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PEDs > PEDs Test 2 > Flashcards

PEDs Test 2 Flashcards

1
Q

The most common head injury in PEDS is?

A

concussion

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2
Q

Symptoms of concussion are:

A
  • fatigue
  • changes in behavior and mood
  • decreased school performance
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3
Q

Common causes of brain injury are:

A
  • falls
  • motor vehicle accidents
  • sports injuries
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4
Q

Absence seizures are characterized by:

SG 17

A
  • brief loss of consciousness
  • often without loss of motor control
  • cluster
  • last only a few seconds
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5
Q

___ seizures are the most common type of seizure for kids between the ages of 3 month and 3 years

SG 16

A

febrile

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6
Q

______ seizure is a seizure associated with a febrile illness who does not have a CNS infection

SG 16

A

febrile

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7
Q

initial treatment of febrile seizures__

SG 16

A

benzodiazepine

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8
Q

The goals of nursing management of the child with a head injury are to:

(list interventions)

A
  • maintain adequate ventilation, oxygenation, circulation
  • monitor and treat increased ICP
  • to minimize cerebral oxygen requirements
  • to support the child and family during the recovery phase
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9
Q

What are some nursing considerations for a child with head trauma?

A
  • place the child on bed rest
  • place the head of the bed elevated slightly and keep the head in the midline position
  • keep a quiet environment and turn the lights down
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10
Q

_____ is the most important nursing observation when caring for a child with head trauma

A

LOC

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11
Q

Signs of increased Intracranial Pressure:

A
  • irritability progressing to lethargy
  • High-pitched cry Increased frontooccipital circumference
  • Distended scalp veins
  • Poor feeding Crying when disturbed
  • Setting-sun sign
  • confusion
  • decreased responsiveness
  • decreased ability to follow commands
  • pupil dilation with decreased response to light
  • reduced spontaneous movement
  • deterioration in posture
  • cushing’s triad
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12
Q

meningitis in infants is associated with an approximately a _____ mortality rate.

A

50%

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13
Q

Prior to shunt placement, the focus of nursing care of a patient with hydrocephalus is making sure that the child and family are __________________________.

A

Physically and emotionally prepared for surgery.

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14
Q

most children with meningitis are seen with:

A
  • fever
  • chills
  • headache
  • vomiting that are quickly followed by alterations in sensorium
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15
Q

___ is the definitive diagnostic test of meningitis

A

lumbar puncture

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16
Q

VP shunts don’t usually last ______. They can be damaged through _________ or _______.

A

forever

rough play

trauma

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17
Q

The major complications of VP shunts are ________ and _________.

A

malfunction

infection

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18
Q

Any child with a history of hydrocephalus with shunt placement who presents with symptoms of increased ICP should be evaluated for assessment of ______________________________?

SG 20

SG 21

A

shunt malfunction

obstruction.

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19
Q

What are the signs of hydrocephalus

SG 5

A
  • The sunset sign
  • a bulging anterior fontanel
  • Widened suture lines
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20
Q

Postop care of the child with a VP shunt includes

A
  • regular assessment of head size and behavior
  • skin care and infection prevention at the surgical site,
  • parent education
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21
Q

the patient with meningitis usually has a high ____

A

white blood cell count

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22
Q

initial therapy of bacterial meningitis is:

A
  • isolation precautions
  • initiation of antimicrobial therapy
  • maintenance of hydration
  • maintenance of ventilation
  • reduction of increased ICP
  • management of systemic shock
  • control of seizures
  • control of temperature
  • treatment of complications
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23
Q

maintaining ____ is a prime concern for children with bacterial meningitis?

A

hydration

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24
Q

what are some quality patient outcomes for patients with bacterial meningitis?

A
  • early recognition of s/s of meningitis
  • antibiotics administered as soon as diagnosis is established
  • cerbral edema prevented
  • exposure prevented by early isolation
  • side effects managed
  • nuerologic sequelae prevented
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25
Q

a ____ is a blood test used to detect a wide range of disorders including anemia, infection, and leukemia.

A

CBC - complete blood count

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26
Q

____ carry oxygen to the cells and reflect the health of the bone marrow

A

RBC

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27
Q

a decrease in RBC will present as:

A

weakness, fatigue, pallor

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28
Q

average RBC count is ___

A

4.5 to 5.5 million/mm3

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29
Q

____ reflects primarily the number of RBCs, but can also show the amount of ____ present in each cell.

A

hemoglobin, hemoglobin

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30
Q

Average hemoglobin values__

A

11.5 - 15.5 g/dl

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31
Q

______ is the percent volume of packed RBCs

A

hematacrit

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32
Q

average hematacrit values__

A

35-45%

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33
Q

__ is the index of production of mature RBCs by the bone marrow

A

reticulocyte count

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34
Q

average reticulocyte counts are__

A

0.5-1.5%

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35
Q

an increased amount of ____ is due to some stimulus to the bone marrow to up production

A

reticulocyte count

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36
Q

____ are on guard to fight infection

A

WBC

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37
Q

normal WBC count is__

A

4.5 to 13.5 x 10~3 cells/mm~3

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38
Q

what are the five major types of WBC

A
  • basophils
  • eosinophils
  • lymphocytes
  • monocytes
  • neutrophils
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39
Q

___ are readily stainged with basic dyes, and release histamine, heparin, and serotonin

A

basophils

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40
Q

______ seen in allergies, asthman, eczema, and autoimmune diseases

A

eosinophils

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41
Q

______ can be type b and t. B become cells that produce antibodies. antibodies attach to a specific antigen making it easier to destroy. T attack antigens directly.

A

lymphocytes

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42
Q

______ are phagocytic, they are formed in the bone marrow, they change into macrophages and eat harmful bacteri, viruses, and fungi

A

monocytes

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43
Q

___they are produced in the bone marry and are also phagocytic

A

neutrophils

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44
Q

chronic anemia will manifest itself as__

SG 9

A

fatigue, decreased growth and pallor

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45
Q

one of the nurse’s responsibilities, when anemia is suspected, is to _____

SG 9

A
  • assess baseline energy functioning

- minimize demands

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46
Q

______ is the most prevalent and most preventable nutritional disorder in the US

SG 9

A

iron deficiency anemia

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47
Q

the term infant will run out of iron stores at about ___ while a premature infant stores may last only _____

A

6 months

2-3 months

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48
Q

an adequate dosage of iron turns the stools _____

A

tarry green or black color

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49
Q

What are signs and symptoms of Congenital Heart Disease?

A
  • Congestive Heart Failure
  • Pallor or Cyanosis
  • Altered pulses
  • Murmur
  • Fatigue/irritability
  • Poor weight gain
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50
Q

Signs of Congestive heart failure

A
  • Tachypnea
  • Tachycardia
  • Diaphoresis
  • Cardiomegaly
  • Hepatomegaly
  • Edema
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51
Q

____________ includes primarily anatomic abnormalities present at birth that result in abnormal cardiac function.

A

Congenital heart disease (CHD)

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52
Q

More frequently the diagnosis of Congenital Heart Disease will be made ___________ but can be seen _______ in severe cases

A

sometime after birth

In Utero

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53
Q

It is important to remember that in infants and children, congestive heart failure is almost always a manifestation of ____________________

A

another underlying problem.

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54
Q

Primary congestive heart failure is ____________ in children.

A

very rare

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55
Q

______________ is an abnormal opening between the left and the right atria

A

Atrial Septal Defect

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56
Q

How does the blood flow in a child with an Atrial septal defect?

A

Blood flows from the left atrium through the defect into the lower pressure right atrium.

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57
Q

In patients with an Atrial Septal Defect blood flows from the left to the right atrium, causing an ___________flow of ___________ blood into the right side of the heart.

A
  • increased

- oxygenated

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58
Q

Patients with an Atrial Septal Defect have an __________ ______________ Blood flow

A

Increased Pulmonary

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59
Q

Because of their compromised lung status, children with Increased Pulmonary Blood Flow are at increased risk of ________________ and also increased risk of _____________ and _________ Deficiencies

A
  • Severe respiratory infection.
  • Poor growth
  • Nutritional deficiencies
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60
Q

Infants with Increased Pulmonary Blood Flow may due best with _________________ feedings?

A

Small frequent feedings

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61
Q

Many children with cardiac defects that similar to ASD will require diuretic therapy and medications such as ______________ and __________________ for the treatment of Congestive Heart Failure

A
  • Lasix

- Digoxin

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62
Q

Which heart defect is often very well tolerated?

It can be a ___________ finding.

A
  • Atrial Septal Defect

- Incidental

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63
Q

How is Atrial Septal Defect treated?

A
  • Surgical Patch - blocks hole

- Repaired surgically

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64
Q

What defect is a failure of the Foramen Ovale to close?

A

Atrial Septal Defect

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65
Q

What is a Ventricular septal defect ?

A

an abnormal opening between the left and the right ventricle.

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66
Q

Why is a Ventricular Septal Defect hemodynamically more significant?

A

B/c there is greater difference in pressure between the right and the left ventricle thus larger amounts of blood may flow from the left ventricle to the right ventricle

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67
Q

Congestive Heart Failure is ________ is patients with Ventricular Septal Defect

A

Common

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68
Q

Like ASD Ventricular Septal Defect can be repaired _______ or _____________?

A
  • surgically with sutures

- by placing a block

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69
Q

What are the Acyanotic Defects?

A
  • Atrial Septal Defect
  • Ventricular Septal Defect
  • Patent Ductus Arteriosus
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70
Q

What causes the Ductus Arteriosus to close soon after birth ?

A
  • Constricts in response to Oxygen and the loss of prostaglandins
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71
Q

Patent Ductus Arteriosus is extremely common in ______________ ?

A

premature infants

72
Q

The Arteriosus can reopen in response to ?

A

Hypoxemia

73
Q

What is the pathway of blood in a child with Patent Ductus Arteriosus?

A

blood is shunted from the aorta through the ductus into the pulmonary artery and back to the lungs leading to congestive heart failure

74
Q

For many premies and some newborns a Patent Ductus Arteriosus defect can be successfully medically treated with a relatively high dose of ____________

A

indomethacin

75
Q

Why can indomethacin be used to treat preemies and some newborns for Patent Ductus Arteriosus?

A

B/c it is an NSAID which are prostaglandin inhibitors

76
Q

Treatment of a Patent Ductus Arteriosus

A
  • Surgically

- Place a block in the Cath lab

77
Q

Signs and symptoms of Defects Obstructing Blood Flow from the Ventricles

A
  • Congestive Heart Failure

- Decreased systemic perfusion and perfusion

78
Q

What should be done prior to performing a cardiac catheterization on a child? and Why?

A
  • Assessment of the pedal pulse and capillary refill

- b/c the Femoral Vein and artery are almost always used during the procedure

79
Q

In obstructive acyanotic defects blood is prevented from moving from the _______________ into the ___________ circulation

A
  • Left ventricle

- Systemic

80
Q

Children with Defects obstructing blood flow from the ventricles will frequently have

A
  • decreased pulses
  • decreased urine output
  • poor gastrointestinal function
  • metabolic acidosis.
81
Q

Nursing management for children with Defects obstructing blood flow from the ventricles

A
  • close monitoring of urine output,

- assessment of acid base balance, and observation of level of consciousness.

82
Q

Newborn infants with defects obstructing blood flow from the ventricles will often be placed on a _____________ infusion to maintain the ____________________ until reparative or palliative surgery can be performed

A
  • prostaglandin e

- patency of the ductus arteriosus

83
Q

In Sickle cell anemia the sickled ___________ form stiff rods in the RBC, preventing easy passage through the vessels, and they can cause blockage or

SG 4

A
  • hemoglobin

- vasoocclusion

84
Q

_______ is called a “painful episode” that is characterized by ischemia causing mild to severe pain that may last from minutes to days longer in children with Sickle Cell anemia

SG 4

A

vasoocclusive crisis

85
Q

Nursing management for a child in sickle cell crisis

SG 8

A
  • rest
  • hydration/fluids
  • electrolyte replacement
  • analgesia
  • blood replacement
  • antibiotics to treat any existing infection
86
Q

____ is a pooling of a large amount of blood usually in the spleen and infrequently the liver that causes a decreased blood volume and ultimately shock

A

sequestration crisis

87
Q

if the mother and father are both carriers, what are the chances that their offspring will have sickle cell anemia?

SG 1

A

1 in 4

88
Q

Given that stroke can be a complication of SCA what is an intracranial doppler used for?

A

to monitor intracranial vascular flow and is performed yearly from 2-16.

89
Q

treatments of SCA

A

blood transfusions

hematopoietic stem cell transplant (HSCT)

90
Q

_____________ offers a curative treatment for children with SCD

A

hematopoietic stem cell transplant (HSCT)

91
Q

the defect in (thalassemia major) Cooley anemia lies in the deficiency to some degree in the ____. the hemoglobin is defective and the RBC’s are weak, easily destroyed, leading to anemia.

A

beta chain

92
Q

symptoms of thalassemia major are

A
  • lacking the ability to produce normal, adult hemoglobin
  • chronic fatigue
  • failure to thrive
93
Q

two major consequences of thalassemia are __ and ____, which leads to poor growth, impaired physical activity, facial and other bone deformities, fragile bones and enlargement of the liver and spleen.

A
  • severe anemia

- expansion of the bone marrow in the bodies effort to produce more RBC

94
Q

the only treatment to combat Cooley anemia is ____ and _____

A
  • regular blood transfusions

- iron chelation therapy

95
Q

Early signs of hemarthrosis (bleeding in the joints) are:

SG 36

A
  • feeling of stiffness, tingling, or achiness in the affected joint, followed by a decrease in joint movement
  • bleeding in the neck, mouth or thorax
96
Q

treatment of hemophilia:

A
  • DDVAP: helps release the manufactures of factor VIII (can be used as a preventative treatment prior to procedures, such as dentistry or sports).
  • clotting factors VIII or IX
  • recombinant clotting factors (bb) manufactured
97
Q

General signs and symptoms of Defects Causing Decreased Pulmonary Blood Flow

A

hypoxemia

cyanosis

increased resp rate w/o resp distress

poor growth

clubbing

polycythemia

low PaO2 and O2 sat

98
Q

What is polycythemia

A

increased production of RBC b/c the body wants more O2. Causes viscous blood, can lead to ischemia, stroke

99
Q

Main Defect Causing Decreased Pulmonary Blood Flow that we studied

A

Tetralogy of Fallot

100
Q

Tetralogy of Fallot SS

A 
blue
no CHF - b/c blood moves to body ok
normal pulse
organ hypoxemia
tec spells
101
Q

Tec Spell (hypercyanotic spell)

SG 37

A

Severe, sudden anoxia
Workload on the heart is too high so the heart beats harder and harder.
Because of this, the musculature around the pulmonary valve can’t relax, and the RV to pulmonary artery passage becomes obstructed by this tension. Patient gets super cyanotic and passes out

102
Q

Signs of a tec spell in children

SG 37

A

Crouching- they can feel the tec spell and crouching causes abdominal pressure, pushing the blood into the right ventricle. This temporarily fixes it.

103
Q

Nursing intervention for tec spell

SG 37

A
  • Bend legs to belly if not already there

- Morphine. O2 won’t do much but we often still give to these kids

104
Q

Nursing Management for Tetralogy of Fallot

A

O2 not really useful so don’t give much.
Reduce cardiac demands.
Supportive care until surgery (will have in first year of life to correct the defects)

105
Q

S&S of Defects causing Mixed Blood Flow

A

cyanosis
L&R heart failure
low PaO2
VERY sick

106
Q

Nursing Care of patient with Defect causing Mixed Blood Flow

A
  • Reduce cardiac demand
  • Give prostaglandins til surgery
    Supportive
107
Q

General pathology of Defects causing Mixed Blood Flow

A

Blood comes from both sides of heart and mixes therefore low PaO2 b/c of the mixing

108
Q

Transposition of Great Vessels pathology

A

Aorta rises off RV and pulmonary artery off LV.
2 Completely separate circulations!
2 Closed systems:
-One that is highly oxygenated and keeps going to lungs
-Second is low O2 and keeps going to body
To prevent baby from dying, body has open ductus arteriosus and a VSD to allow some mixing.

109
Q

Temporary Treatment for Transposition of Great Vessels until they get major surgery to correct defects

A

Prostoglandins!!! Then, in cath lab they pass a balloon thru the forament ovale, blow it thru the LA and yank it back thru the atrial septum to make an ASD and allow more mixing

110
Q

3 Acquired Cardiac Disorders we discussed

A

Bacterial Endocarditis
Rheumatic Fever
Kawasaki Disease

111
Q

Rheumatic Fever pathology

A

untreated Strep throat causes this multisystem disease

112
Q

S&S of Rheumatic Fever

A

Eye inflammation

Heart, brain, cardiac damage

113
Q

Treatment of Rheumatic fever

A

antibiotics

long term aspirin?? verify this

114
Q

Nursing Care for Rheumatic fever

A
  • strep care
  • prevent recurring infxns
  • prevent longterm heart damage (every recurrence of this disease is worse)
115
Q

Pathology of Kawasaki Disease

A

Acute vasculitis everywhere in body leading to heart damage and coronary aneurysm

Self limiting

No known cause!

116
Q

S&S of Kawasaki

A 
High fever unresponsive to antipyretics
irritability
errythema 
peeling of skin
edema
red eyes
strawberry tongue
117
Q

Treatment of Kawasaki

A

IV gamma globulin and aspirin (don’t care about Rye risk b/c benefit outweighs)

118
Q

an abnormal, often cancerous, growth of tissue

A

neoplasms

119
Q

in people with leukemia, the _________ produces abnormal white blood cells, which don’t function properly

A

bone marrow

120
Q

Definitive diagnosis of leukemia is based on

A

bone marrow aspiration and/or biopsy

121
Q

Symptoms of leukemia are:

SG 2

A

-infection
-fever
-enlarged spleen
-lymph nodes and liver enlargement
-persistent fatigue
-weakness
-easy bleeding or bruising
-bone pain or tenderness
-weight loss
-

122
Q

pre-chemo:

CHEMO

A 
C- consent procedures
H- health assessment
E- evaluation of parents understanding
M- securing presence of child's mother or father
O- overview of treatment
123
Q

intra-chemo:

SAFE

A

S- safe administration
A- assessments of intravenous central line site
F- provision of IV fluids
E- assessment of electrolytes

124
Q

post-chemo:

SOUND

A

S- symptoms needing attention
O- observation for adverse effects of chemo
U- adequacy of urine output
N- need for nursing care/ further education
D- drugs needed for symptom management such as nausea or mouth care

125
Q

What defect is caused by narrowing of the aortic arch

A

Coarctation of the aorta

126
Q

Coarctation of the aorta is characterized by localized narrowing near the insertion of the ductus arteriosus, which results in _____________ in the head and upper extremities and ___________ in the body and lower extremities.

A

increased pressure

decreased pressure

127
Q

How is HIV transmitted in children most commonly?

A

During childbirth or breastfeeding for young children; risky behaviors for 13-24 yr olds

128
Q

What do children with Coarctation of the Aorta present with?

A
  • Signs of congestive heart failure
  • elevated pulses and blood pressure above the level of the defect
  • Decreased pulses below the defect
129
Q

What changes would you see in the urinary system, blood gas and GI system be affected in a patient with a Coarctation of the Aorta who has a severe stricture?

A
  • Decreased urine output
  • Metabolic Acidosis
  • Decreased gastrointestinal function
130
Q

What do children with Coarctation of the Aorta present with?

A
  • Signs of congestive heart failure
  • elevated pulses and blood pressure above the level of the defect
  • Decreased pulses below the defect
131
Q

How will the urinary system, blood gas and GI system be affected in a patient with a Coarctation of the Aorta who has a severe stricture?

A
  • Decreased urine output
  • Metabolic Acidosis
  • Decreased gastrointestinal function
132
Q

What is Polycythemia

A

an increased number of red blood cells, increases the oxygen-carrying capacity of the blood.

133
Q

Neonates with a Coarctation of the Aorta will be treated with a _________________ infusion.

A

Prostaglandin E infusion

134
Q

Preoperative care of the child with coarctation of the aorta focuses on _____________ and ________________________________ that may develop due to poor organ perfusion.

A
  • Stabilization

- Correcting metabolic abnormalities

135
Q

The cardinal sign of Coarctation of the aorta is?

A

Marked gradient between pulses and blood pressure in the upper and lower extremities

136
Q

Acyanotic Defects that increase pulmonary blood flow include

A
  • Ventricular Septal Defect
  • Atrial Septal Defect
  • Patent Ductus Arteriosus
137
Q

Acyanotic Defects that obstruct blood from ventricles into the body include?

A
  • Coarctation of Aorta
  • Aortic Stenosis
  • Pulmonic Stenosis
138
Q

Cyanotic defects that decrease pulmonary blood flow include?

A
  • Tetralogy of Fallot

- Tricuspid atresia

139
Q

Cyanotic defects that mix blood flow include?

A
  • Transposition of the Great Vessels
  • Total anomalous pulmonary venous return
  • Truncus arteriosus
  • Hypoplastic left heart syndrom
140
Q

polycythemia

A

Elevated Red Blood Cells

141
Q

Hypercyanotic spells, also referred to as blue spells or tet spells because they are often seen in infants with ____________ may occur in any child whose heart defect includes obstruction to pulmonary blood flow and communication between the ventricles.

A

tetralogy of Fallot,

142
Q

what are some nursing interventions that can be done for a child in VOC (vasoocclusion crisis):

SG 8

A
  • pharmacologic treatments (start with NSAIDS then progress to opioids)
  • hydration
  • physical therapy
  • non-pharmacologic and complementary treatment
143
Q

Family education for child with sickle cell

SG 8

A

(1) seek early intervention for problems, such as fever of 38.5 ° C (101.3 ° F) or greater;
(2) give penicillin as ordered;
(3) recognize signs and symptoms of stroke, splenic sequestration, as well as respiratory problems that can lead to hypoxia
(4) treat the child normally.

144
Q

If a febrile seizure lasts more than ___ minutes, parents should seek medical attention right away. Parents should call for emergency assistance (911) and not place the child who is actively having a seizure in the car.

SG 16

A

5

145
Q

An infant with suspected or confirmed hydrocephalus is observed carefully for signs of increasing ventricular size and increasing ICP. In infants, the head is measured ______at the point of __________ measurement, the frontooccipital circumference

SG 13
SG 20
SG 21

A
  • daily

- largest

146
Q

Nursing interventions for a child with a new ventriculoperitoneal shunt?

SG 20
SG 21

A
  • Accurate and frequent documentation of the incision site;
  • amount, color, and consistency of drainage into the device
  • the child’s vital and neurologic signs are an important part of the nursing care.
147
Q

Because infection is the greatest hazard of the postoperative period of a VP shunt placement, nurses are continually on the alert for the usual manifestations of CSF infection, including

SG 20
SG 21
SG 31

A
  • elevated temperature
  • poor feeding
  • vomiting
  • decreased responsiveness, and seizure activity.
148
Q

nursing interventions for hemophilia

SG 36

A
  • prevent bleeding
  • recognize and control bleeding
  • prevent crippling effects of bleeding
  • support the family and prepare for home care
149
Q

The objectives of nursing care for a patient with thalassemia are to

SG 27

A

(1) promote compliance with transfusion and chelation therapy,
(2) assist the child in coping with the anxiety-provoking treatments and the effects of the illness
(3) foster the child’s and family’s adjustment to a chronic illness
4) observe for complications of multiple blood transfusions.

150
Q

Expected lab values for a child with leukemia

SG 22

A
  • low WBC (leukocyte) count less than 50,000
  • low blood counts
  • Elevated immature cells or blasts.
151
Q

A PaO2 of 100 mm Hg or higher suggests ______ disease, and a PaO2 lower than 100 mm Hg suggests ________ disease

SG 44

A
  • lung

- cardiac

159
Q

Side effects of a child on prednisone?

SG 12

A
  • growth suppression (adrenal suppression)
  • weight gain
  • decreased bone density.
  • immunosuppressed
185
Q

What is the inheritance pattern of Sickle Cell Disorder?

SG 1.

A

essentially that of an autosomal recessive disorder.

186
Q

The Administration of what three vaccines are recommended for children with Sickle Cell Anemia due to their susceptibility to infection?

SG 29

A
  1. pneumococcal
  2. H. influenzae
  3. meningococcal
187
Q

In addition to routine immunizations, children with SCD should receive a yearly ___________ vaccination

SG 29

A

influenza

188
Q

In Children with Sickle Cell Anemia, oral ____________ prophylaxis is recommended by 2 months old to reduce the chance of pneumococcal sepsis.

SG 29

A

penicillin

189
Q

Teaching priorities for a child with sickle cell disorder

SG 15

A
  • Explain signs of developing complications
  • Reinforce basic info about inheritance
  • Offer genetic counseling if appropriate
  • Stress importance of adequate nutrition
  • Stress infection prevention/
  • Encourage frequent health evaluations
190
Q

Nurse prioritizes nursing management of child with HIV

SG 3

A
  • Education concerning transmission
  • Control of infectious diseases
  • appropriate storage of special medications and equipment (e.g., needles and syringes), are emphasized.
191
Q

Discharge teaching for a child with a VP shunt

SG - 31

A
  • Keep child flat in supine position
  • Child will require life long treatment
  • Child will require more than 1 shunt in their life time
  • Head circumference should gradually decrease
193
Q

Parent teaching for a child with a febrile seizure

SG 16

A
  • Children with a family history of febrile seizures are at increased risk for both a single & recurrent febrile seizure
  • If a febrile seizure lasts more than 5 minutes, parents should seek medical attention right away.
  • reassurance that children who have had febrile seizures but do not have underlying developmental problems will perform as well as other children academically and behaviorally
194
Q

Parent teaching for a child with a febrile seizure

SG 17

A
  • Note any changes in behaviors observed before or after the seizure
  • Not activities during the seizure
195
Q

Care of the child with meningitis focuses on

SG 33

A
  • systemic care of the child
  • identification and treatment of the causative organism
  • preventing brain injury caused by increased intercranial pressure.
196
Q

Because bacterial meningitis can be contagious
_______ & _______ may be necessary.

SG 33

A
  • isolation precautions

- contact tracking

197
Q

Nursing assessment for a child on prostaglandin-e

SG 30

A
  • monitor pulmonary artery and descending
    aorta pressures
  • Palpate femoral pulse frequently to assess
  • monitor urinary output.
    circulation to lower extremities.

-BP may be monitored in a lower and an upper extremity
simultaneously.

198
Q

Clinical manifestations of congestive heart failure include

SG 38

A
  • irritability
  • tachypnea
  • poor feeding
  • pallor.
199
Q

Normal Pa02

SG 45
SG 46

A

80 -100mmHg

200
Q

Normal range for PaC02

SG 45
SG 46

A

35 - 45

201
Q

Normal range for HC03

SG 45
SG 46

A

22 - 26

202
Q

Sa02

SG 45
SG 46

A

93 - 100

203
Q

Nursing Interventions for Respiratory Alkalosis

SG 45
SG 46

A
  • Prevent patient from hyperventilating/ slow breathing

- Breath into a paper bag

204
Q

Nursing Interventions for Respiratory Acidosis

SG 45
SG 46

A
  • Administer oxygen

- encourage deep breathing

205
Q

The current treatment of children with Kawasaki disease includes __________ along with _________

SG 48

A
  • high-dose intravenous immunoglobulin (IVIG) (gamma globulin)
  • aspirin therapy.
206
Q

Rheumatic fever is a multisystem disease that involves joints, skin, brain, mucus membranes and the heart. ___________ damage is the most severe complication.

SG 44

A
  • Cardiac valvular
207
Q

What valve is most frequently affected in a patient with Rheumatic Fever?

SG 44

A
  • mitral valve
208
Q

A synthetic form of vasopressin, also known as ________, increases plasma factor VIII activity and is the treatment of choice in mild __________

A

DDAVP

hemophilia

PEDs (7 decks)

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