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;
101 Cards in this Set
- Front
- Back
|
When assessing a newborns head, how many fontanels are there?
|
Anterior Fontanel (Shaped like a diamond)
Posterior Fontanel (Shaped like a triangle) |
|
|
When do the fontanels close?
|
Anterior Fontanel closes by 18 months.
Posterior closes by 3 months. |
|
|
What does it mean if the fontanels are sunken in?
|
Not enough fluids in them (dehydration)
|
|
|
What does it mean if the fontanels are bulging?
|
Fluid build up---Intracranial pressure
|
|
|
When assessing a newborn's ears, what would low set ears mean?
|
Down syndrome
|
|
|
How do you measure to determine if infants ears are low set?
|
Top of the ears should be in line with the outer canthus of the eye
|
|
|
If a newborn has Respiratory Distress. What are some of the causes?
|
Congenital anomalies that usually involve the esophagus
Undeveloped organs and surrounding structures (lungs) Inhaling amniotic fluid containing meconium (aspiration) |
|
|
What are the signs and symptoms of Respiratory Distress?
|
1.) Nasal Flaring
2.) Expiratory Grunting 3.) Retractions (an inward movement of the tissue over the sternum and intercostals muscles) *Suprasternal (above the sternum) *Substernal (below the stermum) *Supraclavicular (above the clavicles) *Intercostal (between the ribs) *Subcostal (below the ribs) 4.) Apneic Spells (20 seconds or longer) 5.) Tachypnea RR>60 6.)Central Cyanosis |
|
|
What interventions should be donefor Respiratory Distress?
|
Observe frequently for signs of respiratory distress and report immediately to the RN and physician
|
|
|
How much does a newborn’s stomach hold when it is first born?
|
20mL
|
|
|
Why is breast milk preferred over formula?
|
Baby:
*Breast milk contains easily digested nutrients and antibodies that can protect against some infections *Colostrum is rich in protein, calories, and immune globulins *Lower incidence of allergies *Lower incidence of SIDS Mother: *Decrease incidence of ovarian, uterine, and breast cancer *Promotes involution *Return to pregnant weight sooner *Unique bonds experience *Convenient *Saves money |
|
|
What is Patent Ductus Arteriosis?
|
•Occurs when the ductus arteriosus fails to close. Blood is pushed from the aorta to the pulmonary artery, resulting in an increase in blood flowing to the lungs.
•The increase in blood blowing to the lungs causes right ventricle hypertrophy and increased pressure in the pulmonary circulation. •Closure is initiated with the first breath, and it normally occurs within 15 hours after the birth but can take up to 3 months. |
|
|
What is Atrial Septal Defect? (ASD)
|
•The opening of the septum (wall) between the left and right atria that remains with the foramen ovale fails to close within a few hours after birth.
•Blood flows directly from the left atrium into the right atrium, increasing the amount of blood in the right side of the heart. •Increased pressure on the right side of the head results in ventricular hypertrophy and increased pulmonary artery blood flow. |
|
|
What is Ventricular Septal Defect? (VSD)
|
•Results from an abnormal opening in the septum between the ventricles.
•This allows blood to flow directly from the left ventricle to the right ventricle. •The size of the VSD determines the degree of problems the child will have. |
|
|
What is Tetrology of Fallot? (TOF)
|
•Is a combination of four defects: pulmonary stenosis, VSD, right ventricular hypertrophy, and an overriding aorta.
|
|
|
What is Coarctation of the Aorta?
|
•Is a narrowing of the aorta.
•Most common site of narrowing is in the arch of the aorta. The narrowed area restricts the flow of blood to the body. •The left ventricle must work hard to force blood through the narrowed aorta. •Over time, the obstruction leads to congestive heart failure. •With coarctation of the aorta, blood pressure will usually be higher in the arms than in the legs |
|
|
What is Pulmonary Stenosis?
|
•A narrowing of the pulmonary value.
•As the right ventricle tries to push blood through the tight pulmonary valve, the ventricular muscle enlarges (right ventricular hypertrophy). As pressure in the right ventricle rises, blood is pushed through the VSD into the aorta, where it mixes with oxygenated blood from the left ventricle and is pumped throughout the body. •The mixing of oxygenated and unoxygenated blood results in the common symptom of cyanosis. |
|
|
What is Transposition of the Aorta?
|
•When the positions of aorta and pulmonary artery are reversed. Unoxygenated blood enters the right side of he heart, travels through the right ventricle, moves out of the heart through the aorta, and flows back to the body.
•The oxygenated blood from the lungs enters the left side of the heart, travels through the left ventricles, moves out of the heart through the pulmonary artery, and flows back to the lungs. •Unoxygenated blood becomes increasingly depleted of oxygen and is an immediate threat to the newborn’s life. |
|
|
What is Aortic Stenosis?
|
•The aorta is the main artery leaving the heart.
•When blood leaves the heart, it flows from the lower chamber (the left ventricle), through the aortic valve, into the aorta. •In aortic stenosis, the aortic valve does not open fully. •This restricts blood flow. |
|
|
What are the signs and symptoms of Aortic Stenosis?
|
•Chest pain (angina) or tightness
•Feeling faint or fainting with exertion •Shortness of breath, especially with exertion •Fatigue, especially during times of increased activity •Heart palpitations — sensations of a rapid, fluttering heartbeat •Heart murmur |
|
|
With Cleft Lip and Palate, when is surgical closure done?
|
First 3 months of life
|
|
|
Pre-surgical closure what precautions should be taken when feeding the child?
|
•Baby must be fed.
•Special feeding equipment such as a long nipple with enlarged holes or a Breck feeder (syringe with a rubber tube) may be used |
|
|
What complications are possible with Cleft Lip and Palate?
|
•Aspiration
•Malnutrition •Obstruction |
|
|
What is Hypospadius?
|
Condition that occurs when the urethra opens on the ventral (lower) surface of the penis
|
|
|
What is Epispadius?
|
Condition that occurs when the urethra opens on the dorsal (upper) surface of the penis
|
|
|
What are the types of Spina Bifida?
|
•Occultra (Little dimple and tuff of hair above coccyx)
•Meningocele (A saclike protrusion through the bony defect in the spinal column containing meninges and cerebrospinal fluid) •Myelomeningocele (Saclike herniation through the defect holding meninges, cerebrospinal fluid, and portion of spinal cord or nerve root) |
|
|
What interventions should be done for a child with Spina Bifida before and after surgery?
|
Before surgery:
•Critical to protect the integrity of the sac until surgical correction is done. •Keep sac moist with sterile towels. •Keep child in prone or side position. •Keep warm Emotional care, tactile stimulation. •Feeding After surgery: *Observe closely for signs of infection, bowel and bladder function, and movement of extremities. •Position in prone, side lying, hold upright. •Passive range of motion exercises. •Clean intermittent catheterization |
|
|
What complications might occur before and after surgery for patients with Spina Bifida?
|
•Occultra-none
•Meningocele & Myelomeningocele-Flaccid paralysis, Bowel and bladder incontinence, Sensory deficits |
|
|
What is Hydrocephalus?
|
•Results from increased production, decreased absorption, or blockage of the flow of cerebral spinal fluid (CSF).
•Chari II malformation. •Dandy-Walker Syndrome |
|
|
What are the signs and symptoms of Hydrocephalus?
|
•Child’s head circumference being greater than normal, with the forehead and top of the head being out of proportion to the face.
•The anterior fontanel bulges with the increasing intracranial pressure (ICP). The sclera of the eyes often can be seen above the iris giving a “setting sun” appearance. •Child may be irritable or lethargic and experience nausea and vomiting because of increased ICP. |
|
|
What are the interventions of Hydrocephalus?
|
a.Surgical placement of ventriculoperitoneal shunt
b.Measure head circumference regularly c.Monitor for increased intracranial pressure d.Prevent skin breakdown, proper positioning e.Give small, frequent feeding |
|
|
What is SIDS?
|
Sudden Infant Death Syndrome. The sudden unexplained death of an infant younger than 1 year.
|
|
|
How does SIDS occur?
|
•Unknown
•The infant is typically found not breathing, and emergency medical help is summoned. |
|
|
When does SIDS usually occur
|
•most common in Native American Infants, followed by African American, Hispanic, white, and In premature infants
•Low birth weight •Twin or triplet birth •Race Asian infants •Gender: more common in males •More prevalent in winter months •Exposure to passive smoke •History of cyanosis, respiratory distress, irritability, and poor feeding in the nursery •Sleeping prone |
|
|
What is Cystic Fibrosis?
|
•Is an inherited recessive disorder of the exocrine glands affecting predominantly white children.
•Defective chloride ion and water transport •Secretion of thick, tenacious mucus •Obstruction of organs with mucus ducts •Loss of electrolytes |
|
|
What are the signs and symptoms of cystic fibrosis?
|
•Meconium ileus, failure-to-thrive
•Chronic recurrent respiratory infections •Constipation, frothy stool, trouble gaining weight •Chronic productive cough with thick mucus •Obstruction of organs with mucus ducts •Loss of electrolytes |
|
|
How is cystic fibrosis diagnosed?
|
•Positive Sweat Test.
•Diagnosis may be made before I year of age, if mild form may not be diagnosed until adolescence. •Not generally terminal until adulthood. |
|
|
What is the treatmen for cystic fibrosist?
|
•Medical treatment is aimed at maintaining maximum respiratory function and nutrition for as long as possible.
*Perform postural drainage (chest physiotherapy) *Treat respiratory infections or allergies aggressively *Administer pancreatic enzymes, vitamins A,D,E,K *Encourage diet high in carbohydrates and protein *Encourage extra fluids and salt |
|
|
What dietary changes should be made for those with cystic fibrosis?
|
•Encourage diet high in carbohydrates and protein
•Encourage extra fluids and salt |
|
|
What is Otitis Media?
|
Inflammation of the middle ear that may be accompanied by fluid in the middle ear.
|
|
|
What are the signs and symptoms of Otitis Media?
|
•Upper respiratory infection symptoms
•Fever, ear pain (otalgia), pulling at the ear •Irritability, vomiting, diarrhea |
|
|
What is the treatment of otitis media?
|
•Treat with broad-spectrum antibiotics, decongestants, analgesics, and antipyretics
•Perform surgery—myingotomy |
|
|
What is RSV
|
Respiratory Syncytial Virus …causative organism of Bronchiolitis
|
|
|
When is RSV most common?
|
Occurs in epidemics from October to March
|
|
|
What are the signs and symptoms of RSV?
|
•Wheezing and crackles on auscultation
•Breath sounds diminish, retractions •Nasal stuffiness, fever, cough •Rapid, labored breathing, nasal flaring •Refusal to eat, dehydration |
|
|
What are the treatments for RSV?
|
•Begin intravenous fluids
•Administer humidified oxygen, medications •Administer breathing treatments •Hospitalize for treatment |
|
|
What is croup?
|
Epiglottis swells and occludes airway
|
|
|
What is the causative agent of croup?
|
Bacteria or virus
|
|
|
What are the signs or symptoms of croup?
|
•Inspirator stridor
•Barking “seal-like” cough, hoarseness •Onset may be sudden r gradual •May or may not have fear •Drooling due to pain and swelling |
|
|
What is the treatment for croup?
|
•Administer cool mist or tent
•Administer antibiotics if bacterial •Endotracheal intubation to keep airway open •Administer medications to reduce swelling |
|
|
What is Kawaski Disease?
|
•Acute systemic inflammatory illness
•Mucocutaneous lymph node syndrome •More common in Asian and male children |
|
|
What are the signs and symptoms of Kawaski Disease?
|
•Acute phase
-fever, conjunctival hyperemia, red throat -swollen hands and feet, rash -enlarged cervical lymph nodes •Manifestations (Acute to subacute phase) -skin on lips, hands, feet slough off -joint pain, thrombosis of heart -large aneurysms of coronary arteries -myocardial infarction •Convalescent phase -decreased inflammation -permanent heart damage |
|
|
What are the treatmentsfor Kawaski Disease?
|
•Admit to hospital
•Administer intravenous immunoglobulin, oral aspirin |
|
|
How do you handle a child with Kawaski Disease?
|
•Take temperature every four hours
•Administer large doses of aspirin •Assess for bleeding •Monitor conjunctiva, oral muscosa, skin •Assess for dehydration, malnutrition •Provide oral and bath care gently •Administer intravenous fluids, soft foods •Maintain bed rest with repositioning and exercises •Teach parents home care |
|
|
What is Hemophilia?
|
A rare heredity X-linked recessive disorder causing a deficiency in a specific blood clotting factor.
|
|
|
What precautions should be taken with a child who has Hemophilis?
|
•Safety measures to prevent injury
•Avoid medications that alter clotting •Wear medic-alert bracelet •Avoid rectal temperatures, rectal suppositories •Avoid unnecessary invasive procedures |
|
|
What is Leukemia?
|
Cancer of the blood-forming organs
|
|
|
What are the two types of Leukemia?
|
•Acute lymphoblastic leukemia (ALL)
•Acute Myelogenous leukemia (AML) |
|
|
What is the management of Leukemia?
|
•Assessment of bruising, bleeding, fever, infection
•Monitor specific gravity, intake and output •Obtain weight daily •Monitor nausea, vomiting, constipation, mouth sores •Assess nutrition status, fluid balance •Assist with side effects of medications •Assure rest periods, safe activities •Provide support and teaching •Organize interdisciplinary resources •Refer to support groups |
|
|
What is Iron-Deficiency Anemia?
|
A condition that results when the demand for stored iron is greater than what the body can supply.
|
|
|
What are the signs and symptoms of Iron-Deficiency Anemia?
|
•Pale, tired, irritable
•Tachycardia, muscle weakness, systolic heart murmur •Growth retardation, mentally delay •Deformed nail beds |
|
|
What is the treatment of Iron-Deficiency Anemia?
|
•Administration of oral supplemental iron preparations
•Arrange dietary counseling for iron intake •Reevaluate laboratory studies in 2 months •Decrease iron and reevaluate in 6 months |
|
|
Is there any special conditions to giving iron supplements?
|
•Liquid should be diluted and given through straw to prevent staining of teeth
•Liquid iron may not be compatible with milk or juice •Iron may turn the stool black, cause constipation, create unpleasant aftertaste •Fluids , a high-fiber diet, and exercise will help avoid constipation |
|
|
What is Sickle Cell Anemia?
|
A hereditary disorder affecting the formation of hemoglobin.
|
|
|
What are the signs and symptoms?
|
•Infant asymptomatic until three to four months
•Severe pain localized to vasoclusion area •Discoloration of skin. Pallor, coolness •Nausea, fever, swelling and painful joints • Vomiting, anorexia and diarrhea |
|
|
How do you manage Sickle Cell Anemia?
|
•Administer blood transfusions, clotting factors, albumin
•Administer parenteral analgesics •Intravenous fluids •Administer O2 therapy •Administer prophylactic antibiotics |
|
|
What is meningitis?
|
•Inflammation of meninges and brain, Bacterial or viral
•May result in significant neurological deficit •Bacterial is worse – spreads really fast and does more damage |
|
|
What are the signs & symptoms of meningitis?
|
•Fever, change in appetite, vomiting and diarrhea
•Lethargic or irritable •Headache, photophobia, nuchal rigidity (stiff neck) •Positive Kernig and or Brudzinski signs Hemorrhagic rash |
|
|
What is the treatment for meningitis?
|
•oral or intravenous fluids
•Broad spectrum antibiotic •NSAIDs •Arrange long term rehabilitation •Refer to appropriate resources |
|
|
What is Cerebral Palsy?
|
•disorder affects motor function and posture Causes:
•Lesions or anomalies of the brain •Hypoxic damage and birth trauma |
|
|
What are signs and symptoms of cerebral palsy?
|
•Abnormal muscle tone
•Lack of coordination Delayed growth and development milestones •Hearing loss, visual defects, speech delay •Seizures, mental retardation |
|
|
What is the treatment for cerebral palsy?
|
•Teach devices to assist motor function
•Use physical occupational and speech therapy •Surgical procedures to improve motor function •Administer Anti-convulsive and anti-spasmodic medications •Refer to appropriate resources |
|
|
What is Wilms’ Tumor?
|
•Metastatic tumor of the kidney, genetic link
•Most common in children 2-5 years of age |
|
|
What are the signs and symptoms of Wilms' Tumor?
|
•Abdominal mass, firm with several lobes
•Hematuria, hypertension and abdominal pain •Anorexia – lack of Iris |
|
|
How is Wilms' Tumor diagnosed?
|
•Ultra sound and MRI
•Can also do genetic testing |
|
|
How is Wilms' Tumor treated?
|
•Perform surgery to remove Kidney, lymph nodes
•Chemotherapy •Radiation |
|
|
What is Pyloric Stenosis?
|
•Obstruction of the pyloric canal caused by a thickening of the pyloric sphincter and narrowing of the passageway between the stomach and the duodenum.
•Stomach tries to push food through the narrowed lumen, mucous membrane becomes inflamed and swollen → narrowing lumen more and eventually causing total obstruction. |
|
|
What are the signs and symptoms of Pyloric Stenosis?
|
•Vomiting after feedings, projectile vomiting
•Dehydration, weight loss •Passes fewer and smaller stools •Small round mass in right upper quadrant •Visible peristaltic waves → irritable then lethargic |
|
|
What is the treatment for Pyloric Stenosis?
|
•Surgical correction (Pyloroplasty-to widen the area)
|
|
|
What is GERD?
|
•Relaxation of the cardiac sphincter
•Gastric contents return to esophagus •Characterized by vomiting, appear hungry, irritable •Eat but lose weight •Aspiration, pneumonia and apnea •More common in preemies and children with neurological impairment |
|
|
How is GERD treated?
|
•Mild cases:
-Add rice cereal to thicken feedings -Position upright 30 degrees after feeding -Avoid acidic juices -Administer meds to reduce stomach acid •Severe Cases -Perform Nissen fundoplication (anchors the lower esophageal sphincter below the diaphragm and reinforces the high-pressure area.) -Gastrostomy tube will be left in for 6 weeks for feeding |
|
|
What is Intussusception?
|
•Mechanical obstruction of the small bowel when one portion of the intestine telescopes into another portion.
•Most common site is the ileocecal valve •As telescoping occurs, the walls of the intestine rub together, producing inflammation, swelling, and obstruction. •Decrease blood flow to intesting → ischemia, necrosis, perforation, and hemorrhage •Occurs more frequently in boys 2 months to 5 years |
|
|
What are the signs and symptoms of Intussusception?
|
•Sudden, severe abdominal pain
•Vomiting •Brown stool •Periods of comfort with recurrence of pain •Stools resemble currant jelly •Palpable abdominal mass |
|
|
What is the treatment for Intussusception?
|
•Administer barium to reduce intestine into place
•Perform surgery to reduce, remove damaged tissue |
|
|
What is Hirschsprung’s Disease?
|
•Also known as “megacolon”
•Condition in which the autonomic parasympathetic ganglion that normally causes peristalsis in the intestine is absent. •Mechanical bowel obstruction of large intestine |
|
|
What causes Hirschsprung’s Disease?
|
Inadequate motility causes mechanical bowel obstruction of the large intestine
|
|
|
What are the signs and symptoms of Hirschsprung’s Disease?
|
•Depends on extent of defect and age of child
•Newborns: -Failure to pass meconium -Refusal to suck -Abdominal distention -Meconium Emesis •Older Children: -History of abdominal distention -History of constipation alternating with diarrhea |
|
|
What is Duchenne’s Muscular Dystrophy?
|
•Most common form of muscular dystrophy
•Muscle degeneration and wasting •Sex linked recessive disorder •Carried by mothers and passed to their sons |
|
|
What are the signs and symptoms of Duchenne’s Muscular Dystrophy?
|
•Onset of symptoms in first 3 to 4 years of life
•Appear normal 1st year but walking may be delayed •Walks but tires easily especially when running or climbing •Waddling gait, may walk on toes •Classic symptom → Gower’s maneuver (Child uses upper extremities to lift up from floor) •Most wheelchair bound by age 12 •As it progresses, scoliosis, respiratory difficulty, inability to sit upright •Swallowing may be affected, leading to respiratory infection and malnutrition |
|
|
What is Down’s Syndrome?
|
•Most common chromosomal abnormality that causes mental retardation
•Trisomy 21 •Frequency increase with maternal age |
|
|
What are the types of Down’s Syndrome?
|
•Trisomy 21
-95 out of 100 people with Down’s have an extra chromosome •Translocation -4 out of 100 people with Down’s have translocation – number of chromosomes is normal but part of 21 breaks off and attaches to another •Mosaic -3 out of 100 people have this type. Abnormal cell division in some cells but others replicate normally. Extra genetic material from chromosome 21. |
|
|
What are the signs and symptoms of Down’s Syndrome?
|
•Short head, flat forehead, short limbs
•Short wide neck, protruding •Epicanthal folds (a fold of skin over the inner canthus of the eyes, simian crease, Brushfield spots (white speckles on the edge of the iris) •Sluggish reflexes as infant •Mental retardation |
|
|
What other conditions are associated with Down’s Syndrome?
|
•Congenital heart defect
•Diabetes •Leukemia •Hearing loss |
|
|
What is Asthma?
|
Chronic inflammatory disorder of the tracheobronchial tree.
|
|
|
What are the triggers of Asthma?
|
•Allergies
•Medication •Household chemicals •Pollution •Vigorous exercise •Infection •Stress |
|
|
What are the signs and symptoms of Asthma?
|
•Fast, labored breathing
•Productive cough •Wheezing on expiration, chest tightness •Nasal flaring, intercostals retractions •Head bobbing •Anxious, suffocating-feeling •Status asthmaticus (when the child develops severe respiratory distress and bronchospasms that do not respond to medication) |
|
|
What is the treatment for Asthma?
|
•Avoid triggers
•Administer medications – Rescue inhaler •Teach family care and avoid smoking •Obtain follow-up care |
|
|
What is Rheumatic Fever?
|
•Inflammatory disorder
•Follows a beta-hemolytic Streptococcus infection (strep throat) •Autoimmune response damages heart, joints, CNS, skin •May recur with further heart damage |
|
|
When does Rheumatic Fever usually occur?
|
Most common in 6-15 year olds (school age)
|
|
|
What are the signs and symptoms of Rheumatic Fever?
|
•Enlarged, painful, inflamed joints (polyarthritis)
•Fever, tachycardia, red rash (erythema marginatum) •Abnormal heart sounds, irregular rhythm (Mitral and Aortic valves are damaged) •Sydenham’s chorea (involuntary facial and upper extremity movement) |
|
|
What is the treatment for Rheumatic Fever?
|
•Antibiotics
•Anti-inflammatories •Steroids |
