Peds Hesi Review

Front 1

When is iron deficiency most common?

Back 1

12 -36 months and in females during childbearing years

Front 2

What is the best indicator of past nutrition?

Back 2

Height and head circumference

Front 3

How do you measure nutritional status?

Back 3

plasma, blood cells, urine, tissues from bone, hair or fingernail, hgb/hct, albumin, Cr, nitrogen

Front 4

Signs of iron deficiency

Back 4

anemia, pale conjuctiva, pallor, brittle/ridged nails, thyroid edema

Front 5

Signs of B2 (riboflavin) deficiency

Back 5

redness of eyelid corners, burning, itchy, tearing eyes, photophobia

Front 6

Source of Iron

Back 6

fortified formula, fortified cereal, liver, beef, pork, eggs

Front 7

Sources of B2 (riboflavin)

Back 7

leafy green vegetables (broccoli, spinach, green beans), enriched cereal

Front 8

Signs of Vitamin A (retinol) deficiency

Back 8

dry, rough skin, night blindness, defective tooth enamel, retarded growth and bone formation, decrease thyroid hormone formation

Front 9

Sources of Vitamin A (retinol)

Back 9

liver, carrots, sweet potatoes, spinach, peaches, apricots

Front 10

Signs of Vitamin C deficiency

Back 10

scurvy, bleeding receeding gums, dry rough skin, decreased wound healing, increased infection risk, irritability

Front 11

Sources of Vitamin C

Back 11

strawberries, oranges, tomatoes, broccoli, cabbage, cauliflower, spinach

Front 12

Signs of Vitamin B6 (pyridoxine) deficiency

Back 12

scaly dermatitis, weight loss, anemia, irritability, convulsions, peripheral neuritis

Front 13

Sources of B6 (pyridoxine)

Back 13

meats, cereal, yeast, soybeans, peanuts, tuna, chicken, bananas

Front 14

Signs of respiratory distress

Back 14

restlessness, increased resp. rate, increased pulse rate, diaphoresis

Front 15

Which happens first, respiratory failure or cardiac failure

Back 15

respiratory failure

Front 16

Asthma

Back 16

airway become edematous, becomes congested with mucous, smooth muscles constrict, airtrapping occurs in alveoli

Front 17

Nursing interventions for acute asthma exacerbations

Back 17

rapid acting bronchodilators and steroids

Front 18

Nursing interventions for asthma maintanence at home

Back 18

identify triggers, reduce allergens, use MDI, monitor through peak flow meter, Asthma Action Plan

Front 19

What type of disease is Cystic Fibrosis?

Back 19

autosomal recessive disease that causes dysfunction of exocrine glands

Front 20

Systemic effects of cystic fibrosis

Back 20

lung insufficiency (most critical), pancreatic insufficiency, increased loss of sodium and chloride in sweat

Front 21

Signs and symptoms of Cystic Fibrosis

Back 21

meconium ileus at birth, recurrent respiratory infections, pulmonary congestion, steatorrhea, foul smelling bulky stools, poor weight gain, salty tasting skin

Front 22

Cystic Fibrosis nursing interventions

Back 22

IV abx, pancreatic enzymes given with food/applesauce, fat soluble vitamins, teach postural drainage and percussion

Front 23

Cystic Fibrosis diet

Back 23

Pts will need 1.5x normal caloric intake, high calories, high protein, moderate fat content, moderate carbohydrates

Front 24

Causes of epiglottitis

Back 24

rapid acute airway obstruction usually caused by H. influenzae type B

Front 25

Signs and symtoms of epiglottitis

Back 25

rapid onset, restlessness, high fever, sore throat, dysphagia, drooling, muffled voice, tripod position

Front 26

What intervention is contraindicated in epiglottitis?

Back 26

Never put anything in the mouth because of the risk of complete airway obstruction

Front 27

Nursing interventions in epiglottitis

Back 27

encourage prevention with HiB vaccine, upright position, NPO, IV abx, prepare for intubation/tracheosomy, prepare for ICU admit

Front 28

Bronchiolitis

Back 28

viral infection of the bronchioles caused by RSV characterized by thick secretions

Front 29

Signs and symptoms of bronchiolitis

Back 29

upper respiratory symptoms, irritability, paroxysmal cough, poor eating, nasal congestion, nasal flaring, prolonged expiration, wheezing and rales

Front 30

What is given to prevent RSV infections in immunocompromised patients?

Back 30

Synagis (palivizumab)

Front 31

Nursing interventions for Bronchiolitis

Back 31

isolation, assess respiratory status, mist tent, maintain hydration, evaluate respiratory treatment effectiveness

Front 32

Newborn RR, HR

Back 32

RR: 30-60
HR:100-160

Front 33

Infant RR, HR

Back 33

RR: 25-35
HR: 100-150

Front 34

Toddler RR, HR

Back 34

RR: 20-30
HR: 80-130

Front 35

Preschool RR, HR

Back 35

RR: 20-25
HR: 80-120

Front 36

School Age RR, HR

Back 36

RR: 18-22
HR: 70-110

Front 37

Adolescent RR, HR

Back 37

RR: 16-20
HR: 60-90

Front 38

Why are young children prone to ear infections?

Back 38

The eustachian tubes are flattened

Front 39

Otitis Media signs and symptoms

Back 39

fever, pain, infant may pull at ear, enlarged lymph nodes, drainage from ear (if eardrum is ruptured), vomiting and diarrhea

Front 40

Nursing interventions for otitis media

Back 40

Abx as prescribed, Tylenol, reduce body temperature (warm tepid bath), monitor hearing loss

Front 41

Tonsilitis

Back 41

inflammation of tonsil (viral or bacterial) related to strep

Front 42

Risks of untreated Tonsilitis

Back 42

may lead to acute glomerulonephritis or rheumatic heart disease

Front 43

Signs and symptoms of tonsilitis

Back 43

sore throat, fever, enlarged tonsils, possible obstructed breathing

Front 44

Nursing interventions for tonsilitis

Back 44

throat culture to determine cause, warm salt gargles, ice chips, possible surgery, abx, Tylenol

Front 45

Post-surgical care of tonsillectomy

Back 45

Monitor for post-op bleeding (frequent swallowing, vomiting fresh blood, clearing throat), soft foods and fluids, ice collar for comfort

Front 46

When is highest risk of hemorrhage after tonsillectomy?

Back 46

first 24 hours, 5-10 days after surgery

Front 47

Acyanotic heart defects

Back 47

VSD, ASD, PDA, AS

Front 48

Cyanotic heart defects

Back 48

tetralogy of Fallot, TA, transposition of great vessels

Front 49

Increased pulmonary blood flow defects

Back 49

ASD, VSD, PDA

Front 50

Obstructive defects

Back 50

coarctation of aorta, AS

Front 51

Decreased pulmonary blood flow

Back 51

Tetralogy of Fallot

Front 52

Mixed blood heart defects

Back 52

TGV, TA

Front 53

Atrial Septal Defect (ASD)

Back 53

Increased pulmonary blood flow. There is a hole between the atria, oxygenated blood from LA is shunted to the RA and lungs.

Front 54

Treatment and consequences of ASD

Back 54

Surgical closure before school age recommended. Can l/t CHF and atrial dysrhythmia.

Front 55

Patent Ductus Arteriosus (PDA)

Back 55

Increased pulmonary blood flow. Hole between aorta and pulmonary artery, usually closes within 72 hours. Oxygenated blood from the aorta returns to the pulmonary artery.

Front 56

Treatment and consequences of PDA

Back 56

Increased blood flow to the lungs l/t pulmonary hypertension. Require Indomethacin or surgical closure.

Front 57

Coarctation of the Aorta

Back 57

Obstruction of blood flow from ventricles c/b narrowing of aorta.

Front 58

Classic signs of coarctation of aorta

Back 58

Hypertension of upper extremities and decreased or absent pulses in lower extremities, requires surgery.

Front 59

Aortic Stenosis (AS)

Back 59

Obstruction of blood flow from ventricles immediately before/at/after aortic valve. Oxygenated blood from LV to body is diminished

Front 60

Three T's of cyanotic heart disease

Back 60

Tetralogy of Fallot, Truncus Arteriousus, Transposition of the great arteries

Front 61

What is tetralogy of Fallot?

Back 61

combination of four defects: VSD, overriding aorta, pulmonary stenosis, right ventricular hypertrophy

Front 62

Truncus Arteriosus

Back 62

One artery (truncus) rather than 2 arteries (aorta and pulmonary artery) arises from both ventricles

Front 63

Transposition of the Great Arteries

Back 63

Pulmonary artery leaves the left ventricle and the aorta exits from the right ventricle.

Front 64

Signs and symptoms of Tetralogy of Fallot

Back 64

Cyanosis because unoxygenated blood is pumped into the systemic circulation, decreased pulmonary circulation. Experiences tet spells or hypoxic episodes and relieved by squatting or put in the knee-chest position.

Front 65

Truncus Arteriosus

Back 65

Pulmonary artery and aorta do not separate. Blood mixes in the R and L ventricles through a large VSD l/t cyanosis and increased pulmonary resistance.

Front 66

Transposition of the Great Vessels

Back 66

Mixed blood flow.Pulm circulation arises from L vent and systemic circulation arises from R vent. Incompatible with life --> medical emergency give prostaglandin to keep ductus open.

Front 67

Assessment of child with CHD

Back 67

Check for murmur, cyanosis, clubbing (>age 2), poor feeding, FTT, fatigue, respiratory infections

Front 68

Feeding a child with CHD

Back 68

Maintain nutrition status with small frequent meals with high-calorie formula. Maintain hydration to prevent thrombus formation.

Front 69

Risks of cardiac catheterization

Back 69

arrhythmias, bleeding, perforation, phlebitis, arterial obstruction at entry site

Front 70

Basic differences between cyanotic and acyanotic defects.

Back 70

Cyanotic: abnormal circulation, all blood entering circulation is oxygenated
Acyanotic: abnormal circulation with unoxygenated blood entering the systemic system

Front 71

Therapeutic digoxin levels

Back 71

0.8-2ng/ml

Front 72

Digoxin administration

Back 72

Check for bradycardia and hold. Do NOT skip doses, not miss with meals

Front 73

Digoxin toxicity

Back 73

Vomiting is early sign, also, anorexia, diarrhea, and abdominal pain, fatigue, muscle weakness

Front 74

What exacerbates Digoxin toxicity?

Back 74

Hypokalemia