peds, test one

Question 1

Children 1-4 years of age, what is the leading cause of death in the home?

Answer 1

Burns. It is also the second leading cause of death after MVA in the overall mortality rate.

Question 2

1st degree burn classification.

Answer 2

Superficial and partial thickness. This involves top portion of epidermis. Dry skin surface, pink or red. Blanches on pressure & refills. Minimal to no edema. Sensitive to pain. No permanent scarring. Skin heals in a few days.

Question 3

2nd degree burns

Answer 3

Destruction of entire epidermis & part of the dermis layer. Moist, red, pink. Capillary damage. Heals spontaneously. Variable degrees of scarring. Sensitive to temperature changes.

Question 4

At birth what immunization is the child due for?

Answer 4

Hep B

Question 5

2At 2 months what immunizations are due?

Answer 5

Hep B, Rota, DTap, Hib (Flu), PCV and IPV

Question 6

at 4 months what immunizations are due?

Answer 6

Rota, Dtap, Hib, PCV, IPV

Question 7

At 6 months what immunizations are due?

Answer 7

Hep B (Range), Rota, DTap, Hib, PCV, IPV (Range), Yearly Flu shot, MMR (Range), Varicella (Range), HepA (Range)

Question 8

12 - 18 months require what immunizations are due?

Answer 8

HepB, Dtap, Hib, PCV, IPV, Yearly Flu, MMR, Varicella, HepA

Question 9

2-3 years requires what immunizations?

Answer 9

PPv (in high risk groups), Hep A series (In high risk groups) MCV4

Question 10

At 7-10 years we give which immunizations?

Answer 10

MCV$, PPV, Flu, HepA, HepB IPV, MMR, Vercella.

Question 11

Age 11-12 years old have what immunizations are scheduled.

Answer 11

Tdap, HPV, MCV$, PPV, Flu, HepA, HepB, IPV, MMR, Vericella

Question 12

Deep Partial Thickness burns etiology?

Answer 12

Destruction of epidermis & dermis. Dry Skin Surface, Mottled, waxy white skin color. Heal more slowly - may require months. Edema is significant (Compartment circulation & nerve entrapment may occur) Dehydrated & tissue paper like blisters. Moderate pain, severe on exposure to air and water.

Question 13

Third degree Burn - Full thickness description

Answer 13

Destruction of epidermis, dermis & underlying tissue. Not able to heal without treatment, require skin grafting. Skin surface dry, leathery, wax-white, brown or black. Cherry red, white, or black skin color. Does not blanch on pressure, edema. Painless due to nerve destruction.

Question 14

4th degree or full thickness burns.

Answer 14

Involves the underlying structures. Wound appears dull and dry. Ligaments, tendons, & bone may be exposed.

Question 15

What do you need to be aware with Sever burns.

Answer 15

Respiratory compromise. (Nasal flaring, tridor/wheezing), Hypovolemic shock - (hypotension, increased HR 7 respiratory effort, weak or absent peripheral pulses), Fluids & Electrolytes (Fluid deficit, increased pulse, decreased urine output), Growth retardation, Hypermetabolism, increased demand for tempoerature control, Infection and sepsis 9hypo and hyper thermia, tachypnea, abdominla distention)

Question 16

How is the extent of a burn measured?

Answer 16

% of body burned - TBSA

Question 17

In a burn a fluid shift occurs. explain

Answer 17

Fluid shifts to the extravascular spaces, with concentration changes of potassium, sodium, chloride and bicabonate.

• Elevated body temp from increased metabolism.
• Energy expenditures increase 40-100% above base levels.

Question 18

What Systemic changes occur ina burn patient?

Answer 18

Cardiovascular changes occur. Vasoconstriction from injured cells, Edema in local & distant organs. Increased capillary permeability. Shock can occurs, Tachycardia and Tachypnea try to compensate for vascular fluid and increased O2 needs.

Question 19

Effects of burns on the Nerological system.

Answer 19

Cerebral edema- Keep head & neck elevated, Reduce ICP, fluid replacement system. Strict I&O!

Question 20

Effects on renal from birns.

Answer 20

Renal vasoconstriction. Reduced renal plasma flow, Decreased GFR. Strict I& O

Question 21

What are the 4 types of burn?

Answer 21

Thermal, Electrical, Chemical, and Radiation.

Question 22

What do burns do to the Immune system?

Answer 22

Burn injuries depress immune system. They are at great risk for infectious complications.

Question 23

What are the grading or burn severity according to the American Burn Association?

Answer 23

Minor- 1st and second degree 20% of body. or #rd degree> 10% of TBSA

Question 24

Thermal burns make up what % of burns in children?

Answer 24

85%. Thermal includes flames, scalds, contact with hot substances, auto accidents. The thermal burn causes cell damage by the heat it generates & exposes to skin.

Question 25

Electrical burn injury occur in infants to four year olds in what way?

Answer 25

Exposed Electrical cords & outlets, Faulty wiring, Inserting conductive objects into outlets (like forks) or chewing on electrical cords (Like Jetta)

Question 26

Signs and Symptoms of electrical burns?

Answer 26

You will seen an entry and exit pint. Paralysis, Fractures and dislocated bones, Seizures or LOC, Respiratory distress or cardiac arrest. Respiratory arrest. Irregular heartbeats.

Question 27

Mortality is what?

Answer 27

Number of deaths over a specific period of time.

Question 28

what is morbidity?

Answer 28

Prevalence of a specific illness ina population at a particular time.

Question 29

Causes of death in infants. under 1 YO, and over 1 YO?

Answer 29

1 cause under 1 YO = congenial abnormality. Over 1 YO = unintentional accidents and injuries.

Question 30

Describe family centered care?

Answer 30

Recognize family as the constant in the child’s life. Enable the opportunity for all members of the family to use abilities to meet the child’s needs. and Empower the family members to maintain a sense of control and make positive changes that foster their strength, abilities, and actions.

Question 31

A sun burn is what kind of burn?

Answer 31

Radiation

Question 32

What is the normal hr, Resp and BP for an infant

Answer 32

HR of 110-160. Resp 32-60 and a bp 82/46

Question 33

Infants have what Reflexes

Answer 33

Blink, Cough, Gag, Swallow.

Question 34

What does a smile indicate in an infant?

Answer 34

Initiates social relationships, Indicates memory traces, Signals the beginning of thought process

Question 35

Chemical burn injuries occur how?

Answer 35

Occur from contact. ingestion, inhalation, or injections of acids alkalis or noxious agents used in cleaning agents.

Question 36

What are the milestones 3 Months

Answer 36

Awareness of strange situations, Recognizes familiar faces.

Question 37

Milestones of a 5 month old?

Answer 37

Birth weight has doubled, Voluntarily grasps and releases objects, exhibits signs of attachment to parents, beginning of teeth eruption, can roll from abdomen to back.

Question 38

7-9 month year old milestones?

Answer 38

Searches for objects outside of viual field. Combines sounds (Dada, Mama), Increasing fear of strangers,

Question 39

Milestones at 10-12 Months of age?

Answer 39

Birth weight has tripled, Birth length has increased 50%, Says Mama and dada with meaning.

Question 40

Milestones at 12-15 months

Answer 40

Begins to walk. Concern should only be if child is not walking at 18 months.

Question 41

Milestones at 16 - 18 years of age.

Answer 41

Get a job, pay your own bills, live independently of parents.

Question 42

Toddler HR, Resp, and BP?

Answer 42

HR ~100, Resp 26, BP 99/64

Question 43

Honey is linked to what disease?

Answer 43

Botulism

Question 44

Signs of abuse in a child?

Answer 44

Frightened around parent. Aggression, Burns, hematomas, and scratches. Poor Hygiene. Withdrawn.

Question 45

Nursing goals with a burn patient?

Answer 45

Reduce pain, High calorie, and high protein diet. TPN or NG if necessary, Avoid complications from infections, Anemia, and Hypovolemic shock. The child may have body image disturbances.

Question 46

Management of a burn wound will include?

Answer 46

Sterile dressings, Escharotomy, Debridement.

Question 47

Biological skin coverings include?

Answer 47

Allograft - from human cadavers
Xenograft - Variety of specise like pigs.
Synthetic skin covering
Permanent skin graft from patients own skin.