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41 Cards in this Set
- Front
- Back
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When and what foods should be introduced into the infants diet? How should parents introduce foods?
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Human milk till 6 months or iron fortified formula. Iron fortified cerals first, rice later. Introduced around 4-6 months. Solid foods should be introduced 4-7 days apart to detect any allergic reaction.
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Factors that put child at risk for developing Reye's syndrome?
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Using aspirin to treat viral infection or having an underlying fatty acid oxidation disorder.
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Factors that predispose infant to organic failure to thrive.
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Result of a physical cause such as congenital heart defects, neurologic lesions, chronic renal failure, endocrine dysfunction, gastroreflux disease, cerebral palsy or AIDS.
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Factors that predispose infant to inorganic failure to thrive.
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definable cause that is unrelated to disease, most often psychosocial factors such as inadequate nutrition information by the parent, deficiency in maternal care or disturbance in maternal-child attachment, disturbance from ability of child to separate from parent, and refusing food for attention.
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Assessments to identify an infant suspected of having failure to thrive.
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complete health history and dietary history. Physical exam for evidence of organic causes, developmental assessment and family assessment, dietary intake history (24 hour or history of 3-5 day) child's activity level, parental height, perceived food allergies, dietary restriction's, household organization and meal time behaviors or rituals should be observed.
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Drugs, techniques, therapies used to teach parents how to manage child with ADHD.
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Calm, firm, respectable approach, model kind of behavior you desire from child, obtain child's attention before giving important information or directions, set limit for acceptable behavior if needed,praise child for cooperation, plan physical activities to expend child's energy, minimize distractions, behavioral management plans, provide opportunities for success, work with school nurse and to teacher to identify child's needs.
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What do you teach parents about ADHD medications?
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Psychostimulants:Ritalin and Dexedrine, Strattera
Effects: lack of appetite, inability to sleep, anger or aggression when medicine wearing off. Best in morning, teach dose and time of medication for maximum effect. Small frequent meals if suppressing child's appetite. |
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Prevention of Sids?
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Place infant on back to sleep, prevent tobacco exposer, keep child from overheating, use firm tight fitting mattress in crib, remove pillows, quilts, sheepskins from crib during sleep, ensure infants head is uncovered during sleep.
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Otitis media: cause, signs and symptoms, and treatment?
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Causes: Virus- RSV and influenza, Bacteria- stept, H. influenza and moraxella catarrhalis.
S/S:acute ear pain, fever, bulging yellow or red tympanic membrane, purulent discharge, infant: crying fussing, restless, irritable, tendency to rub, hold or pull on ear, difficultly comforting child, loss of appetite. Older child: crying and verbalizes feelings of discomfort, irritability, lethargy and loss of appetite. Treatment: Antibiotics after 72 hours to see if spontaneously heals, not for children less than 2, all children under 6 months should be treated with antibiotics right away due to immature immune system, pain should subside in 24-48 hours, infection not gone until all medication is taken, OM could result in hearing loss. Myringotomy a surgical incision to provide drainage and relieve pain. Tympanostomy tube placement to treat recurrent OM. |
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Child with cystic fibrosis: drugs, vitamins, treatment, pulmonary system, prevent complication!
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Vitamins A,D,E,K with multivitamins and pancreatic enzymes.
Prompt treatment of respiratory infections with antibiotic therapy. Chest physiotherapy a minimum of twice a day, bronchodilators, to promote expectoration of excretions, Dornase alfa helps decrease viscosity of mucus, physical activity that child enjoys. Pulmonary system: thick, tenacious mucus obstructs the respiratory passage, causing trapped air and overinflated lungs, chronic respiratory infection classic sign of disease. Atelectasis and small lung abscess are common early complication, bronchiectasis and emphysema may develop. |
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Child having a tonsillectomy, blood tests prior to procedure, early sign and symptoms of post op complications.
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Preop lab: throat cultures to check for GABHS infection and treat with antibiotics, CBC to check for acute infections and anemia.
Post OP: until fully awake children placed on abdomen or side to facilitate drainage suctioning to avoid trauma, child may sit up when awake, should remain in bed, discourage coughing, clearing throat, blowing nose or any activity that may aggravate site, inspect secretions for bleeding, ice collar, analgesics rectally or IV, food and fluids limited until no signs of hemorrhage, no foods of red or brown color. Indication of hemorrhage: pulse greater than 120, pallor, clearing of throat or frequent swallowing and vomiting bright red blood, restlessness, hypotension sign of shock. |
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Nursing role when child is brought into the ER and abuse is suspected, laws governing actions?
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report to local authorities, priority is to remove child from abusive situation to prevent further injury, all states have laws mandating reporting of child maltreatment, obligated to report to the law.
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Chronic iron deficiency anemia, treatment for infant and school age, diet?
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sx/sx: shortness of breath/fatigue, tachycardia, dizziness or fainting, pallor, nail bed deformities, lethargy, irritability, muscle weakness, impaired healing, loss of skin elasticity, thinning hair, low grade fever, heart failure. Treatment: infants- iron supplements liquid form, breatfeeding and iron fortified formula. School age- administer iron on empty stomach, vitamin c to increase absorption, straw with liquid to avoid staining, rinse mouth afterwards.
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Complications of leukemia and what immunization should you not give to a child receiving chemo?
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Complications: anemia- administer blood transfusion as orders, rest periods, administer oxygen therapy, iv fluid replacement.
Infection: private room, restrict visitors, strict hand washing, potential sites of infection, monitor temperature, antibiotics as prescribed, neutrophil count, adequate protein intake. Bleeding: monitor for signs of bleeding, encourage/provide oral care with soft toothbrush, avoid skin punctures, use aseptic techniques, 5 minutes pressure to stop bleeding, nosebleed cold and pressure, control nosebleeds. Avoid live vaccinations, MMR, polio, varicella bodies weak immune system cant fight. |
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Kubler-Ross stages and how staff deal with children deal with terminally ill children.
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Denial, Anger, Bargaining, Depression, Acceptance
Attentiveness, humanistic support, suggestions for care, communication, verbalize feelings, referral to volunteer and community agencies to help parents cope. |
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What has an impact on how children and their families deal with grief associated with death and dying process?
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Cultural and ethnicity, spiritual beliefs, anticipatory grieving, increase potential for dysfunction: lack of support, poor coping skills, social stigma, such as suicide, sudden unexpected death.
Preschool- death is temporary and sense of punishment School-age- fear or unknown, loss of control, curious about funeral services, and what happens after you die Adolescents- adult like concept, guilt and shame, stressed by changes |
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Maternal factors that put mother at risk for having a child with a congenital heart defect, difference between acquired and congenital heart disease?
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Rubella in early pregnancy, alcohol and other substances, DM. Acquired is not heredity. CHD at birth is due to heredity, prenatal infection, injury, effect of drug in uterus.
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Immediate post op care of child with cleft palate surgery, rational, parent teaching?
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Positioned on abdomen, IV fluids until able to drink and eat, monitor packing, assist child to breath by lifting in upright position, don't use harmful objects to feed such as a fork, don't use tongue depressor or pacifier, discharge on soft diet.
Homecare: might require elbow restraints for 4-6 weeks, proper use and periodic removal, proper feeding techniques and finger foods, proper care of operative site, don't pull out packaging, don't swab may cause damage. |
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Wilm's Tumor: sx/sx, location and treatment
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Sx/Sx Metastasis: edema (periorbital) with ecchymosis around eye, lymphadenopathy, weight loss, anemia, fatigue, hepatomegaly, splenomegaly, shortness of breath, decreased breath sounds, cough. Location: Kidney- abdominal swelling or mass that is firm, non tender and unilateral. Treatment: surgery and chemotherapy. Surgery schedule asap, as soon as confirmed renal mass and usually within 24-48 hours of admission, Tumor affect kidney and adjacent adrenal gland removed. Radiation for large tumors, metastasis, and reoccurrence. Chemotherapy for all stages.
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Acute glomerulonephritis, intervention to address and likely cause of this problem?
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Monitor I and O, color, specific gravity and presence of protein in urine. Monitor daily weights and abdominal girth, respiratory system for fluid overload, vital signs watch for hypertension, implement seizure precautions, nutrition intake, restrict sodium and foods, monitor skin break down areas. Prevent pressure sores, medications as prescribed, tolerance activity, frequent rest, age appropriate diversional activity, monitor and prevent infection, emotional support, follows a strept infection.
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Signs and symptoms of urinary tract infection in neonates.
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poor feeding, vomiting, failure to gain weight, rapid respirations, frequent urination, poor urine stream, jaundice, seizures, enlarged kidney or bladder
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Signs and symptoms of UTI in infants
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poor feeding, vomiting, failure to gain weight, excessive thirst, straining or screaming upon urination, foul smelling urine, pallor, fever, persistent diaper rash, seizures, enlarged kidney or bladder.
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Signs and symptoms of UTI in childhood ( 2-14 years)
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oor appetite, vomiting, growth failure, excessive thirst, enuresis, incontinence, frequent urination, painful urination, swelling of face, seizures, pallor, fatigue, blood in urine, abdominal pain or back pain, edema, hypertension, tetany
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Four classic sx/sx of early nephrotic syndrome, other problems, Infection? Interventions, skin problems?
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Increased glomerular permeability to plasma protein which results in massive urinary protein loss, massive proteinuria, hypoalbuminemia, hyperlipemia and edema. Clinical manifestations- weight gain, puffiness of face, abdominal swelling, pleural effusions, susceptibility to infection. Managment: reduce excretion of urinary protein, reduce fluid retention in the tissues, prevent infection, minimize complication related to therapies, dietary restrictions- low salt diet and fluid restriction. Corticosteriods first line of therapy.
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Sickle Cell crisis: Vaso-Occulusive
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severe pain usually in bones, joints, and abdomen, swollen joints, hands, and feet. Anorexia, vomiting and fever, hematuria, obstructive jaundice, visual disturbances. Chronic symptoms: increased risk of respiratory infections adn osteomyelitis, retinal detachment and blindness, systolic murmur, renal failure and enuresis, liver failure, deformities of skeleton
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Sickle Cell Crisis: sequestration
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excessive pooling of blood in the liver and spleen. tachycardia, dyspnea, weakness, pallor, and shock.
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Sickle Cell crisis: aplastic
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extreme anemia as result of decreased RBC production
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Sickle cell crisis: hyperhemolytic
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increased rate of RBC destruction leading to anemia, jaundice, and reticulocytosis
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CBC Normal Values
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2 months: HgB 9.0- 14.0 g/dl HcT 28-42%
6-12 years: 11.5-15.5 g/dl 35-45% 12-18 years: Males 13.0-16.0 g/dl 37-49% Females 12.0-16.0 g/dl 36-46% |
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Child with hemophilia, nursing intervention? Acute bleeding episode? Prevent long term disability in joints?
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Deficiency of one of factors necessary for coagulation of the blood. Therapy: replacement of missing clotting factor VIII and corticosteriods and NSAIDS for pain. Regular exercise and physical therapy to strengthen muscles around joints and may decrease number of spontaneous episodes, prophylaxis involves infusion of factor VIII, decrease risk of injury, environment should be safe, dress toddlers in extra layers, set activity restrictions, protective equipment helmets ect, swimming, walking, jogging, tennis, golf and bowling, prevent oral bleeding, teach how to administer factor at home, sx/sx of internal bleeding
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Communication with school age child in hospital.
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Industry vs. inferiority (5-12 years). COmpany of same sex companions, relationships come from school associations, rival the same sex parent, fears ridicule by peers and teachers, modest and more emphasis on privacy
Talk to them on their level, explain procedures, and answer questions! |
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Fears in preschooler? How can parent help? Developmental level? Who would be a good roommate?
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Initiative vs. Guilt (3 -5 years) Take on new experiences, guilt occur when children cant accomplish a task and believed they misbehaved, help guide them. During stress, insecurity and illnesses they may regress to previous immature behavior or develop habits like nail biting. Child of same age good roommate
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Prodromal stage of chickenpox? When is child first communicable with this virus and for how long? How long should you isolate child and who should they be isolated from? Contraindications for Varicella immunization?
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Zoster virus: spread through direct contact, droplet and contaminated objects. Incubation 10-21 days. COmmunicable one day before lesions to 6 days after lesions appear, not contagious on once lesions have crusted over. Predromal stage lasts 1-5 days before infection becomes active and skin rash irrupts
DOnt give if allergic to gelatin, neomycin, immune globulin, HIV, eggs or allergic reaction. |
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Meningitis, sx/sx? Signs in older children? Brundzinski sign?
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Brundzinski sign: severe neck stiffness causes patients hips and knees to flex when the neck is flexed. Kernig sign: resistance to extension of childs leg from flexed position. Bacterial meningitis- acute inflammation of meninges and the CNS, S/S Neaonates: well at birth but within few days begins to look and behave poorly, refuses feedings, poor sucking ability, vomiting, diarrhea, poor muscle tone, irritability and drowsiness. S/s children: abrupt onset, fever, chills, headache, vomiting, seizures, delirium, nuchal ridgity
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Lumbar positive for bacterial meningitis? Color and consistency of fluid? Protein and glucose? Isolation?
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Appearance of CNS: Cloudy (bacterial) clear (viral), elevated WBC, and protein, elevated cns pressure, decreased glucose. Isolated from other children for first 24 hours after IV antibiotics.
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Types of seizers
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Tonic-clonic- generalized or grand mal (most common) Tonic phase- eyes roll upward and person falls to floor, immediate loss of conscience.
Care: calm, record time of seizures, ease unto floor, lossen restrictive clothing, clear area of hazards. Partial seizures: eye or eyes and head turn form side to side, awareness of movement or loss of conscience. Partial seizure complex: period of altered behavior, inability to respond to environment, drowsiness or sleep follows, inability to respond |
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Decerebrate and decorticate
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Decorticate- dysfunction of the cerebral cortex Abduction of the arms at elbows, flexion of arms, wrists flexed, extension of lower extremities.
Decerebrate- dysfunction of level of midbrain rigid extension of arms and legs |
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Cause of Downs syndrome and what is expected cognitively and behaviorally? how do you help new parents deal?
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Extra chromosome- tri 21. Cognitive range from moderate 35- 50 to low average (90). Preschool age- slower to walk, feed selfand talk to having little to no communication skills. School age- higher IQ can acquire practical skills and useful reading and arithmetic to 3rd- 6th grade level with special education. Can achieve mental age of 8 -12. Walks, barring specific disability. congenital heart defects usually associated
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Cerebral palsy
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Goal of care- early recognition and promotion of optimal development to enable affect children to attain normalization and potential. Nursing managment- passive ROM, stretching, elongating exercise, Initiate early manual skills, incorporate plan into therapeutic program. Possibility of aspiration for severely disabled. Open airway elevate child's head of bed.
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Sx/Sx of anorexia nervousa?
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Sx/Sx severe and profound weight loss, signs of altered metabolic activity, amenorrhea, bradycardia, lower body temp. decreased bp adn pulse, dry skiin adn brittle nails, cold intolerance, lanugo on face and back. Behavioral- if they eat anything they will gain weight.
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Infants growth and development
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Trust vs. mistrust
6 months- begins fear of strangers 8 months- sit unsupported 12 months- age for tripling weight Solitary play |
