Peds Exam II Flashcards
Digoxin Therapeutic range:
0.8-2
S&S of digoxin toxicity
EARLY: vomitting
GI S&S: abdominal pain
Digoxin MOI:
decreases HR
increases CO
What do you have to check before administering Digoxin?
K+ level
apical pulse for 1 min
When should you NOT give Digoxin?
bradycardic
vomiting
What can increase Digoxin toxicity?
Low K+
Lasix MOI:
blocks reabsorption of sodium and water
Diuretic
Lasix considerations:
check chloride and potassium level - it’s a K wasting diuretic and can worsen digoxin toxicity
Expected urine output for all ages:
infant - 2mL/kg/hr
children - 0.5-1 mL/kg/hr
adults - 40-80 mL/hr
Which UTI gives fever and costovertebral angle pain (p! with kidney palp)
Pyelonephritis
S&S of acute vs chronic otitis media:
acute - hallmark is pulling at ear and inflammation
chronic - NO inflammation and fluid behind membrane
Prevention for otitis media:
avoid second hand smoke
YES: breastfeeding vaccinations smaller daycare avoid bottle propping
Range for amoxicillin for otitis media:
80-100 mg/kg/day
What are the INCREASED pulmonary blood flow defects?
VSD - most common
ASD
PDA
AV Canal
What are the DECREASED pulmonary blood flow defects?
Pulmonary Stenosis
Tetralogy of Fallot
Tricuspid + Pulmonary Atresia
S&S of increased vs decreased pulmonary blood flow:
Increased: TACHYpnea TACHYcardia weight gain r/t edema sweating c minimal activity (with eating) retractions
Decreased:
CYANOSIS
clubbing (chronic hypoxia)
hyper cyanotic spells ("tet spells")
Polycythemia (increased RBC)
Characteristics of increased vs decreased pulmonary blood flow defects:
increased:
blood shunt from left to right
kids are NOT cyanotic
decreased:
blood shunt from right to left
kids ARE cyanotic
Interventions for hyper cyanotic “tet” spells:
squat to improve blood flow
What is the treatment for decreased pulmonary blood flow defects?
keep PDA open with prostaglandins until surgery
What is the treatment for increased pulmonary blood flow defects?
conservatively tx with digoxin and diuretics until the defect closes - THEN surgery
Post op care of a cardiac catheterization:
leg must be straight for 4-6 hours with NO movement (can apply sandbags)
assess dressing Q15min for bleeding for the first hour
Etiology, S&S and tx of Infective endocarditis:
etiology: strep and staph
S&S: fever and CHF symptoms
Tx: antibiotics, maintain dental hygiene, potential surgery
Etiology of Rheumatic fever:
etiology: beta hemolytic strep
S&S: nocturnal dyspnea (always cardiac, NOT respiratory), Jones criteria
Tx: Antibiotics
Anti-inflammatory meds
Etiology of Kawasaki:
idiopathic
S&S: strawberry tongue, dry lips
Tx: IVIG for 10 days and Aspirin 100mg/kg/day
Testicular torsion -
sudden severe pain
must have surgery within 6 hours
EMERGENCY
Nursing management for GER vs. GERD
GER - long term H2 antagonists and PPIs
GERD - upper GI series, pH probe and thickened feedings with rice cereal
Which glycemic crisis is rapid onset?
HYPO is rapid
HYPER is gradual
S&S and tx of omphalocele vs. Gastroschisis:
Omphalocele - (sac) keep that sac intact by covering with moist, sterile gauze
Gastrochisis - (no sac) temperature regulation is #1
Should you feed a baby with Omphalocele?
NO NO NO
What is intrasusception? S&S and Tx?
telescoping of one part of the intestine into the other
S&S: abrupt pain, bilious emesis (green/yellow vomit), currant jelly stools (LATE), sausage mass in RUQ
Tx: air or barium enema
How do you know if an air/barium enema worked?
if they pass a brown stool
Bacterial/Viral/Allergic Conjuntivitis S&S:
bacterial - unilateral c purulent discharge
viral - bilateral c watery discharge
allergic - cobblestone eyeballs
Patient teaching with conjunctivitis:
prevent the spread
do NOT force a crusty eye open
Pt teaching for cleft palate baby:
ESSR method to feed (enlarged nipple, stimulate sucking, swallow, rest)
They are more prone to ear infections
Visual Development for bbs : the facts
2 months - can track moving objects
4 months - able to see in color
S&S of glaucoma
tearing, corneal clouding, progressive eye enlargement
Amblyopia S&S and Tx:
lazy eye
S&S - reduced vision in one or both eyes, squinting, close one eye to see
Tx: patch of the GOOD eye or glasses
Eye drop administration:
wash hands warm meds pull lower lid down keep the eye closed for a few seconds wash yah hands again
S&S of of rotavirus. Tx?
explosive diarrhea that smells like wet grass
Tx: balance those electrolytes and hydrate
Short bowel syndrome etiology, tx:
etiology - malabsorption
tx: TPN, central line lipids, serial transverse enteroplasty (to lengthen the bowel)
Hischsprung Disease: etiology, S&S, Tx
etiology - megacolon
S&S - no meconium, constipation, and distention, failure to gain weight, ribbon stools
Tx: colostomy care
congenital HYPOthyroidism S&S:
decreased thyroid hormones lead to irreversible intellectual disability
S&S: jaundice thick, floppy tongue HYPOtonia (floppy baby) dry skin hoarse cry large fontanelles
Rule of Stools:
ribbon stools or anal leakage - Hirschprung’s
Currant jelly stools (blood/mucus) - Intussusception
floating stool - malabsorption (Celiac)
Bladder entropy S&S:
split clit
small penis
