Brainscape's Knowledge GenomeTM

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


See full index

Pediatric Nursing > Peds HESI > Flashcards

Peds HESI Flashcards

You may prefer our related Brainscape-certified flashcards:
Nursing Mental Health flashcards Nursing Management of Care flashcards NCLEX-PN® flashcards NCLEX-RN® flashcards Nursing Fundamentals flashcards Nursing Pediatrics flashcards Nursing Safety & Infection flashcards Nursing Pharmacology flashcards Nursing Maternity flashcards Family Nurse Practitioner (FNP) flashcards
1
Q

Piaget 4 Stages of Cognitive Development

A

Sensorimotor
Preoperational
Concrete Operation
Formal Operation

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

Nursing Implications for the Infant (Birth to 1 Year)

A

Birth weight doubles by 6 months and triples by 12 months

Separation anxiety

Toys include mobiles, squeaking toys, picture books, balls, colored blocks, and activity boxes

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

Nursing Implications for the Toddler (1 to 3 Years)

A

Growth velocity slows

Give simple explanations immediately before procedures

Provide security objects

Expect regression

Toys include board and mallet, push-pull toys, toy telephones, stuffed animals, and storybooks with pictures

Autonomy should be supported by providing guided choices when appropriate

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

Nursing Implications for the Preschool Child (3 to 6 Years)

A

Child learns sexual identity

Therapeutic play or medical play allows the child to act out his/her experiences

Use simple words and give preparation for procedures

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

Nursing Implications for the School-Aged Child (6-12 Years)

A

Maintaining contact with peers is important

Explanation of all procedures is important

Privacy and modesty are important

Toys include board games, card games, and hobbies

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

Nursing Implications for the Adolescent (12-19 Years)

A

Illnesses, treatments, and procedures that alter body image can be devastating

Direct questions to the adolescent when parents are preset

Age of assent

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

Pain Assessment in the Pediatric Client

A

Verbal report from the child (as young as 3 years old)

Observe nonverbal signs of pain

Most often in response to acute pain rather than chronic pain

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

Nursing Interventions for Pain

A

CRIES can be used with infants 32-60 weeks of age

FACES can be used by children preschool aged and older

Numeric Pain Scale can be used by children 9 years and older

Oucher Pain Scale for children 3-12

FLACC pain assessment tool for the nonverbal child

Children as young as 5 can use a PCA pump

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

Rubeola

A

Highly contagious viral disease that can lead to neurologic problems or death

Direct contact with droplets

Fever and upper respiratory symptoms, photophobia, Koplik spots, confluent rash

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

Mumps (Paramyxovirus)

A

Fever, headache, malaise, parotid gland swelling and tenderness

Direct contact or droplet spread

Analgesics for pain and antiseptics for fever

Bed rest maintained until swelling subsides

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

Rubella (German Measles)

A

Teratogenic effects during first trimester of pregnancy

Droplet and direct contact

Discrete red maculopapular rash that starts on face and rapidly spreads to entire body–disappears within 3 days

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

Pertussis

A

Acute infectious respiratory disease occurring in infancy

Begins with upper respiratory symptoms; prolonged coughing and crowing/whooping upon inspiration

Lasts 4-6 weeks

Direct contact, droplet spread, or freshly contaminated objects

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

Varicella

A

Viral disease characterized by skin lesions that begin on the trunk and spread to the face and proximal extremities

Macular, papular, vesicular, and pustular

Direct contact, droplet spread, or freshly contaminated objects

Communicable prodromal period to time all lesions have crusted

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

Nursing Care for Children with Communicable Diseases

A

Treat fever with nonaspirin products

Administer Benadryl for itching

Isolate children during period of communicability

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

Teaching for Immunizations

A

Irritability, fever of 102 degrees, redness, and soreness at injection site for 2-3 days are normal side effects of DTaP and IPV administration

Call HCP if seizures, high fever, or high-pitched crying occurs

Tylenol administered orally every 4-6 hours

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

Pediatric Nutritional Assessment

A

Iron deficiency occurs most commonly

Typical vitamin deficiencies include A, C, B6, and B12

Recommended intake of vitamin D is 400 IU/day

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

Nutritional Nursing Interventions

A

Assess skin, hair, teeth, lips, tongue, and eyes

Hgb, Hct, albumin, creatinine, and nitrogen commonly used to determine nutritional status

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

Causes of Diarrhea

A

Infections

Malabsorption

Inflammatory diseases

Dietary factors

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

Conditions Associated with Diarrhea

A

Dehydration

Metabolic acidosis

Shock

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

Signs of Dehydration

A

Poor skin turgor

Absence of tears

Dry and sticky mucous membranes

Weight loss

Depressed fontanel

Decreased urinary output and increased spec. grav.

Acidotic status

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

Laboratory Signs of Acidosis

A

Loss of bicarbonate (pH < 7.35)

Loss of sodium and potassium through stools

Elevated hematocrit

Elevated BUN

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

Signs of Shock

A

Decreased blood pressure

Rapid, weak pulse

Skin mottled gray color, cool and clammy to touch

Delayed capillary refill

Changes in mental status

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

Nursing Interventions for Diarrhea

A

Monitor intake and output

Rehydrate as prescribed

Check stools for pH glucose, and blood

Assess hydration status and vital signs frequently

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

Scald Burns

A

Children younger than 5 are one of the two highest risk groups

Hot water heater temperature greater than 140 degrees can cause a third degree burn on a child

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

Nursing Assessment of Child Abuse

A

Bruises in unusual places, burns, whiplash injuries, fractures, bald patches

Failure to thrive

Lacerations of genitalia

Bedwetting or soiling

Child with STDs

Child appearing frightened and withdrawn

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

Nursing Interventions for Child Abuse

A

Legally required to report all cases of suspected child abuse

Take color photographs of injuries

Document

Establish trust

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

Nursing Assessment of Poisonings

A

GI disturbance: nausea, abdominal pain, diarrhea, vomiting

Burns of mouth, pharynx

Respiratory distress

Seizures, changes in LOC

Cyanosis

Shcok

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

Nursing Interventions for Poisonings

A

Assess child’s respiratory, cardiac, and neurological status

Determine child’s age and weight

Instruct parents to bring any emesis, stool, etc. to the emergency department

Gastric lavage, activated charcoal, N-acetylcysteine, naloxone HCl

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

Important Respiratory Signs in Children

A

Cardinal signs of respiratory distress: restlessness, increased respiratory rate, increased pulse rate, diaphoresis

Flaring nostrils, retractions, grunting, adventitious breath sounds, use of accessory muscles

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

Nursing Assessment of Asthma

A

Breath sounds typically coarse expiratory wheezing, rales, crackles

Chest diameter enlarges

Increased number of school days missed during past 6 months

Signs of respiratory distress

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

Nursing Assessment of Cystic Fibrosis

A

Meconium ileus at birth

Recurrent respiratory infections, pulmonary congestion, steatorrhea

Delayed growth and poor weight gain

End-stages: cyanosis, nail-bed clubbing, CHF

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

Nursing Interventions for Cystic Fibrosis

A

Monitor respiratory status

Assess for signs of respiratory infections

Administer pancreatic enzymes, fat-soluble vitamins, oxygen, IV antibiotics

High calorie, high protein, moderate to high in fat, and moderate to low in carbohydrates

150% of the usual calorie intake for normal growth and development

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

Nursing Assessment of Epiglottitis

A

Sudden onset

Restlessness

High fever

Sore throat, dysphagia

Drooling

Muffled voice

Child assuming upright sitting position with chin out and tongue protruding (tripod position)

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

Nursing Interventions for Epiglottitis

A

Encourage prevention with Hib vaccine B

Prepare for intubation or tracheostomy

Employ measures to decrease agitation and crying

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

Bronchiolitis

A

Viral infection of the bronchioles that is characterized by thick secretions

Caused by RSV and occurs primarily in young infants

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

Nursing Assessment of Bronchiolitis

A

Irritable, distressed infant

Paroxysmal coughing

Poor eating

Nasal congestion and flaring

Prolonged expiratory phase of expiration

Wheezing, rales can be auscultated

Deteriorating condition that is often indicated by shallow, rapid respirations

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

Nursing Interventions for Bronchiolitis

A

Isolate child

Monitor respiratory status and observe for hypoxia

Clear airway of secretions

Administer oxygen as prescribed, mist tent

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

Nursing Assessment of Otitis Media

A

Fever, pain; infant may pull at ear

Enlarged lymph nodes

Discharge from ear

Upper respiratory symptoms

Vomiting, diarrhea

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

Nursing Interventions for Otitis Media

A

Reduce body temperature

Position child on affected side

Warm compress on affected ear

Antibiotics if prescribed

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

Nursing Assessment of Tonsillitis

A

Sore throat and may have dysphagia

Fever

Enlarged tonsils, purulent discharge on tonsils

Breathing may be obstructed

Throat culture to determine viral or bacterial cause

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

Nursing Interventions for Tonsillitis

A

Encourage soft foods and oral fluids (avoid red fluids)

Do not use straws

Ice collar

Treatment very important if related to strep because it can cause acute glomerulonephritis or rheumatic heart disease

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

Acrocyanotic Congenital Heart Disorders

A

Left to right shunt

ASD, VSD, PDA, coarctation of the aorta

Increased pulmonary blood flow

Increased fatigue, murmur, increased risk of endocarditis, CHF, growth retardation

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

Cyanotic Congenital Heart Disorders

A

Right to left shunt

Tetralogy of Fallot, TGV, TA

Decreased pulmonary blood flow

Squatting, cyanosis, clubbing, syncope

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

Ventricular Septal Defect

A

Hole between the ventricles

Oxygenated blood from left ventricle is shunted to right ventricle and recirculated to the lungs

Small defects may close spontaneously

Large defects cause CHF and require surgical closures

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

Atrial Septal Defect

A

Hole between the atria

Oxygenated blood from left atrium is shunted to the right atrium and lungs

Most defects do not compromise children seriuosly

Can lead to CHF or atrial dysrhythmias later in life

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

Patent Ductus Arteriosus

A

Abnormal opening between aorta and pulmonary artery

Usually closes within 72 hours after birth

If patent, oxygenated blood from aorta returns to pulmonary artery

Increased blood flow to the lungs causes pulmonary hypertension

Characteristic machinelike murmur

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

Coarctation of the Aorta

A

Obstructive narrowing of the aorta

Most common sites are aortic valve and aorta near ductus arteriosus

Common finding is hypertension in upper extremities and decreased/absent pulses in lower extremities

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

Aortic Stenosis

A

Obstructive narrowing immediately before, at, or after the aortic valve

Oxygenated blood flow from the left ventricle into systemic circulation is diminished

Symptoms caused by low cardiac output

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

Tetralogy of Fallot

A

Cyanotic heart disease

Combination of VSD, aorta placed over and above the VSD, pulmonary stenosis, and right ventricular hypertrophy

“Tet” spells or hypoxic episodes relieved by child’s squatting or knee-chest position

50
Q

Truncus Arteriosus

A

Cyanotic heart disease

Pulmonary artery and aorta do not separate

Blood mixes in right and left ventricles through a large VSD, resulting in cyanosis

Increased pulmonary resistance results in increased cyanosis

51
Q

Transposition of the Great Vessels

A

Cyanotic heart disease

Great vessels are reversed

Pulmonary circulation arises from left ventricle, and systemic circulation arises from the right ventricle

Incompatible with life unless there is a VSD, ASD, or PDA present

Medical emergency

52
Q

Nursing Assessment of Children with Congenital Heart Disease

A

Murmur, cyanosis, clubbing of digits

Poor feeding, poor weight gain, failure to thrive

Frequent regurgitation and respiratory infections

Heart rate, rhythm, and heart sounds, respiratory status, pulses, blood pressure

53
Q

Nursing Interventions for Congenital Heart Disease

A

Maintain hydration due to polycythemia

Maintain neutral thermal environment

Monitor frequently for fever, plan frequent rest periods

Administer digoxin and diuretics as prescribed

54
Q

Nursing Assessment for Congestive Heart Failure

A

Tachypnea, shortness of breath, tachycardia, difficulty feeding, cyanosis, grunting, wheezing, pulmonary congestion, edema, diaphoresis, hepatomegaly

55
Q

Nursing Interventions for Congestive Heart Failure

A

Monitor vital signs frequently and report signs of increasing distress

Assess respiratory functioning frequently, elevate HOB

Administer oxygen, digoxin, diuretics

Maintain strict I&O

Low-sodium diet

56
Q

Rheumatic Fever

A

Most common cause of acquired heart disease in children

Usually affects the aortic and mitral valves of the heart

Collagen disease that injures the heart, blood vessels, joints, and subcutaneous tissue

57
Q

Managing Digoxin

A

Take child’s apical pulse for 1 minute to assess for bradycardia; hold if less than normal heart rate

Therapeutic levels are 0.8 to 2.0 ng.mL

Give 1 hour before or 2 hours after meals

Digoxin toxicity associated with vomiting, anorexia, diarrhea, abdominal pain, fatigue, muscle weakness, drowsiness

58
Q

Nursing Assessment of Rheumatic Fever

A

Chest pain, SOB, tachycardia

Migratory large-joint pain

Chorea (irregular involuntary movements)

Rash, subcutaneous nodules over bony prominences

Fever

Elevated ESR and ASO

59
Q

Nursing Interventions for Rheumatic Fever

A

Monitor vital signs, assess for increasing signs of cardiac distress

Assist with ambulation, encourage bed rest

Administer penicillin and aspirin

60
Q

Nursing Assessment of Kawasaki Disease

A

Acute: high fever, conjunctival redness, swollen lymph nodes, red hands and feet

Subacute: peeling of hands and feet, cardiovascular manifestations, GI manifestations

Convalescent: all signs are gone

61
Q

Nursing Interventions for Kawasaki Disease

A

Administer IVIG and aspirin

Monitor cardiac status by documenting child’s intake and output and daily weights

Monitor intake of clear liquids and soft foods

62
Q

Down Syndrome

A

Most common chromosomal abnormality in children

Trisomy 21

Cardiac defects, respiratory infections, feeding difficulties, delayed developmental skills, mental retardation, skeletal defects, altered immune function, endocrine dysfunction

63
Q

Nursing Interventions for Down Syndrome

A

Assess and monitor growth and development

Teach use of bulb syringe

Teach signs of respiratory infection

Feed to back and side of mouth

Monitor for signs of cardiac difficulty or respiratory infection

64
Q

Cerebral Palsy

A

Nonprogressive injury to the motor centers of the brain causing neuromuscular problems of spasticity or dyskinesia

Causes include anoxic injury, maternal infections, kernicterus, low birth weight

65
Q

Nursing Assessment of Cerebral Palsy

A

Persistent neonatal reflexes after 6 months

Delayed developmental milestones

Poor suck, tongue thrust

Spasticity, scissoring of legs

Seizures

66
Q

Nursing Interventions for Cerebral Palsy

A

Administer anticonvulsant medications such as phenytoin

Administer diazepam for muscle spasms

Feed with child positioned upright and support the lower jaw

67
Q

Spina Bifida

A

Malformation of the vertebrae and spinal cord resulting in varying degrees of disability and deformity

Caused by folic acid deficiency

Need to screen for latex allergies

68
Q

Nursing Assessment of Spina Bifida

A

Presence of sac in myelomeningocoele is usually lumbar of lumbosacral

Flaccid paralysis and limited to no feeling below the defect

Associated with hydrocephalus, neurogenic bladder, poor anal sphincter tone, congenital dislocated hip, club feet, scoliosis

69
Q

Nursing Interventions for Spina Bifida

A

Protect the sac; position child on abdomen with legs abducted

Monitor for signs of infection

Place infant in prone position after surgery

Develop a bowel program with high-fiber diet, increased fluids, regular fluids, suppositories as needed

70
Q

Hydrocephalus

A

Abnormal accumulation of CSF within the ventricles that does not drain properly

Enlarged head circumference

Increased intracranial pressure

71
Q

Nursing Assessment of Hydrocephalus

A

Children: Change in LOC, irritability vomiting, headache, motor dysfunction, seizures

Infants: irritability, lethargy, increased head circumference, sunset eyes, feeding difficulties

72
Q

Nursing Interventions for Hydrocephalus

A

Monitor for signs of increased ICP

Seizure precautions, elevate HOB, assess for signs of shunt malfunction

Monitor for signs of infection

73
Q

Tonic-Clonic Seizures (Grand Mal)

A

Consciousness is lost

Tonic: generalized stiffness

Clonic: spasm followed by relaxation

Aura, apnea, cyanosis, incontinence, disorientation

Phenytoin, carbamazepine, phenobarbital, and fosphenytoin

74
Q

Absence Seizure (Petit Mal)

A

Momentary LOC, posture is maintained, has minor face-eye-hand movement

Last 5-10 seconds

Child appears to be inattentive; poor performance in school

Ethosuximide and valproic acid

75
Q

Myoclonic Seizure

A

Sudden, brief contractures of a muscle or group of muscles

76
Q

Nursing Interventions for Seizures

A

Maintain airway by turning client on their side

Do not restrain, support head

Maintain seizure precautions

77
Q

Bacterial Meningitis

A

Exudate covers brain and cerebral edema

Lumbar puncture shows increased WBCs, decreased glucose, elevated protein, increased ICP, positive culture for meningitis

78
Q

Nursing Assessment of Bacterial Meningitis

A

Classic signs of ICP, fever, chills, neck stiffness, photophobia, positive Kernic and Brudzinski

Poor feeding, vomiting, irritability, bulging fontanel, seizures

79
Q

Nursing Interventions for Bacterial Meningitis

A

Administer antibiotics and antipyretics as prescribed

Isolate for at least 24 hours

Monitor vital signs and neurologic signs

Implement seizure precautions

HOB slightly elevated

Monitor hydration status and IV therapy

80
Q

Reye Syndrome

A

Acute, rapidly progressing encephalopathy and hepatic dysfunction

Caused by viral infections, aspirin use

81
Q

Nursing Assessment of Reye Syndrome

A

Lethargy, rapidly progressing to deep coma, vomiting

Elevated AST, ALT, lactate dehydrogenase, serum ammonia, decreased PT

Hypoglycemia

82
Q

Nursing Interventions for Reye Syndrome

A

Monitor neurologic status

Maintain ventilation

Monitor cardiac parameters

Administer mannitol to increase blood osmolality

83
Q

Brain Tumors

A

Third most common cancer in children

Infratentorial, making them difficult to excise surgically

Occur close to vital structures

84
Q

Nursing Assessment of Brain Tumors

A

Headache, vomiting, loss of concentration

Change in behavior or personality

Vision problems

Widening sutures, increasing frontal occipital circumference

85
Q

Nursing Interventions of Brain Tumors

A

Identify baseline neurologic functioning

Monitor IV fluids and output carefully–overhydration can cause cerebral edema and increased ICP

Suctioning, coughing, straining, and turning can cause increased ICP

86
Q

Muscular Dystrophy

A

Inherited disease of the muscles, causing muscle atrophy and weakness

87
Q

Nursing Assessment of Muscular Dystrophy

A

Waddling gait, lordosis, increasing clumsiness, muscle weakness

Gowers sign

Pseudohypertrophy of muscles

Muscle degeneration

Delayed cognitive development

88
Q

Nursing Interventions for Muscular Dystrophy

A

Provide supportive care

Prevent exposure to respiratory infection

Encourage a balanced die

89
Q

Acute Glomerulonephritis

A

Immune complex response to an antecedent beta-hemolytic streptococcal infection of kin or pharynx

Causes inflammation and decreased glomerular filtration

90
Q

Nursing Assessment for Acute Glomerulonephritis

A

Recent streptococcal infections

Mild to moderate edema

Irritability, lethargy, hypertension, hematuria, proteinuria

Elevated ASO and BUN

91
Q

Nursing Interventions for Acute Glomerulonephritis

A

Provide supportive care

Monitor vital signs and I&O

Weigh daily

Low-sodium diet with no added salt

Monitor for seizures, CHF, renal failure (decreased urinary output is the first sign)

92
Q

Nephrotic Syndrome

A

A disorder in which the basement membrane of the glomeruli becomes permeable to plasma proteins; most often idiopathic in nature

93
Q

Nursing Assessment of Nephrotic Syndrome

A

Edema that begins insidiously

Lethargy, anorexia, pallor, frothy urine, massive proteinuria, decreased serum protein, elevated serum lipids

94
Q

Nursing Interventions for Nephrotic Syndrome

A

Monitor temperature and assess for signs of infection

Administer steroids such as prednisone and cholinergics such as bethanechol

Monitor intake and output

Small, frequent feedings of a normal protein, low-salt diet

95
Q

Nursing Assessment of Urinary Tract Infections

A

Infants: vague symptoms, fever, irritability, poor food intake, diarrhea, vomiting, jaundice

Older children: urinary frequency, hematuria, enuresis, dysuria, fever

96
Q

Nursing Interventions for Urinary Tract Infections

A

Collect clean voided or catheterized specimen

Suspect and assess for UTI in infants who are ill

Assess for recurrent UTI

97
Q

Nursing Assessment for Vesicoureteral Reflex

A

Recurrent UTI

Reflux (common with neurogenic bladder)

Reflux noted on voiding cystourethrogram

98
Q

Nursing Interventions for Vesicoureteral Reflex

A

Teach importance of medication compliance

Maintain hydration

99
Q

Nursing Assessment for Hypospadias

A

Abnormal placement of meatus

Altered voiding stream

Presence of chordee

Undescended testes and inguinal hernia

100
Q

Nursing Interventions for Hypospadias

A

Assess circulation to tip of penis postoperatively

Monitor urinary drainage after urethroplasty

Maintain hydration

101
Q

Nursing Assessment of Cleft Lip or Palate

A

Failure of fusion of the lip, palate, or both

Difficulty sucking and swallowing

102
Q

Nursing Interventions for Cleft Lip or Palate

A

Feed in upright position, slowly, with frequent burping

ESSR: Enlarge nipple opening, Stimulate the child to suck, Swallow normally, and Rest

Maintain patent airway and proper positioning (Cleft lip on side or upright, Clef palate on side or abdomen)

103
Q

Nursing Assessment of Esophageal Atresia with Tracheoesophageal Fistula

A

Choking, Coughing, Cyanosis

Excess salivation

Respiratory distress

Aspiration pneumonia

104
Q

Nursing Interventions for Esophageal Atresia, with Tracheoesophageal Fistula

A

Monitor respiratory status

Remove excess secretions

Elevate infant into antireflux position of 30 degrees

Maintain NPO

Monitor for postoperative stricture (poor feeding, dysphagia, drooling, regurgitation)

105
Q

Nursing Assessment of Pyloric Stenosis

A

Vomiting usually begins around the 3rd-6th week of life

Projectile vomiting within minutes after eating

Hungry, fretful infant

Weight loss, failure to gain weight, dehydration, metabolic alkalosis

106
Q

Nursing Interventions for Pyloric Stenosis

A

Assess for dehydration, provide small frequent feedings

Burp frequently to avoid stomach becoming distended

Weigh daily, monitor I&O

107
Q

Intussusception

A

Telescoping of one part of the intestine into another part of the intestine, usually the ileum into the colon

Partial to complete bowel obstruction occurs

Blood vessels become trapped and necrotic

108
Q

Nursing Assessment of Intussusception

A

Acute, intermittent abdominal pain

Screaming with legs drawn up to abdomen

Vomiting, currant jelly stools

Sausage shaped mass in upper right quadrant and lower right quadrant is empty

109
Q

Nursing Interventions for Intussusception

A

Monitor carefully for shock and bowel perforation

Monitor intake and output

Prepare child for barium enema

110
Q

Hirschsprung Disease

A

Congenital absence of autonomic parasympathetic ganglion cells in a distal portion of the colon and rectum

Lack of peristalsis in area of the colon

111
Q

Nursing Assessment of Hirschsprung Disease

A

Suspicion in newborn who fails to pass meconium within 24 hours

Distended abdomen, chronic constipation, alternating with diarrhea

Nutritionally deficient child

Ribbonlike stools

112
Q

Nursing Interventions for Hirschsprung Disease

A

Provide bowel-cleansing program as prescribed

Observe for symptoms of bowel perforation (abdominal distention, vomiting, increased abdominal tenderness, irritability, dyspnea and cyanosis)

Check axillary temperature

113
Q

Nursing Assessment of Anemia

A

Pallor, tiredness, fatigue

Pica

Decreased Hgb, low serum iron level, elevated TIBC

114
Q

Hemoglobin Normal Values

A

Newborns: 14 to 24 g/dL

Infant: 10 to 17 g/dL

Child: 9.5 to 15.5 g/dL

115
Q

Nursing Interventions for Anemia

A

Support child’s need to limit activities

Provide rest periods

Refer family to a nutritionist

116
Q

Nursing Assessment of Hemophilia

A

First red flag may be prolonged bleeding at the umbilical cord or injection site, or after circumcision

Prolonged bleeding with minor trauma

Hemarthrosis

Spontaneous bleeding into muscles and tissues

Loss of motion in joints

117
Q

Nursing Interventions for Hemophilia

A

Administer fresh-frozen plasma, cryoprecipitate of fresh plasma, or lyophilized concentrate

Follow blood precautions risk for hepatitis

118
Q

Nursing Assessment of Sickle Cell Disease

A

Children of African descent, usually over 6 months of age

Frequent infections, tiredness, delayed physical growth

119
Q

Nursing Interventions for Sickle Cell Disease

A

Teach to avoid strenuous exercise, high altitudes, keep well hydrated, avoid infection

Administer IV fluids, monitor intake and output, administer blood products, administer analgesics and warm compress

120
Q

Nursing Assessment of Phenylketonuria

A

Newborn screening using Guthrie test, serum phenylalanine level of 4 mg/dL

Frequent vomiting, failure to gain weight, irritability, musty odor of urine

121
Q

Nursing Interventions for Phenylketonuria

A

Stress importance of strict adherence to low-phenylalanine diet

Screen infants as close to discharge as possible

Pediatric Nursing (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions