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NRSG 421 > Week 2 - maternity/ peds > Flashcards

Week 2 - maternity/ peds Flashcards

1
Q

What are the developmental stages for infants (0-3 months)?

A
  • raising head
  • controlling head
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2
Q

what are the developmental stages for infants (3-6 months)?

A
  • sitting
  • starting to roll
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3
Q

what are the developmental stages for infants (6-9 months)?

A
  • crawling
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4
Q

what are the developmental stages for infants (9-12 months)?

A
  • walking
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5
Q

what are the developmental stages for toddlers (12-24 months?

A
  • autonomy vs. discipline
  • no
  • talking
  • walking
  • dancing
  • parallel play
  • follow simple demands
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6
Q

what are the developmental stages for preschoolers (2-5 years)?

A
  • initiative vs. guilt
  • making friends
  • learning
  • sight words
  • colours
  • shapes
  • lots of emotions not sure what to do with them
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7
Q

what are the developmental stages for school age (5-12 years)?

A
  • abstract thinkers
  • deeper understanding of relationships/ other people
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8
Q

what are the developmental stages for teenagers (13-18 years)?

A
  • identity vs. role confusion
  • who are you in the world
  • gaining independence
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9
Q

What is bronchiolitis?

A
  • swelling/ inflammation of bronchiole
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10
Q

what causes bronchiolitis?

A
  • viral infection
  • normally RSV or influenza
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11
Q

at what age can children get bronchiolitis?

A

6 months - 2 years

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12
Q

what are the signs and symptoms of bronchiolitis?

A
  • low grade fever
  • cough
  • tachypnea
  • use of accessory muscles
  • wheezing
  • increased sleep
  • difficulty eating
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13
Q

RSV is the leading cause of what in inflants?

A
  • pneumonia
  • bronchiolitis
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14
Q

what is used to diagnose bronchiolitis?

A
  • CXR
  • nasopharyngeal swab
  • blood work
  • ABGs
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15
Q

what is used to treat bronchiolitis?

A
  • humidifier
  • up to date on vaccinations including family members
  • O2 therapy
  • oral fluids or IV if child wont drink
  • encourage hand hygiene
  • bronchodilators
  • antivirals
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16
Q

What is the most common emergency abdominal surgery in children?

A

appendicitis

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17
Q

what is appendicitis?

A

inflammation of the appendix which is a small finger like appendage attached to the cecum

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18
Q

what are some symptoms of appendicitis you might see in children ?

A
  • localized RLQ pain
  • low or high fever
  • bloating
  • rebound tenderness
  • guarding
  • vomiting
  • diarrhea
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19
Q

how is appendicitis diagnosed in children?

A

ultrasound with WBC count

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20
Q

what complications can result from appendicitis in children ? List them in the order they would appear

A
  • rupture of appendix
  • abscess
  • peritonitis
  • sepsis/ septic shock
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21
Q

what is included in the treatment of appendicitis in children ?

A

-may be sent home: rest c ABX or may do surgery
- if ruptured: surgery plus 7-10 days abx and/ or NG suction

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22
Q

what is a major problem with appendicitis in regards to children?

A
  • can’t vocalize/ explain pain properly
  • hard to get kids to localize pain therefore harder to diagnose
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23
Q

what Is type 1 diabetes?

A
  • autoimmune disorder
  • occurs in genetically susceptible individuals who may be exposed to chemicals, viruses, toxic agents
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24
Q

what is type 1 diabetes characterized by?

A
  • autoimmune destruction of the pancreatic beta cells that produce insulin
  • results in absolute insulin deficiency
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25
why is insulin needed in type 1 diabetes?
- support metabolism of carbs, fats, proteins - moves substances into the cells from the blood
26
insulin glucose metabolism is essential for what?
- growth - activity - wound healing - brain function
27
when is type 1 diabetes most commonly diagnosed in children?
- winter months - 8-10 years old
28
what assessment findings are used to diagnose a child with type 1 diabetes?
- weight loss (as much as 30%) - polyuria - thirst - ketones in blood and or urine
29
what leads to polyuria and thirst for people with type 1 diabetes?
elevated blood glucose leads to osmotic diuresis
30
what presenting symptoms might you see in a child with type 1 diabetes? explain each one
hyperglycemia - glucose in blood stream glucosuria - sugar in urine polyuria - increased urine output electrolyte imbalance - from dehydration polydipsia - attempt to relieve dehydration polyphagia - attempt to compensate for lost calories
31
what diagnostic tests are used when determining if a child has type 1 diabetes?
- elevated blood sugars - urine sample - glucose tolerance test
32
when testing a child for type 1 diabetes what do you expect the results to be for a urine test?
- glucosuria - possible ketonuria
33
when testing a child for type 1 diabetes what do you expect the results to be for a glucose tolerance test?
low insulin levels with elevated glucose levels
34
what are nursing interventions we want to do when a child with type 1 diabetes first comes in?
- monitor blood glucose levels - once fluids stable THEN add insulin
35
what are short term goals for the management of type 1 diabetes in children?
- prevent development of ketosis - prevent electrolyte abnormalities/ volume depletion secondary to osmotic diuresis - prevent impairment of leukocyte function - prevent impairment of wound healing
36
what are long term goals for the management of type 1 diabetes in children?
- prevent microcirculatory and neuropathic changes - maintain blood glucose levels in target levels
37
what are the target levels for blood glucose in children under 6 years old with type 1 diabetes?
6-12 mmol/L
38
what are the target levels for blood glucose in children 6 -12 years old with type 1 diabetes?
4-10 mmol/L
39
what are the target levels for blood glucose in children 13-18 years old with type 1 diabetes?
4-7 mmol/L
40
what is included in hospital interventions regarding the management of type 1 diabetes in children?
- insulin admin - check blood glucose levels before every meal and every morning - dietary management - monitor A1C concentration for 2-3 months
41
what are home interventions parents can do while managing a child with type 1 diabetes?
- blood glucose levels - carb count - exercise - illness prevention - sick day protocol
42
what is preeclampsia?
- complication of pregnancy - mother gets high BP after 20 weeks gestation with high level of protein in urine
43
what causes preeclampsia?
- age - potential toxic sources - autointoxication - uremia - pylenophritis
44
what are the signs and symptoms a pregnant woman might have preeclampsia ?
- hypertension - proteinuria - edema - sudden weight gain 2lbs/ week - SOB - increased liver enzymes - change in vision - oliguria (late sign) - N/V - upper abdominal pain - severe headache
45
what diagnostics are used to determine if a pregnant women has preeclampsia ?
- urine test - ultrasound - stress and non stress tests - test results may suggest HELLP syndrome
46
what is HELLP syndrome?
H - hemolysis EL - elevated liver enzymes LP - low platelet count
47
what is HELLP syndrome a sign of?
damage to another organ system but most often liver and kidney damage
48
what are some strategies to prevent preeclampsia ?
- adequate nutrition - good prenatal care - control of preexisting hypertension
49
what are some treatments and interventions that can be done for preeclampsia ?
- complete bed rest - antihypertensive drugs (methyldopa, hydralazine) - magnesium supplements to promote diuresis
50
what complications can result from preeclampsia?
- eclampsia - seizures
51
what is postpartum hemorrhage ?
any blood loss from the uterus that exceeds 500ml during a 24-hour period
52
what are the causes of a postpartum hemorrhage?
- lack of muscle tone in uterine - retained placental tissue - laceration - hematoma - inversion - rupture - thrombin
53
What are the risk factors associated to postpartum hemorrhage ?
- hypovolemic shock - previous PPH - over-distension of uterus - prolonged labor - induce/ augmented labor - operative birth
54
what are the signs and symptoms of postpartum hemorrhage ?
- signs of hypovolemic shock - restlessness - light headedness - dizziness - large blood loss - increased HR - shallow rests - pale skin - weak thready pulse
55
what diagnostic tests are used to determine if the pt is suffering from a postpartum hemorrhage ?
- decreased hemoglobin - decreased hematocrit - decreased platelet count - decreased fibrinogen - longer clotting time - increased D-dimer
56
how do you treat a postpartum hemorrhage?
- fundal massage - assess/ empty bladder - breastfeeding > oxytocin release - medication - surgical intervention - fluids
57
what types of fluids would be given to treat a pt with postpartum hemorrhage?
- IV fluids - volume expanders - transfusion
58
what types of medications would be given to a pt with a postpartum hemorrhage ?
- oxytocin - ergometrine - hemabate - misoprostol
59
what does the medication ergometrine do for a pt with a postpartum hemorrhage? What is it contraindicated with?
- causes smooth muscle tissue in the blood vessel walls to narrow - reducing blood flow - can be used secondary to uterine atony - contraindicated in hypotension
60
what does the medication hemabate do for a pt with a postpartum hemorrhage? What is it contraindicated with?
- oxytocic - prostaglandin that stops bleeding
61
what does the medication misprostol do for a pt with a postpartum hemorrhage? What is it contraindicated with?
- prostaglandin - increases uterine tone and decreases postpartum bleeding
62
what is jaundice?
yellowing of the skin in infants
63
when does jaundice occur in babies? what is its peak? When should it disappear?
- day 2-4 of life - peak 4-6 days - disappears after 2 weeks
64
why types of stools are normal for jaundice babies?
loos frequent green stools
65
what complication can jaundice result in? explain it.
- kernicterus - permanent brain damage when unconjugated bilirubin crosses blood brain barrier
66
how do you treat jaundice?
- phototherapy - increased maternal feeding - albumin infusion - IV globulin
67
when treating a baby diagnosed with jaundice, what does an albumin infusion do?
assists in binding bilirubin and facilitates its removal
68
what causes jaundice?
- blood cells broken down and proceed waste (bilirubin) - if liver isn't fully developed can't detoxify bilirubin - bilirubin then builds in body
69
what are other signs of jaundice in a baby?
- very few wet or dirty diapers - not eating well - not gaining weight - shrill/ high pitched cry - cannot be comforted
70
what type of baby always gets jaundice?
pre-term babies
71
how do you screen for jaundice in babies?
- transcutaneous bilirubin - total serum bilirubin blood test
72
describe a transcutaneous bilirubin screening test
- measures yellowness of subcutaneous tissue - non-invasive - immediate results
73
when would you do a total serum bilirubin blood test on a baby with potential jaundice?
when a transcutaneous bilirubin measurement exceeds a certain limit
74
when is a total serum bilirubin blood test done?
- within 24 hours after birth - blood sample taken from heel stick
75
how do you treat jaundice ? list in order
- blue light phototherapy - blood transfusion

NRSG 421 (6 decks)

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