question

Atrial Septal Defect

answer

-abnormal opening between the atria which allows blood to flow from the left atrium into right atrium causes congestive heart failure, murmur and is surgically treated -shunts blood from left to right -increased pulmonary blood flow

question

Cystic Fibrosis

answer

-autosomal recessive, causes thickening of mucous and leads to obstructions in the respiratory and GI systems -sweat chloride test over 60 is consistent with CF -treatment involves salt supplements, pancreatic enzymes, bronchodilators, chest physiotherapy, antibiotics

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Infant dehydration

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-greater water loss due to larger amount of extracellular fluid -tachycardia symptoms include tachycardia, dry skin, sunken fontanel, loss of skin elasticity

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Myringotomy

answer

-incision in tympanic membrane to insert tympanosomy tubes due to recurrent otitis media -no submerging in water without earplugs, wear earplugs when swimming in lake water -tubes will eventually fall out

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Strabismus

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-disorder of eyes, eyes unable to focus on same object -symptoms include squinting, tilts head, headache, dizziness, cross-eyed, closing eye when looking around the room -treatment includes patching the stronger eye

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Ulcerative Colitis

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-inflammatory condition of colon characterized by erosion of mucous membranes -signs and symptoms include rectal bleeding, blood in stool, weight loss, anemia -treatment is high protein, high calorie, and low fiber diet -corticosteroids to reduce inflammation, anticholinergics, antibiotics

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Retinoblastoma

answer

-usually unilateral whitish glow of pupil and causes strabismus -requires enucleation of eye

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Cerebral Palsy

answer

-nonprogressive motor impairment syndrome- spastic, hypotonic, or a combination of all -poor head control after 3 months, stiff or rigid arms or legs, limp posture -progressive muscle loss from the feet/legs that progresses up

question

A child has an elevated blood pressure reading, what is the next appropriate step?

answer

-Normal blood pressure is 110-100/60-56 Assess the size of the blood pressure cuff -a narrow cuff can cause an elevated blood pressure reading

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Cardiac Dysrhythmias

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-rhythm disturbances of the heart -ones most commonly seen in children include:

question

Respiratory Syncytial Virus (RSV)

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-pathogen that occurs during infancy -low grade fever, cough, wheezing, tachypnea -treatment includes humidity, fluids, rest, Ribavirin -make sure that nurse isn't taking care of other high risk children and that the nurse isn't pregnant

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Tetanus

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-infectious disease that causes muscle rigidity -prevented by immunizations -will administer tetanus immune globulin any time a puncture wound is contaminated with dirt, feces, soil, or saliva

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Rheumatic Fever

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-inflammatory disease that occurs with Group A beta hemolytic strep - causes carditis, polyarthritis, erythema, nodules, and chorea

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Nephrotic Syndrome

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-minimal change nephrotic syndrome -causes weight gained, decreased urine output, pallor, fatigue, hyperalbuminuria, hypoalbuminemia, hypovolemia -restricted salt diet, corticosteroids, monitor input and output, daily weights, measure abdominal girth

question

Increased ICP in infants

answer

-bulging fontanel, separated cranial sutures, irritability, high pitched cry, poor feeding -headache, nausea, forceful vomitting, irritability, restlessness, drowsiness, lethargy -late signs include bradycardia, decreased respirations, alterations in pupil size, decorticate/decerebrate posturing

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Wilms Tumor

answer

-Nephroblastoma -most common intra-abdominal kidney tumor -firm contender mass, silent tumor because goes undiagnosed until metastasis occurs -do NOT palpate abdomen

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Intussusception

answer

-slipping of one part of intestines into another part just below it -indications include pain, currant stools, diarrhea, anorexia, weight loss -treatment includes a barium enema

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Otitis Media

answer

-infection of middle ear -caused by eustachian tube being shorter and straighter leading to build up of drainage that leads to infection -symptoms include fever, crying, irritability, tugging of ear, red tympanic membrane -if severe enough/occur quite often will require myringotomy

question

Osteogenesis Imperfecta

answer

-brittle bone disease -causes fractures and bone deformities -nursing considerations include support child when turning, positioning, moving, etc

question

Hypercholesterolemia

answer

-elevated cholesterol level -less than 170 is normal; 170-199 is borderline; greater than 200 is high -treated with whole grains, fruits, vegetables, and can use olive oil or canola oil -medication can also help manage it

question

Diarrhea in Children

answer

-rotavirus is the most common cause in children -abrupt onset, fever, nausea/vomitting, diarrhea, -assess for decreased urinary output, decreased weight, dry mucous membranes, poor skin turgor -instruct parents on wet diapers and voiding -treatment includes oral rehydration therapy, IV fluids, and antibiotics for bacterial infections

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Acute Glomerulonephritis

answer

-damage to glomeruli caused by immunologic reaction -caused by beta-hemolytic strep infection -occurs 10 days after a throat infection -causes proteinuria, fever, chills, dyspnea, fluid overload, joint pain/stiffness, pallor, lethargy

question

Congenital Heart Defect

answer

-symptoms include cyanosis, tachycardia, polycythemia, unusual posturing -will see weight gain, poor feeding habits, exercise intolerance, short stature, failure to thrive, clubbing of nails

question

Congenital heart defects that cause increased pulmonary blood flow

answer

-patent ductus arteriosus -atrial septal defect -ventricular septal defect

question

Congenital heart defect that causes decreased pulmonary blood flow

answer

-tetralogy of fallout -tricuspid atresia

question

Congenital heart defect that causes mixed blood flow

answer

-hypoplastic left heart syndrome -transposition of the great arteries

question

Iron Deficiency Anemia in Infants

answer

-caused by excessive intake of cow milk -should drink iron fortified formula until age 1 -can be determined by CBC

question

Pyloric Stenosis

answer

-obstruction caused by hypertrophy or hyperplasia of pylorus -indications include projectile vomitting, weight loss, diminished stools, olive shapped tumor in epigastrium -treat surgically

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Asthma

answer

-chronic inflammatory disease of the airway -symptoms include cough, dyspnea, wheezing -use peak flow meter, use inhaler, avoid asthma triggers

question

Osteomyelitis

answer

-infection of bone caused by Staph aureus -symptoms include pain, fever, irritability, tenderness -won't want to move extremity and will hold in semi-flexed position -treatment includes bed rest, analgesics, and antibiotics

question

Cohorting

answer

-sharing rooms consider mode of transportation -with infection place in a private room or room with client with same infection -do not place patient with infectious disease with a patient who is immunocompromised, has open wounds, or has anticipated prolonged hospitalizations

question

Digoxin-Infant

answer

-decreases heart rate, increases force of contraction -check for signs of toxicity including anorexia, nausea, vomitting, diarrhea, confusion, visual disturbances -take apical pulse make sure pulse is greater than 90-110 otherwise hold dose -therapeutic serum level is .8-2.0

question

Type 1 Diabetes

answer

-pancreas no longer makes insulin -treatment involves insulin -must have extra snacks if going to increase physical activity so hypoglycemia does not occur

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Sickle Cell Disease

answer

-hereditary disease leads to anemia due to abnormal hemoglobin -symptoms include anemia, pain in joints, priapism, altered pulmonary function -treatment includes rest, oxygen, IV fluids

question

Tonsillectomy

answer

-removal of tonsils -position on side, discourage cough, administer analgesics, check throat for bleeding

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Vesicoureteral Reflux

answer

-reflux of urine from bladder into ureters causing residual urine in bladder -treatment includes antibiotics and frequent urine collections -symptoms include recurrent UTIs

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Duchenne Muscular Dystrophy

answer

-progressive muscle weakness from lower extremities and up, noticed by frequent falling, calves appear large -promote safety and education to child/parents

question

Sudden Infant Death Syndrome (SIDS)

answer

-peaks at 2-4 months of age -increased incidence in winter -commonly occurs in preterm infants, low birth weight, African American infants, infants that sleep on abdomen -place in supine position for sleep, no blankets, keep room cool, no smoking, firm mattress

question

Adolescent Depression

answer

- screen for depression and suicide if grades are declining, chronic sadness, family problems, drug or alcohol abuse -cognitive behavioral therapy and SSRIs

question

Scoliosis

answer

-lateral deviation of one or more vertebrae -curve of 20 degrees or more requires a medical intervention -20-40 degrees requires a brace, must be worn 23 hours a day -Curves greater than this may require surgery have child bend at midline to examine for asymmetry -can use scoliometer

question

Headaches

answer

-assess pattern of headache, lethargy, weakness, family history -immediate follow up is needed if severity increases, headaches awaken child at night, and headaches that worsen, or changes in personality

question

Craniotomy

answer

-incision of the cranium to allow access for brain surgery -assess client every 15 minutes until stable, perform frequent neuro checks, head of bed elevated

question

Glucagon

answer

-reverses hypoglycemia (Blood glucose at or below 60) -side effects include nausea and vomitting -give subQ or IM

question

Epilepsy

answer

- chronic disorder characterized by seizures -document type and progress of seizure, how long it lasted, turn head to side so aspiration does not occur

question

Group A Beta Hemolytic Strep

answer

-strep throat -can be caused by rheumatic fever or glomerulonephritis -ensure correct antibiotic administration, discard toothbrush, can return to school after taking antibiotics for 24 hours

question

Hemophilia

answer

-bleeding disorder caused by deficiency of clotting factor -easy bruising, joint pain with bleeding -use cold packs, acetaminophen for pain, administer factor replacement -avoid contact sports

question

Neuroblastoma

answer

-malignant tumor located on kidney -usually unilateral -nontender mass in lower abdomen -surgical removal of entire kidney

question

Appendicitis

answer

-inflammation of appendix -indicated by RLQ pain, vomiting, increased temperature, leukocytosis -sudden loss of pain indicates perforation and is considered an emergency

question

Hepatitis B Vaccine

answer

-given at birth, given once between ages 1-4 months, then again between ages 6-18 months

question

Idiopathic Thrombocytopenia Purpura (ITP)

answer

-acquired hemorrhagic disorder -excessvie destruction of platelets -bruise easily, petechiae -assess activities that increase risk for bleeding, avoid aspirin, use soft bristled tooth brush, no contact sports -usually resolves within 6 months -WhinRho for RH positive - ________for RH negative

question

Language Development

answer

-10 months: 1 or 2 words -12 months: 1 or 2 words in addition to mama and dada -15 months: common objects -18 months: scribbles -21 months: 300 word vocabulary, obeys easy commands -3 years: 900 word vocabulary, uses sentences -4 years: 1500 word vocabulary -5 years: 2100 word vocabulary

question

Infant hearing

answer

-at birth should respond to loud noise by the moro reflex -age 2-3 months infant should turn head -3-4 months infant should locate sound by turning head in direction -6-8 months infant responses to own name -1 year should now several words and their meaning

question

Head Injury: Infant

answer

-head is larger and heavier in infants -most likely to be injured because of this

question

Oxygen Safety

answer

-no candles, cigarettes, sign posted on door, avoid blankets that could cause a spark, ensure tent is completely closed

question

Aplastic Anemia

answer

- formed elements in blood are depressed -diagnosed via bone marrow biopsy -pale, easily fatigued, bruise easily, petechiae, increased number of infections

question

Coarctation of the Aorta

answer

-narrowing of the aorta -causes increased pressure proximally and decreased pressure distally -high blood pressure and bounding pulses in arms and weak or absent femoral pulses and cooler lower extremities

question

Infant Dental Hygiene

answer

-under 6 months, wipe teeth and gums with cloth -6 months-2 years use rice size amount of tooth paste, do not offer foods high in sugar, do not send to bed with bottle or milk or juice -first dentist appt around 12 months -start dental care when teething begins

question

Respiratory infection in children

answer

-typically caused by viruses -young children have fever, irritability, anorexia, vomiting, diarrhea -warm or cool mist to decrease respiratory discomfort, encourage rest -administer small amounts of favorite fluids to prevent dehydration -

question

Constipation in School Aged Children

answer

-typically due to fear of using school bathrooms -encourage regular toiling, encourage high fiber diet, and exercise

question

Central Precocious Puberty

answer

-develop sexually at a young age; before 8 in girls and age 9 in boys -activated by gonadotropin-releasing hormone -treat with injection of luteinizing hormone -remind parent that child is fertile, discipline and expectations should be based on age not on development of body

question

Developmental Dysplasia of the Hip

answer

-abnormal hip development in which the hip pops out of socket -indicated by uneven gluteal folds and positive Ortolani/Bartlow sign -Will require Pavlik harness or Spica cast

question

Iron supplements

answer

-increases availability of iron -side effects include nausea, vomitting, consitpaiton, and black tarry stools -dilute liquid preparations in juice but not with milk or antacids -use straw for liquid preparations to avoid teeth staining -food decreases iron absorption

question

Hip Spica Cast

answer

-immobilizes hips and knees -instruct family to report swelling or discoloration of extremities -make a path for child -place in prone position to eat

question

Hirschsprung Disease

answer

-dilated colon caused by failure of the myenteric plexus of rectosigmoid area of large intestine -symptoms include constipation, abdominal distention, ribbon like stools -treat surgically -will need diet that is low fiber, high calorie and high protein -measure abdominal girth at level of umbilicus

question

HIV/AIDS: Children

answer

-most infected through perinatal transmission -will need antiretroviral drugs -restrict children who bite or who do not have control of bodily functions

question

Attention Deficit Hyperactivity Disorder (ADHD)

answer

-inappropriate degree of inattention, impulsiveness, and hyperactivity -short attention span, inattention to detail, forgetfulness, excessive talking, interrupts others -do better with strict schedule , channel excess energy, may need stimulant

question

Infant nutrition

answer

-breast milk for formula is all the nutrition needed until 6 months when solids can be introduced -offer iron fortified cereals, vegetables, fruits, and meat -avoid foods that are a choking hazard -eggs and strawberries can be a common allergy

question

Heart Failure

answer

-inability for the myocardium to pump blood effectively to meet body's needs -tachycardia and low blood pressure is common -Left sided: Couch, Dyspnea, Tachycardia, Crackles -Right sided: Edema, Jugular Vein distention

question

Turner Syndrome

answer

-occurs in females -one X chromosome -lower posterior hairline, widely spaced nipples, edema of hands and feet, web neck, short stature, amenorrhea -treatment: growth hormone, estrogen replacement, surgical removal of gonads if present

question

Vital Signs -Newborn -Age 1-4 -Age 5-12

answer

-Newborn: respirations 30-50, pulse 120-140, blood pressure 80-60/50-40 -Age 1-4: respirations 20-40, pulse 80-140, blood pressure 99-90/65-60 -Age 5-12: respirations 15-25, pulse70-115, blood pressure 110-100/60-56

question

Gastroesophageal Reflux

answer

-transfer of gastric contents into the esophagus -found in premature infants -poor weight gain and irritability -place in prone position, offer more frequent feeding, thickened formula, don't eat before bedtime

question

Meningitis

answer

-infection or inflammation of membranes covering brain and spinal cord -changes in levels of consciousness, bulging fontanel, high pitched cry, observe for signs of increased ICP -Positive Brudzinski or Kernigs sign

question

Down Syndrome

answer

-involves and extra chromosome #21 -separated sagittal suture, slanted eyes looking upward and outward, small nose with depressed nasal bridge, muscle weakness -hypotonia at birth -Simian crease; single crease along palm of hand

question

Car-Seat Safety

answer

-Rear facing seats should be used until 2 years of age -Front facing used until 4 years of age or 40 pounds -Booster seat 4 years until 12 years or height 4'9" -Seat belt should be used

question

Spinal Muscular Atrophy

answer

-progressive muscle weakness and wasting of skeletal muscles -signs and symptoms include inactivity, weakness, weak cry/cough, unable to sit/roll over -no effective therapy exists

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