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