Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

NURS 132 OB/Peds > Peds Exam 1 > Flashcards

Peds Exam 1 Flashcards

1
Q

As a general rule, if PO meds require to be mixed w/ food, what foods are not recommended for that particular use?

A

The essential foods =

  • Formula
  • Milk
  • O.J
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What type of play do toddlers engage in?

A

Parallel play = alongside of other children rather than playing w/ them.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What does the infant nutrition consist of?

A
  • Breast feed or formula = 0-12 months
  • Vitamins/ Supplements:
    1) vitamin D = 2 months
    2) iron = 4-6 months
    3) Fluoride = 6 months
  • Avoid excess water and limit juice
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

When a narcotic drug is administered to a child, what is the next nursing intervention?

A

1) Assess RR and HR for signs of respiratory depression and/or bradycardia
2) Assess pain level for med efficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

How is pain assessed w/ developmentally delayed (DD) children?

A
  • Assess facial and body expressions (FLACC scale can be appropriate)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What does the FLACC scale stands for?

A 
Face
Legs
Activity
Cry
Consolability
--> scoring from 0-2 for each standard
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the appropriate dosages for Acetaminophen, Ibuprofen, and Ketorolac (Toradol)?

A 
Acetaminophen = 10-15 mg/kg/ Q 4-6 h 
Ibuprofen = 5-10 mg/kg Q 6-8 h
Ketorolac = 0.5 mg/kg Q 6 h
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is a disadvantage about Meperidine (Demerol)?

A

No analgesic properties and can cause CNS excitability and lead to SEIZURES.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the contribution of dietary fat for an infant?

A

It contributes greatly to brain development and should not be restrained.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Why is regular milk not recommended for children between the ages of 0-12 months?

A

Their GI tract does not have the enzymes required to breakdown proteins –> could cause GI bleeding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

When should solid foods be introduced?

A

Around 4-6 months

  • Introduce 1 food at a time to recognize allergies
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are some nursing considerations in regards to infant hospitalization?

A
  • Encourage parent participation
  • Use transitional objects
  • Room close to nursing station
  • Maintain infant’s routines
  • birth - 18-24 months
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are some nursing considerations in regards to toddlers hospitalization?

A
  • Encourage parent involvement
  • Separation = major stressor
  • Fear of: pain, dark, change, procedures
  • Follow routines and rituals
  • Give choices when possible
  • 18 months - 3 y old
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are some nursing considerations in regards to preschoolers hospitalization?

A
  • Think illness is punishment
  • Fears of mutilation
  • 3-6 y old
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are some nursing considerations in regards to school age patients hospitalization?

A
  • Fears of mutilation
  • Peer contact important
  • Encourage self-care
  • Praise cooperation
  • 7-11 y old
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are some nursing considerations in regards to adolescent patients hospitalization?

A
  • Independence
  • Body image
  • Peers
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are the values that define a fever?

A
  • Rectal > 100.4
  • Oral > 100
  • Axillary > 99
  • Temporal > 99.5
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are the disadvantages of a fever?

A
  • Dehydration
  • Metabolic rate ⬆
    > O2 and caloric demand
  • Discomfort
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are the risk factors for a serious infection?

A
  • HIV
  • Sickle cell anemia
  • Immunosuppressant
  • Past febrile seizures
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are the recommended pharmacological measures for fever?

A

1) Acetaminophen = 10-15 mg/kg/dose
2) NSAIDS = 5-10 mg/kg/dose

=> For a temp > 102.5

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is a potential outcome if the respiratory rate is > 60?

A

Aspiration risk ⬆ –> NPO

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What are some signs of Dyspnea in children?

A

1) Accessory muscle contraction
–> causes neck flexion + head bobbing
2) Glottis closure
–> GFR = Grunting
Flaring
Retractions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What sound can be heard when airway is obstructed?

A

Stridor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What are the S x S of urgent respiratory threats?

A
  • ⬆ restlessness
  • ⬆ irritability
  • unexplained sudden confusion
  • rapid HR + rapid RR
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What are the demonstrations of Bronchiolitis?

A
  • Inflammation of bronchioles

- Thick mucus production (occludes bronchiole tubes + small bronchi)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What are the causes of Bronchiolitis?

A
  • 50% of cases = RSV
  • Adenovirus
  • Parainfluenza
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What are the S x S of Bronchiolitis?

A

1) Starts as URI
2) Tachypnea > 60-80
3) Retractions + nasal flaring
4) Breath sounds (wheezing, crackles)
5) Distended abdomen
6) Feeding pbs due to ⬆ RR
7) Intermittent fever

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What are the S x S of impending Respiratory Failure?

A

1) ⬇ breath sounds
2) Tachypnea > 70
3) Cyanosis
4) Pallor
5) Apneic episodes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What interventions can be used to treat the S x S of Bronchiolitis?

A

1) Mist therapy w/ O2
2) Monitor O2 sat
3) HOB 30-40 degrees
4) NPO if RR > 60/min
5) Strict I & O = Dehydration risk

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What pharmacological treatment can be used w/ Bronchiolitis?

A
  • Nebulized adrenaline (Epi)
  • Albuterol & Steroids
  • Antibiotics if secondary infection
  • Hypertonic 3% NS = helps loosen secretions
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What are the demonstrations of Laryngotracheobronchitis (LTB)?
(Aka Croup)

A
  • Inflammation of the mucosa lining the larynx and trachea

- -> leading to airway narrowing.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What are the main causes of LTB?

A

(Viral)

  • Parainfluenza
  • RSV
  • Influenza A and B
33
Q

What are the S x S of LTB?

A

1) Gradual onset w/ start of URI
2) Low grade fever
3) Irrability, restlessness, fear
4) Barking cough
5) Stridor
6) Crackles and wheezes
7) Retractions
8) Use of accessory muscles

34
Q

What are the signs of impending obstruction?

A

1) > HR due to hypoxia
2) > RR (>60)
3) > retractions
4) > nasal flaring
5) > restlessness and anxiety
6) Pallor
7) Diaphoresis
8) Anoxia and hypercapnia (⬆ CO2 in blood)
9) Respiratory acidosis

35
Q

What pharmacological treatment can be used w/ LTB?

A
  • Racemic epinephrine
  • Corticosteroids (inhaled and IV Decadron)
  • Bronchodilators
  • Respiratory support
36
Q

What are the main causes of Epiglottitis?

A

1) Bacterial

2) Most are from H-flu (HIB vaccine ⬇ considerably the occurrence of Epiglottitis)

37
Q

What are the S x S of Epiglottitis?

A

1) Rapid onset
2) Drooling (sore throat, can’t talk)
3) Agitation
4) Toxic high temp

  • DO NOT try to visualize the epiglottis
38
Q

How can the nurse attempt to open the airway in the instance of Epiglottitis?

A
  • Tripod position
  • Leaning forward
  • Chin thrust out
  • Mouth open
39
Q

What are the treatments for Epiglottitis?

A

1) Oxygen
2) Airway maintenance
3) IV fluids
4) IV Antibiotics
5) Corticosteroids
6) Rest

40
Q

What are the S x S of Tonsillitis?

A

1) Sore throat
2) Tonsils w/ exudate
3) Cervical lymphadenopathy
4) Edema of tonsild

41
Q

What are some precautions to be taken post-op for Tonsillitis?

A
  • Position on abdomen or side til awake
  • No coughing, throat clearing or nose blowing
  • Suction w/out trauma to operated side
  • Assess bleeding
  • Ice collar
  • Analgesics
42
Q

What foods can be consumed and which ones need to be avoided post-op for Tonsillitis?

A

1) To consume =
- Cool fluids
- Ice
- Popsicles
- Soft diet

2) To avoid =
- Red or brown fluids
- Citrus juice
- Dairies
- NO straws

43
Q

What are the S x S of Otitis Media?

A

1) Ear ache
2) Purulent discharge
3) Crying, irritability
4) < appetite
5) Lethargy

  • Bottle feeding can increase the occurrence of OM as well as dental carries if baby left w/ bottle at night.
44
Q

What are the potential treatments for Chronic Otitis Media?

A
  • Antibiotics
  • Myringotomy (removal of fluids)
  • Tympanostomy tubes
  • Adenoidectomy
45
Q

What can be done to prevent Otitis Media?

A
  • Pneumococcal conjugate vaccine
  • Upright position when bottle feeding
  • Avoid pacifier use
  • Passive tobacco use
46
Q

What complications can patients w/ Otitis Media endure?

A
  • Perforated and scared tympanic membrane
  • Hearing loss
  • Mastoiditis
  • Intracranial infections (Meningitis)
47
Q

What are the demonstrations of Asthma?

A

Airway hyperresponsiveness

  • -> Leading to =
  • Wheezing
  • Breathlessness
  • Chest tightness
  • Cough
48
Q

What are the various causes of Asthma?

A

1) Allergens (40%)
2) Exercise (cold air exposure)
3) Air pollutants
4) Respiratory infection
5) Sinuses pbs
6) GERD (reflux aspiration can cause bronchoconstriction)
7) Emotional stress (panic and anxiety can trigger asthma)

49
Q

With Asthma, what do the inflammatory mediators cause?

A

1) Early phase =
- vascular congestion
- edema
- thick tenacious mucous
- bronchial muscle spasm
- thickening of airway walls

2) Late phase =
- signs can worsen and last for 24h

  • Without treatment –> possible permanent lung damage
50
Q

With an Asthmatic patient, what does the absence of wheezing signify?

A

Severe attacks may have no audible wheezing

–> Pt is not moving enough air - Assess O2 sat

51
Q

What are the S x S of an asthma attack?

A

1) > HR and BP
2) Restlessness
3) ⬆ anxiety
4) Inappropriate behavior

52
Q

What is the main danger for Status Asthmaticus?

A

Patient is at risk for respiratory failure.

53
Q

What are the S x S of Status Asthmaticus?

A

1) ⬆ airway resistance from edema
2) Mucous plugging
3) Bronchospasm
4) Respiratory acidosis

  • Complication = can lead to respiratory arrest!
54
Q

What is a measure that can be taken for patients at risk of an exercise-induced asthma attack?

A

Premedicate prior to exercising.

55
Q

What is a preventive measure that can be used by all asthmatic patients?

A

A Peak Flow Meter will measure narrowing of the airway well in advance prior to an attack.

56
Q

What is the difference between treating an asthma attack and status asthmaticus?

A

Same measures but ⬆ frequency and dose of bronchodilators (IV magnesium sulfate) along w/ corticosteroids Q 4-6 h

57
Q

What are the drugs used for maintenance treatment of asthma?

A

For maintenance =

1) Corticosteroids (use spacer to avoid candidiasis and other AE)
2) Mast cells stabilizers (inhibits inflammatory response)
3) Leukotriene modifiers (bronchodilator)
4) Monoclonal antibody to IgE (Xolair)

58
Q

What drugs are used for acute asthma attacks?

A

For Acute episodes =

1) Beta adrenergic agonist (Albuterol)
2) Methylxanthines (toxicity = seizures!)
3) Anticholinergic (Ipratropium = common AE dry mouth)

59
Q

What are some tips the nurse can teach to her asthma patients?

A

1) Use dust covers
2) Use of scarves or masks for cold air
3) Avoid aspirin and NSAIDS
4) Increase fluid intake
5) Take beta adrenergic prior to exercising
6) Importance of continuing maintenance medication while asymptomatic
7) Measure peak flow at least daily

60
Q

What are the different results found w/ the Peak Flow Meter?

A

1) Green zone
2) Yellow zone
3) Red zone

61
Q

What does the Green zone indicate in terms of Asthma?

A
  • 80-100% of personal best
  • No symptoms
  • Remain on meds
62
Q

What does the Yellow zone indicate in terms of asthma?

A
  • 50-80% of personal best
  • Indicates caution
  • Something is triggering asthma
  • S x S: coughing, wheezing, chest tightness
  • Difficulty w/ ADLs

–> Maintenance meds + short and long-acting inhaled bronchodilators

63
Q

What does the Red zone indicate in terms of asthma?

A
  • 50% of personal best
  • Refer to HCP right away
  • Take acute meds
64
Q

What is Cystic Fibrosis?

A

Autosomal recessive trait disease =

  • Affects respiratory and GI function
  • Affects also sweat glands and reproductive system (mucus build up)
  • Dysfunction of exocrine gland
  • Production of thick secretions
  • Obstruction and fibrosis of tissues
  • Mutation on chromosome 7
65
Q

What is the progression of CF?

A

Small airways are affected, progressing to the large airways finally causing the destruction of lung tissue.

66
Q

When affected by CF, what is the impact of having thick secretions?

A
  • Obstruction of bronchioles
  • Air trapping
  • Hyperinflation
67
Q

What are some complications of CF?

A
  • Large cysts start forming in lungs (severe signs of destruction)
  • Hemoptysis which can be fatal (coughing blood)
  • Pneumothorax
  • Exocrine function of pancreas is altered (enzymes cannot reach intestine and breakdown nutrients)
  • Fat, proteins and fat-soluble vitamins are malabsorbed = Results in steatorrhea (fatty stool) and failure to grow and gain weight
  • Diabetes Mellitus (from lack of pancreatic function)
68
Q

What are the early symptoms of CF?

A

1) Failure to grow
2) Clubbing
3) Persistent cough w/ mucus production
4) Tachypnea
5) Large, frequent bowel movements
6) Large, protuberant abdomen

69
Q

What are later S x S of CF?

A

1) Exacerbations of ⬆ cough
2) Weight loss
3) ⬆ sputum
4) ⬇ in pulmonary function

  • Ultimately results in respiratory failure
70
Q

What is the impact of distal intestinal obstruction caused by CF?

A
  • Lower abdominal pain
  • Loss of appetite
  • Emesis
  • Palpable mass
71
Q

What is the impact on the reproductive system w/ CF patients?

A

1) Males =
- become sterile

2) Females =
- delayed menarche
- menstrual irregularities
- may be unable to become pregnant

72
Q

What is Cor Pulmonale in CF patients?

A

Hypertrophy or failure of right ventricle.

73
Q

What are the possible tests to determine whether a child has CF or not?

A

1) Newborn blood test = IRT immunoreactive trypsinogen assay (false positive)
2) Sweat chloride test w/ pilocarpine iontophoresis method = values > 60 mEq/L for Na and Cl suggest CF

74
Q

What are some other diagnostic studies to determine presence of CF in the existing child?

A
  • Chest X-Rays
  • Pulmonary function tests
  • Fecal analysis for fat
75
Q

What are the 2 possible tests to determine CF w/ fetus in utero?

A

1) Amniocentesis

2) Chorionic villus sampling

76
Q

What are some medical measures to relieve CF symptoms?

A

1) Aerosol and nebulization treatments to liquefy mucus and facilitate coughing
2) Mucolytic agents = Pulmozyme (⬇ mucus viscosity)
3) Bronchodilators
4) Hypertonic NS 3% inhalations
5) Massage therapy

77
Q

What are some techniques w/ CF to promote airway clearance?

A

1) CPT: Chest percussion therapy
2) Postural drainage
3) PEP breathing: Positive expiratory pressure (Acapella, IS devices)
4) Aerobic exercise (w/ frequent rest periods)

78
Q

What is the treatment of choice w/ CF when the lungs start being infected?

A
  • Antibiotics (long course)
  • Aerosolized Tobramycin
  • Lung transplant
79
Q

What are some necessary interventions in concerns to the diet of CF patient?

A
  • 150% of RDA
  • > calorie > protein
  • Supplemental G tube feedings at night
  • Salt supplements (w/ fevers, hot environment)
  • Fluid and electrolytes in hot weather
  • Vitamins (multiple + ADEK)
  • Enzyme replacement (never mix w/ starchy foods or proteins - do not chew)

NURS 132 OB/Peds (4 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions