSF accumulation
dysplasia of the hip
femur not in proper place
s/s of dysplasia of the hip
hard to move hip, shortening of limb on affected side, Ortolani click/hip click
nursing for dysplasia of the hip
Pavlik harness
s/s of measles
fever, 3 C’s (coughing, choking, cyanosis), *RASH ON FACE ONLY Koplik’s spots: spots before measles rash occur
nursing for measles
droplet + contact, cool mist, meds (antipyretics)
s/s of German measles
fever, *BODY RASH, rash on soft palate
nursing for German measles
*AIRBONE + droplet + contact, meds (antipyretics)
cause of measles
viral
s/s of chickenpox
fever, rash on body,
nursing for chickenpox
airbone + droplet + contact, acyclovir
cause of chickenpox
viral
pertussis/Whooping cough
whooping cough, high RR
nursing for pertussis/Whooping cough
airbone + droplet + contact, reduce rritants, suction O2 with humidity
do infants have maternal immunity to pertussis?
no
honey with infants
not pt under 1 yr due to risk of botulism which causes muscle paralysis
infant nutrition
B-6 months: only breastfeeding
4-6 months: solid food
*start with
1 year: cow’s milk
how many days between food to check for allergies?
5-7 days
when starting solid food, what to start out with?
iron fortified cereal
immunizations
1 month: Hep B
2 months: polio, diphtheria + tetanus + acellular pertussis /DTAP, haemophilus influenzae
Type B/HiB, pneumococcal/PCV, rotavirus/RV
4 months: same as 2 months
6 months: polio, DTaP, HiB, PCV, RV, Hep B
12-15 months: HiB, PCV, MMR, Hep A
15-18 months: DTaP
18-33 months: Hep A
4-6 yrs: IPV, DTaP, MMR, chickenpox
11-12 yrs: MMR, TDAP (instead has acellular pertussis adolescent), meningococcal, HPV
