Unit 2-Pilliterri

Question 1

Appendicitis Signs/Symptoms

Answer 1

Begins with Nausea (few hrs)
1-2 hr of generalized abdominal pain.
Women may have vomiting.
Progressing to sharp RLQ pain

Question 2

Mcburney’s point

Answer 2

Halfway between the umbilicus
and the iliac crest on the RLQ
Pain sharp and localized here

Question 3

Appendicitis Precautions

Answer 3

Do not omit pain with meds no pain can indicate rupture, NO food, liquid, or laxatives, Increased perstalisis could cause the appendix to rupture

Question 4

GERD ( gastroesophogael reflux disease)

Hiatal Hernia

Answer 4

in which a portion of the stomach extends and

protrudes up through the diaphragm into the chest cavity(hernia)

Question 5

Hernia / GERD signs and symptoms

Answer 5

Heartburn, which is particularly extreme when lying
supine after a full meal
• Gastric regurgitation
• Dysphagia (difficulty swallowing)
• Possible weight loss because of the inability to eat
• Hematemesis (vomiting of blood) if extreme esophageal
irritation occurs from the reflux of hydrochloric acid from
the stomach

Question 6

Pre-op Child Assessment

Answer 6

Current Knowledge level
Emotional-explain procedure-minimizes fear
Prepare in stages- (before/after)hard for them to absorb all at once: be careful with wording
Physical- NPO- parents need to understand risk of aspiration during surgery. Reassurance you are only cleaning(won’t sting)

Question 7

Before Surgery

Answer 7

Check ID band, batteries, bobby pins, loose teeth,

Question 8

Suctioning (Trach Care)

Answer 8

Ineffective suctioning can cause more mucous to form.
Some children only need to be suctioned the length of the tube but other need deep suction to prevent thickening of mucous
Some may need elbow restraints
Assess for resp difficulty (irritability)

Question 9

Steps to Suctioning

Answer 9

1. wash hands, identify pt, explain
2. assess breath sounds
3. gather supplies:suction cath 12-14F, normal saline, bag-valve mask, method of distraction for child
4. Open the bottle of sterile normal saline and suction cath. Pour NS in disposable container. put on sterile gloves.
5. Hold cath with one gloved hand, suction
   tubing with other gloved hand, and attach tubing to
   sterile catheter; dip tip of catheter into normal saline
6. If necessary have asst to hyperventilate pt before and between suctioning.
7. suction on the way out through cath 5-10 sec (adult 10-15 sec) rotating gently
8. Rinse cath by dipping in NS
9. Repeat until lung sounds are clear
10. Effective? pt less restless? better oxygenation?
11. Provide comfort

Question 10

Trach tips -children

Answer 10

cover tube opening with gauze while eating to prevent anything from falling in.
always keep oburator at bedside in case tube becomes dislodged.

Question 11

Endotracheal Intubation

Answer 11

bypasses upper airway obstruction
cannot speak
held in place by tape to face
connected to ventilator; hard to wean off of

Question 12

Ventilator Terms

Answer 12

IMV- intermittent mandatory ventilation # breaths hr
PEEP- Positive end expiratory pressure- pressure delivered to lungs at the end of each expiration
sigh- deep inhalation by machine
CPAP- continuous positive airway pressure- constant pressure on alveoli
FiO2-concentration of O2 inspired-22%-100%