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ABSN > Peds Final - Review > Flashcards

Peds Final - Review Flashcards

1
Q

how to give meds to reluctant toddler / pre schooler

A

-give them a choice
-mix w/ food
-reward
-change method of delivery

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2
Q

Coarctation of the aorta

A

narrowing of aortic arch distal to the ductus so all the blood gets shunted up lower will have reduced blood flow, upper get high causing headaches, nose bleeds & bounding pulses
treated w/ prostaglandin E and surgery within first 2 years

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3
Q

kawasaki

A

body wide inflammation of veins, capillaries & coronary arteries treated with high dose aspirin for anti inflam & low dose for anti platelet and IVIG if fever is caught within 10 days

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4
Q

CHF

A

failure of the heart to supple enough blood to meet needs leading to sweating, tachy, decrease BF to kdineys, low urine output, cyanosis, SOB, edema, long cap refill

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5
Q

how to give digoxin

A

-1hr before or 2hr after eating
-check apical HR for 1 min prior
-do not mix with food or fluid
-put behind teeth then oral care

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6
Q

when to hold digoxin

A

if apical pulse is <90 in infants / young kids or <70 in older kids or low K+
if missed dose, can give within 4 hrs, but longer hold

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7
Q

signs of digoxin toxicity

A

-vomiting
-nausea
-bradycarida
-anorexia
-neurological & visional dysfunction

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8
Q

tetralogy of fallot

A

1) palmonic stenosis
2) overriding aortic arch
3) VSD
4) right ventricular hypertrophy

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9
Q

pre op care for cath lab

A

-npo for 4 to 6 hrs, clarify morning meds
-assessment including ht & wt
-assess skin can’t bring with a diaper rash or cystic ache
-mark pedal pulses

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10
Q

post op care for cath lab

A

observation of color, LOC, VS, res status, distal extremities, assess dressing for bleeding, fluids, blood sugar (esp hyper) & keep flat for 4-6hrs

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11
Q

bacterial endocarditis

A

infection of the valves and inner lining of the heart (usually occurs from a picc line or dental procedure) -> manifests w/ janeway spots, osler nodes, splinter hemorrhages under nails, petechia, anorexia, joint point & murmur

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12
Q

transposition of the great arteries

A

pulmonary artery arises from left ventricle and the aorta arises from the right ventricle -> treated w/ prostaglandin E until surgery

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13
Q

Hypospadias immediate post op care & teaching

A

urethral opening is on the ventral surface of the penis, surgical correction between 6-18mo no circ before surgery-> post opt care include assessing pressure dressing for drainage, cath care and teaching no tub baths, straddle toys, and baby cannot be carried on hip
more at risk for uti

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14
Q

key facts for GN

A

-caused by untreated strep, give abx
-S/s: headache d/t htn, coke colored urinne, facial edema
-urinalysis: hematuria, proteinuria & elevated SP w/ a negative culture
-diet: no salt, low pro
-bed rest, isolation
manual BP

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15
Q

key facts for acute renal failure

A

-caused by dehy (give fluids) or toxic meds (stop med then fluids)
-dx: low urine out, edema, classic dehy signs
-labs: bun & creatinine elevated, hypo Na, hyper K, hyper Phos
-meds: albumin then lasix

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16
Q

UTI teaching

A

wipe front to back, no tight clothes, hydrate, pee after sex, potty schedule, no bubble baths, change pads frequently
VCUG is reoccurring -> if reflux founds then abx or surgery in severe cases

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17
Q

key facts for NS

A

-S/s: massive proteinuria, rapid wt gain + generalized edema, decreased urine out, normal or slightly decreased BP, hypoalbuminemia
-bed rest & no salt, high pro if edema present + isolation
-meds: steroids & loop diuretics

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18
Q

key facts for HUS

A

-hx of GI bug + V/D, edema, oliguria, elevated BP, abdominal pain
-labs: low platelets & RBCs anemia
-Prevent: wash hands/fruits/vegs, cook & temp, avoid unpasteurized dairy & fruit juices

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19
Q

Downs S/s + treatment

A

-dx: depressed nose bridge & small nose, loose skin, large protruding tongue, wide space in between big toe, delayde sexual development, constipation
-tx: suction, antihis @6mo, blow nose, mist ; persistent feeding ; support neck & swaddle for thermal reg ; fluids & fiber

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20
Q

ADHD

A

-dx: 2 people say difficult concentrating, struggling in school and social settings
-tx: behavioral therapy 1st (front of class, low distraction, short written out task list) then meds (psychostim so clinic every couple months so assess growth & BP)
-med teaching: empty stomach, 7am and noon, no med holidays

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21
Q

DDH + harness

A

head of femur is not in hip socket so harness all the time besides baths prevent sink breakdown & avoid lotions/powders

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22
Q

MD

A

meets milestones then regression around 3-5 yrs
-brainstorm and work with family to keep them independent
-work w/ the therapies

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23
Q

SB

A

-paralyzed from waist down, incon of bowel and bladder (**high risk for uti d/t in&out cathing) + bowel training
-high risk for hydrocephalus after surgery

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24
Q

cast care

A

-neuro vascular checks + skin assessments 5 Ps
-do not stick anything into cast besides fingers
-ice for itching and swelling
-NSAIDs for pain No ibuprofen
-isometric exercises on affected side
kids are scared of removal -> ear plugs, demo on self, distraction

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25
Q

CP

A

-dx by missed milestones & persistent reflexes
-keep independent as long as possible
-support use of muscle

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26
Q

asthma

A

-proper deliver of meds (control= steroids & long beta 2s, rescue= short beta 2s, bronchodi’s & mag sulfact)
-med teaching (sit up, shake, breath out, inhale & press, hold 10 sec or spacer)
-PERF chart

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27
Q

croup

A

swelling or obstruction of airway creating horse, barky cough, stridor & res distress
viral = LTB, bacterial =epiglottis

28
Q

Juvenile arthritis meds

A

1) NSAIDs
2) DMARDs
3) humira or enbrel (biologic agents)
4) corticosteroids
+ pt and warm baths

29
Q

RSV

A

airway infection resulting in inflammation
-S/s: rhinorrhea, pharyngitis, intermit fever, cold symptoms -> wheezing, fever, feeding problems, increased secretions -> tachy, apneic spells, cyanosis
-tx: ribavrin, bronchdilators, cortsteroids, hydration & treat symptoms
suction the child first
vaccines only for high risk, <29wkers

30
Q

pertussis

A

prevent! w/ Tdap
S/s: coughing so much that they cannot catch breath, decreased intake
tx: erythromycin, humidified oxygen, <6mo might need to be vented

31
Q

techniques to reduce reflux

A

-elevate head of bed
-avoid caffeine, chocolate, mint, spicy food, high fat foods

32
Q

tonsillectomy what to watch for post op

A

-excessive swallowing 8-10 after surgery bc that means bleeding, blood tinged sputum, discourage straws/coughing/laughing/crying
-diet: soft, no red foods, no milk products
contraindication for cleft palate, acute infections, uncontrolled systemic disease or blood dyscrasias, <4 y/o

33
Q

Otitis medias

A

-how to prevent: limit exposure to cig smoke, no bottles in bed, breastfeed, no pacifier use beyond infancy
-allergies increases
-S/s: irritable, holds or pulls ears, may roll head, hearing loss if chronic
-tx: abx, Tylenol/Ibuprofen, warm compress

34
Q

gastroschisis tx before surgery

A

no sac around organs
c section -> loosely cover organs w/ saline -> give fluids & abx -> bring to nicu -> multiple surgery (place organs inn silo in between)

35
Q

gastroschisis nursing role

A

-sterile, careful handling
-monitor for ileus
-support family

36
Q

cleft lip post surgery

A

z plasty in first weeks of life, after surgery place child on back or side use restraints so they don’t pick at sutures and suction only if necessary

37
Q

cleft palate post surgery

A

close palate w/ obturators between 12-18months, after surgery place on their bellies w/ restrains and suction only if necessary

38
Q

how to feed baby with cleft lip/palate

A

caused by inheritance, teratogens during pregnancy, maternal smoking -> long nipple & stim suck reflex , upright, lots of burping, stop after 30-45min

39
Q

calculate fluid needs

A

-1st ten kg (100 x kg)
-2nd ten (50 x kg)
-20+ (20 x kg)
divide by 24 to get per hour

40
Q

ways to prevent and reverse constipation

A

-child should have 5g of fiber + their age & fluids and potty schedule
tx: water -> add fruit juice into water -> miralax
if intestines expanded, keep them cleared out for 6 mo

41
Q

how to care for a child w/ HIV

A

-aggressive antibiotics & prophylactic in the future
-modify immunization schedule
-very irritable so be calm and supportive
-can go to school but if bodily fluids then gloves
-increase kcals & protein

42
Q

how to prevent HIV

A

-safe sex
-do not share needles
-take meds during pregnancy + c section

43
Q

how to give iron

A

-acidic environment
-use straw to push past teeth then oral care
-increase fluids and fiber
-do not mix with foods

44
Q

what is the first sign of a sickle cell crisis

A

swelling & s/s of anemia
joints for vaso occlusive, spleen for splinic

45
Q

s/s of anemia

A

pale, bruise easily

46
Q

what triggers a sickle cell crisis

A

-dehydration
-hypoxia / increased O2 needs
-infection
-trauma
-physical and emotional stress
-high altitudes

47
Q

effects of chemo

A

-immunosuppression
-hair loss
-N/V, decrease appetite & intake

48
Q

DKA treatment

A

BS >300, fruit breath, lethargy
1)fluid replacement w/ 10mL/kg 0.9% NS IV priority- 1st hr
2)lyte replacement over 48hr (0.9% NS + 20 mEq/L KPhos + 20 mEq/L KCl) 2nd hr
3)insulin therapy 0.1u/kg/hr drip 2nd hr (do not give bolus)
-begin dextrose infusion when BG reaches 250-300 (D5 0.45% NS + 20 mEq/L KPhos + 20 mEq/L KCl)
4)careful monitoring, D/c fluids when pt tolerates oral fluids & then give SubQ insulin and stop the drip

49
Q

DM key points

A

-aspart (novolog), lispro (humalog) are rapid acting, glargine & detemir are long
-carb count, no restrictions besides high sugar
-when sick stay on insulin routine, check urine ketones, stay hydrated, check BS often
-biggest complication is DKA and then cerebral edema if we drop BG too fast

50
Q

PKU diet

A

-no meat or dairy
-limit fruits & vegetables
-limit grains
most nutrition comes from pku formula
can be breast fed

51
Q

cong hypothyroid med admin

A

oral thyroid hormone replacement -> start low and then slowly increase
will need to see dr and correct often d/t growth changes

52
Q

teaching for growth hormones

A

-administer at night subQ 5-7x/wk
-can ice area before to decrease pain
-squeeze fat
not making super tall, just to predicted height

53
Q

in a DKA pt, what do we flush the insulin line with

A

insulin

54
Q

how do we know if the cancer has spread into the brain

A

high risk in leukemia
headache, persistent nausea & vomiting, irritability, dizziness, seizures, behavioral changes, lateral eye movement

55
Q

what does digoxin do

A

allows hard to contract harder

56
Q

tet spell

A

be calm & comforting
-knees to chest
-100% oxygen by face mask
-give morphine
-IV fluid replacement
-repeat morphine
**do one at a time & do not advance in list unless needed)

57
Q

bacterial endocarditis therapeutic mgt

A

-IV antibiotics for 2 to 8 wks
-surgical removal of significant emboli and/or valve replacement

58
Q

how to prevent bacterial endocarditis

A

prophylactic antibiotics 1hr before risky procedure for high risk kids

59
Q

Kawasaki clinical manifestations

A

-fever that is unresponsive to meds
-rash & dry lips
-strawberry tongue
-bilateral pink eye w/o junk
-swollen palms
most dangerous when symptoms free in recovery phase bc embolism can form increasing risk for MI

60
Q

Autism

A

-dx: social+communication+behavior, abnormal eye contact, flaps, repeating phrases
-tx: non verbal com, dim lights, limit ppl in room, calm, talk to caregivers, what to do vs what not to do

61
Q

SB procedure immediately after birth

A

baby on belly -> apply non adherence sterile dressing over the sac -> NICU -> sedate & intubate -> surgery

62
Q

reflexes time frame

A

-rooting & moro: 4mo
-tonic & grasping: 6mo
-babinski: 2yr

63
Q

LTB

A

-slowly progressives and sounds worse than it is
-home mgt as long as not inn distress
-barky cough
-high humidity, fluids, & racemic epinephrine
-bed rest and continuous observation
avoid cough syrup/cold meds, bronchodilators & antibiotics

64
Q

epiglottitis

A

life threatening d/t losing airway
-abrupt onset, open mouth, tongue out, drooling & agitated, looks sick & wants to be upright
-tx: no tongue blades or looking at throat, portal x ray if needed, sedate -> intubate -> abx - extubate

65
Q

long term consequences of cleft L/P

A

-altered speech, dentition and hearing
-ear infections
teach good oral care, watch the ears and promote speech

66
Q

CF key facts

A

always suction or pulmonary toilet or vest first
-lose extra salt, dehydration
-dx: pilocarpine electrophoresis (salt chloride) >60
-tx: CFTR modulators, abx, hydration, pancreatic enzymes
-diet: full fat, high kcal

67
Q

hyperthyroid med : PTU

A

makes you immunocompromised so if pt gets a sore throat or infection, see medical professional immediately

ABSN (161 decks)

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