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PEDS > PEDS EXAM 1 > Flashcards

PEDS EXAM 1 Flashcards

1
Q

Growth and Development: What are Erikson’s theories?

A

1.Trust vs. Mistrust
2. Autonomy vs. Shame and Doubt
3. Initiative vs. Guilt
4. Industry vs. Inferiority
5. Identity vs. Role Confusion
TAIII

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2
Q

Example of Trust vs. Mistrust and when does it occur?

A

Ex: Babies trusting you when you care for them while theyre crying, feed them, dont ignore them when they are seeking for attention/help.
-Occurs during first year of life

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3
Q

Example of Autonomy vs Shame and Doubt. When does it occur?

A

Ex: Babies/toddlers wanting to do things on their own. Saying “no” to you and wanting to be independent/do things on their own.
-Occurs 1-3 yrs old

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4
Q

Example of Initiative vs Guilt. When does it occur?

A

Ex: Wanting to explore, new activities and ideas
-Occurs 3-6 yrs old

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5
Q

Example of Industry vs Inferiority. When does it occur?

A

Ex: New social activities, pride in accomplishments
-Occurs 6-12 yrs old

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6
Q

Example of Identity vs Role Confusion. When does it occur?

A

Ex: Self identity, developing own beliefs/morals
-Occurs during teen yrs

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7
Q

What are Freud’s theories?

A

1.Oral stage infancy
2.Anal-toddlerhood
3.Phallic preschool/early school-age
4.Latency school-age
5.Genital adolescence

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8
Q

Example of oral stage infancy?

A

Infants developing sucking, eating pleasure

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9
Q

Example of Anal-toddlerhood?

A

Babies developing pleasure from control of bodily secretions

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10
Q

Example of phallic preschool/early school-age?

A

Working out gender relationships “making friends”

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11
Q

Example of latency school-age?

A

Sexual energy at rest Think of when kids start to develop hormones/discover sexuality

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12
Q

Example of genital adolescence?

A

Mature sexuality, end of physical growth, building adult relationships

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13
Q

What are Piaget’s theories?

A

1.Sensorimotor
2.Pre-operational
3.Concrete operational
4.Formal operational

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14
Q

Example of sensorimotor? When does it occur?

A

Gaining sensory contact/object permanence
-Occurs during birth to 2yrs old

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15
Q

Example of Pre-operational? When does it occur?

A

Use words to describe things but doesnt have well developed thought process
-Occurs during 2-7yrs old

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16
Q

Example of Concrete Operational? When does it occur?

A

Understands cause and effect
-Occurs during 7-11yrs old

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17
Q

Example of Formal Operational? When does it occur?

A

Can think abstractly, consider diff outcomes
-Occurs during adolescence to adulthood

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18
Q

Major milestones in each age group? Toddlers (0-3 months)

A

-Holds rattles
-Can turn head to find noise
-Coos/cries/babbles
-Can hold neck up with support by arms
-Posterior fontanel closes
-Smiles in response to stimuli
THINK OF CHLOE

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19
Q

Major milestones in each age group? Toddlers (4-6 months)

A

-Can turn from stomach to back. BIG MILESTONE!
-Birth weight doubles

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20
Q

Major milestones in each age group? Toddlers (6-8 months)

A

-Can sit alone/start crawling. BIG MILESTONE!

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21
Q

Major milestones in each age group? Toddlers (8-10 months)

A

-Can stand, crawl
-Understands object permanence
-Understands “mama, dada”
-Uses pincer grasp
-Stranger anxiety occurs

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22
Q

Major milestones in each age group? Toddlers (10-12 months)

A

-Can stand alone
-Understands object permanence
-Birth weight tripled

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23
Q

Major milestones in each age group? Toddlers (1-3 yrs old)

A

-Runs, walks, jumps, kick balls. BIG MILESTONE!
-Anterior fontanel closes at 18months

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24
Q

Major milestones in each age group? PRE-SCHOOL (3-6 yrs old)

A

-Wants to do things on their own
-Role plays adults
-Can throw ball overhead. BIG MILESTONE*

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25
Q

Major milestones in each age group? School-age (6-12 yrs old)

A

-can concentrate for longer periods
-jump rope/rides bikes, can do art crafts, like rewards (stickers, prizes out of box)

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26
Q

Major milestones in each age group? Adolescence (12-20 yrs old)

A

-Growth spurts
-want independence
-understand consequences
-thinks abstractly
-understand moral values
-growing social skills (going out on their own, driving)

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27
Q

Pain Assessment and Treatment: What are the pain scales used for peds?

A

-NIPS SCALE (Neonatal/infant pain scale)
-FLACC SCALE (Faces, Legs, Activity, Consolability, Crying
-FACES (Smile scale from sad to happy)

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28
Q

What are the common myths of pain for infants/children

A

-They cant feel pain
-They wont remember the pain
-They are less sensitive to pain
-They will tell you when they are in pain
-If they can be distracted, then they are not in pain
-They cant tolerate the side effects of pain medication
-Narcotics can lead to addiction

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29
Q

Procedure pain adjuncts (meds used for procedures)

A

-EMLA cream
-LMK cream
-Refrigerent sprays

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30
Q

Non-pharmacologic methods for pain-relief

A

-Relaxation methods
-Distraction
-Guided Imagery
-Massage
-Play and art
-Skin to skin
-Oral sucrose (for infants)

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31
Q

Pharmacologic uses for pain-relief

A

-NSAIDS
-Acetaminophen
-Ibuprofen
-Naproxen
-Trilisate
-Indomethacin
-Diclofenac

Opiods:
-Morphine
-Fentanyl
-Hydromorphone
-Methadone
-Oxycodone

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32
Q

Peds med orders should include what?

A

The dose in mg/kg

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33
Q

Gastro: Diarrhea/Vomiting CM?

A

-Diarrhea/watery stool
-Fever
-Vomiting
-Dehydration
-Tachycardia
-Hypotension
-Tachypnea
-Pain
-Aches/cramps

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34
Q

Diarrhea/V: Treatment?

A

-IV Fluids
-starchy foods (toast)
-rest

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35
Q

Diarrhea/vomiting: NC?

A

-Monitor electrolytes
-Get stool culture
-Get urine sample
-Admin antiemetic
-Promote hygiene
-Promote skin integrity
-Strict I&Os

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36
Q

Constipation: CM?

A

-Distended abdomen
-discomfort/pain
-cramping

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37
Q

Constipation: Treatment

A

-Docusate, Miralax (laxatives)
-Increase fluids, fiber, fruits and veggies
-Encourage activity

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38
Q

Constipation: NC?

A

-Educate about diet and opportunity to go to bathroom
-Assess diet changes
-Assess environmental changes
-Assess stool

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39
Q

Hirschsprung disease: CM?

what is it?

A

Is the inflammation and blockage of intestine due to damaged nerves
-Abdomen distention
-vomiting
-feeding intolerance
-constipation
-Failure to pass meconium during first 48hrs of life
-explosive diarrhea
-ribbon-like very smelly stool

THINK OF “SPRUNG” OR SPRING LIKE A RIBBON IS LOOPED AROUND LIKE A SPRING

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40
Q

Hirschsprung Treatment?

A

-Removal of affected colon area
-Temporary colostomy

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41
Q

Hirschsprung: NC?

A

-Assess abdominal girth daily
-Pain control
-frequent feedings of protein
-decrease sodium to improve nutrition
-encourage low fiber, high protein and high calorie diet

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42
Q

GERD CM

A

-low weight
-spitting up
-excessive crying
-stridor,gagging,choking
-stomach pain/heartburn

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43
Q

GERD management

A

-thickened feedings
-smaller frequent feedings
-elevate HOB
-PPI (-prazole) meds
-Histamine 2 recpetors(pepcid)
-Fundoplication surgical procedure for severe complications

44
Q

Pyloric Stenosis CM?

A

-projectile vomiting
-dehydration
-vomiting
-failure to thrive
-olive shaped mass to right of umbilicus
-increased pH and bicarb
-decreased electrolytes (due to vomiting)

45
Q

Pyloric Stenosis Treatment and managment?

A

-surgical relief/removal
Pre-op:
-NG decompression
-NPO
-Rehydration
-Record descriptions of vomiting
-Strict I & O
-Small feedings after surgery
-Increased feedings 48hrs after surgery

46
Q

Appendicitis CM?

A

-Periumbilical pain
-N/V
-RLQ pain
-fever
-tachycardia (because of vomiting
-Increased WBC because of fever

47
Q

Appendicitis treatment and managment?

A

-IV antibiotics
-IV Fluids for hydration
-pain management
-wound care
-surgical removal
-ultrasound, UA, CBC

48
Q

Intussusception CM

A

-Vomiting
-pain (comes and goes)
-between cramping, child has no pain
-rectal bleeding
-sausage shaped mass
-jelly like stool
-weight loss because of decreased appetite

49
Q

Intussusception treatment and management

TREATMENT FOR BEFORE AND AFTER SURGERY?

A

-IV fluids
-monitor for septicshock
-NG decompression
-watch stools
After surgery:
-Pain control
-strict I&O’s
-stool monitoring

50
Q

What makes children (girls or boys) different? What the diff between infants and children?

A

Female ureters are shorter than male putting them at greater risk for infection
-babies are more dependent on others for perineal care and hygiene

51
Q

UTI: CM?

A

-pain/burning with urination
-fever (infection)
-cloudy urine
-frequent urge of urination
-toilet trained but bed wetting

52
Q

UTI: Treatment?

A

Antibiotics:
-Amoxicillin
-Ceftriaxone
-Gentamycin
-Trimethoprim-sulfa
-Phenazopyridine

53
Q

UTI: NC?

A

-examine child
-ask for symptoms
-ask for family hx of UTI
-ask for diet changes

54
Q

Urinary reflux: CM?

A

-recurrent uti

55
Q

Urinary reflux: Treatment?

A

-surg repair

56
Q

Urinary reflux: Management?

A

-minimize risk of infection
-prepare for surg repair
-monitor UOP

57
Q

What puts infants/children at greater risk for dehydration?

A

-greater body surface area
-majority of body surface being water

58
Q

Signs and symptoms for dehydration?

A

-weight loss
-LOC changes
-decreased skin turgor
-prolonged cap refill
-tachycardia
-sunken eyes
-sunken fontanels
-circulatory failure (pale,cyanosis,grey)

59
Q

Dehydration management/treatment

A

-IV Fluids (normal saline)
-measure I&O
-Fluid restriction

60
Q

What are Isotonic fluids. What is it given for?

A

0.9% Normal Saline
Lactated Ringers
Ringers solution
5% Dextrose
-given at admission until we establish fluid labs

61
Q

What are hypertonic fluids. What is it given for?

A

“more than 0.9%”
3% Nacl
5% Nacl
Dextrose 10% in water
-to decrease swelling/hyponatremia/edema

62
Q

What are hypotonic fluids. What is it given for?

A

“less than 0.9%”
0.45 Nacl
0.33% Nacl
0.2% Nacl
2.5% Dextrose water
-to increase swelling/hypernatremia

63
Q

Types of dehydration, which one is most common?, which one is most dangerous and their findings

A
  1. Isotonic (most common) water and electrolyte loss is balanced
  2. Hypertonic (most dangerous) more water loss than sodium/electrolyte loss
  3. Hypotonic more electrolyte loss than water loss
64
Q

Ringworm: which precautions are needed? What symptoms/signs are seen?

A

Precautions: Isolation (contagious)
Symptoms: ring-like/circles that can be on skin and head

65
Q

Ringworm tx:
Nurs conisderations?

A

TX: -Oral griseofulvin for several months
-Topical miconazole
NC: Dont share helmets/hats, hairbrushes

66
Q

Varicella: which precautions are needed? What signs/symptoms are seen?

A

Precautions: contact
Cardinal symptoms: centripetal rose petal rash
CM: fever, rash, irritability, highly pruritic, teardop, malaise (feeling of being unwell/tired)

67
Q

Varicella tx:
Nurs Considerations? (during what time is it contagious)

A

TX:Benadryl (to help relieve itch), IV Acyclovir
NC: contagious 1 day before symptoms pop up until 6 days after they crust over

Think of virus=vir “acyclovir”

68
Q

Varicella vaccine education

A

Its a live vaccine
-cant give to preg women, little babies or immunocompromised people

69
Q

Complications of varicella

THINK R.M

A

-reyes syndrome
-meningitis

reyes-swelling of brain
Meningitis-inflammation of brain
they share smtg

70
Q

Impetigo/cellulitis: caused by?
Which precautions are needed?

A

Cause: strep or staph infection (2-5y/o)
-Contact precautions

71
Q

Impetigo/cellulitis: signs and symptoms?

A

Cardinal symptom: sores that can pop and turn into honey colored crust MAINLY ON NOSE AND MOUTH
CM: Pruritus, redness, yellow exudate/honey colored crust

72
Q

Impetigo/cellulitis tx?

A

-Wash 2-3 times a day with soap and water
-warm saline soaks
-topical/oral antiobiotic
-cut fingernails DONT PICK AT IT

73
Q

Head lice: Isolation precautions?
Tx:

A

Precautions: can return to school before resolved
Tx:Permethrin, beauty shops may treat, incubation of eggs

74
Q

Head lice: Nurs Considerations?

A

-found along nape of neck
-separate sections with q-tip
-everyone must be treated
-all linen/clothes may be washed in hot water
-change pillow cases daily
-find eggs not louse
-remove with fine tooth comb

75
Q

Scabies NC/TX?

A

If not resolved in days it may be an allergy
Tx: Permethrin 5%, leave on for 8-12 hrs repeat for 7 days

76
Q

Eczema: tx? symptoms/signs? causes?

A

signs/symptoms: scaly patches common in skin folds/creases
tx: clean, apply topical meds, avoid tight clothing
Causes: detergent and fragrances may cause itching, food allergies and genetic tendences

77
Q

Diaper dermatitis: CM? Tx?

A

CM: Redness/demarcation lines, inflammation
Tx: soap and water, NO WIPES, keep dry and aired, apply topical meds and keep on DO NOT WASH OFF WITH CHANGING, avoid eating acidic foods if eating solids

78
Q

Diaper dermatitis: NC?

A

-teach about fragrance free diapers, creams, proper hygiene and diaper changes, will go away and prn pain meds

79
Q

Oral candidiasis/thrush: CM? Tx?

A

CM: white patches on tongue that cannot be removed
Tx: fungicide, -zole meds

80
Q

Oral candidiasis/thrush: NC?

A

wash all bottles and nipples after every feed, breastfed babies-mom must wash nipples after feeds

81
Q

Burns: what are infants/kids at risk for when experiencing burns? Tx:

A

-infection, dehydration, resp probs
Tx:
-IV hydration
-IV antibiotics

82
Q

Immunization meaning

A

Active or passive immunity obtained by artificial immunobiologic

83
Q

Immunity meaning

A

inherited or acquired state in which individual is resistant to disease

84
Q

Natural immunity meaning

A

State of immunity/resistance to disease in which you were born with

85
Q

Acquired immunity meaning

A

Think of the meaning of acquired. It means getting/obtaining something. Therefore remember this as immunity you get after exposure to/getting the disease

86
Q

Active immunity meaning

A

State in which immune bodies are actively formed against specific antigens

87
Q

Passive immunity meaning

A

Think passing by means being there temporarily.
-Means temporary immunity obtained by antitoxins from another human ex: mother to fetus

88
Q

Antibody meaning

A

a protein formed from exposure to antigen

89
Q

Antigen meaning

A

viruses, toxins, bacteria, foreign substances/proteins

90
Q

Immunoglobulin meaning

A

Sterile solution containing antibodies from blood

91
Q

Herd immunity meaning

A

Condition in which majority of population is vaccinated and are able to protect those who are not vaccinated (spread of disease decreases)

92
Q

Combination vaccine meaning

A

combo of vaccines given into one form

93
Q

Monovalent vaccine meaning

A

Vaccine given for one single antigen or organism

94
Q

Conjugate vaccine meaning

A

A carrier protein with immuno potential combined with an antigen to enhance type and magnitude of immune response

95
Q

Hib vaccine: viral or bacterial?
Complication?

A

-Bacterial
Complication: meningitis, sepsis

Think bacteria=sepsis

96
Q

Rubella vaccine: what does rubella look like? what are the symptoms?

A

looks like pink rash on face which spreads to trunk, fever, h/a, sore throat, red inflammed eyes

97
Q

Rubella complications & isolation precautions?

A

Complications: arthritis, encaphalitis, CRS, dont give to preg women
Isolation precautions: contact, droplet

A.C.E Think All,Children,Eat

98
Q

Measles: CM?

A

-Highly contagious, resp/airborne, mobillvirus
CM: high fever, conjunctivitis, coryza, cough, anorexia, malaise, koplik spots, rash from face to trunk extremities

99
Q

Measles complications?

A

pneumonia, bronchitis, encephalitis, blindness

think resp and brain/head(eyes) probs

100
Q

Mumps: isolation precautions?
CM? Complications?

A

-Contact precautions
CM:
-Fever, malaise, earache, h/a, pain while chewing, swollen parotid gland
Complications: orchitis, deafness

101
Q

Pneumococcal vaccine: PPV (who is it recommended for? What diseases is it given for?

A

-Recommended for children older than 23 months
-sickle cell disease, nephrotic syndrome, renal disease/failure, HIV, organ transplant, cochlear implants

102
Q

What are live virus vaccines?

A

varicella
MMR
Intranasal (flu)
Rotavirus
V.I.R.M

103
Q

Bacterial vaccines?

A

Hib-DBT
Meningcoccal-Pneumococcal

104
Q

Viral vaccines?

A

Influenza
Varicella
HPV
MMP
Hep B
Polio
Rotavirus

H.I.H.M.R.P.V “HI.I.HAVE.MOST.RESP.PULMONARY.VIRUSES”

105
Q

Newborn vitals (rr,bp,temp,hr,02) and how to take these vital signs for this group

A

RR: 30-55 (1min)
02: 100%
HR: 100-170bpm (take on brachial artery or count apical pulse for 1 min)
BP: take on calf
TEMP: 37.5-37.7 (take in axillary or rectal-most accurate)

106
Q

Infant-2y/o vitals (rr,bp,temp,hr,02) and how to take these vital signs for this group

A

RR: 25-40
HR: 80-130; average is 120 (take on brachial artery)
TEMP: 37.3 (axillary)

107
Q

2-6 y/o vitals (rr,bp,temp,hr,02) and how to take these vitals for this group

A

RR: 16-30; 22 is highest by age 6
HR:70-120; average 110; take at radial for ages older than 2y/o)
BP: upper arm
TEMP: 37.2-36.8 (axillary, tympanic, oral if they can hold it, rectal most accurate but only for emergencies)

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