Brainscape's Knowledge GenomeTM

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


See full index

Fourth Semester > Peds Exam 4 > Flashcards

Peds Exam 4 Flashcards

1
Q

What is amblyopia?

A

lazy eye, poor visual acuity in one eye caused by strabismus/ ptosis. can lead to blindness if uncorrected

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

What is the therapuetic treatment for amblyopia?

A

patches covering stronger eye/ atropine in the stronger eye

weakening the stronger eye forces the weaker eye to work harder

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

This sensory disorder is caused by the opacity of the optic lens. It is the leading cause of visual impairment and blindness in children.

A

Congenital cataracts

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

Your patient presents with opacity of the optic lens, cloudy cornea, and an absent red reflex. What do you suspect as the nurse?

A

Congenital cataracts

opacity of the optic lens can lead to amblyopia

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

What is the tx for congenital cataracts?

A

surgery, ideally before 3 months of age, as early as 2 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

How do you teach about the post op management of congential cataracts?

A

elbow restraints, ABX, steroids, eye patching, sunglasses to prevent UV ray exposure

patch the stronger eye after the operated eye has healed to strengthen the operated eye

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is infantile glaucoma?

patho

A

obstruction of aqeous humor flow, causing increased ICP, causing vision loss from retinal scarring and optic nerve damage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Your patient comes in with spasmodic winking, corneal clouding, enlargened eyeball with excessive tearing, frequent eye rubbing, keeping eyes closed, and a red reflex green/ grey in 1 eye. What do you suspect as the nurse?

A

Infantile glaucoma

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

What will be used to manage infantile glaucoma?

A

3-4 surgeries is 1st line tx

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

What will you teach post op to parents of a child with infantile glaucoma?

A

protect surgical site, elbow restraints, eye patch, bedrest, no rough housing, how to admin eye drops

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

What is proper nursing care of children with a vision impairment?

A

use child’s name to gain attention
identify presence before touching child
name and describe people/ objects/ activities so child is more aware of what is happening
use touch/ tone of voice appropriate to situation
use simple/ specific directions
use child’s body parts as reference
encourage exploration of objects through touch

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Type of hearing loss where the transmission of sound through middle ear is disrupted, often caused by frequent OME or a ruptured TM

A

conductive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Type of hearing loss where there is damage to the hair cells in the cochlea, often caused by ototoxic meds (furosemide), meningitis, rubella

A

Sensorineural

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Your patient comes in complaining of ears feeling full, hearing loss and balance disturbances and says “huh?” every time you ask a question. You also note during your assessment that the TM is dull, opaque, orange discolaration, visible fluid and air bubbles and decreased TM movement. What do you suspect?

A

Otitis Media with Effusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How do you manage OME?

A

it should resolve on its own, check in 4 weeks. If it persists for three months, refer to ENT and assess for hearing loss/ speech delay

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

The parent of a patient with OME asks if she could give antihistamines, steroids, or decongestants to help with the symptoms. What do you teach her?

A

No! It does not help. Avoid bottle propping and feeding in a supine position

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

A patient presents with fever, ear pulling, irritability, poor feeding, lymphadenopahty, and a dull red bulging TM with decreased or no movement. The child also has had RSV recently. What do you suspect?

A

Acute otitis media

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

How do you manage acute otitis media?

A

Acetaminophen/ ibuprofen for pain and fever
Benzocaine drops if TM isnt ruptured
Warm/ cool compress
ABX (Amoxicillin, Azithromycin) PO 10-14days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is a myringotomy and a tympanostomy?

A

small incision in TM, tubes to equalize pressure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is the management for tubes?

A

General anesthesia, surgery, PACU, discharge in same day, post op pain uncommon

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

What are some post op teaching points for tubes?

A

Ear plugs when swimming, notify PCP if there is drainage from tubes, tubes remain in place for months and spontaneously fall out

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

What cues will you note for an infant with hearing loss?

A

wakes only to touch, doesnt babble around 6 mo

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

What cues will you note for a child with hearing loss?

A

doesnt speak by 2, communicates using gestures and relies on reading facial expression, doesnt respond to doorbell/ telephone

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

What cues will you note for an adolescent with hearing loss?

A

asks for things to be repeated, day dreams/ inattentive, poor school performance, monotone speech

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What is the proper ear drop admin for a child under 3?

A

pull pinna back and down

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

What is the proper ear drop admin for a child over 3?

A

pull pinna back and up

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What is a macule?

A

circular, flat discoloration < 1cm

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

What is a papule?

A

superficial solid elevated, less than 0.5cm

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

Plaque/ annular

A

ring with central clearing

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

vesicle

A

circulation collection of free fluid, less than 1cm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

pustule

A

vesicle containing pus, pimple

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

What are the types of skin injuries?

A

abrasion, laceration, bites, bruises, burns

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What are your risk factors for injuries?

A

poverty
prematurity <1yr
chronic illness
intellectual disability
parent w abuse/ substance abuse hx
extreme stressors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Be suspicious when…?

A

Injuries in uncommon locations
Bruises in infants < 9mo
Multiple injuries other than LEs
Frequent ED visits; delay in seeking care
Inconsistent stories
Usual caregiver – child interaction
injuries on butt, thigh, back

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Sun safety in children

A

broadspectrum, oxybenzone free nonscented spf > 15
zinc oxide products for nose
hats, sunshirts
infants < 6mo out of direct sun

apply sunscreen 30 min prior, then q2hr or q60-80 min

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What is the primary assessment for burns?

A

Airway
Breathing
Circulation

Airway patent, maintainable or unmaintainable
Assess for signs of airway injury or smoke inhalation
Respiratory effort, symmetry of breathing, breath sounds; Pulse oximetry, ABG, carboxyhemoglobin levels
Skin color, pulse strength, HR, perfusion status, edema; ECG if electrical burn

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

What is the secondary assessment for burns?

A

Burn depth
BSA
other injuries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

What does a 1st degree burn look like?

A

(superficial thickness) epidermis, painful, pink- red, no blisters, blanches

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

What does a 2nd degree burn look like?

A

(partial thickness) damage to entire epidermis, painful, moist, red blisters, mild-mod edema, blanches
or
(intermediate thickness) entire epidermis and some dermis, painful, mottled, red-white with blisters and mod edema, blanches

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

What does a 3rd degree burn look like?

A

(full thickness) damage down to some subq, red, black, tan, waxy white, dry, leathery and no blanching

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

What does a 4th degree burn look like?

A

(deep- full thickness) all layers damaged, tendon and bone exposed, variable color, dry and dull, charring

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

What are the priorities of care with burns?

A

prevent hypothermia, wound care, manage pain, prevent infx, provide nutritional support, restore mobility, psychological support

review in notes, but yk this

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

What is atopic dermatits?

A

AKA eczema, inflammation caused by antigen response to environmental changes/ sweating. indicates secondary infx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

What are the s/s of atopic dermatitis?

A

dry, scaly, purtitic skin with a rash/ erythema path on wrist, AC of arm, popliteal space. presence of wheezing is common (asthma)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

What dx will you note for atopic dermatitis?

A

elevated IgE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

What medications will you use to treat atopic dermatitis?

A

topical corticosteroids and immune modulators - tacrolimus
antihistamines @HS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

What will you teach you patient who has atopic dermatitis?

A

avoid hot water, shower in warm water 2x/day
nonscented/ not dyed soap
pat skin dry, apply moisturizer often
cotton only clothes/ sheets/ etc
keep nails short

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

What are the phsyical cues of non-candida diaper dermatitis?

A

red shiny, within the diaper area

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

What are the physical cues of candida diaper dermatitis?

A

deep red lesions, scaly with satellite lesions (outside of diaper area), usually in creases & folds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

How do you tx non candida diaper dermatitis? Candida?

A

Zinc oxide (skin barrier), Vitamin A/E/D ointment/ petroleum
Nystatin/ Antifungal/ Miconazole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

What is the management for diaper dermatitis?

A

blow dry the area if candida
change diaper frequent
avoid rubber pants/ harsh soaps/ wipes
go diaperless to get some air to the area

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

What is the hx for acne?

A

fam hx, onset of acne, use of meds that exacerbate, hx of endocrine disorder, LMP

meds that exacerbate: steroids, androgens, lithium, phenytoin, isoniazid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

What are the physical s/s of acne?

A

comedomes, pustules, hypertrophic scarring, oily skin/ hair

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

What are the meds that treat acne?

A

tretinion
benzyl peroxide
topical abx clindamycin
po abx tetracycline, erythromycin
isotretinion
oral contraceptives

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

How does tretinion affect acne?

A

interrupts abnormal keratinization that causes microcomedones

56
Q

How does benzyl peroxide affect acne?

A

OTC, inhibits growth of P. Acnes

57
Q

How does isotretinion affect acne?

A

for severe cases, teratogenic, inhibits sebaceous gland function

58
Q

How does oral contraceptive effect acne?

A

decreases endogenous androgen production

59
Q

What patient teaching will you give to a patient who has acne?

A

avoid oil based cosmetics and hair products
headbands/ helmets may exacerbate
balanced diet
clean skin with mild soap and water BID; shampoo hair regularly
avoid picking/ squeezing comedones
take topical meds as prescribed for 4-6 weeks
emotional counseling
monitor for infx/ cellulitis

60
Q

What are some hx cues of immunodeficiency r/t frequency of certain infections?

A

4+ episodes of AOM in 1 yr
2+ episodes of severe sinusitis in 1 yr
2 episodes of PNA in 1 yr
2+ serious infx such as sepsis

61
Q

If a child comes in with a hx of FTT as an infant, tx with abx for longer than 2 months with little/ no effect, requires IV abx to clear infx, has recurrent deep skin/ tissue abscesses and peristant oral thrush and skin candiasis at 1 year of age. Mom also has primary immunodeficiency. What do you suspect?

A

immunodeficiency

62
Q

What are some lab cues of immunodeficiency?

A

ESR/ CRP, WBC differential

63
Q

What does an increased ESR/ CRP detect?

A

presence of inflammatory response

64
Q

What does an increased neutrophil detect?

A

ACUTE bacterial infx

neutrophils are the 1st line of defense against bacterial infx

65
Q

What does an increased eosinophil detect?

A

allergic reaction

associated with antigen-antibody reactions

66
Q

What does an increased T lymphocyte and B lymphocyte detect?

A

viral infx, or chronic bacterial infx

principle component of immune system

67
Q

What are the different immunoglobulins?

A

IgG
IgA
IgM
IgE

GAME

68
Q

What is IgG?

A

only one to cross placenta and trasnferred via breastmilk, protects against viruses, bacteria, toxins. lack of causes severe immunodeficiency

produced at 6mo -1 yr

69
Q

What is IgA?

A

1st line defense against respiratory, GI, GU

pathogens produced at 3 mo

70
Q

What is IgM?

A

most important in primary immune response, indicates active infx

produced before IgA

71
Q

What is IgE?

A

increased in allergic states, parasitic infx, and hypersensitivity reactions

72
Q

What is the patho behind severe combined immune deficiency? SCIDs

A

T and B cell function ABSENT

potentially fatal and requires emergency intervention

73
Q

Your patient has a hx of persistent thrush, FTT, chronic diarrhea, and frequent infx. What do you suspect?

A

SCIDs

74
Q

What levels will be low with SCIDs?

A

IgA and IgM, CMV is negative

75
Q

What are some important interventions to provide to a patient with SCIDs?

A

prevent infx, admin IgG, bone marrow transplant desired

76
Q

What are the physical findings of HIV?

A

HIV rapidly invades infants CNS, causing encephalopathy –> acquired microcephaly, motor deficits, and loss of previously achieved developmental milestones

77
Q

A 19 mo old child presents to clinic with history of recurrent infections and fever of 102.4. HIV is suspected. What diagnostic tests would the nurse expect to be ordered for this child?

A

+ ELISA and Western Blot

78
Q

9-month-old infant born to a mother with HIV presents to clinic with history of recurrent infections and fever of 102.4. What diagnostic tests would the nurse expect to be ordered for this child to check HIV status?

A

+ PCR and viral culture

79
Q

What are the priorities of care for a child with HIV?

A
80
Q

What is the patho behind Juvenille Idiopathic Arthritis?

A

autoimmune, body release antiinflammatory chemicals targetting synovium. may effect eyes/ other organs

81
Q

Your patient presents with joint stiffness especially with inactivity or in the morning, irritable, withdraws from play, pain, swelling, severe anemia, poor weight gain, fever (103 for 2 weeks). What would you suspect as the nurse?

A

Joint Idiopathic Arthritis

82
Q

What are the diagnostic labs for JIA?

A

elevated ESR/CRP and WBC
+ RA factor
+ ANA
CBC shows anemia

83
Q

How do you manage JIA?

A

NSAIDs, Steroids, Antirheumatic (methotrexate, etanercept)
maintain and strengthen mobility (swimming), warm bath and compress @ HS, pain management, splints to prevent contractures

some antirheumatics are not approved for use in children

84
Q

A patient has a reaction to peaches, but is not allergic to them. Why is that?

A

Patient must have an allergy to latex, 35% of these patients will have a cross reaction to kiwi, avocado, banana, peach, chestnut, fig, tomato, white potato

IgE response, forming and releasing cytokines

85
Q

Patient is rushed into the ED, presenting with hvies, urticaria, angioedema, flushing, wheezing, mouth/ throat itching, and anaphylaxis? What do you suspect?

A

allergic reaction

86
Q

What are the s/s of a severe, life threatening reactin? What is it called?

A

Anaphylaxis, respiratory compromise, low BP, Skin-mucosal tissue involvement, GI symptoms

87
Q

How do you manage an allergic reaction in pediatric patients?

A

ABC’s, admin Histamine blocker and Epipen, airway, comfort

88
Q

What do you teach the parents and patient about their allergic reaction?

A

have a written emergency plan
dietary consult
teach s/s of reaction and avoid triggers
plan for school/ daycare

89
Q

A patient presents with a maculopapular rash that started on the face –> neck –> trunk –> arms -> legs –> feet, fever, and Koplik spots. The patient is coughing, has conjunctivits, malaise, and nasal inflammation. What do you suspect as the nurse?

A

rubeola (measles)

90
Q

The nurse knows that these are complications of Rubeola?

A

PNA, diarrhea, encephalitis

91
Q

What management techniques should the nurse plan for the patient who has Rubeola?

A

MMR vaccine (to prevent), antipyretics, supportive care, fluids, humidification, bedrest,

Post-exposure vaccination within 72 hours or immune globulin (IgG) within six days may reduce severity

92
Q

What type of precautions will a patient with Rubeola have? How long will they be on these precautions?

A

airborn precautions until 4 days after the onset of rash

93
Q

What will you give a hospitalized child who is 6mo-2 years old/ immunocompromised, who has Rubeola?

A

vitamin A

94
Q

A mom brings her child in who has been experiencing a paryoxsymal cough (10-30x in a row) with a red face, cyanosis, protruding tongue when coughing, whooping cough, copious nasal/ oral secretions, with airway swelling and irritation. What do you suspect?

A

Pertussis

95
Q

What medication class will you give to a patient with pertussis? What medication will you specifically give to a patient who is less than a month old?

A

Macrolides “-mycins”. Azithromycin if < 1 mo

96
Q

What therapuetic management is used for patients with pertussis?

A

high humidity, droplet/ standard precautions, DTaP vaccine for all contacts less than 7 who are under/nonvaccinated

97
Q

True or False: You should use a different site and a different device when assessing temperature.

A

FALSE, use same site and device

98
Q

How do you assess temps in a patient with a fever?

A

assess temp q4-6hr when fever, and q30-60min after antipyretic med
keep linens dry and clean
admin ibuprofen and tylenol

use caution with ibuprofen in infants

99
Q

What is lyme disease?

A

History of tick bite; Firm, discrete, pruritic nodule; Urticaria or localized edema

100
Q

Your patient is experiencing erthema migrans @ bite site, chills, fever, HA, stiff neck, weakness. What stage of lyme disease are they at?

A

Stage 1; 3-30 days

101
Q

Your patient is experiencing systemic involvement (neuro, cardiac, MS); paralysis/ weakness in the face; muscle pain; swelling in joints; fever, fatigue, splenomegaly. What stage of Lyme disease are they in?

A

Stage 2; 3-10 weeks

102
Q

Your patient has advanced systemic involvement; MS pain, arthritis, deafness, cardiac complications, encephalopathy, speech issues. What stage of Lyme disease are they in?

A

Stage 3; 2-12 mo

103
Q

What is the tx for Lyme disease for children over 8? Under 8? How long is their treatment regimen?

A

Doxycycline for over 8
Amoxicillin for under 8
(or Cefuroxime if there is an allergy)
14-28 days

104
Q

What are the physical cues of pediculosis capitus?

A

extreme puritis, small red bumps on scalp, white specks attached to hair shaft, lice visible behind the ear or back of neck

105
Q

What is the management of pediculosis capitus?

A

contact precautions
follow exact directions of pediculide, repeat if severe, lice comb hair q2-3 days, treat linens/ toys

106
Q

Describe contact precautions.

A

diseases transmitted when in close proximity to patients or their environment (pediculosis capitus)
don gown and gloves before entering, dof before leaving room

107
Q

Describe droplet precautions.

A

diseases caused by large droplets, generated by coughing, sneezing or talking, mask if within 3 feet (pertussis)

108
Q

Describe airborn precautions.

A

used for infectious pathogens that remain suspended in the air & can travel great distances. N95 and negative pressure room (rubeola / measles)

109
Q

Immunizations are what type of prevention for communicable diseases?

A

Primary

110
Q

What is the patho behind acute lymphoblastic leukemia?

A

overproduction of immature WBC (leukoblasts) w/ neoplastic characteristics, leading to organ/ tissue infiltration

111
Q

CASE STUDY

Your patient comes to the ED presenting with the following s/s:
low grade fever
s/s of infx
pallor
bruising/ petechia/ purpura
enlargened liver and lymph nodes

You just got their labs back, they are listed below:
CBC: low Hgb, low Hct, low RBC, low platelets, high WBC
bloor smear: + leukoblasts
LP: + leukoblasts
CXR: detects PNA and mediastinal tumor
Bone Marrow Aspirate: lymphoid and myeloid cell type, prolific quantities of blasts.

What do you suspect as the nurse?

A

Acute Lymphoblastic Leukemia

BMA is the most definitive way to test for leukemia

112
Q

What is the patho behind lymphoma?

A

abnormal cell growth in lymphatic system, resulting in altered immune response nd increased r/f infx

113
Q

A patient will have the following complaints in their history with lymphoma…

A

frequent night sweats, unintentional weight loss, Epstein Barr infx, frequent infx, immunodeficiency

114
Q

CASE STUDY

A 16 year old patient comes in for a doctors appointment. They have an unexplained fever, cough, SOB, puritis, splenomegaly, hepatomegaly, painless enlarged supraclavicular/ cervical lymph nodes (sentinel nodes).

The doctor has a feeling they know what the patient has, so they order a lymph node biopsy. It comes back positive for reed sternberg cells.

What does the patient have?

puritis occurs d/t cytokine release

A

Lymphoma

115
Q

The nurse prepares for a BMA by…?

A

prone position iliac crest (may use tibia in infants)

Local/topical anesthetic & Conscious sedation meds (Fentanyl/Versed)

Explain procedure/Comfort/Infx prevention

Hold pressure/pressure dressing & Monitor for bleeding & infection

116
Q

What are the pre op nursing interventions for a brain tumor?

A

Monitor for ↑ ICP and manage accordingly
Steroids to decrease intracranial swelling
Pre-op teaching/Emotional support

117
Q

What are the post op nursing interventions for a brain tumor?

A

I&Os, frequent V/S with pupil and LOC checks, monitor for increased ICP

treat hyperthermia with antipyretics, pain management, treat HA with analgesics

position on unaffected side at level ordered by provider, keep head midline

JP drain monitoring and care

118
Q

What is Wilm’s tumor?

A

aka nephroblastoma, malignancy occuring in abdomen (kidneys) usially right sided unilateral and deep in flank

119
Q

CASE STUDY

3-year-old presents to clinic with reported firm, nontender abdomen that was assymetrical, vomiting and weight loss. Other s/s include hematura, HTN , and dyspnea with cough. When asked about pain, the patient pointed to his chest.

Your team decided to get diagnostics and they are listed below:
ultrasound, CT, and MRI all show a renal mass
CBC: anemic
UA: + WBC + RBC
24 hour urine negative for HVA and VMA.

What do you suspect the child’s diagnosis will be?

A

Wilm’s Tumor

120
Q

What key nursing intervention should be done for a patient with Wilm’s tumor?

A

do NOT palpate abdomen, hang a sign above the door and bed saying so as well, as palpation can rupture the tumor

121
Q

What are some neutropenia precautions?

A

Hand hygeine
vitals q4hr and assess for signs of infection q8hr and PRN
Avoid rectal temps, enemas, suppositories, urinary catheters, and invasive procedures
No raw fruits, vegetables, fresh flowers, or live plants in room
Restrict visitors, mask on child when outside room
Soft toothbrush

122
Q

What are some adverse effects of chemo?

A

Anemia- limit blood draws, iron rich food, Epoetin admin
Thrombocytopenia- avoid rectal temps and meds, IM, LPs, avoid ASA and NSAIDs, give acetominophen instead
Neutropenia- private room, hand hygeine, abx prophylactic
ANC < 1000
N/V/D- bland dry food, small frqnt meals, ice, carbonated drinks, popsicles, relaxation and guided imagery

123
Q

What are some patient teaching points for radiation? Whats a common complication?

A

Wash skin with mild soap & water
Avoid lotions/powders/ointments, sun/heat exposure, use aloe vera
Diphenhydramine or hydrocortisone cream for itching, Antimicrobial cream to desquamation

Altered skin integrity

124
Q

What are the s/s of iron deficient anemia?

A

pallor, MM, conjuctiva, spooning of nails, dizziness, SOB, Weakness, unstead gaist, difficulty feeding/ pica, HA, irritable

125
Q

What are the labs for iron deficiency anema?

A

RBC, Hgb, Hct, MCV/ MCH, Ferritin decreased
RDW increased

126
Q

What management should be used for treating anemia?

A

feed only formula fortified with Fe+
supplement Fe+ in breast fed infants by 4-5 mo, encourage moms to increase iron
> 1 yr old, less than 24 oz/cow milk/day
encourage Fe+ rich foods (beef, leafy greens, apricots)

place Fe supplements behind teeth to avoid staning, increase fiber and fluids d/t constipation, dark green stools normal

127
Q

What are your physical cues of Hemophilia A?

A

(hemarthrosis) swollen/ stiff joints
multiple bruises
hematuria
bleeding gums/ sputum/ emesis
black tarry stool
chest/ abd pain (internal bleeding)

128
Q

What is your only abnormal lab cue for hemophilia?

A

PTT, itll be greater than 35 seconds

129
Q

What is the tx for hemophilia?

A

First, factor VIII admin (slow iV push)
Mild cases: Desmopressin

Desmo triggers the endothelium of blood vessels to release factor VIII

130
Q

How do you manage a bleeding episode with hemophilia?

A

apply direct pressure to external bleeding, RICE to joint bleeding

131
Q

What is sickle cell vaso occlusive crisis?

A

circulation of blood vessels is obstructed by abnormally shaped RBCs causing ischemia and infarction. RBC lysis occurs.

132
Q

CASE STUDY

Your patient presents with extreme fatigue, irritability pain (abdomen, thorax, joints, digits) dactylitis (severe finger/ toe swelling) cough, increased WOB, fever, tachypnea, hypoxia
splenomegaly, jaundice (from hemolysis) or pale conjuctiva/ palms/ soles/ feet.

Her labs are presented below:
Hgb decreased
Hct decreased
Platelets increased
ESR decreased
Reticulocyte count increased
Bilirubin increased

What do you think she has? How should you manage it?

A

Sickle cell vaso occlusive crisis

Pain control on a regular schedule Hydration doubled (150ml/kg/day)
Hypoxia, O2 NC if SpO2 is < 92%

133
Q

What are your risk fators for lead poisoning?

A

live in home built before 1956, live near busy road, toys/ imported products, poverty/ malnutrition, age, pica

134
Q

What are the s/s of lead poisoning?

A

abd pain/ cramps, irritability, decreased appetite, V, ataxia, hematuria, new onset of seizures

135
Q

What is chelation therapy?

A

tx for lead poisoning (blood lead levels > 45 ug/dL)- removes lead from soft tissue and bone then excreted via kidneys

136
Q

What are the meds for chelation therapy? What do you need to monitor for as the nurse?

A

Succimer/ Dimercaprol/ Adetate calcium disodium

Adequate fluid intake, I&Os

Fourth Semester (5 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions