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Peds_Exam1 Flashcards

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1
Q
  1. Always begin assessment with
  2. a normal baby should be
  3. Key indicator of what could be wrong
A
  1. observation
  2. consolable
  3. positioning
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2
Q
  1. Who to talk to about care first
  2. What actions are first
  3. How long to count respirations, heart rate?
A
  1. Parents
  2. Least invasive
  3. one full minute
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3
Q
  1. Sign of dehydration
  2. Position after tonsillectomy
  3. Bad sign after tonsillectomy
A
  1. sunken eyes
  2. prone, or side with HOB elevated
  3. frequent swallowing, sign of hemorrhaging
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4
Q
  1. What should you think of with fluid retention
  2. What is very important for pt with sickle cell disease
A
  1. heart problems
  2. hydration and analgesics
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5
Q
  1. Sign when child scratches scalp excessively
  2. What are NITS
A
  1. Pediculosis Capitis
  2. White eggs on hair shaft, dandruff flakes away (this does not)
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6
Q
  1. How is scabies transmitted?
  2. How does it manifest in the skin
  3. What type of reaction
A
  1. close personal contact with infected person
  2. burrows in, fine grayish lines, hard to see
  3. puritis rash
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7
Q
  1. Special consideration tx for scabies
A
  1. household members need to be treated simultaneously
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8
Q
  1. Priority Actions for Burn Patient
A
  1. Stop burning process
  2. ABC’s
  3. Resucitation if not breathing
  4. remove burned clothing, jewelry
  5. cover wtih clean cloth
  6. kepp child warm
  7. transport to ER
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9
Q
  1. What should you NOT do if epiglottis is suspected?
  2. epiglottis risk
A
  1. visualize the posterior pharnx, obtain a throat culture or take an oral temp
  2. spasms leading to airway occlusion
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10
Q
A
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11
Q
  1. Laryngotracheobronchitis Stage 1
  2. Stage 2
  3. Stage 3
A
  1. low grade fever, hoars, croup (brass cough), inspiratory stridor, irritated
  2. continuous stridor, retraction, accessory muscles, crackles, wheezing
  3. restlessness, pallor, diaphoresis, tachypnea, anoxia, hypercapnia
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12
Q
  1. What are advatages of oxygen mask
  2. Disadvantages
  3. Advatages of nasal cannula
A
  1. higher O2 concentration than cannula. Predictable concentration
  2. skin irritation, fear of suffocation, moisture, aspiration, difficult to control
  3. low moderate O2 (22-44%), can eat, talk and east to observe
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13
Q
  1. Disadvatages of nasal cannula
  2. Advantages of oxygen tent
  3. Disadvantages of tent
A
  1. Mst have patent nasal passages, abdominal distention, difficuult control of O2, no mist
  2. lower O2 concentration, can eat Up to 0.3-0.5 F102
  3. tight fit, poor access to child
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14
Q
  1. Oxygen hood advtanges
  2. Hood disadvantages
  3. Action if upper respiratory infection
A
  1. O2 up to 1.00, access to child’s chest for assessment
  2. high humidity, remove child for feeding/care
  3. isolation until infection is known
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15
Q
  1. Initial manifestation of Syntial Virus
  2. As disease progresses
  3. When it is severe
A
  1. rhinorrhea, ear drainage, pharyngitis, coughing, sneezing, intermittent fever
  2. increasing coughing, signs of air hunger, tachypnea, periods of cyanosis
  3. more than 70 breaths/min, decreased breath sounds, poor air x change
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16
Q
  1. What could occur when administering cough suppressants?
  2. What should you monitor for respiratory disorders?
  3. What meds trigger asthma attacks?
A
  1. May interfere with respiratory secretions
  2. Weight loss/dehydration
  3. Aspirin, NSAIDS, antibiotics, B-Blockers
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17
Q
  1. Priority Nursing Interventions for Asthma Attack
A
  1. Assess airway patency and respiratory status
  2. administer humidified oxygen by nasal cannula/face mask
  3. admin quick relief rescue meds
  4. IV line
  5. prep for chest radiograph
  6. prep to obtain blood sample
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18
Q
  1. Meds that control asthma
  2. What is a positive skin test in < 4 yrs
  3. What is a positive skin test for high risk groups
A
  1. Steroids, antiallergy, NSAIDS, B-agonists, Leukotriene modifiers, monoclonal antibody (IgE)
  2. 15 mm
  3. 5mm or more, HIV, immunosuppressive
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19
Q
  1. Best way for children to express themselves?
  2. What age might children have imaginary friends?
  3. Hhow much should nurse deliver IM injection in child 6 months
A
  1. Drawings
  2. 3 or 4
  3. no more than 1 mL
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20
Q
  1. Fruits or vegetables first?
  2. Where are children more comfortable when assessing
  3. How long does pre-term infants iron store last
A
  1. Vegetables
  2. in proximity to parents
  3. 2 months
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21
Q
  1. How long does full term iron store last
  2. When should infants regain birthweight
  3. When should child be walking independently
A
  1. 4-6 weeks
  2. 2 weeks of age
  3. 15-18 months
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22
Q
  1. Do adolescents have right to privacy
  2. When is first dose of hepatitis B vaccine given?
  3. When should posterior fontanel close?
A
  1. Yes
  2. between birth and 2 months
  3. between 6 and 8 weeks
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23
Q
  1. How much does child grow per year in school age
  2. How should parents not administer meds to child
  3. What decreases absorption of iron
A
  1. 2 inches
  2. mixed, b/c cannot be sure that child took entire feeding
  3. Formula
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24
Q
  1. Normal respers for child between 3-6 years
  2. How much weight should child gain at 12 months of age
  3. When to weight a child for accuracy
A
  1. 20 - 30
  2. Triple
  3. before they eat
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25
Q
  1. Best place to stand/ sit in assessment
  2. Effective communication means
  3. Other block in communication
A
  1. Eye level
  2. avoid analogies, don’t give too many choices
  3. socializing, advice, interrupting/finishing sentence, judgment, talk too much
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26
Q
  1. Children under 5 are
  2. School age children are
  3. Adolescents need x3
A
  1. Egocentric
  2. function aspects
  3. honesty, privacy, confidentiality
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27
Q
  1. What are some verbal techniques
A
  • “i” messages
  • Third person
  • Facilitative (fill in the blank)
  • Reading
  • Dreams
  • What if, 3 wishes
  • Word association
  • Sentence completion
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28
Q
  1. Kids order of assessment
  2. Abdomen assessment
  3. What is Apley’s Role
A
  1. respirations, pulse, temp, BP (only if order)
  2. Inspection,Auscultation, Percuss, Palpate
  3. Further from umbilicus more damage (pain)
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29
Q
  1. At what age should infant be able to sit up straight
  2. How many cm = 1 inch?
  3. What is pigeon chest or pectus carniatum?
A
  1. 6 - 8 months
  2. 2.5
  3. chest is extruding
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30
Q
  1. What is pectus excavatum?
  2. How do you measure tympanic in child under 3
  3. Older than 3?
A
  1. chest is sunken in
  2. down and back
  3. Up and back
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31
Q
  1. Best way to measure temp if under 1 yr
  2. How long are babies nose breathers?
  3. What can this lead to?
A
  1. axillary
  2. 4-6 months
  3. increased difficulty if congested. Nasal saline drops with gentle suction/bulb syringe is recommended
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32
Q
A
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33
Q
  1. Where is the PMI under 7 yrs
  2. Over 7 years
  3. Where does sound travel (auscultation)
A
  1. left 4th ICS
  2. Left 5th ICS
  3. Away from blood flow
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34
Q
  1. Babinski is normal under 2 years of age (true/false)
  2. If development is on target what can children do?
  3. What toys are good choice for children 12 moths
A
  1. True
  2. throw large objects (before small ones)
  3. gross/fine motor skills- push pull, popup, jack in the box
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35
Q
  1. When should Chest Physiotherapy be done?
  2. What are early symptoms of CF
  3. Tx for child with strep and pharyngitis
A
  1. in the morning prior to feeding to avoid risk of vomitiing
  2. wheezing, dry non productive cough
  3. 10 day course of penicillin
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36
Q
  1. How is pharyngitis treated?
  2. When are children with strep no longer contagious?
  3. What foods decrease pain and bleeding after tonsillectomy>
A
  1. does not require antibiotics b/c self limiting viral illness. Rest, Tylenol, throat spray, cold liquids, popsicles
  2. 24 hours after antibiotic therapy
  3. Soft foods
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37
Q
  1. How does a parent administer and MDI?
  2. What is albuterol
  3. What is an urgen priority when a child has asthma
A
  1. one puff at a time and wait 1 minute before administering 2nd puff
  2. quick relief bronchodilator for tx asthma attack
  3. when no longer has wheezes and diminished breath sounds
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38
Q
  1. Ways to increase child’s expiratory phase
  2. Precautions for mono
  3. What is an early sign of respiratory distress?
A
  1. blowing a pinwheel, blowing bubbles
  2. susceptible to secondary infections. Should be limited to visitoris within family only
  3. Tachypnea
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39
Q
  1. When is influenza most contagious
  2. Technique for staying hydrated
  3. why are infants at higher risk of aspiration?
A
  1. 24 hours before and 24 hours after onsent of symptoms
  2. small amounts of fluid frequently
  3. airways are shorter and narrower
40
Q
  1. How is RSV determined?
  2. What is the expected urine output for a child
  3. Why are pediatric armboards utilized
A
  1. wabbed for nasal secretion which are tested
  2. 1 mL / kg / hr
  3. maintain the ingegrity of IV site
41
Q
  1. Behavior that signal readiness to cooperate in phys exam?
  2. Name 4 opitmal locations for IV’s
  3. What is the max amount to give via IM
A
  1. talking to nurse, making eye contact, allowing phys touching, choosing to sit on examination table (as oppose to parent’s lap)
  2. hands, forearm, feet, scalp
  3. 2 mL
42
Q
  1. Max amount of tylenol to give
A
  1. 650 mg
43
Q
  1. Priority action for extremity fracture
A
  1. Asess extent of injury and immobilize affected extremity
  2. Cover the wound with a sterile dressing
  3. Elevate
  4. Apply cold to injured area
  5. monitor neurovascular status
  6. transport to ER
44
Q
  1. What should you assume of fractures in infancy
  2. Neglect findings
  3. What are nurses legally required to do
A
  1. Rare, sign of abuse
  2. inadequate weight gain, poor hygiene, consistent hunger, inconsistent school attendance, constant fatigue, delinquency
  3. report all cases of suspected chid abuse
45
Q
  1. Physical abuse findings
A
  1. Unexplained bruises, burns, fractures, bald spots, apprehensive child, withdrawal, fear of parents, lack of crying, spiral fractures
46
Q
  1. Emotional Abuse Signs
A
  • speech disorders
  • habit disorders, sucking, biting, rocking
  • psychoneurotic reactions
  • learning disorders
  • suicidie attempts
47
Q
  1. Sexual Abuse Signs
A
  • Difficulty walking/sitting
  • torn, stained or bloody underclothing
  • pain, swelling or itching of genitals
  • bruises, bleeding lacerations in genital area
  • unwillingness to change clothes
  • poor peer relations
48
Q
  1. Shaken Baby Syndrome
A
  • no external signs of trauma
  • retinal hemorrhages
  • bulging fontanels and head circumference greater than expected
49
Q
  1. What are 2 forces that affect mechanics of breathing
  2. Compliance problems
  3. Resistance problems
A
  1. Compliance, Resistance
  2. lungs, pneumothorax, asthma
  3. restricting, mucous, pleural effusion, atelectasis.
50
Q
  1. Respiratory Complication 3-6 months
  2. Toddler
  3. > 5 years
A
  1. infection rate increases
  2. viral infections
  3. mycoplasma pneumonia (community acquired), strep
51
Q
  1. Causes for decreases resitance
  2. Mycoplasma infection seasons
  3. Asthmatic bronchitis season
  4. RSV season
A
  1. immune, allergies, cardiac, CF, day care, second hand smoke, malnutrition
  2. Fall, Winter
  3. Cold Weather
  4. Winter/Spring
52
Q
  1. When does stridor occur
  2. Stridor is a result of
  3. When does wheezing occur
A
  1. inspiration and expiration
  2. turbulent flow in upper airway, obstruction, croup
  3. exhalation
53
Q
  1. Wheezing is the result of
  2. When does grunting occur?
  3. Grunting is a result of
A
  1. Asthma
  2. end of expiratory
  3. pulmonary edema, RDS, pain pneumonal
54
Q
  1. What could indicate hypoxia
  2. Major causes of respiratory dysfunction
  3. How are URI’s commonly treated
A
  1. LOC, cyanosis
  2. CNS, MSK, Thoracic (pidgeon chest), CF, Infection, Structure
  3. Cool mist humidifier, no cold meds
55
Q
  1. Another name for common cold?
  2. Manifestations of Pharyngitis (strep)
  3. Risks associated with pharyngitis
A
  1. nasopharyngitis
  2. fever, sore throat, ab pain, malaise
  3. glomerulonephritis, rheumatic fever
56
Q
  1. Tx/Dx of Pharyngitis
  2. What URI is seen with pharyngitis
  3. What type of infection is tonsillitis
A
  1. Throat culture, antibiotics
  2. Tonsillitis
  3. Viral or Bacterial
57
Q
  1. What virus causes mono
  2. How long is the incubation period for mono
  3. What other body systems can it affect?
A
  1. Epstein Barr
  2. 30-50
  3. spleen, throat, lymph
58
Q
  1. When can you give tamiflu for influenza
  2. What type of isolation is influenza
  3. Dx for influenza
A
  1. within first 48 hours
  2. droplet
  3. Nasopharngeal swab or nasal wash
59
Q
  1. Most prevalent disease of early childhood
  2. Tx for Ear infection
  3. What are 5 Croup Syndromes
A
  1. Otitis Media
  2. Surgery, antibiotics, let it drain
  3. epiglotittis, Spasmodic laryngitis, LTB, Acute Bacterial Tracheitis
60
Q
  1. Is Croup Viral or Bacterial?
  2. What does croup effect
  3. What is epiglotittis caused by?
A
  1. viral, usually
  2. larynx, trachea, bronchi
  3. bacteria
61
Q
  1. What important to manage with epiglottis
  2. What vaccine is preventitive?
  3. Drug tx for Epiglottis
A
  1. stress to child, let parent hold baby
  2. HIB (Haemophilus influenzae type B)
  3. Steroids or antibiotics
62
Q
  1. Positioning for Epiglottitis
  2. Type of breath sound for epiglottitis
  3. What age range is spasmodic laryngitis common in
A
  1. tripod (can’t swallow)
  2. stridor, mild hypoxia
  3. 1-3 years of age
63
Q
  1. chief complaint of spasmodic laryngitis?
  2. Tx for Spasmodic laryngitis
  3. LT(Bronchitis) age range
A
  1. hoarseness
  2. humidified air, NO ALBUTEROL, cool mist
  3. < 5years
64
Q
  1. LTB Breath sounds
  2. S/Sx of LTB
  3. What does their larynx look like?
A
  1. inspiratory stridor
  2. Retractions, barking cough, acidosis, hypoxia
  3. steeple
65
Q
  1. Tx for LTB/Croup
  2. This could be a complication of LTB
  3. Lower Airways, sterile or aseptic?
A
  1. humidity, heliox, nebulizer, RACEMIC EPI
  2. Acute Bacterial Tacheitis
  3. sterile
66
Q
  1. Lower Airway Respiratory disorders
  2. How is bronchitis usually transmitted
  3. Lung sounds for pneumonia
A
  1. Bronchitis, RSV Bronchiolitis, Pneumonia
  2. Viral
  3. Fine Crackles, Rhonchi
67
Q
  1. S/Sx of Pneumonia
  2. Key nursing managment for pneumonia
  3. What is Pertussis (Whooping Cough)
A
  1. Stomach pain, retractions, inflammation of lung tissue
  2. lots of position changes
  3. coughing to the point of throwing up
68
Q
  1. What seasons is pertussis transmitted
  2. How is it transmitted
  3. How do they diagnose?
A
  1. Spring and Summer
  2. Risk to kids under 2 months, droplet
  3. nasal wash
69
Q
  1. Complication of foreign body ingestion
  2. Describe ARDS
  3. This that can cause ARDS
A
  1. Aspiration Pneumonia, meconium aspiration
  2. previous normal lungs, hypoxia within 72 hours after injury
  3. viral pneumonia, smoke inhalation, drowning, septic shock, trauma
70
Q
  1. Tx for ARDS
  2. Prognosis for ARDS
  3. S/Sx of ards
A
  1. Mech ventilation, nitric oxide, surfactant, HFOV, ECMO
  2. 24-88%
  3. pulmonary edema, stiff lungs,
71
Q
  1. What is the first sign of CF
  2. Other S/Sx of CF
  3. Causes for respiratory failure
A
  1. Meconium Illeus, 30% have CF
  2. distal intestinal obstruction, undigested food in stool, frothy, foul, prolapse rectum, salty
  3. cerbral trauma
72
Q
  1. Tx for Respiratory failure
  2. What side is congential diaphragmatic hernia
  3. What can it lead to
A
  1. CPR, Sunctioin, bag valve mask
  2. Left Side
  3. hypoplasia of the lung
73
Q
  1. Causes for Infant Trauma
  2. Causes for Toddler Trauma
  3. Causes for Schoolage Trauma
A
  1. Fall, Suffocation, NAT,
  2. autopedestrian, MBC, burns, drowning, maltreatment
  3. posioning, homicide
74
Q
  1. What is the leading cause of unrecognized fatal injuries in peds?
  2. What is the first response in kids with shock
  3. What is shock?
A
  1. Abdominal injuries
  2. respiratory then cardiac
  3. cell dysfunction/organ failure, circulatory failure
75
Q
  1. When does anterior fontanel close?
  2. What is phys development pattern
  3. What to expect 10 mnth old fine motor
A
  1. 12-18 months
  2. center-periphery, head to toe
  3. pincer grasp
76
Q
  1. School age weight per year
  2. How do preschoolers interpret time?
  3. How do adolescents learn best?
A
  1. 2-3 kg
  2. In relation to events- i.e. after a nap
  3. peer led programs
77
Q
A
78
Q
  1. When should premature infants be given iron supplements?
  2. What is the protest phase?
  3. Intervention for separation anxiety?
A
  1. By 2 months
  2. incolosable child, asks to go home
  3. establish routine similar to home
79
Q
  1. Communication for abused child
  2. According to Erickson & Freud what is essential for toddler to master
  3. School age how to maintain sense of industry?
A
  1. Tell them it is not their fault
  2. potty training
  3. provide child with homework
80
Q
  1. What do girls of 9 & 10 prefer?
  2. What terms to adolescents think in?
  3. How do 3 year old think
A
  1. To hang out with the same gender
  2. Concrete
  3. Literal
81
Q
  1. Most common cause of injury and death among 7 month old?
  2. Most common injury for toddlers?
  3. Denver Development Test Screens
A
  1. Aspiration
  2. Falls
  3. fine/gross motor, language
82
Q
  1. When a child is in pain, what 3 vital signs increase?
  2. Common Stressors fo hospitalized toddler?
  3. Major Complication of Cawasaki disease
A
  1. Heart Rate, Blood Pressure, Respiratory Rate
  2. Interrupted routine, sleep disturbances, fear of being hurt
  3. O2 saturation, Cardiovascular
83
Q
  1. Highest priority of neonate
  2. What assessment should be made newborn with CF
  3. Vaccines routinely due at 15 motnhs
A
  1. Respiratory rate
  2. Stool frequency and nature
  3. HIB and DTAP
84
Q
  1. Drug to have available if severe allergic reaction?
  2. Highest priority prevention instruction for newborn
  3. Wrist sprain, ice or heat wrap?
A
  1. Epi 1:10,000 injection
  2. Never leave the baby unattended on a riased ungauarded area
  3. Ice
85
Q
  1. Which assessment is most important after any injury in a child?
  2. Child with a near drowning experience
  3. Blunt force trauma to the eyes, action
A
  1. Serial assessment of LOC’s
  2. observed for 24 hours for respiratory distress or brain swelling
  3. ER ensure that no internal eye damage (if visual blurring)
86
Q
  1. What is the major intervention for carbon monoxide poisioning
  2. First step if child ingests any unknown substance
  3. 4 Aspects of child abuse
A
  1. 100% oxygen, via non rebreather mask
  2. Call poison control
  3. intentiona, physical emotional, sexual, or neglect
87
Q
  1. What is the health care providers highest priority when assessment of 6 month old
  2. Suspcicion of child abuse on 2 year old with burns on his feet
  3. What could indicate sexual abuse
A
  1. Find out history (after ABC’s have been assessed)
  2. symmetrical on both feet
  3. masturbation, temper tanstrums, sleep disorders, depressiion
88
Q
  1. Common for abused children to tell you
  2. What would be the result of CF patient not takying enzymes
  3. What do viral illness NOT requilre
A
  1. They repeat same story as their parents
  2. Azotorrhea and steatorrhea
  3. antibiotics, it is self limiting
89
Q
  1. A child that is diagnosed with asthma early
  2. Complications of otitis
  3. Highest risk with RSV
A
  1. earlier= more significant symptoms
  2. recurrent ear infections
  3. choose the youngest child
90
Q
  1. How would you determine epiglottitis?
  2. What is the tx for epiglottitis?
  3. What rate do symptoms progress
A
  1. Lateral neck x-ray of soft tissue
  2. IV antibiotics, and 10-day oral antibiotics
  3. rapidly, unpredictable
91
Q
  1. Which children are sicker with pneumonia, bacteria or viral
  2. What symptom of pneumonia is more severe and requires hospitalization?
  3. How can you determine if a child has aspirated something
A
  1. bacterial
  2. vomiting
  3. bronchoscopy (Not xray)
92
Q
  1. When does skin achieve full thickness
  2. What is the primary complication of burns
  3. Things that can mimic abuse
A
  1. 5 years
  2. infection
  3. mongolian spots, osteogenesis, imperfecta, hemophilia, cupping
93
Q
  1. What is factitious disorder
  2. Symptoms of retinal hemorrhage
  3. What age is prone to abuse
A
  1. Caregiver inflicts pain, vomiting or allow child to have seizure
  2. flu like, bradycardia, vomiting, listless
  3. Less than 2 because they can’t talk
94
Q
  1. What can be the result of strabismus?
  2. How to view tonisls
  3. Recall open vs close-ended questions
A
  1. Ambylopia
  2. Open wide say “ah”
  3. closed end in yes answers
95
Q
  1. Health history includes x3
  2. Humidified air does what
  3. Medical Emergency Froglike, drooling (epiglottitis)
A
  1. Sexual history, review of systems, family med hx
  2. Soothes inflamed mucous membranes
  3. HCP, tracheosotmy or intubation
96
Q
  1. Signs of pneumothorax
  2. Nursing interventions epiglottitis
A
  1. Tachypnea, tachycardia, dyspnea, pallor, cyanosis
  2. VS, Med Hx, Assess breath sounds, ER airway ready (NO THROAT CULTURE)

Nursing School Pt 4 (8 decks)

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