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;
373 Cards in this Set
- Front
- Back
|
Birth weight will double by:
|
4-6 months
|
|
|
Birth weight will triple by:
|
the end of the first year
|
|
|
Birth weight will be quadrupled by:
|
the end of the second year
|
|
|
birth length is doubled by:
|
4 years
|
|
|
the child will be 50% of their adult height at:
|
2 years
|
|
|
How do children grow?
|
cephalocaudal (head to tail/ proximal to distal)
|
|
|
The trust v mistrust stage lasts from ages:
|
0-1
|
|
|
The Erickson stage involving faith and optimism is ____.
What is the nursing measure associated? |
Trust v mistrust
comfort |
|
|
The autonomy v doubt stage lasts from ages:
|
1-3
|
|
|
The Erickson stage associated with independence is____.
What is the nursing measure associated?! |
Autonomy v doubt
let them do things themselves! |
|
|
The initiative v guilt stage involves ages:
|
3-6
|
|
|
The Erickson stage involving direction and purpose is ____.
What nursing care is associated? |
initiative v guilt
they need to feel a sense of accomplishment |
|
|
The stage industry v inferiority involves ages:
|
6-12
|
|
|
What Erickson stage focuses on competence?
|
industry v inferiority
|
|
|
The stage identity v role confusion involves ages:
|
12-18
|
|
|
The Erickson stage involving devotion and fidelity to others and to values and ideology is:
|
identity v role confusion
|
|
|
A child will sit unsupported at what age?
|
8 months
|
|
|
a child will flip over at what age?
|
5-6 months
|
|
|
A child can throw a ball overhead at what age?
|
18 months
|
|
|
A child can speak 2-3 word sentences at what age?
|
2 years
|
|
|
A child will need a neuro evaluation if they still have head lag after what age?
|
6 months
|
|
|
The type of play when toddlers play beside each other, but not with each other
|
parallel play
|
|
|
The type of play where preschoolers play together but with no organization
|
associative play
|
|
|
the type of play where school aged children play sports or board games
|
cooperative play
|
|
|
He set up milk stations, and was the first peoson to be concerned with and improve child health. Called the father of pediatrics.
|
Jacobi
|
|
|
What is the most common infectious agent to cause RTIs in infants and young children?
|
viruses
*other causes are RSV, group A strep, staph, H. flu, chlamydia trachomatis, mycoplasma, and pneumococci |
|
|
At what age of infancy does infection risk increase? Why?
|
3-6m: because the time between the disappearance of maternal antibodies and infants own antibody production.
*rates continue to increase in toddlers/preschool |
|
|
There is a decrease of viral respiratory infections at this age, but increased mycoplasma pneumoniae and group A strep infections
|
age 5
|
|
|
Children have fewer respiratory infections as they grow older for two reasons:
|
increased lymphoid tissue
increased immunity |
|
|
What issues related to size increase infants/small cildren's risk of infection?
|
diameter of airway is smaller
distance between structures is shorter short and open Eustachian tube |
|
|
An infant/young child's ability to resist invading organisms depends on these factors:
(there are 7) |
immune system deficiencies
malnutrition anemia fatigue chilling congenital defects secondhand smoke |
|
|
Conditions that weaken the respiratory tract defenses and predispose infants/young children to infection are:
|
allergies and asthma
cardiac anomalies (cause pulmonary congestion) cystic fibrosis seconhand smoke |
|
|
What season is RSV season (for infants/young children)
|
winter/spring
|
|
|
What season is mycoplasmal infections season (for infants and young children)?
|
fall/early winter
|
|
|
what season is asthmatic bronchitis season for infants and young children?
|
winter
|
|
|
Fever (100.4 or higher), meningismus, anorexia, vomiting, diarrhea, abdominal pain, nasal blockage, nasal discharge, cough, respiratory sounds, and sore throat are all signs and symptoms of what in infants and small children?
|
respiratory infections
|
|
|
What are some nursing interventions for respiratory infections in infants and small children?
|
ease respiratory efforts
rest comfort prevent spread reduce temp hydration/nutrition family support |
|
|
This is the "common cold." It is caused by rhinovirus, RSV, adenovirus, influenza, or parainfluenza.
|
Nasopharyngitis
|
|
|
A young child presents to the nurse with fever, sneezing, vomiting, irritability, and edema of the nasal mucosa. This child probably has:
|
nasopharyngitis
|
|
|
An older child presents wtih dry, irritated nose and throat; muscle aches, cough, sneezing, edema of the nasal mucosa. This child probably has:
|
nasopharyngitis
|
|
|
Therapeutic managment of naspharyngitis is:
|
fever managment, rest, decongestants (not for children <2), cough suppressants.
|
|
|
Should a child with nasopharyngitis be prescribed antibiotics?
|
NO!
|
|
|
Nursing considerations for nasopharyngitis include:
|
elevate head of bed
saline drops and suction bulb adequate fluids handwashing edu |
|
|
Does green nasal drainage in a child mean a bacterial infection?
|
NO! (not necessarily)
|
|
|
80-90% of pharyngitis are caused by what?
|
virus
|
|
|
What is the most common bacterial cause of pharyngitis?
|
group A beta hemolytic strep
|
|
|
Strep throat is not common before what age?
|
1 year
|
|
|
A child child presents with sore throat, headache, fever, abdominal pain, lymphadenopathy, vomiting, petechiae on palate. What does this child probably have?
|
pharyngitis
|
|
|
If a child develops a rash with pharyngitis, it is probably
|
scarlet fever
|
|
|
How do you diagnose pharyngitis?
|
throat culture, rapid strep test
*throat culture most accurate *rapid test always follows with TC if negative *treat strep carriers if symptomatic |
|
|
What is the drug of choice for pharyngitis (bacterial- strep)?
|
penicillin- PenVK, Amoxicillin (bubblegum flavor)
*can also use Cephalosporins, Macrolides, Rifampin, And injectable antibiotics. |
|
|
If a child is a sterp carrier and is being treated for pharyngitis (bacterial), the MD will order this medication in addition to the choice antibiotic (penicillin, etc)
|
Rifampin
|
|
|
Nursing considerations for pharyngitis
|
reduce temp
rest comfort hydration edu: complete antibiotics, change toothbrush, contagiousness |
|
|
Indications for tonsillectomy are:
|
more than 3 strep infections in one year
history of peritonsillar abscess cases of massive hypertrophy that result in difficulty breathing/eating |
|
|
Postop nursing interventions for tonsillectomy include:
|
-pain meds
-food and fluid restrictions until alert and no s/s hemorrhage -avoid fluids with red/brown color -offer cool water, crushed ice, flavored ice pops, dilute fruit juice -discourage coughing, sneezing, clearing throat, blowing nose -gelatin, cooked fruits, sherbet, soup and mashed potatoes - no milk products or pudding |
|
|
A child has had a tonsilectomy and now has an increased pulse, decreased blood pressure, pallor, frequent clearing of the throat, frequent swallowing, vomiting bright red blood, and restlessness. the nurse suspects this child has developed:
|
hemorrhage
|
|
|
Influenza has a ____day incubation period
|
1-3 day
|
|
|
A child has a sudden onset of high fever, myalgia, fatigue/tiredness, dry cough, nasal congestion/drainage, nausea and vomiting. What does the child probably have?
|
flu
|
|
|
The nurse knows that when managing a child with the flu, she should look for these complications: (there are 5)
|
pneumonia (esp. if child has asthma)
encephalitis bronchitis sinusitis otitis media |
|
|
What should the nurse do for a child with the flu?
|
treatment is symptomatic
flu test (type A or B?) antivirals rest increase fluids control fever |
|
|
Tamiflu works for type ____ flu
|
A&B
|
|
|
A child with type B flu might be prescribed:
|
symmetrel
|
|
|
The flu mist is what kind of vaccine? Who cannot get it? Who can?
|
live vaccine
Not give nto pts with asthma, chronic conditions, or pregnancy only approved for ages 2-49 years |
|
|
The patient cannot get a flu vaccine at all if he/she is allergic to:
|
eggs
|
|
|
The flu shot is what kind of vaccine?
Who can get it? |
inactivated "dead" vaccine
all ages >6m |
|
|
Incidence of otitis media is highest at what age?
|
6m-2y
|
|
|
Incidence of otitis media increases in what season?
|
winter
*because there are more colds |
|
|
Otitis media affects more: (boys than girls) or (girls than boys).
|
boys than girls
|
|
|
What are two risk factors for otitis media?
|
family history of OM
children with smoke exposure *these also increase incidence of colds |
|
|
severe acute infection of the ear
|
acute otitis media (AOM)
|
|
|
AKA serous otitis media, meaning fluid on the ear
|
Otitis media wit heffusion (OME)
|
|
|
chronic condition of fluid on the ear (>1m)
|
Chronic otitis media with effusion
|
|
|
swimmer's ear is also called
|
otitis externa
|
|
|
Acute otitis media is caused by what organisms?
|
strep pneumonia
pneumococcus H flu |
|
|
Otitis media with effusion can be caused by:
|
blocked eustachian tubes from
URI allergic rhinitis hypertrophic adenoids |
|
|
A child presents with ear pain, fever, nasal drainage, irritability/crying, and is pulling at his ear. The nurse suspects:
|
acute otitis media
|
|
|
a child presents with only a feeling of fullness in his ear. The nurse suspects:
|
otitis media with effusion
|
|
|
a child presents with redness of the ear lobe, a painfal tragal tug(when the nurse pulls on the ear), drainage from the ear, fever, and some temporary hearing loss. then nurse knows these are s/s of:
|
otitis externa
|
|
|
If a nurse sees a bright red, bulging tempanic membrane with loss of bony landmarks and a light reflex, she knows the child has
|
acute otitis media
|
|
|
If a nurse using an otoscope sees a slightly inflamed, dull gray tympanic membrane with obscured landmarks and can see visible fluid, she knows the child has:
|
otitis media with effusion
|
|
|
Antibiotics used for otitis media:
|
amoxil
augmentin cephalosporins macrolides rocephin *there may be antibiotic resistance |
|
|
treatment used for otitis media other than drugs includes-
|
tympanocentesis
myringotomy tympanostomy tubes (must have 6 ear infections in 1 y or fluid on ear>3mos) |
|
|
Nursing considerations for otitis media include:
|
numbing ear drops
facilitate drainage prevent complications/recurrence educate caregiver emotional support |
|
|
What are the 4 types of croup syndromes?
|
acute epiglottitis
acute laryngotracheobronchitis(LTB) acute spasmotic laryngitis acute tracheitis |
|
|
What is the most common croup syndrome?
|
LTB
|
|
|
LTB primarily affects children of what age?
|
<5 years
|
|
|
What most commonly causes LTB?
|
parainfluenza virus
|
|
|
A child presents with fever, irritability, restlessness, hoarseness, inspiratory stridor, and a seal-like bark. What does this child most likely have?
|
LTB
|
|
|
For a child with LBT, what can the nurse do?
|
maintain airway
cool mist humidifier racemix epinephrine via nebulizer (only for stridor at rest, retractions, or difficulty breathing) *a child is only treated in the hospital if stridor does not cease. |
|
|
What drug may be ordered for STB?
|
Corticosteroids-
prednizolone (prelone) methylprednisolone (solu-medrol) Dexamethosone (decadron) |
|
|
What is the bacterial form of croup called?
|
epiglotitis
*H flu is the normal cause!!! |
|
|
What ages most commonly get epiglottitis?
|
2-5
|
|
|
Which form of croup is considered an EMERGENCY?
|
epiglottitis
|
|
|
A child has an abrupt onset of sore throat, difficulty swallowing, fever, irritability, restlessness, and is frightened. He has a red, edematous epiglottis. He is drooling and is sitting in the tripod position with his chin thrusted out, mouth open, and tongue protruding. What does the nurse suspect?
|
epiglottits
*EMERGENCY!!- take to OR, have trach set with you on the way. Intubation, trach, IV, etc all done in OR. Delay throat exam until later. |
|
|
What medications are used for epiglottitis?
|
IV antibiotics
IV corticosteroids |
|
|
How can you prevent epiglottitis?
|
Hib vaccine
given at 2,4,6,12-15 months has caused a large decrease in occurrence |
|
|
infection of the large airways (trachea and bronchi) is called:
(it's usually viral, it usually occurs with a URI) |
bronchitis
|
|
|
Bronchitis caused by mycoplasma pneumoniae is common in children of what age?
|
>6 years
|
|
|
A child presents with a fever, dry, hacky, non-productive cough; and chest discomfort. His mother says his condition worsens at night. What does this child have?
|
bronchitis
|
|
|
How do you treat bronchitis?
|
-it is mild, and self-limiting
only treat symptoms treat with analgesics, antipyretics, and humidity recovery in 5-10 days |
|
|
An acute viral infection that primarily occurs in winter that infects young children mostly <2years is called:
|
bronchiolitis/RSV
|
|
|
What organisms cause bronchiolitis (besides RSV)?
|
adenovirus
parainfluenza virus |
|
|
What organism causes 1/2 of the hospitalizations for bronchiolitis?
|
RSV
|
|
|
What months does bronchiolitis/ RSV normally occur in?
|
October--> March
|
|
|
How do you test for RSV/bronchiolitis?
|
nasal washing-
(suction with nasal bulb, put secretions in test tube for the test) |
|
|
How is bronchiolitis/RSV spread?
|
from the hand to mucous membranes- eye, nose, etc
|
|
|
A child initially presents with rhinorrhea, pharyngitis, coughing, grunting, wheezing, fever, ear or eye drainage, and sneezing.
Later, the child has air hunger, retractions, tachypnea, increased coughing, increased wheezing, and cyanosis. What does this child have? |
bronchiolitis/ RSV
|
|
|
What are severe s/s of RSV/bronchiolitis
|
tachypnea (>70/min)
listlessness apneic spells poor breath sounds poor air exchange |
|
|
What are some therapeutic managment measures for bronchiolitis/RSV?
|
high humidity
adequate fluid intake NPO if RR>70 bronchodilators and corticosteroids(not recommended but frequently used) intubation if necessary |
|
|
What are some nursing interventions of RSV/bronchiolitis?
|
close observation
handwashing adequate hydration edu |
|
|
What can prevent RSV/bronchiolitis?
|
synagis
*an antibody, not a vaccine *this is given to preemies and high-risk infants who meet criteria- is VERY expensive *given q month x 6months oct--> march |
|
|
recurrent episodes of pneumonia (>3 pneumonia episodes in 1y) should be tested for:
|
Cystic Fibrosis
|
|
|
This type of pneumonia has an abrupt onset, is proceded by a viral URI, and most cases can be treated at home.
|
bacterial pneumonia
|
|
|
A child presents with fever, malaise, tachypnea, deep cough, crackles, rhonchi, chest pain with inspiration, and abdominal pain. What does this child have?
|
bacterial pneumonia
|
|
|
What are some therapeutic managment/nursing interventions for bacterial pneumonia?
|
fluids
fever measures hospital admission if warranted frequent respiratory status checks postural drainage and chest physiotherapy family support rest |
|
|
How can you diagnose bacterial pneumonia?
|
CXR
|
|
|
What medications are used for bacterial pneumonia?
|
amoxicillin
erythromycin |
|
|
How can you prevent pneumonia?
|
pneumovax- pneumococcal polysaccharide vaccine
*given at >2y to high risk pt.s prevnar- pneumococcal conjugate vaccine *given routinely at 2,4,6,12 months |
|
|
This lower respiratory infection is more common in infancy to early childhood. It may be a primary disease or a comlication of another process. Types are viral, atypical, bacterial, aspiration, and fungal.
|
pneumonia
|
|
|
What can dx a foreign body aspiration?
|
bronchoscopy of larynx/trachea
fluoroscopic exam of bronchi *Xray not much help unless obj is metal |
|
|
This lower respiratory infection is highly contagious, peaks in spring and summer months. it is caused by bordetella pertussis. One attack provides a lifetime immunity.
|
Pertussis.
|
|
|
How long is the incubation period for pertussis?
|
7-10 days
|
|
|
A child presents with coughing atacks characterized by flushed cheeks, cyanosis, bulging eyes, a short, rapid cough followed by a "whoop" sound. She has post-tussive vomiting. The "attacks" last a few minutes without pauses. What does this child have?
|
pertussis
|
|
|
What should you do for a patient with pertussis?
|
bedrest
fluids humidifier hospitilization (depends on age/severity) possible intubation possibly on ventilator keep child occupied provide quiet, restful environment |
|
|
What medication can be used to treat pertussis?
|
antibiotic- EES (erythromycin)
|
|
|
Foreign body aspirations are most common for what age?
|
<3 years
|
|
|
A child presents with stridor, wheezing, cough, and retractions. What is the problem?
|
foreign body aspiration
|
|
|
If a foreign body is lodged in the larynx, what are the s/s
|
inability to speak or breathe
|
|
|
If a foreign body is lodged in the bronchi, what are s/s
|
cough, decreased airway entry, wheezing, dyspnea
|
|
|
What is nursing managment for foreign body aspiration?
|
emergency tx: BLS
back blows/abd thrusts<1y abd thrusts>1y antibiotics for secondary infection *a child can die within 4 minutes of aspiration!!! |
|
|
Aspiration pneumonia can be caused by:
|
food
fluid vomit nasopharyngeal secretions powder |
|
|
Paralysis, weakness, absent cough reflex, congenital anomalies, and force feeding while crying or breathing rapidly can all cause
|
aspiration pneumonia
|
|
|
What injuries can occur from inhalation injuries?
|
local- irritation, inflammation, damage to pulmonary tissues
systemic |
|
|
These substances when inhaled combine with water in the lungs to form acids
|
aldehydes
|
|
|
Systemic inhalation injury: two gases that are nontoxic to airways can still interfere with or inhibit cellular respiration are:
|
carboxyhemoglobin
cabon monoxide |
|
|
headache, irritability, visual disturbances, nausea, confusion, hallucinations, ataxia, and coma all indicate what kind of inhalation injury?
|
carbon monoxide poisoning
|
|
|
Therapeutic managment of inhalation injuries include:
|
100% O2
hyperbaric oxygen chamber for CO poisoning intubation resp. assessment family support same as for any child with resp. distress |
|
|
What medications can be used for inhalation injury?
|
bronchodilators
*corticosteroids not recommended- increase risk of infection *antibiotics not recommended |
|
|
Maternal smoking can cause:
|
decreased birth wt
increased stillbirths preterm deliveries higher incidence of SIDS |
|
|
A chronic inflammatory disorder that is the primary cause of school absences. This is responsible for major proportions of pediatric admissions to the ED/hospitals.
|
Asthma
|
|
|
Inflammation/edema of mucous membranes, bronchospasm, accumulation of secretions, and obstruction characterizes this disease:
|
asthma
|
|
|
A child presents with a cough, SOB, a prolonged expiratory phase, wheezes, restlessness, deep/dark-colored lips, hyperresonance on percussion, coarse, loud breath sounds, crackles, and is speaking with short, broken phrases. what does this child have?
|
asthma
|
|
|
how do you diagnose asthma?
|
based on clinical manifestations, history, physical, lab tests
CXR to r/o other dz will have chronic cough without infection/wheezing PFTs allergy skin testing |
|
|
A child with asthma has symptoms less than or equal to 2 times a week. Has nighttime symptoms less than or equal to 2 times per month. The child is asymptomatic and has a normal PEF between exacerbations. Their PEF is greater than or equal to 80% of predicted, with a PEF variability of <20%
|
Mild intermittent asthma
|
|
|
How many times per week does a child with intermittent asthma have symptoms?
|
less than or = 2
|
|
|
how many times per month does a chld with intermittent asthma have symptoms?
|
less than or equal to 2
|
|
|
What is the PEF of a child with intermittent asthma?
|
greather than or equal to 80% of predicted, with a variability of less than 20%
|
|
|
A child with asthma has symptoms greater than 2 times a week but less than 1 time per day. Exacerbations may affect his activity. He has nighttime symptoms more than 2 times per month. his PEF is greater than or equal to 80% of predicted value with a PEF variability of 20-30%. What type of asthma does this child have?
|
mild persistent
|
|
|
How many times per week does a child with mild persistent asthma have symptoms?
|
greater than 2 times per week but less than 1 time per day
|
|
|
How often does a child with mild persistent asthma have nighttime symptoms?
|
more than 2 times per month
|
|
|
what is the PEF of a child with mild persistent asthma?
|
greater than or equal to 80% of predicted value, with a variability of 20-30%
|
|
|
A child with asthma has daily symptoms. She uses an inhaled short-acting beta-agonist daily. Her activity is affected by her exacerbations. She has exacerbations more than or equal to two times per week. She has nighttime symptoms more than once a week. Her PEF is more than 60-80% or predicted, with a variability of more than 30%. Which type of asthma does she have?
|
Moderate persistent asthma
|
|
|
In moderate persistent asthma, how often does the pt experience symptoms?
|
daily
|
|
|
In moderate persistent asthma, exacerbations affect activity. How often do patients experience exacerbations?
|
greater than or equal to two times per week
|
|
|
In moderate persistent asthma, how often does the patient experience nighttime s/s?
|
greater than once a week
|
|
|
What is the PEF of a patient with moderate persistent asthma?
|
60-80% of predicted, with a variability of more than 30%
|
|
|
A child with asthma has continual symptoms, frequent exacerbations, frequent nighttime symptoms, and can only engage in limited physical activity. His PEF is less than or equal to 60% of predicted, with a variabilit of more than 30%. What type of asthma does this child have?
|
severe persistent asthma
|
|
|
What is the PEF of a child with severe persistent asthma?
|
less than or equal to 60% of predicted
variability of greater than 30% |
|
|
What is therapeutic managment and nursing considerations for asthma?
|
allergen contorl
relieve bronchospasm provide acute asthma care support child/family |
|
|
What are some medications used to control asthma?
|
metered dose inhalers (older children)
nebulizers (young children) corticosteroids beta-adrenergic agonists NSAID cromolyn sodium Nedocromil Leukotriene modifiers (singulair) methylxanthines- theophylline |
|
|
Improper use of metered dose inhalers can lead to what condition?
|
thrush
|
|
|
What drug is given for managment of severe persistent asthma, or is used for short periods of time to gain prompt control of persistent asthma?
|
corticosteroids
*Advair, Pulmicort, Flovent, AeroBid, Azmacort, Beclovent, QVAR |
|
|
This drug is used to treat acute exacerbations of asthma, and to prevent exercise-induced asthma. It is inhaled or PO.
|
Beta-Adrenergic Agonists
*albuterol, Xopenex, Ternutaline |
|
|
Side effects of this asthmatic drug include: irritability, tremor, nervousness, instomnia
|
Beta-Adrenergic Agonists
*albuterol, Xopenex, Ternutaline |
|
|
This is a last resort NSAID used for asthma
|
Cromolyn Sodium
|
|
|
This is a third-line agent used for asthma. The nurse must monitor levels and may need to change dose frequently. It may cause behavior problems and poor school performance.
|
Methylxanthines- Theophylline
|
|
|
This condition occurs in asthmatics who continue to have respiratory distress despite vigorous therapeutic measures. It may be rapid or gradual in onset. It may require hospitalization.
|
status asthmaticus
|
|
|
Therapy for status asthmaticus is directed at:
|
-improving ventilation
-correcting dehydration/ acidosis -Treating concurrent infection |
|
|
Goals for asthma patients include:
|
1. will not experience asthmatic episode
2. improve ventilatory capacity 3. maintain optimal health 4. not develop complications 5. engage in normal activities 6. support/edu family |
|
|
This disease is caused by an autosomal recessive trait. Mucous gland secretions have increased viscosity (mainly in lungs and pancreas). There is an elevation of sweat electrolytes. There is an increased in several organic and enzymatic constituents of saliva. The autonomic nervous system does not function correctly.
|
cystic fibrosis
|
|
|
How can a parent most easily catch/notice cystic fibrosis in their child?
|
they taste salt when they kiss them.
|
|
|
What is the earliest manifestation of cystic fibrosis (it is not always present, though)?
|
meconium ileus (tarry stools)
|
|
|
what is it called when stools form undigested fat due to CF?
|
steatorrhea
|
|
|
what is it called when foul smelling stools form from putrified protein due to CF?
|
azotorrhea
|
|
|
What pulmonary complications arise from CF?
|
-evidence of respiratory s/s before age 1
-bronchial and bronchiolar obstruction -difficult to expectorate the mucous -excellent medium for bacterial growth= increase in pneumonia and other bacterial infections |
|
|
How is CF diagnosed?
|
-dx based on Hx of dz in fam
-absence of pancreatic enzymes -increase in electrolyte concentration of sweat -chronic pulmonary involvment -CXR -stool studies -barium enema (dx meconium ileus) |
|
|
How are pulmonary problems in CF managed?
|
-CPT twice daily and PRN
-administer bronchodilators as needed -pulmozyme- decreases viscosity of mucous (bid qd) -physical exercise- stimulates mucous secretion -tx pulmonary infections ASAP |
|
|
How are GI problems managed in CF?
|
-oral pancreatic enzymes are taken with snacks and meals
-well balanced, high protein, high-cal, high-fat diet -fat soluble vitamin absorption inhibited- take vitamins ADEK and miltivitamins |
|
|
birth wt droubles by age:
|
6 months
|
|
|
birth wt triples by age:
|
1 year
|
|
|
what are some reasons why it is better to breast-feed infants instead of bottle-feed
|
-lower incidence of CVD and obesity
-gain less wt as infants - immunity passes through breast milk |
|
|
Height increases ___ inch(es) per month the first _____ months, then slows.
|
1
6 |
|
|
birth length increses by 50% by age:
|
1 year
|
|
|
The head increases by ___% by 1 year
|
33%
|
|
|
The posterior fontanel closes at what age?
|
6-8 weeks
|
|
|
the anterior fontanel closes at what age?
|
12-18 months
|
|
|
Why is it important to look at the infant's fontanels in assessment?
|
-it can show whether the infant is dehydrated (sunken in) or overhydrated (swollen)
|
|
|
The brain increases in weight by how much in infancy?
|
2 1/2 times
|
|
|
The chest circumference equals the head circumference by what age?
|
1 year
|
|
|
How many teeth should a child have based on their age?
|
For the first two years:
age of child in months - 6 = number of teeth they should have |
|
|
How many teeth should a 9 month old child have?
|
3
|
|
|
what teeth are the first to erupt? What is next?
|
lower central incisors, then upper central incisors
|
|
|
Binocularity starts at age _____ and is developed by age _______. (cannot make double image into one until this time.)
|
6 weeks
4 months |
|
|
Depth perception begins at age_______
|
7-9 months
|
|
|
Grasp reflex begins at age _____
|
2-3 months
|
|
|
Voluntary grasp begins at age________
|
5 months
|
|
|
An infant can transfer objects at age ______
|
7 months
|
|
|
neat pincer grasp begins at age ________
|
11 months
|
|
|
A child is able to pick up small objects like raisins at what age?
|
10 months
|
|
|
A child is able to put objects in containers at what age?
|
11 months
|
|
|
A child can roll over abdomen to back at what age?
|
5 months
|
|
|
A child can roll over back to abdomen at what age?
|
6 months
|
|
|
What is the startle reflex called (where they are startled when you kick their crib)? When does it disappear?
|
Moro reflex
4 months |
|
|
What age can a child sit supported by their hands?
|
7 months
|
|
|
What age can a child sit unsupported?
|
8 months
|
|
|
What age does a child begin playing peek-a-boo?
|
after 6 months
|
|
|
What age does a child begin crawling (start by creeping on belly and progresses to hands and knees)
|
8-9 months
|
|
|
What age does a child walk with assistance?
|
10-12 months
|
|
|
Three new processes of human behavior begin in the second half of the first year. What are they?
|
imitation
play affect (outward manifestation of emotion) |
|
|
Stranger anxiety begins at what age?
|
7-9 months
|
|
|
What age does a child normally say his/her first word?
|
8 months
|
|
|
What age does a child say a word with meaning?
|
10-11 months
|
|
|
What age does a child know what "no" means and can obey simple commands?
|
9-10 months
|
|
|
What age does a child have a meaningful vocabulary of 3-5 words?
|
1 year
|
|
|
What age does a child develop a social smile?
|
2 months
|
|
|
What age does a child turn his/her head to locate sound?
|
3 months
|
|
|
What age does a child turn to locate sound?
|
3 months
|
|
|
What nutritional needs does a child have at 0-6 months?
|
breast milk
*need iron by 4-6 months |
|
|
What age should fluoride supplementation begin?
|
6 months
|
|
|
What age is best to start introducing finely mashed foods?
|
6 months
|
|
|
How do you introduce solid foods for the first time?
|
one at a time in 4-7 day intervals
*start with iron-fortified cereal, strained fruits, vegetables, and then meats |
|
|
What age can a child begin drinkning whole milk?
|
1 year
|
|
|
The health department will not give an immunization in the temperature is >______
|
101.5 R
|
|
|
When do you give a Hep B vaccine to an infant if the mom is positive (of if mom's status is unknown?
|
within 12 hours of birth
|
|
|
An infant has just received an immunization. He is experiencing a high fever, encephalopathy, seizures, has been inconsolably crying for >3 hours. What vaccine are these side effects of? Can the child receive additional doses of the vaccine?
|
DTaP
NO! |
|
|
A child as a temperature of 104, a family history of seizures, SIDS, and adcerse reactions to vaccines. Should this child receive the DTaP vaccine?
|
YES
|
|
|
What can parents give a child after receiving a vaccine as long as they are closely watched for side effects?
|
tylenol
*watch closely though- may not have a fully developed liver to absorb drug. |
|
|
This vaccine protects against bacterial meningitis, epiglottitis, bacterial pneumonia, and sepsis.
|
Haemophilus influenzae type b
(Hib) |
|
|
Is the haemophilus influenzae type b (Hib) vaccine used for the flu?
|
NO
|
|
|
Should a child who has already had bacterial meningitis, epiglottitis, bacterial pneumonia, or sepsis still get the Haemophilus influenzae type b (Hib) vaccine?
|
YES
|
|
|
Is meningococcal meningitis covered by the haemophilus influenzae vaccine (Hib)?
|
NO
|
|
|
What are contraindications of MMR?
|
immunodeficiency
Hc of anaphylactic reaction to eggs or neomycin |
|
|
Can you receive a MMR vaccine if you have TB, a positive skin test?
|
YES
|
|
|
Can you receive a MMR vaccine if you are pregnant, or if a household contact is immunodeficient?
|
YES
|
|
|
You can give this vaccine along with DTaP, IPV, HBV, and/or Hib.
|
Varicella
|
|
|
Can a immunocompromised child who is receiving a corticosteroid receive a varicella vaccine?
|
NO
|
|
|
Can children who have asymptomatic HIV receive a varicella vaccine?
|
YES
|
|
|
What polio vaccine is safe for immunocompromised?
|
Salk
*given IM |
|
|
What polio vaccine is not safe for immunocompromised, or if an immunocompromised is in contact with the vaccinated patient?
|
Sabin
*oral- gives better immunity but is shed in stool and can give by contact. |
|
|
Can a HIV-infected person get the Sabin vaccine? Can a patient with a household contact that has HIV get the Sabin vaccine
|
NO
NO |
|
|
Can a person who is on antibiotic therapy receive the Sabin vaccine?
|
YES
|
|
|
Can a person who has diarrhea receive the Sabin vaccine?
|
YES
|
|
|
What are some common reactions to immunizations?
|
local tenderness, swelling, redness, low-grade fever, behavioral changes, drwosiness, fretfulness, eating less, prolonged or unusual crying
|
|
|
What are some contraindications for all immunizaitons?
|
moderate or severe illnesses with or without fever
anaphylaxis |
|
|
A child who has mild/moderate local reactions, a mild acute illness like the cold, on current antibiotic therapy, and in the convalescent phase of illness (SHOULD) or (SHOULD NOT) receive a vaccination
|
SHOULD
|
|
|
Should a premature infant still receive vaccinations?
|
YES
|
|
|
should a child who has had a recent exposure of the infectious disease still receive the vaccine?
|
YES
|
|
|
Should a child with a history of penicillin or other nonspecific allergens or family hx of such still receive a vaccination?
|
yes
|
|
|
What is the leading cause of fetal injury in children less than 1 year old?
|
aspiration of foreign bodies
|
|
|
What is the guideline for carseats?
|
face the rear from birth to 20 pounds and one year
|
|
|
How much folic acid per day is recommended for infants?
|
0.4mg
|
|
|
Causes of protein and energy malnutrition include:
|
lack of food
diarrhea poor sanitation/bottle feeding inadequate knowledge parental illiteracy economic and political factors |
|
|
Protein malnutrition in infants (due to a diet high in carbohydrates-starch grains or tubers), with adequate calories is called:
|
Kwashiorkor
*meaning from Ghana language: "The sickness the older child gets when the next baby is born" |
|
|
General malnutrition of both calories and protein in infants is called:
|
Marasmus
|
|
|
Food sensitivity in infants happens because:
|
immature intestinal tract of infant makes it more permeable to proteins making an immune response likely
|
|
|
The most common food allergies are to:
|
eggs
cows milk chocolage wheat |
|
|
A baby has been introduced to more types of foods recently. He is experiencing GI, respiratory, and integumentary symptoms. He is crying excessively, and has pallor. What is the most likely cause?
|
cow's milk allergy
|
|
|
What is given to people with cow's milk allergy?
|
caesin hydrolysate
*yogurt is a good substitution also |
|
|
An infant has paroxysmal abdominal pain and cramping occuring inthe morning and at night. He is 2 months old. What does this child most likely have?
|
colic
|
|
|
What is it called when an infant has inadequate growth resulting from an inability to obtain and/or use calories, and their weight is <5%?
|
failure to thrive (FTT)
|
|
|
What are the causes of failure to thrive (FTT)?
|
organic (physical cause)
nonorganic (definable cause unrelated to dz) Idiopathic (unexplained) |
|
|
What is a sign of FTT?
|
child will avoid eye contact
|
|
|
A child has impaired social relations and behavior. Development, language and sensory/perceptual processes are all impaired. What does this child likely have?
|
autism
|
|
|
For toddlers, how much weight are they supposed to gain per year?
|
4-6 lbs
|
|
|
How much is a toddler supposed to grow in height per year?
|
3 inches
|
|
|
When is a toddler supposed to be able to walk alone?
|
12-13 months
|
|
|
What age does a toddler try to run at?
|
18 months
|
|
|
What age is a toddler able to jump with both feet?
|
2 1/2 years
|
|
|
what age can a toddler stand on one foot (for a brief period)?
|
2 1/2 years
|
|
|
What age can a toddler walk up and down stairs?
|
age 2
|
|
|
What age can a toddler tiptoe at?
|
3 years
|
|
|
You know there is a developmental delay if a toddler is not walking by age:
|
15 months
|
|
|
A child can drop a small object into a bottle or cup by age
|
15 months
|
|
|
What age can a child throw an object and retrieve it?
|
15 months
|
|
|
What age can a toddler throw a ball overhead without losing balance?
|
18 months
|
|
|
What age can a child build a tower with blocks?
|
2 years
|
|
|
What age can a toddler draw a circle on paper by?
|
3 years
|
|
|
A speech delay is evident if the child is not putting two words together (i.e. "my cup," "go there") by age:
|
2 years
|
|
|
A child is ready to toilet train by age:
|
2 1/2 to 3 years
*girls faster than boys |
|
|
In preschool, a child should gain how much wt per year?
|
5 lbs
|
|
|
In preschool, a child should grow how much in height per year?
|
2 1/2 to 3 inches
|
|
|
A child can skip and hop on one foot by age
|
4
|
|
|
a child can skip on alternate feet, and do activities such as jump rope, skate, and swim by age
|
5
|
|
|
Children are aware of their own size in comparison to other by age:
|
5 years
|
|
|
How is chicken pox transmitted?
|
through respiratory tract secretions of an infected person
|
|
|
How long is the incubation period of chicken pox?
|
2-3 weeks (14-16 days)
|
|
|
When is a child with chicken pox contagious?
|
from 1 day before eruption of lesions to 6 days after the first crop of vesicles when crusts have formed.
|
|
|
A toddler/preschooler presents with a slight fever, malaise, anorexia, lymphadenopathy, irritability, and a highly pruritic rash. What does this child have?
|
chicken pox
|
|
|
How does the rash develop in chicken pox?
|
begins as macule
rapidly progresses to papule progresses to vesicle surrounded by erythematous base, becomes umbilicated and cloudy, breaks easily forms crust |
|
|
What medications are used to treat chicken pox?
|
acyclovir (use within first 24 h)
varicella-zoster immune globulin benadryl |
|
|
What are some complications of chicken pox? how can you prevent them?
|
secondary bacterial infections
pneumonia encephalitis *good skin care/handwashing including wash under fingernails |
|
|
What are some nursing considerations for chicken pox?
|
strict isolation
good skin care trim fingernails apply pressure to pruritic area, no scratching remove crust calamine lotion oatmeal baths encourage varicella vaccine |
|
|
Why can't you use aspirin for chicken pox?
|
causes rhye's syndrome
|
|
|
How is diphtheria spread?
|
through discharges from mucous membranes of the nose and nasopharynx, skin, and other lesions of infected person
|
|
|
How long is the incubation period for diptheria?
|
2-5 days
|
|
|
A toddler/preschooler presents with nasal discharge, epistaxis, fever, hoarsness, cough, cyanosis, retractions, malaise, sore throat, fever, white or gray membranes over tonsils, pseudomembranes over the tonsils, and lymphadenitis (bulls neck). What does this child have?
|
Diptheria
|
|
|
What are more serious CM of diptheria?
|
potential airway obstruction
septic shock toxemia death |
|
|
What medications are used for diptheria?
|
antitoxin IV
antibiotics (penicillin, erythromycin) |
|
|
Whata re some nursing considerations for diptheria?
|
complete bedrest
tracheostomy for airway- suction prn obstruction O2 strict isolation close resp. observation |
|
|
What are some complications of diptheria?
|
myocarditis
neuritis |
|
|
What disease is caused by the human parvovirus?
|
erythema infectiosum (fifth disease)
|
|
|
How if fifth disease transmitted?
|
possibly through respiratory or blood secretions
|
|
|
What is the incubation period for fifth disease?
|
4-14 days
|
|
|
When is fifth disease contagious?
|
before the onset of symptoms
|
|
|
How does the rash in fifth disease progress?
|
stage 1: erythema on face- "slapped cheeks"
stage 2: maculopapular red spots on extremities and trunk (may last 1 week or more) stage 3: rash subsides but reappears if skin is irritated or traumatized *can reappear for up to 1 month |
|
|
what is the treatment for fifth disease?
|
symptomatic and supportive
|
|
|
What are some complications of fifth disease?
|
aplastic anemia
myocarditis fetal death if mother infected during pregnancy |
|
|
A toddler/preschooler presents with a red face looking like slapped cheeks, the rash does not itch, and he has red spots on his arms and trunk. What does this child have?
|
fifth disease
|
|
|
What are some nursing considerations for fifth disease?
|
hospitalization if immunosuppresed or has aplastic crisis
edu- do not expose pregnant women |
|
|
What organism causes exanthem subitum (Roseola)?
|
human herpesvirus type 6
|
|
|
What is the incubation period for Roseola?
|
5-15 days
|
|
|
A toddler/preschool child is brought to the clinic by his mother. She says he had a high fever of 103 for 4 days, but no other symptoms. The fever disappeared yesterday morning, and now the child has developed a rash on his trunk, neck, face, and arms. The rash does not itch, and blanches with pressure. What does this child have?
|
Roseola
|
|
|
How does the rash in Roseola progress?
|
rose-pink macules/ maculopapules
appear on trunk first, then on neck, face, extremities |
|
|
How do you treat Roseola?
|
antipyritics to control fever
|
|
|
What are some complications of Roseola?
|
febrile seizures
encephalitis |
|
|
How are Mesles (Rubeola) spread?
|
through direct contact with respiratory droplets, blood, or unrine of an infected person
|
|
|
What is the incubation period of measles (rubeola)?
|
10-20 days
|
|
|
When are measles (rubeola) contagious?
|
4 days before to 5 days after rash appears
|
|
|
A preschool/toddler child presents with fever, malaise, conjunctivitis, Koplic spots, and a cough. a rash has appeared on his face and is spreading downward. Since the rash has appeaered, his symptoms have increased in severity. What does this child have?
|
mesles (rubeola)
|
|
|
How does the rash in measles (rubeola) progress?
|
it begins as an erythematous maculopapular eruption on face
spreads downward becomes brownish after 3-4 days |
|
|
How do you treat measles (rubeola)?
|
vitamin A supplementation
antibiotics (prevent secondary infection for high-risk child) antipyretics bedrest |
|
|
What are some nursing considerations for measles (rubeola)?
|
isolate until the 5th day
respiratory isolation eye care skin care rest |
|
|
What organism causes mumps?
|
the paramyxovirus
|
|
|
How is mumps transmitted?
|
through direct contact with or droplets spread from an infected person
|
|
|
How long is the incubation period for Mumps?
|
14-21 days
|
|
|
When is mumps most contagious?
|
immediately before and after swelling begins
|
|
|
A preschool child presents with fever, headache, earache aggravated by chewing, and enlargment of the parotid gland accompanied by pain/tenderness. What does this child have?
|
mumps
|
|
|
What is the treatment for mumps?
|
analgesics
antipyretics IVF if not eating or drinking |
|
|
What are some complications of mumps?
|
deafness
myocarditis encephalitis arthritis |
|
|
What are some nursing considerations for mumps?
|
isolation (respiratory)
fluids soft,bland food aviod chewing hot/cool compresses to neck |
|
|
Poliomyelitis is transmitted by:
|
through feces and oropharyngeal secretions of infected persons
|
|
|
How long is the incubation period for polio?
|
7-14 days (or can be 5-35 days)
|
|
|
When is polio contagious?
|
for 4-6 weeks after infection
|
|
|
A preschool child presents with fever, sore throat, uneasiness, headache, anorexia, vomiting, and abdominal pain. what does this cild have?
|
Inapparent polio
|
|
|
A preschool child presents with severe symptoms of fever, sore throat, uneasiness, headache, anorexia, vomiting, and abdominal pain. The child also has pain and stiffness in the neck, back, and legs. What does this child have?
|
nonparalytic polio
|
|
|
A child initially presents with severe symptoms of fever, sore throat, uneasiness, headache, anorexia, vomiting, and abdominal pain. He also has pain and stiffness in his neck, back, and legs. After recovery, he develops signs of CNS paralysis. What does this child have?
|
paralytic polio
|
|
|
How is polio treated?
|
-supportive tx
-acute phase lasts up to 2 weeks- complete bed rest -assist respiratory ventilation in case of resp paralysis -physical therapy for muscles following acute stage |
|
|
What are some complications of polio?
|
permanent paralysis
respiratory arrest |
|
|
What are some nursing considerations for polio?
|
- prevent contractures/ decubiti
- encourage movement - analgesics -ROM exercises - close observation for resp. paralysis |
|
|
What dz does the rubella virus cause?
|
Rubella (german measles)
|
|
|
How is rubella transmitted?
|
primarily through nasal secretions of infected persons
also through blood, stool, urine |
|
|
How long is the incubation period for rubella?
|
14-21 days
|
|
|
How long is rubella contagious?
|
for 7 days before to about 5 days after appearance of rash
|
|
|
A preschool child presents with a rash that appeared first on the face and then the neck, arms, trunk, and legs. The rash is now beginning to disappear on the face and neck. What does this child have?
|
Rubella
|
|
|
An adolescent presents with fever, headache, malaise, mild conjunctivitis, sore throat, and lymphadenopathy. She has a rash that started on her face and progressed downward. Now the rash is disappearing on her face. What does this child have?
|
rubella
|
|
|
What is the treatment for rubella?
|
antipyretics
analgesics |
|
|
what are some complications of rubella?
|
it has terotogenic effects on the fetus (can cause baby to have congenital cataracts)
|
|
|
What are some nursing considerations for rubella?
|
reassure parents of benign nature
isolate child from pregnang women |
|
|
Iflammation of the conjunctiva of the eye. Common in newborns following vaginal births.
|
Conjunctivitis
|
|
|
What kinds of organisms cause conjunctivitis?
|
bacteria
virus fungus |
|
|
A child presents with purulent drainage from hte eye, swollen lids, crusting of the eyelids, and inflamed conjunctiva. What does this child have?
|
bacterial conjunctivitis
|
|
|
A child presents with watery drainage from the eye, inflammed conjunctiva, and already has a upper respiratory infection. what does this child have?
|
viral conjunctivitis
|
|
|
A child presents with itchy eyes, thick stringy discharge, inflammed conjunctiva. What does this child have?
|
allergic conjunctivitis
|
|
|
How do you treat viral conjunctivitis?
|
remove secretions
will resolve on its own |
|
|
How do you treat bacterial conjunctivits?
|
topical antibiotic drops or ointment
|
|
|
How do you treat allergic conjunctivitis?
|
topical allergy drops or oral antihistamines
|
|
|
What are some complications of conjunctivitis?
|
peri-orbital cellulitis
corneal ulceration |
|
|
What are some nursing considerations for conjunctivitis?
|
advise parents of contagiousness of bacterial and viral conjunctivitis
avoid touching tip of med to eye good hand washing |
|
|
This disease is most common in summer and fall, is most commonly cause by enteroviruses (coxsackie virus).
|
Hand Foot Mouth Disease
|
|
|
How is Hand Foot Mouth Disease transmitted?
|
through respiratory droplets or fecal-oral contact with infected person
|
|
|
A cild presents with sores in the mouth, raised red spots on the palms, soles of feet and perineal area, fever, sore throat, and a decreased appetite. What does this child have?
|
Hand Foot Mouth Disease
|
|
|
How do you treat Hand Foot Mouth Disease?
|
analgesics
antipyretics "magic" mouth wash- lidocaine, benadryl, and maalox |
|
|
What are some nursing considerations for Hand Foot Mouth Disease?
|
encourage PO fluids
good handwashing |
|
|
What causes Scarlet Fever?
|
group a strep
|
|
|
How long is the incubation period for scarlet fever?
|
2-5 days after exposure with respiratory secretions
|
|
|
How is scarlet fever diagnosed?
|
from physical findings and results of a throat culture of rapid strep test
|
|
|
A child presents with a strawberry tongue, fever, headache, decreased appetite, vomiting, palatal petechia, lymphadeopathy, and a sandpaper rash on his neck, trunk, and extremeties. What does this child have?
|
scarlet fever
|
|
|
How does the rash in scarlet fever progress?
|
it starts as an erythematous, sandpaperlike rash on the neck and spreads to the trunk and extremeties.
|
|
|
How do you treat scarlet fever?
|
*same as strep throat
isolate from others antipyretics oral or IM antibiotics- penicillin |
|
|
What are some nursing considerations for strep throat?
|
educate parents
rest test other family members |
|
|
what are some potential complications from scarlet fever/strep throat?
|
rheumatic fever
glomerulonephritis septic arthritis |
|
|
What causes giardiasis?
|
a protozoan- giraia lamblia
|
|
|
This is the most common intestinal parasite in the US. It is transmitted through water, lakes, streams, diapers, etc.
|
Giardiasis
|
