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NSG 434 - Peds > Peds Exam 2 > Flashcards

Peds Exam 2 Flashcards

1
Q

pre-procedure for cardiac cath

A

-accurate height and weight
-allergy history (especially to iodine)
-NPO for 6-8 prior
-locate and mark distal pulses

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2
Q

post-procedure for cardiac cath

A

-position affected leg STRAIGHT
-check temperature bilaterally
-ASSESS INSERTION SITE AND PRESSURE DRESSING
-assess peripheral perfusion

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3
Q

disorders with increased pulmonary blood flow

A

patent ductus arteriosus (PDA), atrial septal defect (ASD), and ventricular septal defect (VSD) in these defects, blood is shunted from high pressure left side to low pressure right side

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4
Q

patent ductus arteriosus (PDA)

A

passageway (ductus arteriosus) between the aorta and the pulmonary artery remains open (patent) after birth

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5
Q

treatment for patent ductus arteriosus (PDA)

A

Indomethacin (Indocin)

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6
Q

atrial septal defect (ASD)

A

an opening in the septum separating the atria; may close spontaneously, if it doesn’t surgical intervention is needed

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7
Q

ventricular septal defect (VSD)

A

an opening in the septum separating the ventricles; may solve spontaneously, but if VSD is severe enough HF can result

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8
Q

Disorders with decreased pulmonary blood flow

A

Tetralogy of Fallot, Tricuspid atresia; pressure of right heart is high so desaturated blood from right side shunts to left

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9
Q

What are the 4 defects of Tetralogy of Fallot?

A

-Pulmonary stenosis
-ventricular septal defect
-overriding aorta
-right ventricular hypertrophy

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10
Q

key symptom of tetralogy of fallot

A

Tet spells manifested as increased cyanosis, hypoexemia, agitation comes with crying feeding or defacating

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11
Q

for hypercyanotic spells

A

-calm the child
-knee to chest postion
-administer O2
-administer morphine
-IV fluids

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11
Q

interventions for tetralogy of fallot

A

KNEE TO CHEST POSITION; helps to improve pulmonary blood flow by increasing systemic vascular resistance

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12
Q

tricuspid atresia

A

Tricuspid valve orifice fails to develop; right ventricle is hypoplastic

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13
Q

in tricuspid atresia, what must remain open to maintain minimally adequate oxygenation?

A

foramen ovale and PDA

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14
Q

Tricuspid Atresia Treatment

A

Prostaglandin (PGE) to maintain patency of PDA, Surgical Repair

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15
Q

coarctation of the aorta

A

congenital cardiac condition characterized by a narrowing of the aorta

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16
Q

key symptom of coarctation of the aorta

A

blood pressure higher in the upper extremities and decreased in lower extremities (20mmHg or >)

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17
Q

intervention for coarctation of the aorta

A

-balloon angioplasty
-resection of narrowed aorta followed by end-to-end reanastomosis

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18
Q

aortic stenosis

A

narrowing of the aorta; resulting in decreased CO

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19
Q

difference in symptoms for coarctation of the aorta and aortic stenosis

A

coarctation of the aorta: dizzy and LEG PAIN
aortic stenosis: dizzy and CHEST PAIN

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20
Q

Transposition of the great vessels

A

a congenital abnormality where the aorta is attached to the right ventricle and the pulmonary artery to the left ventricle (this is backwards and leads to two separate blood routes)

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21
Q

Transposition of the great vessels presents with

A

significant cyanosis at birth

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22
Q

interventions for Transposition of the great vessels

A

corrective surgery performed at 4-7 days

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23
Q

Hypoplastic Left Heart Syndrome

A

underdevelopment of the left side of the heart, usually resulting in an absent or nonfunctional left ventricle

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24
Q

without intervention of hypoplastic left heart syndrome…

A

death will occur rapidly

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25
Q

treatment of choice for hypoplastic left heart syndrome

A

heart transplant

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26
Q

s/s of heart failure in children

A

-weight gain
-activity intolerance
-poor feeding
-depends on L or R side HF

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27
Q

medication for improved cardiac function

A

digoxin, ACE, B-Blockers

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28
Q

do not give digoxin to infants if pulse is

A

<90-110bpm

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29
Q

do not give digoxin to older children if pulse is

A

<70bpm

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30
Q

medication to remove accumulated fluid and sodium

A

Furosemide

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31
Q

Digoxin effects on heart

A

slows HR but deepens contractions

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32
Q

interventions for heart failure

A

-semi-fowlers
-feeding every 3 hours and have infant take required food in within a 30 minute time period
-neutral environment to prevent cold stress
-cool humidified oxygen

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33
Q

rheumatic fever

A

inflammatory disease that may develop as a delayed reaction to insufficiently treated group A beta-hemolytic streptococcal; effects connective tissues of the heart, joints, skin, blood vessels, CNS

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34
Q

rheumatic fever can manifest

A

2-6 weeks after strep throat

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35
Q

s/s of rheumatic fever

A

-chorea
-fever
-carditis
-erythema marginatum
-abdominal pain
-sub-q nodules
-polyarthritis

36
Q

Erythema marginatum

A

Small red spots w/ bright red margins, sand papery
rash Rheumatic fever; painless

37
Q

treatment for rheumatic fever

A

antibiotics (penicillin) , antiinflammatories

38
Q

what is needed before the dentist if a child has rheumatic fever

A

antibiotics

39
Q

Kawasaki disease

A

acute systemic vasculitis of unknown cause

40
Q

S/S of Kawasaki disease

A

-fever
-strawberry tongue
-conjunctival redness
-red throat
-erythematous body rash
-swollen hands and soled of feet
-desquamation of skin on tips of fingers and toes
-red dry cracked lips
-enlarged cervical lymphnodes

41
Q

Treatment for Kawasaki disease

A

Aspirin and IV gamma globulin

42
Q

aspirin in kawasaki’s disease is initially used for

A

fever, then for antiplatelet use

43
Q

interventions for kawasaki disease

A

-measures to lower fever
-monitor signs of bleeding sue to aspirin therapy
-passive ROM to facilitate joint movement
-monitor cardiac
-oral hygiene; lips moist

44
Q

common respiratory infection manifestation

A

-tachypnea (>60)
-tachycardia (>160)
-cyanosis
-nasal flaring
-grunting
-apnea/dyspnea
-retractions
-fever, V/D/abd pain
-wheeze, crackles, absence of breath sounds

45
Q

common management for respiratory infection

A

-fluids
-cool mist
-rest: play quietly
-handwashing
-acetaminophen/ibuprofen
-OCT cold meds

46
Q

Acute Viral Nasopharyngitis

A

common cold

47
Q

management of Acute Viral Nasopharyngitis

A

-fluid
-rest
-humidified air
-handwashing
-elevate HOB
-suctioning

48
Q

acute infections pharyngitis

A

strep

49
Q

diagnosis of acute infections pharyngitis

A

throat swab; infection with group A-B hemolytic streptoccus

50
Q

treatment for acute infections pharyngitis

A

azithromycin

51
Q

strep increases the risk for

A

rheumatic fever

52
Q

tonsillitis s/s

A

-swollen red tonsils
-Sore throat
-Difficulty swallowing
-White or yellow coating or patches
-Fever

53
Q

management for tonsillitis

A

tonsillectomy

54
Q

Post-op of Tonsillectomy

A

-position prone/side lying to facilitate drainage
-watch for FREQUENT SWALLOWING
-no milk products

55
Q

otitis media s/s

A

-crying, irritability
-rolling head side to side
-rubbing ear

56
Q

prevention from otitis media

A

feed upright, maintain routine immunizations

57
Q

interventions for otitis media

A

-increase fluid
-avoid chewing during acute phase (chewing increases pain)

58
Q

when giving medication in the ear of a child <3y/o

A

pull ear lobe down and back

59
Q

medication for otitis media

A

amoxicillin

60
Q

infective agent for mononucleosis

A

epstein barr virus

61
Q

diagnosis for mononucleosis

A

monospot test

62
Q

S/S of mononucleosis

A

-fever
-sore throat
-swollen lymph nodes
-increased WBC,
-fatigue
-lyphadenopathy and hepatosplenomegaly

63
Q

interventions for mononucleosis

A

no specific treatment; self-limiting monitor for signs of splenic rupture

64
Q

Croup (laryngotracheobronchitis)

A

inflammation of larynx, trachea, and bronchi

65
Q

S/S of croup

A

-Hoarseness
-barking cough with inspiratory stridor
-low-grade or no fever

66
Q

what should be avoided in patients with croup

A

cough syrup and cold medications as it can dry and thicken secretions

67
Q

Epiglottitis

A

medical emergency; inflammation of epiglottis, can rapidly develop to respiratory distress

68
Q

what vaccine decrease risk factor of epiglottitis

A

Hib

69
Q

s/s of epiglottitis

A

-drooling
-difficulty swallowing
-retractions
-inspiratory stridor
-sore throst
-tripod

70
Q

interventions of epiglottitis

A

-NO THROAT INSPECTION BY NURSE
-resuscitation equipment
-intubation or trachepstomy

71
Q

bronchitis

A

inflammation of the bronchi; viral, mostly self limiting

72
Q

S/S of bronchitis

A

-dry hacking non productiv ecough
-worse at night
-fever

73
Q

management for bronchitis

A

cough suppressanrs, fluids, rest (basically treat the symptoms)

74
Q

bronchiolitis and respiratory syncytial virus (RSV)

A

inflammation of the bronchioles that causes production of thick mucus, RSV is acute viral infection that causes this

75
Q

s/s of bronchiolitis and respiratory syncytial virus (RSV)

A

-rhinorrhea
-coughing
-sneezing
-wheezing
-ear and eye drainage

76
Q

protection from RSV

A

Palivizumab (synagis), monthly injection

77
Q

pertusis (whooping cough)

A

A HIGHLY CONTAGIOUS acute upper respiratory infection caused by the bacterium Bordetella pertussis.

78
Q

s/s of pertusis (whooping cough)

A

-severe cough with loud whooping inspiration
-cyanosis
-tongue pertrusion

79
Q

management for pertusis (whooping cough)

A

-airborne, droplet, contact precautions
-Tdap should be administered for prevention
-antimicrobial therapy
-hydration, suction, humidified air

80
Q

foreign body aspiration

A

swallowing/aspiration of objects into air passages

81
Q

s/s of foreign body aspiration

A

Choking, gagging, coughing

82
Q

intervention for foreign body aspiration

A

abdominal thrust maneuver

83
Q

prevention of foreign body aspiration

A

-Teach parents how to prevent foreign body aspiration
-Very mindful of small pieces around infants/children that can be easily put into their mouths

84
Q

asthma

A

chronic inflammatory disorder of the airways

85
Q

s/s of asthma

A

-Sense of breathlessness
-Tightening of the chest
-Wheezing
-Dyspnea
-Cough

86
Q

Drug therapy for asthma

A

-albuterol (SABA)
-salmeterol (serevent) (LABA)
-methoprednisone

87
Q

peak flow meter

A

tests severity of asthma

88
Q

status asthmaticus

A

a severe, life-threatening asthma attack that is refractory to usual treatment and places the patient at risk for developing respiratory failure.

NSG 434 - Peds (17 decks)

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