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139 Cards in this Set

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An infant born with a myelomenigocele should be in which position?
Prone position always or on side.
What are nursing priorities post-op for a myelomenigocele?
Avoid infection, antibiotics, sterile technique, maintain moist sterile, non-adherent saline dressing to sac.
What is the cause of myelomenigocele?
Severe genetic predisposition and folic acid deficiency from mother.
What are the different forms of spina bifida?
Spina bifida oculta (bony defect - missing bone)
Spina bifida dystica meningocele (meninges are exposed)
Myelomeningocele - meninges and spinal cord protruding.
What supplement is suggested to prevent this disease?
Folic Acid
How can spina bifida be predicted while still in utero?
Prenatal alphfetoprotein level checked at 16 weeks.
What are the signs and symptoms of hydrocephalus?
Neural functions
What are nursing priorities post-op for shunt placement?
Monitor for infection or malfunction of shunts.
What teaching should parents receive after a child gets a shunt?
Be able to recognize signs of infection to shunts
What symptoms do you look for if a shunt has complications?
Neural function stops.
What are signs and symptoms of an infant with ICP?
Irritable, double vision, dycoplia.
What nursing strategy is done to prevent increased ICP in the unconscious child?
Semi-fowlers position.
What should parents do with care of unconscious but stable child?
Talk, touch, and associate like normal.
What is an epidural hematoma?
Bleeding between the dura and skull.
What is a subdural hematoma?
Bleeding between the dura and the brain.
After a minor head injury, what S&S may indicate a need for medical help?
Change in Level of consciousness, change in behavior.
What is decorticate posturing?
Aduction of the hand and feet toward the cord.
What is decerebrate posturing
Abduction of hands and feet.
What symptoms do you see with spastic cerebral palsy?
Muscle stiffness.
What is the major goal of therapy for children with Cerebral Palsy?
Child will develop to the best potential.
What test is done to diagnose meningitis?
Lumbar puncture.
How is a lumbar puncture done?
Child is lying on his side. Hold the head and legs.
What specimen is obtained in a lumbar puncture?
Cerebrospinal fluid.
What is the priority nursing care for a child with bacterial meningitis?
Administer medication as soon as possible.
What vaccine is available to prevent meningitis?
Hepatitis B.
What type of illness precedes Reyes Syndrome?
Viral Infection such as the flu.
What does an absence seizure look like?
Daydreaming. Staring into space.
What information is important to gather about absence seizure?
When, type, how many episodes, any information.
After a tonic-clonic seizure, what symptoms would be expected?
Lethargy, Headache, sleepy, fatigue.
What nursing interventions are done for failure to thrive?
The parent needs to know when the child is hungry (feed on demand)
Mental retardation is caused by?
Various genetic biochemical, viral, nutritional factors.
IQ of 30 is described as?
Sever retardation (needs constant directional supervision)
The best method for early detection of cognitive deficit is?
Routine developmental assessment tests (Denver screening)
The priority nursing diagnosis for a child with cognitive dysfunction with limited ability to ancitipate danger is?
Safety
What is monitored during the first year of life in a child with Down's syndrome?
Cardiac and GI disorders.
What is the most common disorder of Down's Syndrome children?
Congenital heart defects.
What are the major features of a child with Down's Syndrome?
Simian Crease on palm, hypotonic muscles.
With a hospitalized child with Down's Syndrome, what would a nurse do?
Encourage the parents to stay with the child.
What is myopia?
Near-signtedness (image focusing in front of retina)
What is conjuctivitis?
Pink eye, bacterial, viral chemical, alergic infection (never touch the tip of the medication applicator)
Eye surgery puts a child at risk for?
Infection of the eyes
The priority nursing diagnosis for a child with eye surgery is?
Treat the patient as if their vision is impaired (announce your presence when entering the room)
How is the eye patch placed on a child for strabismus?
The patch is placed on the stronger eye to strengthen the weaker eye.
Is strabismus normal for a 5-month-old?
No. It's normal for a 4-month-old.
If an infant stops babbling, what should be assessed?
Hearing
How do nurses meet the needs of children with hearing loss?
Get their attention, look face to face.
What are the symptoms of visual-impaired children?
Squinting, rubbing eyes frequently.
What are signs and symptoms of hypokalemia?
Hypoactive bowel sounds, low potassium, below 3.5mEq/L.
What is the priority nursing diagnosis when caring for infants with dehydration?
Monitor I&O, daily weight checks.
What assessment should be done before administering IV solution with Potassium to a child with dehydration?
Urinating well.
What is the primary concern with persistant vomiting?
Find the cause.
Do we give antidiarrheal medication to toddlers?
No, will prolong diarrhea.
What are the teaching concerns with diarrhea in children?
Monitor skin turgor, monitor for low BP, tachycardia, mucous membranes moist, capillary refill.
What are the signs and symptoms of dehydration?
No urination for 6 hours, notify doctor.
How do we treat dehyration at home?
Oral rehydration, pedialyte, gatorade.
How do we avoid the spread of gastroenteritis?
Hand washing.
What are the complications of severe dehydration?
Renal failure, immature function of kidneys make children more prone to dehydration.
What is the most common test for pinworms?
Scotch tape test immediately upon wakening.
What is the cause of cleft lip?
Unknown
How do you help parents cope with cleft lip?
Show before and after surgery pictures. (Encourage parents to verbalize feelings.)
What is the post-op care for cleft lip?
Mittens, elbow restraints, do not put face down.
What is pre-op care for cleft lip?
Provide suction needs (pacifiers and nipples.)
What maternal conditions relate to the infants diagnosis of TEF?
Polyhydramnios (too much amniotic fluid)
What is the nursing care of an infant with TEF?
Place in upright position until surgery (NPO)
What is a major symptom of pyloric stenosis?
Olive size bulge in the RUQ, vomiting, visible perstalsis.
What is intussusception?
Telescoping of the bowels.
What is an assessment finding in infants with intussusception?
Current Jelly stool.
What is the first step in emergency treatment of poisoning?
Assess the patient first.
What is the most common source of lead poisoning?
Lead paint.
What is the discharge teaching for an infnat with GE Reflux?
CPR, Risk for aspiration.
What is celiac disease?
An intolerance to foods with gluten such as wheat, barley, rye and oats.
What is the priority nursing diagnosis for a child with celiac disease?
Altered nutrition less than body requirments.
What are classic symptoms of celiac disease?
Abdominal distention, thin arms & legs, foul smelling stool.
What is an assessment finding with hirschsprungs disease?
Constipation.
What is the nursing care post-op of Hirschsprungs disease?
No rectal temps, colostomy care.
What are the symptoms of a recently ruptured appendix?
Sudden relief of pain.
What are the appropriate interventions for a ruptured appendix?
No heat to abdomen, IV fluids, CBC, pain medications.
What is the treatment for thrush?
Antifungal cream. (apply to gums with gloves)
What is the oral treatment for ringworm?
Griseofulvin po q 12 hours.
What is impetigo?
Bacterial infection of the skin, papule and vesicle around the mouth.
What is the treatment for impetigo?
Antibacterial meds. 48 hr. after starting antibiotics - can return to school.
What causes cellulitis?
It is secondary to injury and infection.
What is the nursing priority for a child with herpetic gingivostomatis?
Risk for dehydration due to sore mouth.
What is the treatment for Herpes simplex virus?
Oral antiviral medication.
What are the side effects of anti-lice products?
Neuro toxin effects.
What are the signs and symptoms of lice?
Itching
What are the complications of atopic dermatitis?
Impetigo.
What are the classifications of burns?
First - Superficial
Second - Partial - Epidermis & Dermis
Third - Full - all 3 layers of skin
What is the relationship between the prognosis?
More tissue damage - more severe
What is the priority outcome of mandatory newborn screening?
Hypothyroidism
The lack of growth hormones lead to what metabolic alteration?
Hypoglycemia - low glucose.
What are the symptoms fo hypoglycemia?
Sweating, pallor, low sugar between 60-80, give simple sugars.
What is the honeymoon phase of diabetes?
The pancreas starts to produce insulin for 1-6 months.
What should a diabetic child do who plays sports?
Eat more carb snacks.
What is a good age to administer insulin?
Age 9-12
Know proper care for type 1 diabetes and need for education.
Teenager states "I can't wait till I'm older so I can take a pill"
What does a teenager with diabetes think?
I just want to be like everyone else.
What labs are associated with diabetes ketoacidosis?
Acidosis pH levels below 7.0
How should pH levels below 7.0 be treated?
Go to hospital - life threatening.
What are some teaching items for UTI prevention?
Cotton underwear, no bubble bath, cranberry juice.
What are the symptoms of UTI?
Abdominal pain, enuresis, dysuria, polyuria, hematuria.
Why are girls more prone to UTI's?
They have a shorter urethra and are more susceptible to infection.
What is a sign that a person with acute post-streptococcal glomerulonephritis is showing improvement or recovery?
Increased urination.
What are complications and symptoms of acute post-streptococcal glomerulonephritis?
Edema, crackles in lungs, tea color urine.
What does it mean if you have casts in the urine?
Glomerular injury.
What are diagnostic findings associated with nephrotic syndrome (Phephrosis)?
Protein in the urine, hypoalbumin, edema.
What is a sign that nephrotic syndrome (Phephrosis) is in remission?
No protein in the urine for 2 weeks.
What is the treatment for Nephrotic Syndrome (Phephrosis)?
Corticosteroids.
What is a no-salt diet?
No salt in cooking or on table.
What is a nursing intervention for a child with nephrotic syndrome?
Risk for impaired skin integrity - turn every 2 hours.
What is a teaching item for a child with vesicoureteral reflux?
Importance of taking antibiotics.
What is the best way to examine an infant for cryptorchisism?
Warm room, warm hands.
What age should hypospadias be accomplished by?
18 months.
Why is it corrected early?
To maintain a good body image.
What is epispadias?
Dorsal placement of urethral opening.
What are the effects of chemotherapy?
Suppression of immune system (bone marrow)
What are signs and symptoms of leukemia?
Bone pain, weakness, pallor, bruising, weight loss, enlarged lymph nodes.
Why would a child scream when moving?
Bone pain.
What is the priority nursing diagnosis for a newly diagnosed leukemia patient?
Infection control.
What test is done to confirm a leukemia diagnosis?
Bone marrow biopsy.
Why does a leukemia patient have excessive bleeding?
They have low platelets.
What is a home going teaching item for parents of a child with leukemia?
Take temp routinely to catch infection in the early stages.
How do you respond to guilt about not taking child to Dr. sooner?
It is normal to overlook subtle changes in a child's health.
What are S&S of Hodgekin's disease?
Non-tender lymph nodes, enlarged firm, no pain, lethargy, pruritis.
What is the appropriate care for a child with Wilm's tumor?
Do not palpate abdomen
What is the post-op treatment for a child with Wilm's tumor?
Chemotherapy with or without radiation.
What are hallmark symptoms of a child with a brain tumor?
Headache, vomiting in the morning.
What is the significance of a neuroblastoma-embryonic tumor in utero?
Diagnosis after its metastis.
What is the most common site for a osteogenic sarcoma (bone cancer)?
Femur
What electrolyte disturbance causes cardiac dysrhythmia?
Hyperkalemia - High potassium levels.
What is the most common way of contracting HIV in children?
Perinatal
What are the signs and symptoms of malignant hyperthermia?
High temperature.
What is the appropriate way to give a tepid sponge bath?
If the child is chilled - stop bath.
What is the most reliable way to determine safe dosage for a child?
Body weight in Kg.
What is a nursing consideration when using a mist tent?
Keep the child warm and dry.
What is a papule?
An elevated circumscribed area such as a wart or mole.
What is a nodule?
An elevated area that is firm and round.
What is a vesicle?
An elevated area that is round, superficial such as chicken pox, herpes zoster.
What is a pustule?
A pus filled area such as herpes simplex or acne.