Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
70 Cards in this Set
- Front
- Back
|
Mis-aligned
-Involves the eyeball being in the wrong place, not the muscle -Usually bilateral -No depth perception -Requires surgery |
Strabismus
|
|
|
One eye points in
- |
Esotropia
|
|
|
One eye points out
|
Exotropia
|
|
|
One eye points up
|
Hypertropia
|
|
|
One eye points down
|
Hypotropia
|
|
|
Pink eye
-No 1 problem in children -Most contagious -Allergic: Not contagious, rubbing can turn it into viral or bacterial -Viral: White stuff under eye, keep wiping with cloth and throw away -Bacterial: Yellow stuff, eyes stuck together, white part gets red, can be 1 or 2 eyes, antibiotic drops to treat |
conjuctivitis
|
|
|
Usually checked at age 3 includes ophthalmic exam and continued
checked through school |
Visual Acuity
|
|
|
-Middle ear infection
-Getting them over and over can cause hearing impairment and language deficit -Fluid stays in Eustachian tube -Pain is worse when lying down -Accompanies stuffy nose -Happens when they begin to teeth -Antibiotics to treat -Decongestants may help also Tylenol and Ibuprofen |
Oitis Media
|
|
|
Pressure equalizing tubes
-Used to drain fluid from ear -Biggest problem is water in tubes -Use ear plugs or silly putty when swimming, showering -Should not bleed but should see a little fluid |
Tympanostomy Tubes
|
|
|
Incision of the tympanic membrane, done before
inserting tubes |
Myringotomy
|
|
|
-Inflammation of the skin surrounding the ear canal
-Swimmers ear -Ear canal is swollen -Use eyedropper with a little rubbing alcohol to get water out -Antibiotics used sometimes, don’t use cotton and keep head out of water |
Oitis Externa
|
|
|
The common cold
-Can turn into sinusitis |
Nasopharyngitis
|
|
|
From common allergies
|
Allergic Rhinitis
|
|
|
Inflammation of the sinuses
-Antibiotics: teach parents how to administer |
Sinusitis
|
|
|
Nosebleed
-Caused by dryness, allergies, picking, trauma -Humidify air, put vaseline under nose -Lean forward and squeeze to stop bleeding -5 minutes bleeding is too long -Cauterize superficial vessels if having chronic nosebleeds |
Epistaxis
|
|
|
-No liquid in mouth at first
-Will have G-tube at first -Provide emotional support for parents -Teach about feeding, special nipples and risk for aspiration Post Op Teaching -Suture line – clean intact (hard to do) -Elbow restraints -NPO -No sucking pacifier or thumb with sutures -Comfort measures -Developmental needs |
Cleft Lip and Palate
|
|
|
-Avoid spicy foods
-Usually occur with certain medications or diseases -Keep mouth clean and use topical anesthetics |
Mouth Ulcers
|
|
|
-Infants up to 6 wks have no immunity against
-Acyclovir used as treatment |
Herpes Simplex I (Cold Sores)
|
|
|
-Baby’s need baby toothbrush and toothpaste
-Need to see dentist at age 3 -Need fluoride if not in water already -Use pacifier designed to not affect teeth -Try to reduce thumb sucking (moves teeth) -No bottle at bedtime (go from formula to water, wont want it anymore) |
Dental Hygiene
|
|
|
-Mouth guards
-Put in milk or cool water -Take to dentist, puts baby teeth back in for spacing for permanent teeth -Chipped or broken, can replace with new permanent tooth |
Teeth Trauma
|
|
|
-Barking cough
-Virus (just treat symptoms) -Use cool mist vapor or hot water in bathroom -Call squad if this doesn’t help and having trouble breathing -Complication: epiglotitis (swollen tongue) -No tongue depressor used in assessment -Tripod position for better breathing -Drooling -Rapid respirations |
Croup
|
|
|
-Can turn into kidney infection, osteoarthritis, rheumatic fever if penicillin
resistant |
Strep Throat / Tonsillitis
|
|
|
-Enteroviris
-Blisters -Rinse with salt water -Cool liquids |
Herpangina
|
|
|
-Comfort measures r/t symptoms
-NO ASA -Double dosing (Tylenol and Advil) |
Pain Relief
|
|
|
-Smaller airways
-Shorter trachea -Difference in bifurcuation – angle of right bronchus more acute -Less distance to lungs -Increased lymph tissue back of throat (tonsils) -Smaller oral cavity (obstructed) -Smaller nasal cavity (occluded) -Increased exposure to communicable respiratory diseases (school, child child care, siblings, poor hygiene practices) -Nose breathers / mouth breathers (infants cant eat and breathe at the same time -Use abdominal muscles to breathe instead of thoracic muscles -Increased O2 requirements -> increased metabolic rate |
Children Are More Vulnerable to Respiratory Problems
|
|
|
-Rhinovirus
-Virus (treat the symptoms) -Nursing Care: comfort, ease breathing, fluids, prevent complications |
Common Cold
|
|
|
-Allergies (drugs, environment, food)
-Allergic “salute” -Allergic “shiners” -Headache, toothache |
Sinusitis
|
|
|
-Viral: usually accompanies cold
-Bacterial: strep -Scarlet fever: strep + rash on trunk (belly rough like sandpaper) -Tonsillitis -Penicillin resistant strep |
Pharyngitis
|
|
|
-Viral
-Classic symptom: bark -Change of seasons / weather -Humidity / barometric pressure -Complication: epiglottis: emergency -Tripod position (promotes breathing) |
Croup
|
|
|
Occurs low in the chest
|
influenza
|
|
|
-Allergic or infectious
-Loose cough -Occurs high in the chest |
Bronchitis
|
|
|
-Crib without clutter
- <6 months more vulnerable -Preterm infants at higher risk -Put on back to sleep -No pillows |
Sudden Infant Death Syndrome
|
|
|
complication pneumonia
|
influenza
|
|
|
-Bronchiolitis: less severe
-RSV: more severe -Chest cold -Loose secretions -Worse in preterm infants -Need to rest lungs -Ventilator: because they will stop breathing very quickly *clue* -Ribavirin (inhaled medication) (not good for pregnant women pregnant nurses can’t have pts who need this -Vaccine – 5 monthly doses (RespiGam, Synagis) get every 2 years if a prone |
Bronchiolitis / Respiratory Syncytial Virus (RSV)
|
|
|
-Highly contagious
-Exhaustion from coughing, causes respiratory distress because they will just stop breathing -Tylenol or Ibuprofin before giving DTap -Treat with Erthyromycin -Vaccine: DTap (becomes inactive after age 6) -Boostrix: reactivates immunity from DTap in kids older than 6 |
Pertussis (Whooping Cough)
|
|
|
-Reactive Airway Disease
-Chronic -Inflammation, irritation, obstruction -9 Million children affected in U.S. -Muscles tighten in airway and get inflamed -Triggers: allergens, environmental, stress -Classic symptom: wheezing -Chest tighness -Shortness of breath -Mild Intermittent: comes and goes -Mild Persistant: >2 times a week day and night -Moderate Persistent: Daily and nightly -Severe Persistent: All day and night -Quick relief: Albuterol (check pulse! makes child hyper -Long term control: Chromolyn Sodium (intal) |
Asthma
|
|
|
-Persistant, inhaled treatment not working, moving toward respiratory
failure… arrest -Epinephrine SubQ |
Status Asthmatucus
|
|
|
-Inhaled steroids: Fluticasone
-Systemic Steroids: Prednisone / Prelone -Bronchodilators -Singulair -Antibiotics -Allergy Injections -Need testing to see if allergies changed, can grow out of |
Asthma Medications
|
|
|
-Congenital: pale, thin, delayed growth
-Chronic -All secretions in body are thick -Respiratory – chest PT -Digestive system – enzymes -Pancreas – diabetes because insulin is thick -Respiratory system – chest percussion therapy chronic hypoxia (clubbing) -Digestive System enzymes thick -Do not absorb food -Postural drainage -End up with a dead pancreas |
Cystic Fibrosis
|
|
|
-Respiratory distress: trouble breathing, characteristics/observations
-Respiratory Failure: Lack of o2 to tissues and organs, characteristics/ observations -Respiratory Arrest: No respirations -Anxious, retractions, drooling, respiratory failure if don’t intervene increased HR |
Complications of Respiratory Alterations
|
|
|
A syndrome or disease process of the brain causing distorted and
bizarre thoughts, perceptions, emotions, movements, and behavior |
Schizophrenia
|
|
|
delusions, hallucinations, grossly disorganized thinking, speech and
behavior, loose associations, clanging |
Positive
|
|
|
Flat affect: not happy or sad
Avolition: No motivation Social withdraw or discomfort Apathy Alogia: no speech |
Negative
|
|
|
-False belief that has no bases for reality
-Persicution: Someone or something is out to get them -Granger: Have contacts in high places, very important -Religiosity: Pre occupied with what (God) tells them -Psumatic: Worms eating up inside (example) -Reference: Controlled by things outside of self |
Delusions
|
|
|
-See something that is not there, sensory perceptions
-Not an unhealthy response in healthy people, but they can correct the misconception -Auditory: hearing things -Visual: seeing things -Olfactory: smell, greatest risk for behavior -Gustatory: Taste -Somatic: Tactile, feel things on them -Command: Receiving commands to do something |
Illusion
|
|
|
-Persecutory or grandiose, delusions and hallucinations
-Bad things are happening, people are trying to hurt them -Can’t talk them out of it -Defense Mechanism: projections (put feelings of self on someone else and think that is what the other person thinks about them -Idea of reference: all refers to them -Thought broadcasting: I know what you are thinking! -Thought Insertion: Thinks people can put thoughts in their head -Thought Withdraw: People can take thoughts out of their head |
Paranoid Schizophrenia
|
|
|
-Inappropriate or flat affect
-Incoherence, loose associations -Extremely disorganized behavior -Affects day to day functioning -Inappropriate responses -Cannot live alone -Family needs to support -Vague delusions and hallucinations -Social withdraw |
Disorganized Schizophrenia
|
|
|
-Marked psychomotor disturbances
-Waxy flexability -Peculiarities of movement or speech (echopraxia, echolalia) -Agitated purposeless movement -Mute |
Catatonic Schizophrenia
|
|
|
-Mixed schizophrenia symptoms along with disturbances or thought, affect
and behavior Residual Schizophrenia -At least one previous psychotic episode but not current -Social withdraw, flat affect, loose associations -Older people: have for a long time, no active hallucinations or delusions but negative s/s are there |
Undifferentiated Schizophrenia
|
|
|
-Onset often slow and gradual (men in early teens, women in 20s)
-In first years after diagnosis, client may have relatively symptom-free periods between psychotic episodes or fairly continuous psychosis with some shift in severity of symptoms -Many clients with schizophrenia have difficulty functioning independently in the community -Early detection and aggressive treatment of the first psychotic episode improves outcomes |
Clinical Course
|
|
|
-2 or more are present for significant portion of previous month (delusions,
hallucinations, disorganized speech, negative s/s -Social or occupational dysfunction -Continuous signs of disturbance persist for at least 6 months -Disturbance not due to physical effects of a substance or a medical condition -Not occurring in relationship to pervasive development D/O unless delusions or hallucinations are also present for at least 1 month |
Schizophrenia: DSM IV Criteria
|
|
|
Symptoms of schizophrenia are experienced
for less than the 6 months required for a diagnosis of schizophrenia |
Schizophreniform Disorder
|
|
|
Symptoms of psychosis and thought disorder
along with all the features of a mood disorder |
Schizoaffective Disorder
|
|
|
Does not interfere with functioning
|
Delusional Disorder
|
|
|
S/S of schizo are there for about a month then
back to normal and does not come back. Identifiable stressor |
Brief Psychotic Disorder
|
|
|
-Ideas that are considered delusional in one culture may be commonly
accepted by other cultures -Ethnicity may be a factor in the way a person responds to psychotropic meds -Black, whites, Hispanics appear to require comparable therapeutic doses of antipsychotic medications -Asian clients need lower doses of drugs to have same effects |
Cultural Considerations
|
|
|
-Primary treatment involves antipsychotic meds
-Conventional antipsychotics target positive symptoms but have no affect on negative symptoms -Thorazine, Haladol, Prolixin, -Primary treatment may involve another group of antipsychotic medications -Atypical Antipsychotic medications diminish positive symptoms, and also lessen the negative signs |
Treatment
|
|
|
-Two antipsychotic are available in depot injection forms for maintenance
therapy -Prolizin, Haldol -Atypical antipsychotic: Risperdal constal |
Maintenance Therapy
|
|
|
-Neurologic Side Effects: Extrapyramidal (acute dystonia, akathisia,
psudo-parkinsonism) -Tarditive Dyskinesia -Seizures -Neuroleptic Malignant Syndrome -Non Neurologic Side Effects: weight gain, sedation, photosensitivity, -Anticholinergic Symptoms: dry mouth, blurred vision, constipation, urinary retention -Orthostatic Hypotension -Agranulocytosis (clozapine) |
Side Effects of Antipsychotic Medications
|
|
|
very guarded and mistrustful, believes the thought process
help to develop trust, acknowledge that you understand that the things are real to them |
Delusions
|
|
|
olfactory is most dangerous because
of commands. Hallucinations (what are they telling you?) |
Sensorium and intellectual process
|
|
|
no sense of safety ability to be safe,
insight: what causes it and what it takes to be well and sick -Self Concept -Roles and relationship |
Judgement and insight
|
|
|
(water intoxication -> sodium depletion, monitor
and regulate intake) (difficulty sleeping) |
Self care considerations
|
|
|
-Risk for other-directed violence
-Risk for suicide -Disturbed thought process -Disturbed sensory perception -Disturbed personal identity -Impaired verbal communication |
Positive Symptom Diagnosis
|
|
|
-Self care deficits
-Social isolation -Deficient diversional activity -Inefective health maintenance -Ineffective therapeutic regimen management |
Negative Symptom Diagnosis
|
|
|
-I understand you are experiencing this
-Build trust -I don’t perceive that but I understand you do -never play along with them -Here to help, your medicine will help |
Interventions for Delusional Thoughts
|
|
|
-Rate intensity
-Subjective -Reinforce safety -When meds are helping; what was happening, how are you feeling? -Distract (earplugs, tune out, talking to voices, chemicals make it worse, exercise, stay healthy, sleep, containing, keep record, relaxation techniques) |
Interventions for Hallucinations
|
|
|
-Point out boundaries
-Comments (remind of acceptable ones, ignore, draw away to positive behavior) -Protect other clients -Reintroduce to larger setting after being away as soon as possible |
Protecting Client with Socially Inappropriate Behavior
|
|
|
-Psychotic symptoms that appear in later life are usually associated with
depression or dementia, not schizophrenia -Elderly people with schizophrenia experience a variety of long term outcomes 20%-30% of clients experience dementia, resulting in a steady, deteriorating decline in health 20%-30% experience a reduction in positive symptoms, sort of like a remission 40%-60% remain mostly unchanged |
Elder Considerations
|
|
|
-Asservive community treatment (ACT)
-Behavioral home health -Community support programs -Case management |
Community Based Care
|
