Unit 5: Nursing care of High-Risk Infant Flashcards
Condition with inappropriate degree of inattention, impulsiveness, and hyperactivity
ADHD
Average age of ADHD onset
7 years old
2 Criteria for Diagnosing ADHD
6 or more symptoms of (1) Hyperactivity-Impulsiveness
present for at least 6 months or
(2) Inattention present for at least 6 months
to an extent that is disruptive and
inappropriate for developmental level.
Does not like quiet activities Fidgets and Squirms Unlimited Talking Constant motion Cannot Sit Still Dashes and Touches Everything
These are symptoms of _________
Hyperactivity
Blurts Inappropriate Comments Acts without thinking of consequences No emotional restraint Difficulty waiting Aggressive/Unruly Interrupts Conversations...Impatient
Are Symptoms of ________
Impulsivity
Forgetful Easily Distracted Looses important things Avoids Effort Not following instructions Does not listen
Are Symptoms of________
Inattention
2 Types of ADHD
Predominantly Inattentive Type
Predominantly Hyperactive-Impulsive Type
Aka Rabbit Type ADHD
Predominantly Hyperactive-Impulsive Type
Aka Pooh Type ADHD
Predominantly Inattentive Type
The client has poor impulse control, difficulty sitting still, and is fidgeting or squirming. What is the type of ADHD?
Predominantly Hyperactive-Impulsive Type
or
Rabbit Type
The client is inattentive, sluggish, slow-moving, unmotivated, daydreamer
Predominantly Inattentive Type
or
Pooh Type
Behavior Disorder
Antisocial Disorder
Developmental Disorder
Disruptive Behavior Disorder
Oppositional Defiant Disorder
Conduct Disorder
6 Classifications of ____
ADHD
Preservatives Artificial Food Coloring Genetics Environment Sugar and Coffee
Are etiologies for ____
ADHD
Wellbutrin
Effexor
Tricyclic Depressants
Pamelor
Intuniv
Catapres/Tenex
Strattera
7 Drugs for Treating______
ADHD
Few Simple Rules/Firm Limits
Avoid Fatigue/Overstimulation
REgular Daily Routine
Structured Environment
Treatment Plan for _____
ADHD
1st Line of treatment for ADHD
Methlyphenidate (Ritalin)
Stimulant used to treat for ADHD and Narcolepsy
A group of Disorders with common disabilities in (1) Social awareness (2) Communication Skills (3) Imaginative Play
Autism Spectrum Disorder (ASD)
Withdrawal of the child into the self and into the fantasy world of his creation
Imaginative Play
Autism appears in the first __ years of life
3
No medical detection
No known cure
Autism affects the brain’s normal development of ___ and _____ skills
Social
Communication
Autism happens in ____ out of every ___ children
1…110
More common than pediatric cancer, AIDS, and Diabetes combined
Autism is ___ times as many in boys than girls
4
Parents over ___ years old can have a child with autism
40
Have distinctive abilities in art, music, mathematics or memory
Autistic Savants
1% of the population
7x as many as people as classic autism; average to higher IQ
Asperger’s Syndrome
A pervasive developmental disorder defined by same social impairments and restricted stereotyped behaviors seen in autistic disorder but no LANGUAGE and COGNITIVE delays involved
Asperger’s Disorder
Type of Autism: Severely to mildly handicapped in cognition and intellect
Classic or Kanner Autism
Classic Autism is ____ times more common in boys than in girls
4
Unusual distress in changing routines
Repeated body movements
Unusual attachment to objects
Sensitive Senses
Are Signs or Symptoms of ____
Autism
Main problem of ADHD
Decreased Attention Span
Refers to Autistic behavior wherein one gets stuck on a single topic or
task
Perseveration
During Play, a child with Autism does not _______
Imitate the actions of others
A complication of Autism wherein a child has a developmental problem including learning disabilities & cognitive impairment.
Fragile X Syndrome
Growth of numerous
noncancerous benign tumors in many parts of the
body( Kidney tumors ) - life threatening
Tuberous Sclerosis
3 Medications for Autism
Methylphenidate chloride (stimulant) Opiate blockers (naltrexone/ReVia) Antidepressants (fluvoxamine/Luvox)
Described by John Langdon Down in 1866: a group
of children with common traits that differed
from other children with mental retardation.
Down’s Syndrome or Trisomy 21
aka mongoloid
Most common chromosomal abnormality affecting
children today
Down’s Syndrome or Trisomy 21
Down’s Syndrome occurs from the presence of ___ copies of _____rather than the normal ___
3…chromosome 21…2
What age category/gender is at risk of giving birth to babies with Trisomy 21
Older women
51% over age 35 of individuals with Trisomy 21 presented with _______
Dementia
What gender lives longer in clients with Trisomy 21?
Males
Why is Caffeine or Sugar not allowed for clients with ADHD?
Because of drug interactions
Why is Autism more common in boys?
Due to x chromosome mutation
A client may have autism if he/she is unable to (4)
Gesture (12 months)
Babble (12 months)
Say a word (16 months)
Say two words (24 months)
Teaches a specific and comprehensive system of autism treatment & education designed to help families and caregivers enable their children to dramatically improve in all areas of learning, development, communication and skill acquisition.
Son-Rise Program
2 Nursing Management for Children with autism
Parents should be around as much as possible
Allow objects the client is attached to
The most common form of chromosomal translocation in humans. It means that two chromosomes, the structures that make up a person’s DNA, join together in an abnormal way.
Robertsonian Translocation
3 Types of Down Syndrome
Trisomy 21 Mosaicism
Trisomy 21
Robertsonian Translocation
Difference between Trisomy 21 and Robertsonian Translocation in terms of Maternal Aging
Trisomy 21 - frequency of trisomy
increases with increasing maternal age
Robertsonian translocation- not related
to maternal age
Inherited Robertsonian Translocation can result in (4):
Monosomy
Normal Chromosomes
Trisomy
Carrier of the Translocation
Protruding Tongue is a clinical feature of ______
Down’s Syndrome
Children with Down’s Syndrome Sit, creep, and Walk approximately at the age _____ the normal age
Twice
Typical Heart Disease in Down’s Syndrome
AV Septal Defect
50% of those with DS have heart disease
4 Common eye problems with Down’s Syndrome
Strabismus
Refractory Error
Glaucoma
Cataract
In Down’s Syndrome which occurs more frequently? Hypothyroidism
Hyperthyroidism
Hypothryoidism
People with Down’s Syndrome are at an increased risk of excessive mobility of atlas (C1) and the axis (C2), which may lead to spinal cord compression injury, this is called ______
Atlantoaxial
instability
Due to Atlantoaxial
instability what should nurses say to the parents of children with Down’s Syndrome?
Avoid participation in contact sports
Common Sleep Disorder in Down’s Syndrome
Sleep Apnea
Palmoplantar hyperkeratosis Seborreic dermatitis Fissured tongue Cutis marmorata Xerosis ...are skin disorders common in clients with \_\_\_\_\_\_
Down’s Syndrome
Prenatal screening (amniocentesis, chorionic villus sampling (CVS), or percutaneous umbilical cord blood sampling, ultrasound) are diagnosis methods for\_\_\_\_\_\_\_
Down’s Syndrome
Growth Measurements for children with Down’s Syndrome will help in the prevention of _______ and early diagnosis of ______ and _______.
Obesity…Celiac Disease…Hypothyroidism
An eye exam should be
performed in the newborn period or at least
before____ of age to detect ______
and ______.
6 months…strabismus…cataracts
Hearing Screening should be done in the newborn
period, every ____ until ____of age and then
____
6 months…3 yrs…annually
Thyroid Function assessment should be done in newborn period and should be repeated at ___ and ___months , and then _____
6…12…annually
Celiac Disease
Screening should begin at ___
yrs. Repeat screening if signs/Sx develop.
2
Is inadequate growth resulting from inability
to obtain or use calories required for growth
Failure to Thrive (FTT)
Described as a condition rather than a
specific disease.
For FTT, measurements drop more than ____percentiles from baseline
2
For FTT weight and height persistently falls below the ____ to ____percentile on a standard growth
chart
3rd…5th
Type of FTT where weight is below standard
Acute FTT
Type of FTT where Weight, Height, and Length are below standard
Chronic FTT
Types of FTT
Acute FTT
Chronic FTT
_____ is the single most common cause
of FTT that results from___ and___
Under feeding…parental poverty…ignorance.
2 Categories for FTT Etiology
Organic causes
Inorganic causes
Cardiac Disease, celiac, chron’s, hepatic, etc. are what type of FTT cause?
Organic cause
Disturbance in the parent-child
relationship resulting in maternal role
insufficiency is what type of FTT cause?
Inorganic cause
4 FTT Pathophysiology Classifications
- Inadequate caloric intake
- Inadequate absorption
- Increased metabolism
- Defective utilization of calories
Premature birth Maternal Vices Mechanical problems Poor appetite Inadequate Intake Metabolic Abnormalities Poor Food Absorption Increased Nutrient Loss
…are what type of FTT cause
Organic cause
Causes due to caregiver’s actions are what type of FTT cause?
Inorganic Cause
The most common cause of FTT
Malnutrition
Prenatal factors such as Prematurity,
Exposure in utero to toxic agents,
and Intrauterine growth restriction from any cause may result to ________
FTT
Postnatal factors such as: Inadequate caloric intake Inadequate absorption Increased caloric requirement Defective utilization of calories ..may cause \_\_\_\_\_\_
FTT
During FTT, weight is lower than the _____ percentile
3rd
History Taking for FTT include______ or history of _______ in a 3-5 day period.
24h dietary recall…Food consumption
The _____ was devised to provide a simple method of screening for evidences of slow development in infants and preschool children
Denver Developmental Screening Test (DDST)
Assess the Degree of FTT:
Weight 75-90%
Mild
Assess the Degree of FTT:
Weight 60-74%
Moderate
Assess the Degree of FTT:
Weight <60%
Severe
Assess the Degree of FTT:
Height 90-95%
Mild
Assess the Degree of FTT:
Height 85-89%
Moderate
Assess the Degree of FTT:
Height <60%
Severe
Assess the Degree of FTT:
Wt/Ht ratio 81-90%
Mild
Assess the Degree of FTT:
Wt/Ht ratio 70-80%
Moderate
Assess the Degree of FTT:
Wt/Ht ratio <70%
Severe
Catch up growth for FTT is _ to _ times greater the
expected rate for age.
2..3
For FTT management Feeding interval should not be greater than __ hours and a maximum time allowed for
sucking should be_____ minutes
4.. 20
For FTT management ,older and young children meals should last for ___, solid foods should be offered
before liquid.
30 mins
For FTT what liquids should be avoided in excess?
Fruit juice
-Occur between the age of 6 and
60 months
-Temperature of 38C or higher
-Not the result of CNS infection or any metabolic
imbalance
-Occur in the absence of a history of prior afebrile seizures.
Febrile seizure
Febrile seizure is not the result of ___ infection
CNS
Febrile Seizures mostly resolves within ___ hours & require no treatment.
24
Is a fit that can happen when a child has a fever.
Febrile seizure
Febrile seizure is aka ____
Febrile convulsions
Relatively common and, in most cases, aren’t
serious
Age< 1 yr old
-is a ___risk factor for febrile seizure recurrence
Major
Duration of fever < 24hr
-is a ___risk factor for febrile seizure recurrence
Major
Fever 38-39 C
-is a ___risk factor for febrile seizure recurrence
Major
Family history of febrile seizures
-is a ___risk factor for febrile seizure recurrence
Minor
Family history of epilepsy
-is a ___risk factor for febrile seizure recurrence
Minor
Complex febrile seizure
-is a ___risk factor for febrile seizure recurrence
Minor
Male gender
-is a ___risk factor for febrile seizure recurrence
Minor
Lower serum sodium
-is a ___risk factor for febrile seizure recurrence
Minor
3 Types of febrile seizure
Simple febrile seizure
Complex febrile seizure
Febrile status epilepticus
The most common type of febrile seizure
Simple febrile seizure
8 out of 10 cases
Simple febrile seizure is a fit that: is a\_\_\_\_ seizure lasts \_\_\_\_\_\_ minutes doesn't reoccur within \_\_\_or the period in which the child has an illness
tonic clonic…less than 15…24 hours
The stiffening of muscles
Tonic
During _____ seizures , the mouth snap shuts, tongue may be injured… and there is increased salivation
Tonic
Type of simple febrile seizure that lasts 10-30 seconds
Tonic seizures
upward rolling of eye balls loss of consciousness may fall when standing cyanotic ..are due to \_\_\_
Tonic seizures
Rigidity is replaced by intense jerking
movements
Clonic
Type of Simple febrile seizure where there is a generalized contraction of entire body
Tonic seizure
Type of Simple febrile seizure where there is Uncontrolled oral secretions
Clonic Seizure
Simple Febrile Seizures that last 30-50 seconds
Clonic Seizures
Trunk and extremities undergo rhythmic
contraction & relaxation
Incontinence of urine and feces
is due to ______
Clonic Seizures
______ seizures cause a stiffening of muscles while ____ seizures are characterized by jerking or twitching
Tonic…clonic
Type of Seizure where it lasts longer than 15 minutes
Complex Febrile Seizure
Type of Seizure where the child only has symptoms in one part of their body
Complex Febrile Seizure
aka Partial or focal seizure
Type of Seizure where the child has another seizure within 24 hours of the first seizure,
or during the same period of illness
Complex Febrile Seizure
Type of Seizure where the child doesn’t fully recover from the seizure within one hour
Complex Febrile Seizure
Type of Seizure:
Less common
2 out of 10 cases
Complex Febrile Seizure
Type of Febrile Seizure that is
Rare and is Continuous or in series
Febrile status epilepticus
Type of Febrile Seizure that Lasts longer than 30minutes
Febrile status epilepticus
Type of Febrile Seizure where the child does not regain premorbid Level of Consciousness
Febrile status epilepticus
Treatment should begin within 5 minutes
The main symptom of a febrile seizure is _____that occurs while a child has a fever.
a Fit
Febrile seizures often occur during the ___
day of a fever, which is defined as a high
temperature of ____ or above.
1st…38C (100.4F)
Simple Febrile Seizures usually lasts _____ minutes
Less than 5
Type of seizure that tend to last longer than 15 minutes, only affect one area of the child’s
body, and recurs within 24 hours or
during the period in which the child is ill.
Complex Febrile Seizure
Exact cause of Febrile Seizure
Unknown
2 First Aid Medications for Febrile Seizures
Diazepam
Midazolam
Recommended in children less than 12mo of age after
their first febrile seizure to rule out meningitis
Lumbar Puncture
Why is it important to consider if the child has
received prior antibiotics before Lumbar Puncture
It would mask the clinical symptoms of Meningitis
The presence of an identified source of fever , such as
otitis media , does not eliminate the possibility of
_____
Meningitis
_____are the major sign of meningitis in 13-15% of
children
Seizures
In drawing CSF samples _____ is sent to the chemistry laboratory for glucose and
protein.
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