Test One Flashcards
2. Vital signs and children Temp Pulse Resp Blood pressure.
Temp
New borns 99.1 hr 120-160 rep 30 to 60 Bp 65to 95/50 to 60
4yrs 98.6 hr 80-125 Resp 20 to 30
Rate. Count apical for 1 min.
Head circumference. Measure above eyebrows. Occipital prominence.
Communicating with children in the hospital
Developmental level
- Physical Exam approaches for children
From head to toe.
Painful procedure left until last.
Do to child developments age or level. Stage.
Involve parent
Infants pacifiers. Rattle to distract. Calm voice.
Toddlers- cry a lot. Provide toys and books. Allow them to handle objects.
Preschool -cooperative. Praise for cooperation and allow to participate
School-establish trust.
Adolescents. Straight forward questions.
- Fontanel
Posterior close by 2-3 months.
Anterior should be soft flat closed btn 12 to 24 months.
Sunken. Dehydration.
Bulging Icp normal wen child cries
- Vision disturbances in Children
Strabismus. Eyes not aligned. Lack of extra ocular coordination. Eye patch on the stronger eye. And Botox.
Light reflex be equal.
Blocked lacrimal duct. Excessive crying. Massage or surgical.
- Myopia
Hyperopia
Near signteness Give lenses.
Sees things that are far.
- Amblyopia
Astigmatism
Conjunctiva
Lazy eye. Same as amblyopia. One eye Not seeing.
Ast - Unequal curvature of corner
C pink eye. Inflamation. Poor hand washing. Can be allergic- Itching or bacterial- think.
- Psychosocial Development and hospitalization of the adolescent (Erickson)
Identity and role confusion. Sense of peer important. Independence.
9Factors that influence Child growth
Ff
- Piaget’s Cognitive Development stages and the hospitalized child
Developmentally appropriate activity
Infants Toddlers Preschool School Adolescent
11 Stanger Anxiety and the nurse
Let parents hold the children
12 Weaning
Not during stress Decreased interest Throwing bottle. Chewif on nipples Taking few onces. Refusing breast.
Wen to give. Formula. Galactosemia. Body unable to use simple sugars. Illegal drug use. Chem therapy. HIV.
13 Appropriate infant play by developmental
Solitary Onlookers Parallel Associative. Cooperative.
14 Appropriate weight gain
1 and half pounds.
- Signs of Stress in the pediatric client
1
- Developing fine motor skills
Wen
17 Developmental assessment
0
18 Hirschsprung’s Disease
Absence of ganglion cells in rectum and colon. Poor or absent peristalsis. Accumulation of fecese. dilation of bowle.
Delayed meconuim 1st 24. Hours. Cardianal sign.
Abdominal pain.
Distention. Vomiting. Failure to thrive. Robbin like stool or pellet. Foul smell
Removin of a ganglion portion of intestine surgically. Colostomy until 18 to 22 lbs
Op. Keep child Npo maintain IV fluids.
Expect constipation.
Do not take recto temp.
- Dehydration
Have higher extracellar fluids. Cause susptability to dehydration.
Infants are at higher risk. Larger ratio of extracellar to intrcellular.
Insensible water. Resp and skin. Sweating. Breathing.
Sensible. Irine.
High Resp rate. Increased water output.
Less able to concentrate urine. Have large body surf area to body mass. Skin and gi fluid loss.
dehydration occurs in n/v diarrhea. Hyperventilation , hemorrhage.
Unable to communicate thirst. Less concentration of irine. Loose of water.
High rate of peristalsis.
Infection lead to fluid and electrolyr imbalance.
Few diapers. No tears. High pithed. Difficult awaking diff breathing or incre Resp
Sunken fontanel. Sunken eye.
- Oral Rehydration solution
For treatment of diarrhea. Vomiting and dehydration.
Hypernaremic. Hypertonic.
Mpre water loss. Less electric loss. Sodium higher in concentration in body. Measure weight daily. Water loss. Increased sodium. D insipidus
Unable to take fluids by moth give. IV. Lr or 0.9 ns.
Give potasuim in IV.
diarrhea feve. Hyperglycemia.
Hyponatremic or hyoptonic.
Less water loss more sodium loss. Electrolyr loss higher.
Fever increased water. Keyoackdosis. Burns vomiting and diarrhea
- Diarrhea
Weight indicator. Thirsty. Skin togor.
Can leans to impending shock. Increase heart rate. Sensorium lethargic. Pale skin color. Increased motility and rapid empting impairs absorption. Electrolytes are lost on still and
- Diet and diarrhea
Bland but nutritious. To prevent dehydration. And hasten revery.
Rice. Wheat.potatoes. Yorgut. Cereals. Cooked vegstables.
Acct. amount. Color. Constance. Time.
Do not give antidiarrhea meds. Slow pathogens.
Meds prolon diarrhea.
Call doc if babe hasn’t urinated in 6 hours. No tear wen crying. Sunken fontanel. Child behavior or status changed. Fever of 101 38.3
Diarrhea more the a week.
Diet.
- Persistent Vomiting
Detect cause and treat. Assess for dehydrationg Record intake and outputs. Prevent aspirations. Reduce vomit.
- Preparing and administering oral medications
Formula decreases absorption.
Slow gastric emptying and have less gastric acid and have more digestive enzyms
Assess gag reflexes. Prepare using string less that 5 ml.
Cup up to 30 ml put the meds
…..NON essential food…..
Never in formula.
Admi. Upright strkng along side the chick .
- I.M. Injections. Safe volumes and locations
Faster.
22 to 25 gauge.
1/2 inch.
Infant. 0. 5. Ml.
Adolescent 3 ml.
90 degree and aspirate.
Vastus laterallas. Or deltoid.
- SubQ Injections
Upper arm and outer thigh.
25 to 27 gauge needle. 45 degre angle.
Do not give in edema areas.
- Administering Otic drops
Ears. Pull piña down and back. Younger than 3 years.
Older than 3. Pull pinna up and back.
- Buretrols
IV monitoring machine.
Volume controlled device which allows to set specific volume. Usually 1 hour.
To decrease the risk of giving. Large*
amounts of fluids.
- I.V. fluid therapy in children
10 kg. 100ml/kg /day.
10 to 20 kg 1000 ml/ day plus 50 ml/kg/day.
Over 20 kg. 1500ml/day plus 20 ml/kg/day. M
- I.V. assessment
Assess development level
Not in toddlers foot.
Not in dominant hand.
Scalp used in infants. No valves. Use. House. Boards.
Assess every HOUr of the rate and quantity.
31 Administering otic medication in children
Otic
32 Admit of eyes
Eyes
- 24 hour fluid maintenance
24 hour
- Pain and children
- Infants crying fist clinching. Grimcsing. Wrinkling forehead. Tremors.
- Toddlers. Restlessness. Guarding. Loud crying. Ouch. Avoid eye contact.
- Preschool cry struggle. May deny injections. Think magically go way.
- School stuff body. Withdraw. Fear body harm. Bargain to delay procedure.
- Adolescents. May not report pain becoz thing the nurse already know.
- Analgesic administration
Analgesic
Patient controlled analgesia
topical anesthetic.
They are proffered route is intravenous IV or oral.
Infants recieve IV and epidural opioids should be monitored by pulse oximetry.
- Respiratory depression and analgesic administration
Naloxone should be administered to reverse wen oxygen and stimulation of the child are innefective.
- Alterations in acid base balance (Metabolic acidosis, Alkalosis) (Respiratory Acidosis, alkalosis)
Ph 7.35 to 7.45
Cos 35 to 45
Hco3 22 to 26.
7.35 to 7.45
Resp Acidosis Increas Resp ,ph fall. Coz falls.
Resp alkalosis. Decrease coz. Ph Increas. Resp decrease
Metabolic acidosis extreat hydrogen. Conserve bicarbonate rise ph.
Metabolic alkalosis. Regulate bicarbonate conserve hydrogen lower ph.
- Potassium rules
Do not give IV push.
Give no more than 40 at rate no more than 1 MEQ /kg/hr.
Irritates the Vessels. Plebitis.
Do not give solutions greater than 30 MEQ through a periphal vein.
Potasuim chloride should never be added to a soliton in presence of Oliguria or anuria or out of 0.5ml/kg/hr.
- Body surface area calculations
39
- Immunizations
Immature immune system.
Neonate are protected by passive immunity. Only effects for 3 months.
Beast feeding recieve add immunoglobulin.
Breast feed for 6 months.
- Rubella virus –fetal anomalies in infected fetus
41
- Infants and MMR vaccination
42
- Whooping cough vaccine
43
- Reyes syndrome
44
- Solid food and infants
Able to sit. Leans forward and opens mouth. Extrusion reflexes have disappeared. Can move food back to mouth and swallow. Introduce one at a time. Las than 4 leads to obesity. Rice cereals recommended first.
Fingure good 8 to 10.
No Hotdogs. Grapes. Carrots. Marshmallow. Hard can’dy. seeds. Popcorn nuts.
- Fetal alcohol syndrome
Mal face and skull. Skeletal malformation. Cns defect.
Thin vermilion fissure. Small palpable fissure. Smooth philtrum
Lee then 10 percentile in both height and weight.
Cleft clip
Seizure.
Short distal phalangers.
- Austism spectrum disorders
Asperger. Milder.
Autism. More severe.
Impairs abilit for social cues. Inability to behave according to social norms.
No regard to lister. Rigid schedule. Motor clumsiness. Trouble writing.
Autism. Repeated stimuli.
Over reAcfion to change. No sense of personal space. Self Injury behavior.
Wen taking care. evaluate of able to eat or dress. Verbal skills. Routins. Safety.
- Cleft lip/palate assessment questions and educating parents
Genetic patten failure from multiple genetic and environmental factors.
Do u know anyone with Clift plate.
High risk of Otis media.
Keep the infant hand way from incision. Specials bottle with longer nipple allow eject milk.
- Safety by age
49
- Pain management in children
50
- Pain assessment in children
Me
- Pain assessment tools for children
52
- Recognizing child abuse
Increase during hardship or emotional stress.
Report suspected abuse.
Informers are kept confidental
Cigaret burns. Hand prints.
Unappopriate dressing for weather dirty. Crouching in corner. Response after looking to others. Labile
Dehydration. Important factor.
Type of dehydration. Isonamtremic and hypotonic dehy resuscitation involves fluid replacement over 24 hours.
Priority in diagnoses of diarrhea and dehydration is MEASUrInG weight.
Able to assess hydration and respond to fluid replacement.
Treatment goal of acid base imbalance
Metabolic. Treat underlying cause.
Reps. Reestqblisjjng alveolar ventilation.
