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Pathopharm > review I > Flashcards

review I Flashcards

1
Q

What are 3 major causes of death in patients under 1 year of age?

A

Congenital anomalies, Prematurity, SIDS

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2
Q

What is the number one cause of death in neonates?

A

Prematurity

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3
Q

What should you attain from each visit?

A

Height/ length, weight, head circimference

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4
Q

When should you take note of growth measurements?

A

When the patient is under the 5th percentile or over the 95th percentile

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5
Q

Weight

A

doubles by 4-7 months, triples by first birthday

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6
Q

True or False. Infants gain 5-7 oz. weekly?

A

TRUE

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7
Q

True or False. Birth length increases by 50% at 6 months?

A

False, height increases by 50% at 12 months

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8
Q

Posterior fontanel

A

Closes by 6-8th week

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9
Q

Anterior fontanel

A

Closes by 12-18th month

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10
Q

Normal temp.

A

36.5- 37.6

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11
Q

Normal HR/ pulse

A

100-160, 180 if crying

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12
Q

Normal RR

A

30-60

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13
Q

True or False. Birth weight is regained in 3 weeks?

A

False. 2 weeks, depending on feeding method

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14
Q

Solitary play

A

one-sided playing, no sharing

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15
Q

Parallel play

A

plays alongside, but not with others

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16
Q

Associative play

A

group play in similar or identical activities, but without rigid organization or rules

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17
Q

Cooperative play

A

shares with and plays with others

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18
Q

True or False. During a physical assessment, you should start with BP?

A

False. Start with least invasive procedure such as RR

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19
Q

What is the best physical assessment approach for peds patients?

A

Observe then RR, HR, Temp, BP, organ systems assess. Palpate liver last

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20
Q

When should you expect to see a social smile?

A

2 months

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21
Q

When does head control usually occur?

A

4 months

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22
Q

Rolls from abdomen to back?

A

5-6 months

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23
Q

Plays peek-a-boo?

A

6 months

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24
Q

When do infants transfer objects from one hand to the other?

A

7 months

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25
Q

When should children usually sit unsupported?

A

8 months

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26
Q

When would you expect infants to crawl?

A

9-10 months

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27
Q

What age would you expect to see infants wave goodbye?

A

10 months

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28
Q

What age are infants expected to walk with assistance?

A

10-12 months

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29
Q

In addition to MAMA and DADA, when should infants say a few words?

A

12 months

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30
Q

Identify appropriate toys that facilitate G&D for infants under the age of 1

A

Mobiles, rattles, squeaky toys, picture books, balls, colored blocks, activity boxes

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31
Q

Sucking reflex

A

elicited by placing a nipple or nonlatex gloved finger in the pt’s mouth

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32
Q

Rooting reflex

A

elicited by stroking the cheek and noting the infant’s response of turning towards the stimulating side and sucking

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33
Q

Babinski reflex

A

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

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34
Q

What age should infant’s coo?

A

2 months

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35
Q

What is FLACC?

A

A pain assessment tool used to evaluate the child’s FACIAL expression, LEG movement, ACTIVITY, CRY, CONSOLABILITY

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36
Q

True or False. NPASS is a pain assessment tool specific to preterm infants and babies with anomalies?

A

True. May be used in neonates as young as 23 weeks and up to infants 100 days old.

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37
Q

What does NPASS stand for?

A

Neonatal Pain, Agitation, and Sedation Scale

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38
Q

DDST, DDST-R, Denver II

A

The most widely used developmental screening test for young children. It determines if child is at the appropriate developmental stage for their age.

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39
Q

How is the Denver II interpreted?

A

Normal, suspect, or untestable

40
Q

How many admissions have medication errors?

A

4- 17%

41
Q

How many hospitalized patients suffer an adverse event?

A

4%

42
Q

What are common cause of errors?

A

Distractions, increased workload, inexperienced staff, insufficient staffing, shift change, staff from agency, emergency situations

43
Q

What are the consequences of medical errors?

A

Morbidity, mortality, cost

44
Q

In addition to the 5 rights, what other rights should nurses consider in regards to medication?

A

Right reason, Right documentation

45
Q

Identify 3 other causes for potential errors

A

Reconsitution error, wrong diluent, incorrect dilution amount, admin. of Rx that is too concentrated, incorrect rate, use of wrong port or IV line

46
Q

For newborns and infants, what is the preferred ROA for IM injections

A

Vastus lateralis

47
Q

For children 3 years of age and older, what is the preferred ROA for IM injections?

A

Deltoid

48
Q

True or False. IM medications absorb the fastest?

A

False, medications adminsitered IV absorb the fastest.

49
Q

Volutrol/ Buretrol

A

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.

50
Q

True or False. Infants can handle large fluid influxes like adults?

A

False. Less able, 80% of body weight is fluid.

51
Q

Schedule of visits during infancy include?

A

Newborn, 2 weeks, 2 months, 4 months, 6 months, 9 months, 12 months.

52
Q

What 3 components should be addressed during each scheduled visit?

A

Safety, nutrition, health care

53
Q

What safety issues are most important to discuss?

A

Car seats, SIDS prevention, smoke detectors, bath water temp., crib safety, sun exposure, walkers

54
Q

What nutritonal issues should be discussed during visit?

A

Review feeding schedules, solid-food introduction, picky eater concerns

55
Q

In regards to health care, what issues should be discussed during visits?

A

Vaccines, dental, next visit

56
Q

True or False. The dangers children get into are directly related to their developmental capabilities

A

TRUE

57
Q

True or False. Age appropriate guidance is only important to give to the baby?

A

False, nurses should give age appropriate guidance to baby and age appropriate teaching strategies to the parents

58
Q

Name 3 common safety issues for infants and toddlers

A

Car safety, pets/ allergens, poisoning, toys, medications

59
Q

True or False, 1/2 of injuries occur at home

A

False, 2/3.

60
Q

Unintentional injuries such as MVAs are the number 1 cause of death in children age 1- 24, T or F.

A

TRUE

61
Q

Car Safety seats depend on age, T or F?

A

False, recommendations for car seats depends on weight and age.

62
Q

Who should sit in backward facing bucket seats?

A

Infants up to 1 year and up to 20lbs.

63
Q

Who should be restrained in forward facing car seats?

A

Children over 1 year and over 20lbs until they’re 6 years of age and/or 60lbs.

64
Q

What other measures are included to reduce SIDS?

A

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.

65
Q

True or False. Newborns gain 4-7oz. a week?

A

TRUE

66
Q

How long should Back to Sleep PLUS measures be followed?

A

Should be followed for a year

67
Q

Why aren’t vitamin D levels checked before 2 months?

A

Passive immunity, lasts up to 6 months

68
Q

What is HEADSS?

A

Teen assessment tool/ Psychosocial interview for adolescents

69
Q

What information is gathered during a HEADDS assessment?

A

Home and environment, Education, Activities, Drugs, Sexuality, Safety/ Suicide/ Depression

70
Q

Morbidity and mortality in teens is commonly caused by disease, True or False?

A

False, physically damaging behaviors such as depression, suicide, obesity, and substance abuse are the cause, not disease.

71
Q

What important questions should you ask when you see a rash?

A

Immunization status, traveled outide of the US, Prodrome, When/ Where did it start, Painful or Pruritic, Tx used at home

72
Q

Chickenpox

A

Child is only contagious 1 day before eruption of lesions and up to 6 days after the lesions crust

73
Q

What precautions should be in place for patient with Chickenpox?

A

Maintain contact, respiratory, droplet precautions until all lesions are crusted.

74
Q

What supportive treatment should you promote when a child has Chickenpox?

A

Low dose BENADRYL to decrease itch, good skin care

75
Q

What nursing care could you give a patient with Chickenpox?

A

Give bath, change clothes and linen daily, keep child cool, low dose benadryl

76
Q

What are the clinical manifestations of Measles/ Rubeola? Hint, 3 C’s.

A

Koplik spots, coryza, photophobia. Coryza, cough, conjuctivitis

77
Q

What type of ISOLATION would you expect for a patient diagnosed with Measles?

A

Maintain respiratory isolation until 5th day of rash, institute droplet precaution if child is hospitalized.

78
Q

What complications can occurs from Measles/ Rubeola?

A

Otitis media, pnemonia, encephalitis.

79
Q

As a nurse, what supportive treatments can you provide to patients suffering with Measles/ Rubeola?

A

Administer antipyretics for fever, eye care, cool mist vaporizer for cough, tepid bath to improve skin care

80
Q

True or False. The prodrome period for Measles/ Rubeola is 7 days?

A

False. 3- 5 days.

81
Q

Exanthem Subitum/ Roseola

A

Caused by Herpesvirus type 6, peak at 18 months.

82
Q

Symptoms of Exanthem subitum include

A

Sudden high fever up to 105F, febrile seizures, pink discrete maculopapular rash

83
Q

What should you discuss with the parents of children diagnosed with Roseola?

A

Teach measures for lowering temperature with antipyretic Rx, discuss appropriate precautions and possibility of recurrent febrile seizures.

84
Q

Erythema Infectiosum/ Fifth Disease

A

caused by Human parovirus B19

85
Q

True or False. Isolation is necessary for patient diagnosed with Erythema Infectiosum/ Fifth disease?

A

False, isolation is not necessary, except hospitalized child suspected of HBV infection is placed on respiratory isolation and standard precaution.

86
Q

Classic slapped-cheek appearance

A

Erythema Infectiosum, usually disappears with 1-4 days but then spreads to extremities

87
Q

True or False. Blood tests that look for antibodies against parovirus B19 is used for exposed pregnant women?

A

TRUE

88
Q

Body rash followed by lace-like pattern of erythema that persists up to 2 weeks

A

Characteristics of Erythema Infectiosum/ Fifth Disease

89
Q

Characteristics of Measles/ Rubeola

A

Confluent maculopapular rash

90
Q

Charateristics of Chickenpox

A

No or mild prodrome, superficial vesicles, pruitic, crops in different stages, concentrated on trunk.

91
Q

True or False, CRIES is a pain rating scale that can be used with infants 32 to 60 weeks of gestational age?

A

TRUE

92
Q

What two viruses are most likely to precipitate Otitis Media (OM)?

A

RSV and Influenza

93
Q

Otitis Media

A

May occur because of blocked eustachian tubes from the edema of URIs, allergic rhinitis, or hypertrophic adenoids.

94
Q

True or False. Many cases of bacterial OM are preceded by a viral respiratory infection?

A

TRUE

95
Q

True or False. Children living in households with many members (especially smokers) are more likely to have OM?

A

TRUE

96
Q

What is the pathophysiology of OM?

A

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

Pathopharm (24 decks)

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