review I Flashcards
What are 3 major causes of death in patients under 1 year of age?
Congenital anomalies, Prematurity, SIDS
What is the number one cause of death in neonates?
Prematurity
What should you attain from each visit?
Height/ length, weight, head circimference
When should you take note of growth measurements?
When the patient is under the 5th percentile or over the 95th percentile
Weight
doubles by 4-7 months, triples by first birthday
True or False. Infants gain 5-7 oz. weekly?
TRUE
True or False. Birth length increases by 50% at 6 months?
False, height increases by 50% at 12 months
Posterior fontanel
Closes by 6-8th week
Anterior fontanel
Closes by 12-18th month
Normal temp.
36.5- 37.6
Normal HR/ pulse
100-160, 180 if crying
Normal RR
30-60
True or False. Birth weight is regained in 3 weeks?
False. 2 weeks, depending on feeding method
Solitary play
one-sided playing, no sharing
Parallel play
plays alongside, but not with others
Associative play
group play in similar or identical activities, but without rigid organization or rules
Cooperative play
shares with and plays with others
True or False. During a physical assessment, you should start with BP?
False. Start with least invasive procedure such as RR
What is the best physical assessment approach for peds patients?
Observe then RR, HR, Temp, BP, organ systems assess. Palpate liver last
When should you expect to see a social smile?
2 months
When does head control usually occur?
4 months
Rolls from abdomen to back?
5-6 months
Plays peek-a-boo?
6 months
When do infants transfer objects from one hand to the other?
7 months
When should children usually sit unsupported?
8 months
When would you expect infants to crawl?
9-10 months
What age would you expect to see infants wave goodbye?
10 months
What age are infants expected to walk with assistance?
10-12 months
In addition to MAMA and DADA, when should infants say a few words?
12 months
Identify appropriate toys that facilitate G&D for infants under the age of 1
Mobiles, rattles, squeaky toys, picture books, balls, colored blocks, activity boxes
Sucking reflex
elicited by placing a nipple or nonlatex gloved finger in the pt’s mouth
Rooting reflex
elicited by stroking the cheek and noting the infant’s response of turning towards the stimulating side and sucking
Babinski reflex
Stroking the outer sole of the foot upward from the heel across the ball of the foot, causes the big toe to dorsiflex and other toes to hyperextend
What age should infant’s coo?
2 months
What is FLACC?
A pain assessment tool used to evaluate the child’s FACIAL expression, LEG movement, ACTIVITY, CRY, CONSOLABILITY
True or False. NPASS is a pain assessment tool specific to preterm infants and babies with anomalies?
True. May be used in neonates as young as 23 weeks and up to infants 100 days old.
What does NPASS stand for?
Neonatal Pain, Agitation, and Sedation Scale
DDST, DDST-R, Denver II
The most widely used developmental screening test for young children. It determines if child is at the appropriate developmental stage for their age.
How is the Denver II interpreted?
Normal, suspect, or untestable
How many admissions have medication errors?
4- 17%
How many hospitalized patients suffer an adverse event?
4%
What are common cause of errors?
Distractions, increased workload, inexperienced staff, insufficient staffing, shift change, staff from agency, emergency situations
What are the consequences of medical errors?
Morbidity, mortality, cost
In addition to the 5 rights, what other rights should nurses consider in regards to medication?
Right reason, Right documentation
Identify 3 other causes for potential errors
Reconsitution error, wrong diluent, incorrect dilution amount, admin. of Rx that is too concentrated, incorrect rate, use of wrong port or IV line
For newborns and infants, what is the preferred ROA for IM injections
Vastus lateralis
For children 3 years of age and older, what is the preferred ROA for IM injections?
Deltoid
True or False. IM medications absorb the fastest?
False, medications adminsitered IV absorb the fastest.
Volutrol/ Buretrol
A type of infusion device that holds limited quantities of IV fluids or medications. Designed to prevent free flow of fluids or air once infusion is done.
True or False. Infants can handle large fluid influxes like adults?
False. Less able, 80% of body weight is fluid.
Schedule of visits during infancy include?
Newborn, 2 weeks, 2 months, 4 months, 6 months, 9 months, 12 months.
What 3 components should be addressed during each scheduled visit?
Safety, nutrition, health care
What safety issues are most important to discuss?
Car seats, SIDS prevention, smoke detectors, bath water temp., crib safety, sun exposure, walkers
What nutritonal issues should be discussed during visit?
Review feeding schedules, solid-food introduction, picky eater concerns
In regards to health care, what issues should be discussed during visits?
Vaccines, dental, next visit
True or False. The dangers children get into are directly related to their developmental capabilities
TRUE
True or False. Age appropriate guidance is only important to give to the baby?
False, nurses should give age appropriate guidance to baby and age appropriate teaching strategies to the parents
Name 3 common safety issues for infants and toddlers
Car safety, pets/ allergens, poisoning, toys, medications
True or False, 1/2 of injuries occur at home
False, 2/3.
Unintentional injuries such as MVAs are the number 1 cause of death in children age 1- 24, T or F.
TRUE
Car Safety seats depend on age, T or F?
False, recommendations for car seats depends on weight and age.
Who should sit in backward facing bucket seats?
Infants up to 1 year and up to 20lbs.
Who should be restrained in forward facing car seats?
Children over 1 year and over 20lbs until they’re 6 years of age and/or 60lbs.
What other measures are included to reduce SIDS?
Use a firm sleep surface, practice room-sharing without bed- sharing, use a fitted sheet, no loose bedding or soft objects in crib, avoid overheating.
True or False. Newborns gain 4-7oz. a week?
TRUE
How long should Back to Sleep PLUS measures be followed?
Should be followed for a year
Why aren’t vitamin D levels checked before 2 months?
Passive immunity, lasts up to 6 months
What is HEADSS?
Teen assessment tool/ Psychosocial interview for adolescents
What information is gathered during a HEADDS assessment?
Home and environment, Education, Activities, Drugs, Sexuality, Safety/ Suicide/ Depression
Morbidity and mortality in teens is commonly caused by disease, True or False?
False, physically damaging behaviors such as depression, suicide, obesity, and substance abuse are the cause, not disease.
What important questions should you ask when you see a rash?
Immunization status, traveled outide of the US, Prodrome, When/ Where did it start, Painful or Pruritic, Tx used at home
Chickenpox
Child is only contagious 1 day before eruption of lesions and up to 6 days after the lesions crust
What precautions should be in place for patient with Chickenpox?
Maintain contact, respiratory, droplet precautions until all lesions are crusted.
What supportive treatment should you promote when a child has Chickenpox?
Low dose BENADRYL to decrease itch, good skin care
What nursing care could you give a patient with Chickenpox?
Give bath, change clothes and linen daily, keep child cool, low dose benadryl
What are the clinical manifestations of Measles/ Rubeola? Hint, 3 C’s.
Koplik spots, coryza, photophobia. Coryza, cough, conjuctivitis
What type of ISOLATION would you expect for a patient diagnosed with Measles?
Maintain respiratory isolation until 5th day of rash, institute droplet precaution if child is hospitalized.
What complications can occurs from Measles/ Rubeola?
Otitis media, pnemonia, encephalitis.
As a nurse, what supportive treatments can you provide to patients suffering with Measles/ Rubeola?
Administer antipyretics for fever, eye care, cool mist vaporizer for cough, tepid bath to improve skin care
True or False. The prodrome period for Measles/ Rubeola is 7 days?
False. 3- 5 days.
Exanthem Subitum/ Roseola
Caused by Herpesvirus type 6, peak at 18 months.
Symptoms of Exanthem subitum include
Sudden high fever up to 105F, febrile seizures, pink discrete maculopapular rash
What should you discuss with the parents of children diagnosed with Roseola?
Teach measures for lowering temperature with antipyretic Rx, discuss appropriate precautions and possibility of recurrent febrile seizures.
Erythema Infectiosum/ Fifth Disease
caused by Human parovirus B19
True or False. Isolation is necessary for patient diagnosed with Erythema Infectiosum/ Fifth disease?
False, isolation is not necessary, except hospitalized child suspected of HBV infection is placed on respiratory isolation and standard precaution.
Classic slapped-cheek appearance
Erythema Infectiosum, usually disappears with 1-4 days but then spreads to extremities
True or False. Blood tests that look for antibodies against parovirus B19 is used for exposed pregnant women?
TRUE
Body rash followed by lace-like pattern of erythema that persists up to 2 weeks
Characteristics of Erythema Infectiosum/ Fifth Disease
Characteristics of Measles/ Rubeola
Confluent maculopapular rash
Charateristics of Chickenpox
No or mild prodrome, superficial vesicles, pruitic, crops in different stages, concentrated on trunk.
True or False, CRIES is a pain rating scale that can be used with infants 32 to 60 weeks of gestational age?
TRUE
What two viruses are most likely to precipitate Otitis Media (OM)?
RSV and Influenza
Otitis Media
May occur because of blocked eustachian tubes from the edema of URIs, allergic rhinitis, or hypertrophic adenoids.
True or False. Many cases of bacterial OM are preceded by a viral respiratory infection?
TRUE
True or False. Children living in households with many members (especially smokers) are more likely to have OM?
TRUE
What is the pathophysiology of OM?
OM is primarily the result of malfunctioning eustachian tubes. Mechanical or functional obstruction of these tubes causes accumulation of secretions in the middle ear. Obstruction results in negative middle ear pressure and produces a transudative middle ear infusion. Drainage is inhibited by sustained negative pressure and impaired ciliary transport within the tubes