Peds Final Flashcards
Signs of increased intracranial pressure. Infant verses older child
Separation of cranial features. Poor feeding. Vomiting. Irritability. Headache. Slurred speech. Lethargy. Bulging Fontenalr.
Glasgow coma scale - The Glasgow Coma Scale assesses eye opening,
- Eye opening
- Verbal response
- Motor response
Abscsnce
Blank stair Absence seizures are very brief episodes of altered awareness. The child has a blank expression. Daydream episodes are suggestive of absence seizures, and data about activity associated with the daydreams should be obtained.
Atonic Seizures
Atonic seizures cause an abrupt loss of postural tone, loss of consciousness, confusion, lethargy, and sleep.
1st Action to Take when Child has Seizure? Turn the child on their side to prevent ASPIRATION
What will you see in a child after a tonic clonic seizure? Fatigue
Tonic Clonic Seizures
1. Ativan is What is one of the 1st drugs given in the ER for a Tonic-clonic seizure?
Tonic-clonic seizures involve sustained generalized muscle contractions followed by alternating contraction and relaxation of major muscle groups.
There is no change in level of consciousness with simple partial seizures. Simple partial seizures consist of motor, autonomic, or sensory symptoms.
1. Cause an abrupt arrest of activity and impairment of consciousness
2. Tonic phase consists of a sustained generalized stiffening of muscles
3. Clonic phase is symmetrical and rhythmic, consisting of alternating contraction and relaxation of major muscle groups
4. Tonic-clonic seizure is followed by a variable period of confusion, lethargy , and sleep (postictal phase)
Focal
Status
Status Epilepticus 1. A prolonged seizure lasting more than 30 minutes with no return to a normal level of consciousness
2. Most common form of status epilepticus is generalized status, which has the highest potential for complications and possible death
Focal seizures may arise from any area of the cerebral cortex, but the frontal, temporal, and parietal lobes are most commonly affected.
Partial seizures are caused by abnormal electric discharges from epileptogenic foci limited to a circumscribed region of the cerebral cortex.
Generalized seizures indicate that the initial involvement is from both hemispheres.
Acquired seizures- A seizure disorder that is acquired is a result of a brain injury from a variety of factors; it does not specify the type of seizure.
Loc
Level of consciousness:
The most important nursing observation after a head injury is assessment of the child’s level of consciousness. Alterations in consciousness appear earlier in the progression of head injury than do alterations of vital signs or focal neurologic signs.
Disoriented
- Awake, alert, oriented, interacts w/ environment
Confused. 1. Lacks ability to think clearly and rapidly
-Usually oriented to person
Delirious 1. Not oriented to person, place, or time - Impairment of reality with auditory or visual hallucinations possible
Disoriented Lacks ability to recognize place or person
Lethargic Very drowsy and needs increased stimuli to be awakened
Stupor. Requires vigorous stimulation to arouse
ComaVigorous stimulation produces no motor or verbal response
Aspiration
Aspiration
Foreign body aspirations.
1. Latex balloons account for a significant number of deaths from aspiration
2. Occurs most frequently in children younger than 2 years of age
1. Foreign body aspiration is seen most frequently in children ages 6 months to 5 years
1. Most foreign bodies become lodged in the bronchi (Right side)
1. Sudden, violent coughing
2. Gagging
3. Wheezing
4. Vomiting
5. Brief episodes of apnea, and possible cyanosis
Lodge in brochi. Right. Brochi.
Liquid assess for gag reflexes.
Candy. Hot dog. Peanuts. Grape. Raising. Chew gum
Head injury
Most Important Thing to assess after head injury is? ….LOC
Second Impact syndrome A second concussion may cause more harm to the brain and may even lead to death
2. Talk with health provider before child returns to activities or sports
Head Injury Can Cause? Change in a child’s behavior
Tonic Tonic-clonic seizures X3 questions
Tonic seizures
Tonic-clonic seizures involve sustained generalized muscle contractions followed by alternating contraction and relaxation of major muscle groups.
There is no change in level of consciousness with simple partial seizures. Simple partial seizures consist of motor, autonomic, or sensory symptoms.
1. The tonic-clonic seizure is followed by a variable period of confusion, lethargy and sleep (postictal phase)
Absence seizures X3 questions
Absence seizure Blank stair Absence seizures are very brief episodes of altered awareness. The child has a blank expression. Daydream episodes are suggestive of absence seizures, and data about activity associated with the daydreams should be obtained.
- No muscle activity occurs except for upward rolling of the eyes
- The child has a blank facial expression
- Only last 5 to 10 seconds or less
- may occur hundreds of times per day - Children immediately return to activity they were participating in prior to the seizure ***
Atonic seizures X 2 questions
Atomic
Atonic seizures cause an abrupt loss of postural tone, loss of consciousness, confusion, lethargy, and sleep.
1. Cause an abrupt loss of postural tone
2. Child may experience head drop or a drop attack
-fall to the ground, often face down, lose consciousness for a few seconds
Dilantin Administrations
Dilantin Oral care due to meticulous. IV given normal saline. Filtered. Big veins. good dental hygiene adequate intake of vitamin D avoid dairy products
IM injections in children by age X 2 questions
Faster.
22 to 25 gauge.
1/2 inch.
Infant. 0. 5. Ml.
Adolescent 3 ml.
90 degree and aspirate.
Vastus laterallas. Or deltoid.
Choking in children by age X2
Chocking upright. Side lying.
90% deaths of peds.
Eardrops
Ear drops Ears. Pull piña down and back. Younger than 3 years.
Older than 3. Pull pinna up and back.
Hand hygien. Gloveee
Priority drugs during a seizure
Ativan or Valium. IV
Lorazepam. Tegetol.
Nursing intervention during a seizure
Pad rails.
Safety.low position.
Oxygen.
Abcdes. Immobzasw nake. Nero assessment.
Level of Consciousness
Loc
Ketogenoc diet
Ketogenic diety. Fat. Protein. No carb.
Comsitspation
Dehydration. Vitamin defficiet. Gall stone.
Cardiopulmonary arrest priority 851
Cardio pulmonary
Respiratory stabilization.
Look for skin color. Response to envin. Tach
Decrease peripheral rate are early signs ……..hypotension. Late sign.
Bag
Emergency triage
Emerge cy triage
Abcdes. Reps. Skin color. Response to environment.
Oral medication administration
Oral med
Formula decreases absorption.
Slow gastric emptying and have less gastric acid and have more digestive enzyms
Assess gag reflexes. Prepare using string less that 5 ml.
Cup up to 30 ml put the meds
…..NON essential food…..
Never in formula.
Admi. Upright strkng along side the chick .
Abdominal assessment
Inspect
Austate first.
Puercise and
Palate.
Pulses. Brachial. 0-1
Carotid. Femor. 1 above
BlDder empty. Inspect.
Scaphoid. They are malnourished. Listen to one quardrsht for 5 minutes
Obtunded X2
Obtunded X2
- Sleeps unless aroused
- Once aroused has limited interaction with the environment
- Answers questions with minimal response
Assessing a child’s respiration
Child Resp
Observe abdomen.
30. 60 4 years 20_40 10 yrs 16-22 16 years. 15-20. Influenced by exercise and emotions 1 full MINUTE
Eyedrops X2
After let them look down close eyes for several sec.
Put into conjunctiva sac. Edge of the Lowe lid from the Inner to outer contnus
IV line
Assess development level
Not in toddlers foot.
Not in dominant hand.
Scalp used in infants. No valves. Use. House. Boards.
Assess every HOUr of the rate and quantity.
IV line check
10 kg. 100ml/kg /day.
10 to 20 kg 1000 ml/ day plus 50 ml/kg/day.
Over 20 kg. 1500ml/day plus 20 ml/kg/day. M
Dental emergency
Dental emergecny
Check for aspiration of the tooth.
Lack of cordinaction
Submersion injury/drowning
Airway suction. CPR. Maintain oxygen and circulation
Hypoxia. Panic. No air. Swallow and vomit water. Largia spasm
Electro shift
Celebes Edema
CPR. Air.
Triage priority
Triage prior
Abscdes. Initial observation.
Assessing pulse per age X2
Pulse per age
Newborn 120 160
80 to 125
70 to 110.
55 to 90. Apical for children younger 2.
Fontanel assessment anterior vs posterior
Fontenalr
Posterior close by 2-3 months.
Anterior should be soft flat closed btn 12 to 24 months.
Sunken. Dehydration.
Bulging Icp normal wen child cries
Increased intracranial assessment X2
Icp. Blood. Brain increases the rest decreases.
Behavior. Late opening
Respiratory distress in the child
RDS retractions
Liquid medication administration
Liquid meg
Leading cause of child death
Lead cause of child desth
Burns leading for unintentional deaths motor vehicle injustices highest desth
Drowning leading desth of age 1 to 4
Head injuries.
Common cause of infant death and injury
Common cause of infant death
Burns leadin cause of unintentional deaths on children 1 to 14. US. Scald burn most common. Kitchen injuries. Lack of super ions
Drowning mostly. 1-4 Motor vehicle. 19
Suffocation.
Choking by age X2
Chocking by age
Aspiration of objects. Causing partial or complete obstruction
6 months. Poor swallowing coordination.
Hot dog. Sliced hard can day. Peanut. Grapes. Raisin. Chewing gum.
Balloons not given to infants or young children.
Poison
Stabilizing child. Highest intervention. Abcde.
Poison
History and treat the child with innitial signs snd symptoms.
ABCDE. AND stablize the child oxygen.
ALoc intubation the child.
IV wen child in shock.
Sat abd ECG needed.
Give antidote. Charcoal. Dilute never force Child to puke.
BP. Urine and tissue perfusion.
Burn assessment priorities
Burn assessment
Assess the temp. To determine rapid heat loss leading to hypothermia.
Pain level.
Airway breathing circulating. Major burn. Assess urine outputs.
Child with 10% burn. Requires fluid resuscitopn.
Hourly maintenance
Hourly maintaince
IV site. Rate of onfusion.
10 kg or less 100 mg.
10 to 20 . 1000 ml + 50 ml xkg more.
20 and obove. 1500 + 20 ml x kg
