Test 3 Peds Flashcards
These things trigger a sickle cell crisis:
fever, infection, dehydration, hot or humid environment, cold air or water temperature, high altitude, or excessive physical activity.
Babies may present with sickle cell at six months because
The sickle shape comes from the shape of the hemoglobin molecule. Fetal hemoglobin is different. They start making non-fetal hemoglobin after they’re born, and around about six months they’ve made enough of it to be a problem.
A child with idiopathic thrombocytopenic purpura is going to get what drugs?
What drugs shouldn’t they get?
IVIG, steroids, platelets
They shouldn’t get anything that prevents clotting, like ASA, ibuprofen, etc
Hemophilia A and B go with which factors?
A sounds like 8 - A goes with Factor VIII
B is the next one, Factor IX, The Christmas Factor, which means this is sometimes called Christmas Disease. Xmas has a lil babby Jebus, so B goes with Christmas
What do spleens do? Splenectomy increases the risk of what?
They’re a giant lymph node, big enough to deal with manage red blood cells in addition to managing white ones. Lose your spleen, you lose immune function. You also require a special vaccination, and a spleen laceration can lead to deadly hemorrhage.
The nurse treating clients with hemophilia knows that if bleeding is not treated effectively, which body part is at greatest risk for the development of chronic, disabling disease?
Major bleeds to the joints will limit the range of motion in the joint and the function of the joint. Bleeding can occur in any body organ but the kidneys, liver, and heart are muscles and do not bear weight or have range of motion.
The nurse is conducting a physical examination of a toddler with suspected lead poisoning. Lab results indicate blood lead level 52 mcg/dL. Which action would the nurse expect to happen next?
A) Repeat testing within 2 days and prepare to administer chelation therapy as ordered.
B) Repeat testing within 1 week with education about lead
exposure.
C) Confirm with repeat testing in 1 month and referral to local health
department.
D) Prepare to admit child to begin chelation therapy.
a
The recommendation for blood lead levels :
> 70 admit to hospital now for chelation
45 to 69 mcg/dL is to confirm the level
with a repeat laboratory test within 2 days and educate the parents to decreased lead exposure. Begin chelation therapy as ordered and refer the case to the local health department for investigation of home lead
reduction with referrals for support services
20-44 mcg-dl repeat testing in one week and parent education
15-19 repeat testing in 1 month and parent education
A nurse is conducting a physical examination of a 5-year-old with suspected iron-deficiency anemia. How would the nurse evaluate for changes in neurologic functioning?
A) “Open your mouth so I can look inside your cheeks and lips.”
B) “Do you have any bruises on your feet or shins?”
C) “Will you show me how you walk across the room?”
D) “Let me see the palms of your hands and soles of your feet.”
c
Neurologic effects of iron deficiency may be demonstrated when the child’s ability
to sit, stand, and walk are impaired. Inspecting the mouth, looking for bruises, and
checking the hands and feet provide information about signs of petechiae, purpura,
or pallor.
The nurse is caring for a 12-year-old boy with idiopathic thrombocytopenia.
The nurse is providing discharge instructions about home care and safety
recommendations to the boy and his parents. Which response indicates a need for
further teaching?
A) “We should avoid aspirin and drugs like ibuprofen.”
B) “He can resume participation in football in 2 weeks”
C) “Swimming would be a great activity.”
D) “Our son cannot take any antihistamines.”
B) “He can resume participation in football in 2 weeks”
A nurse is providing care to a child with idiopathic thrombocytopenic purpura
with a platelet count of 18,000/mm3. Which medication would the nurse most likely expect to be ordered?
A) Folic acid
B) Intravenous immune globulin
C) Dimercaprol
D) Deferoxamine
B) Intravenous immune globulin
The nurse is teaching the parents of a child diagnosed with iron deficiency anemia about ways to increase their child’s intake of iron. The parents demonstrate
understanding of the teaching when they identify which foods as good choices for
the child? Select all that apply.
A) Tuna
B) Salmon
C) Tofu
D) Cow’s milk
E) Dried fruits
abce
A nurse is leading a discussion with a group of new mothers about newborn
nutrition and its importance for growth and development. One of the mothers asks, “Doesn’t the baby get iron from me before birth?” Which response by the nurse would be most appropriate?
A) “You give the baby some iron, but it is not enough to sustain him after
birth.”
B) “Because the baby grows rapidly during the first months, he uses up
what you gave him.”
C) “The iron you give him before birth is different from what he needs
once he is born.”
D) “If the baby didn’t use up what you gave him before birth, he excretes
it soon after birth.”
b
A 5-year-old girl is diagnosed with iron-deficiency anemia and is to receive
iron supplements. The child has difficulty swallowing tablets, so a liquid formulation is prescribed. After teaching the parents about administering the iron supplement,
which statement indicates the need for additional teaching?
A) “She needs to eat foods that are high in fiber, so she doesn’t get
constipated.”
B) “We’ll try to get her to drink lots of fluids throughout the day.”
C) “We will place the liquid in the front of her gums and just below her
teeth.”
D) “We need to measure the liquid carefully so that we give her the
correct amount.”
Ans: C
Name three things they use for lead chelation in children:
EDTA
dimercaprol
succimer
(succimer is a derivative [water soluble mesoisomer] of dimercaprol)
What are the 4 p’s of morphine side effects?
Poopin - they don’t be poopin
Peein - they don’t be peein
Pruritis - they do be itchy tho
Puffin - do they be puffin? because they forget to breathe
