question

Chicken Pox, MMR

answer

Name 2 live vaccines

question

When seizure occurred after previous DTAP

answer

When is DTAP absolutely contraindicated

question

aspirated

answer

Peanuts can be easily ___________

question

grazers

answer

In terms of nutrition, toddlers are considered ___________

question

quality; quantity

answer

In terms of nutrition the ____________ of food is more important than the _____________ of food for preschoolers.

question

respiratory symptoms (think fumes)

answer

If lighter fluid (hyrdocarbon) is ingested what symptoms will the child present with?

question

tongue edema, mouth sores, pharynx problems

answer

If a corrosive poison is ingested what symptoms will the child present with?

question

be persistent through 10-15 minutes of food refusal

answer

Tip for parents with children diagnosed with Failure to thrive:

question

report changes in stool patterns to doctor, do not want firm stools

answer

Teaching for family after child underwent high rectum malformation surgery:

question

27

answer

The neonatal period is the first _____ days

question

28 days; 1 year

answer

The postnatal period is days _________ through __________

question

Birth weight

answer

What is the major determinant of neonatal death in the US?

question

2500

answer

Low birth weight is < ______ g?

question

injury

answer

What is the #1 cause of death in children > 1 year?

question

Recognizing the family as the constant in a child's life

answer

What is family centered care?

question

address the needs of all family members

answer

What does family centered care strive to do?

question

families are given the opportunity to display caring

answer

Enabling

question

giving the family the skills to care

answer

Empowerment

question

first do no harm

answer

Atraumatic care goal

question

prevent separation, promote sense of control, minimize bodily injury

answer

3 principles of atraumatic care:

question

is part of primary prevention of disease

answer

Immunization

question

flushed cheeks, white strawberry tongue, rash shows increased density on neck and groin and transverse lines on elbow, Koplik's spots

answer

Rubella (measles)

question

Small, irregular red spots with a bluish-white center appearing on the buccal mucosa in association with measles

answer

Koplik's spots

question

decreases morbidity and mortality in rubella (measles)

answer

Vitamin A

question

viral; droplet; 10-20

answer

Rubella (measles) is a _________ disease, it is droplet/airborne/contact and has an incubation period of ____ to _____ days.

question

viral; droplet or contact; 14-21

answer

Mumps is a _________ disease, it is droplet/airborne/contact and has an incubation period of ____ to _____ days.

question

bacterial; droplet or contact; 6-20

answer

Whooping cough (pertussis) is a _________ disease, it is droplet/airborne/contact and has an incubation period of ____ to _____ days.

question

viral; airborne; 2-3

answer

Chicken pox(varicella) is a _________ disease, it is droplet/airborne/contact and has an incubation period of ____ to _____ weeks.

question

viral; direct; 14-21

answer

German measles is a _________ disease, it is droplet/airborne/contact and has an incubation period of ____ to _____ days.

question

fever, headache, malaise, parotitis (may lead to orchitis & meningoencephalitis

answer

Mumps

question

short rapid cough followed by crowing of "whoop" sound

answer

Whooping Cough (pertussis)

question

pneumonia

answer

Usual cause of death with pertussis (whooping cough)?

question

teratogenic effect on fetus

answer

Greatest danger of German measles if nurse or family member is pregnant?

question

secondary bacterial infections, encephalitis, pneumonia, hemorrhage and chronic or transient thrombocytopenia

answer

Chicken Pox (varicella) complications

question

Live vaccines (Varicella and MMR)

answer

What vaccines should not be given to immunocompromised patients?

question

it delays treatment

answer

Denial of chronic illness by family member is considered maladapative only if ...

question

cry and scream, cling to parent

answer

Protest stage of separation anxiety

question

crying stops, evidence of depression

answer

Despair stage of separation anxiety

question

denial or resignation but not contentment; may seriously affect attachment to parent after separation

answer

Detachment phase of separation anxiety

question

anxiety

answer

A child's concept of illness is more important than intellectual maturity in predicting __________.

question

facial expression

answer

The F in the FLACC pain scale for infants stands for:

question

legs (normal, relaxed, tense, kicking, drawn up)

answer

The L in the FLACC pain scale for infants stands for:

question

activity (quiet, sqirming, arched, jercking)

answer

The A in the FLACC pain scale for infants stands for:

question

cry (none, moaning, whimpering, scream)

answer

The first C in the FLACC pain scale for infants stands for:

question

consolability (content, easy or difficult to console)

answer

The second C in the FLACC pain scale for infants stands for:

question

18 months

answer

Physiological anorexia occurs at what age?

question

picky eaters with strong taste preferences, 18 months of age

answer

What is physiological anorexia?

question

tobacco smoke

answer

The incidence of Vitamin C deficiency is increased with exposure to what?

question

Maturity Onset Diabetes of the Young (MODY)

answer

What autosomal disorder is similar to Type 2 diabetes mellitus?

question

urine testing for ketones every 3 hours

answer

What should be tested during illness and whenever glucose is greater than or equal to 240 mg/dL without illness?

question

congenital hypothyroidism

answer

What leads to cretinism, mental retardation and growth retardation?

question

< 5th percentile in weight

answer

Failure to thrive

question

developmental delays, apathy, withdrawn behavior, no fear of strangers, avoidance of eye contact, wide eyed gaze & continual scan of environment, stiff & inyielding or flaccid & unresponsive, minimal smiling

answer

Manifestations of failure to thrive

question

primary core staff to feed child, quiet, unstimulating atmosphere, calm, even temperment throughout meal, give directions, be persistent (10 -15 min of meal refusal), rhythm of feeding, develop a structured routine

answer

Guidelines for feeding a child with failure to thrive

question

4-5.9

answer

Normal HgbA,C

question

<7

answer

Good control of HgbA,C

question

greater than equal to 8

answer

Poorly controlled HgbA,C

question

equal loss of fluid and electrolytes

answer

Isotonic dehydration

question

lose more fluid than electrolytes

answer

Hypertonic dehydration

question

lose more electrolytes than fluid

answer

Hypotonic dehydration

question

ORS (oral rehydration solution)

answer

Treat mild to moderate dehydration with

question

IV rehydration is necessary

answer

Treat severe dehydration with

question

allow 100 mL/Kg for first 10 Kg of body weight allow 50 mL/Kg for next 10 Kg of body weight allow 20 mL/Kg for remaining body weight

answer

To determine daily maintenance fluid requirement calculate child's weight in kg and then:

question

bananas, rice, applesauce, toast, tea

answer

BRATT diet

question

diarrhea due to poor nutritional value

answer

BRATT diet is contraindicated for

question

maternal drug use or poor maternal nutrition

answer

Primary etiology of cleft lip/cleft palate

question

suction, tongue depressors, themometers, pacifiers, spoons, straws

answer

Avoid what in the mouth for patients with cleft lip/palate following a palatoplasty to maintain the integrity of the surgically repaired palate?

question

congenital aganglionic megacolon, accumulation of stool with distension

answer

Hirschsprung Disease

question

failure of esophagus to develop as a continuous passage

answer

Esophageal Atresia (EA)/Transesophageal Fistual (TEF)

question

Esophageal Atresia (EA)/Transesophageal Fistual (TEF)

answer

An infant with an excessive amount of frothy saliva in the mouth or difficulty with secretions and unexplained episodes of cyanosis should be suspected of?

question

3 C's: coughing, choking, cyanosis

answer

Clinical manifestations of Esophageal Atresia (EA)/Transesophageal Fistual (TEF)

question

NPO (child may need intubated)

answer

If Esophageal Atresia (EA)/Transesophageal Fistual (TEF) is suspected, place child on immediate ____________.

question

constriction of pyloric sphincter, palpable as an olive like mass in the upper abdomen

answer

Hypertrophic Pyloric Stenosis (HPS)

question

projectile vomitting

answer

Primary clinical manifestation of Hypertrophic Pyloric Stenosis (HPS)

question

telescoping or invagination of one portion of intestine into another

answer

Intussusception

question

currant jelly stools

answer

Primary clinical manifestation of intussusception?

question

abd pain, abd mass, bloody stools

answer

Classic triad of intussusception signs and symptoms

question

29-33%

answer

The classic triad of intussusception signs and symptoms is only present in what percent of cases?

question

screaming, irritability, lethargy, vomitting, diarrhea, constipation, fever, dehydration and shock

answer

A patient with intussusception may present initially with ...

question

emergency

answer

Intussusception is an ___________.

question

Inform the physician immediately, it may have resolved itself

answer

If child waiting for intussusception surgery passes a normal stool what should a nurse do?

question

steatorrhea (fatty stools), general malnutrition, abdominal distension, vitamin deficiencies (A,D,E,K)

answer

Celiac disease signs and symptoms

question

intolerance to gluten, BROW (barley, rye, oat, wheat)

answer

Celiac disease definition

question

frequent spit ups or acid smelling breath, some have respiratory symptoms instead of any of these symptoms

answer

Identifying kids with GERD

question

elevate HOB 30 degrees during feeding and for 1 hour after

answer

Positioning for GERD

question

do NOT induce vomiting

answer

If poisoning is suspected ...

question

severe burning pain with swelling in the mouth, throat and stomach, violent vomiting, hemoptysis

answer

Signs a corrosive poison has been ingested

question

dilute with water or milk

answer

Treatment for a corrosive poison ingestion

question

altered sensory, respiratory symptoms due to pulmonary involvement, primary danger is bronchitis and chemical pneumonia

answer

Signs a hydrocarbon poison has been ingested

question

maintain airway

answer

Treatment for a hydrocarbon poison ingestion

question

acetylcysteine (mucomyst)

answer

Antidote for acetaminophen

question

150 mg/kg

answer

Toxic dose of acetaminophen is

question

bleeding tendency, coma, diaphoresis, tinnitus

answer

Aspirin poisoning

question

may turn urine red or orange, mush have working kidneys, may cause hypotension or shock if given quickly

answer

Iron chelation therapy

question

10 mcg/dL

answer

Diagnostic level for lead poisoning is

question

elevate the legs, restrict activity and keep warm

answer

If shock is imminent what should a nurse do?

question

splenic sequestration, RBC's clump in the spleen and it may become engorged and rupture

answer

Sickle cell anemia

question

spleen

answer

What organ needs close monitoring with sickle cell anemia?

question

bacterial infections due to immunocompromise (especially after splenectomy)

answer

Sickle cell patients are at increase risk for what?

question

Hgb electrophoresis

answer

What test is a definitive test for sickle cell anemia?

question

increased oxygen demands, trauma, infection/fever, physical and emotional stress, dehydration or hypoxia

answer

Sickle cell crisis is caused by:

question

golf, bowling, baseball (low oxygen requirements)

answer

What sports would be good for a sickle cell patient?

question

severe joint, chest and leg pain, high spiking fever, tissue engorgement

answer

Type of sickle cell crisis: Vasa-occlusive thrombolytic crisis (VOC)

question

profound anemia (pallor), hypovolemia (decreased blood pressure), shock, medical emergency

answer

Type of sickle cell crisis: Splenic sequestriation crisis

question

profound anemia, pallor, can't be treated with antibiotics because it is viral, treatment is packed RBC's

answer

Type of sickle cell crisis: Aplasic crisis

question

2 months to 5 years

answer

Prophylactic antibiotics are given for what ages in sickle cell kids as the immune system develops?

question

blood transfussion

answer

If given early in a sickle cell crisis this may help to reduce ischemia

question

reticulocyte count (bone marrow)

answer

What count should be monitored with sickle cell?

question

hemosiderosis (iron)

answer

Frequent blood transfusions may increase __________.

question

Iron chelation - feroxamine plus Vitamin C

answer

What is the treatment for hemosiderosis?

question

wear gloves

answer

Hydroxyurea handling caution

question

Sickle cell due to risk for seizures

answer

Demerol is contraindicated for use in what disease?

question

hemarthrosis, ecchmosis

answer

Hemophilia signs and symptoms

question

6 months of age

answer

Hemophilia may not occur until what age?

question

ROM and joint moving to prevent contractures

answer

Despite the pain it may cause a patient with hemophilia needs to do what exercises?

question

hemophilia

answer

A prolonged PTT may indicate what disease?

question

drug for mile hemophilia

answer

DDAVP

question

blood in a joint cavity

answer

Hemarthrosis

question

elevate and immobilize the joint, ROM after bleeding stops to prevent contractures

answer

During episodes of hemarthrosis a nurse should ...

question

ALL acute lymphoid leukemia

answer

Most common type of leukemia with best prognosis

question

AML acute Myelogenous leukemia

answer

Most rare type of leukemia with poor prognosis

question

liver and spleen

answer

What organs are most severely affected with leukemia?

question

overproduction of WBC's but low leukocyte count, it leads to anemia, infection and bleeding as well as infiltration, enlargement and fibrosis of liver, spleen and lymph nodes

answer

What is leukemia?

question

the first stage occurring for 4-6 weeks

answer

Induction therapy is what phase of therapy for leukemia and occurs for how many weeks?

question

CNS prophylactic therapy or intrathecal chemotherapy

answer

What phase of therapy for leukemia is needed if there is CNS involvement?

question

eradicate residual leukemic cells

answer

What does the 3rd phase of leukemia therapy, Intesification (consolidation) therapy do?

question

During the Maintenance therapy to preserve remission

answer

At home PO Methotrexate is given when to a leukemia patient?

question

a sibling

answer

Who is the most likely match for hematopoietic stem cell transplantation (HSCT)?

question

rejection

answer

After HSCT, red patch rash on palms and feet means what?

question

A round of induction therapy to wipe out WBC's

answer

What should be done prior to HSCT?

question

Fresh flowers and fruit

answer

What is contraindicated for visitors to bring to a patient with leukemia?

question

prednisone

answer

What is kept at a leukemia patients bedside to treat anaphylaxis?

question

chemotherapeutic agents are dosed by weight, to prevent overdose

answer

Why should weight loss be reported for a patient with leukemia?

question

Reglan, Zofran 30 minutes prior to starting, ran continuously with and then 1 more dose afterwards

answer

When should antiemetics be given for chemo patients?

question

irratibility, pica, malnourishment, exercise, intolerance, inattentive/cognitive delays, beeturia, bluish sclera

answer

Anemia manifestations

question

Increase

answer

Length of time between S1 and S2 should ____________ on inspiration?

question

congenital anomaly

answer

If there is fixed time between S1 and S2 what could this indicate?

question

Have child hold their breath when auscultating, normally there is an increase in HR during inspiration and a decrease in HR during exhalation

answer

Since children have arrhythmias normally how to you tell if it is a "real" arrhythmia?

question

cyanosis, decreased oxygen saturation, lethargic or restless, may have murmur, abnormal or arrhythmic HR, CHF s/s, tachypnea, retractions, nasal flaring

answer

Congenital Heart Defect (CHD) clinical manifestations

question

crackles in lungs (fluid), SOB, edema, poor tissue perfusion

answer

Normal signs and symptoms of CHF

question

Oxygen administration, thermoregulation, cardiac medications, special feeding

answer

Interventions for CHD

question

Atrial Septal Defect (ASD), Ventricular Septal Defect (VSD), Patent Ductus Arteriosus (PDA)

answer

Name 3 Increased Pulmonary Blood Flow Defects

question

an abnormal connection between 2 sides of the heart, it leads to increased blood volume on the right side of the heart and too much blood to the lungs causing right sided CHF

answer

What is an Increased Pulmonary Blood Flow Defect?

question

Blood shunts from left to right, hypertrophy of Right Atrium

answer

Atrial Septal Defect (ASD)

question

s/s of CHF, murmur over area of shunting, atrial arrhythmias (b/c of SA mode is in RV), poor activity tolerance, poor nutrition, poor growth, pulmonary manifestations later

answer

Signs and symptoms of ASD

question

may wait unitl 18 months to allow hole to close on it's own before surgery is performed to repair

answer

Treatment for ASD

question

Blood shunts left to right, hypertrophy of Right Ventricle

answer

Ventricular Septal Defect (VSD)

question

s/s of CHF, murmur, high risk for endocarditis, Eisenmenger syndrome in severe cases

answer

Signs and symptoms of VSD

question

When the left to right shunts cause pulmonary hypertension, vascular hypertrophy, and eventually shift the L=>R shunt to a R=>L shunt, and cause late cyanosis.

answer

Eisenmenger syndrome

question

Cardiac medications such as antihypertensives, digoxin, diuretics and antibiotics

answer

Treatment for VSD

question

decrease work load of the heart

answer

Antihypertensives

question

increase cardiac output

answer

Digoxin

question

decrease fluid

answer

Diuretics

question

prophylaxis, infection occurs when fluid is in th elungs

answer

Antibiotics

question

Keep the Patent Ductus Arteriosus open

answer

Prostaglandins

question

block the action of aldosterone

answer

Ace Inhibitors

question

A fall in the serum potassium level

answer

What enhances the effects of digoxin?

question

normally closes w/in hours to days in term infant, may be delayed in premies, if not, the systemic resistances pushes blood from the aorta into the pulmonary artery (left to right shunt)

answer

Patent Ductus Arteriosus

question

CHF, hypertrophy of the left atrium and left ventricle, pulmonary congestion, increased risk for endocarditis and pulmonary obstructive diseases

answer

Signs and symptoms of PDA

question

wait to see if it closes, ventilator support, fluid restriction, admin of Indomethacin, admin of NSAIDS

answer

Management of PDA

question

Prostaglandin inhibitor, may help to get the PDA closed

answer

Indomethacin

question

Ibuprofen works to inhibit prostaglandin which may help to get the PDA closed

answer

NSAID

question

Coarction of the Aorta (COA), Aortic Stenosis

answer

Name 2 Obstructive Defects

question

blood can not exit the heart because of a stenosis of some type

answer

What is an obstructive defect?

question

Narrowin gof the descending aorta, common in Turner's Syndrome.

answer

What is a Coarction of the Aorta (COA)?

question

the PDA will act compensatory, once the PDA closes symptoms will appear

answer

Why do symptoms of COA start several days after birth rather than immediately?

question

CHF, left ventricular hypertrophy, murmur, increased blood pressure and bounding pulses in upper extremities, decreased blood pressure and weak or absent pulses in lower extremities (feet often cyanotic & cold)

answer

Signs and symptoms of COA

question

Mechanical ventilation, cardiac meds, prostaglandins (to keep PDA open), surgical resection, 2 anastomosis

answer

Treatment for COA

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