Term
| How has family-centered care changed over time? |
|
Definition
| don't separate pt from family anymore, parents are part of care team, tell them what they can do |
|
|
Term
| Normal specific gravity of urine |
|
Definition
|
|
Term
| baby's specific gravity of urine |
|
Definition
|
|
Term
| why do baby's urine have lower specific gravity |
|
Definition
| baby's kidneys can't concentrate urine as well |
|
|
Term
| minimum infant urine output |
|
Definition
|
|
Term
| minimum children urine output |
|
Definition
|
|
Term
| minimum adolescent urine output |
|
Definition
|
|
Term
| since baby's have higher urine output, what do u need to do |
|
Definition
| drink a lot more often than adults |
|
|
Term
| metabolisms of pediatric v. adult pts |
|
Definition
| kids have faster metabolisms! |
|
|
Term
| medical conditions of pediatric v. adult pts |
|
Definition
| children are born w/ their conditions. Adults develop it (generally) |
|
|
Term
| most common problems of peds vs adults pts |
|
Definition
| children = airway/respiratory problems. Adults = cardiac problems |
|
|
Term
| why peds have higher risk for respiratory probs (3) |
|
Definition
| less developed lungs, have lots of EC fluid so cant be cold or dehydrated, trachea smaller |
|
|
Term
| Children have ____ (not conset) to participate in research |
|
Definition
|
|
Term
| where should the bar of a carseat be? |
|
Definition
|
|
Term
| where should the bottom strap of a carseat be? |
|
Definition
|
|
Term
| first 2 things you do when pt comes into ER |
|
Definition
| ask parents what's wrong (they know best) & check ABCs (neuro/behavior & respiratory!) |
|
|
Term
| A of systematic assessment |
|
Definition
|
|
Term
| B or systematic assessment |
|
Definition
|
|
Term
| C of systematic assessment |
|
Definition
|
|
Term
| D of systematic assessment |
|
Definition
| disabilities, dermatology, drugs |
|
|
Term
| E of systematic assessment |
|
Definition
| electrolytes, weight, expose pt |
|
|
Term
| if you take the baby from parents and the baby doesn't put up a fight |
|
Definition
| it should worry you (part of brain: neuro/behavior) |
|
|
Term
| F of systematic assessment |
|
Definition
|
|
Term
| G of systematic assessment |
|
Definition
|
|
Term
| H of systematic assessment |
|
Definition
|
|
Term
| I of systematic assessment |
|
Definition
|
|
Term
| how airway changes as one ages |
|
Definition
| airway/trachea increases in diameter and length |
|
|
Term
| how alveli & respiratory bronchioles changes as one ages |
|
Definition
| increases in number (24 mill at birth-->296 by adult) |
|
|
Term
| approximate size of child's airway |
|
Definition
|
|
Term
| what are children at a high risk for (airway) |
|
Definition
| laryngospasm & bronchospasm |
|
|
Term
| why are children at a high risk for laryngospasm & brconhospasm? |
|
Definition
| just a small amount of mucous or edema obstructs airway |
|
|
Term
|
Definition
| uncontrolled/involuntary muscular contraction of the laryngeal cords (vocal folds) |
|
|
Term
|
Definition
| detection of entry of water, mucous, blood, or other substance |
|
|
Term
| characteristics of laryngospasm |
|
Definition
| stridor and/or retractions |
|
|
Term
| laryngospasm (definition, cause, and clinical manisfestation) |
|
Definition
| involuntary contraction of laryngeal cords - from detection of entry of substance like water & mucous - stridor & retractions |
|
|
Term
|
Definition
| epiglottis-->larynx-->trachea-->primary bronchi-->secondary then tertiary bronchi-->bronchioles (no cartilage)-->alveoli |
|
|
Term
|
Definition
| sudden constriction of muscles in the walls of bronchiols |
|
|
Term
|
Definition
| release of substances from mast cells or basophils from a lower resp diseases (pneumonia, asthma), allergic reaction (anaphylaxis), side effect of beta blockers (treatment is beta 2 AGONIST) |
|
|
Term
| characteristics of bronchospasm |
|
Definition
| constriction-->inflammation&inc mucous production-->SoB, coughing, hypoxia, wheezing |
|
|
Term
| bronchospasm (definition, cause, and clinical manisfestation) |
|
Definition
| sudden constriction of bronchioles-from activation of mast cells or basophils, lower resp diseases (pneumonia, asthma), anaphylaxis, beta blockers-causes inflammation & inc mucous production-manifested as SoB, coughing, hypoxia, wheezing |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| cause of bulging fontanelle (physiology) |
|
Definition
| inc. cerebral spinal fluid/intracranial pressure |
|
|
Term
| age anterior fontanelle closes |
|
Definition
|
|
Term
| behavior changes from inc. intracranial pressure |
|
Definition
| irritability & bad behavior |
|
|
Term
| why children throw up in the morning sometimes |
|
Definition
| quick change in pressure from getting up after lying flat for a long time |
|
|
Term
| 3 categories the glasgow coma scale measures |
|
Definition
| motor, spontaneous movement, painful stimuli |
|
|
Term
| glasgow coma scale (definition & purpose) |
|
Definition
| national basline and tool that measures LoC after brain injury |
|
|
Term
|
Definition
| head circumference, fontanelle, spinal column, behavior, reflexes, symmetry (compare bilaterally) |
|
|
Term
| babinski reflex (response & age) |
|
Definition
| fanning then curling of tosed when foot stroked - disappears 8 m to 1 y (when start walking) |
|
|
Term
|
Definition
| hyperreactive since not enough fat to cover nerves |
|
|
Term
|
Definition
| exclusive human milk protein in infants w/ LBW reduces risk of necrotizing enterocolitis so donor human milk products encouraged in NICU |
|
|
Term
| infants breathe w/ what type of muscles |
|
Definition
| abdominal breathers (& diaphragm) |
|
|
Term
| why do infants have more pronounced reactractions |
|
Definition
|
|
Term
| formula for cardiac output |
|
Definition
|
|
Term
| 3 common reasons for tachycardia |
|
Definition
|
|
Term
|
Definition
| 90+ (2x age in years) / 70+ (2x age in years) |
|
|
Term
| top number of blood pressure |
|
Definition
|
|
Term
| 3 most common reasons for low BP |
|
Definition
| blood loss &/or dehydration, THEN sepsis |
|
|
Term
| when looking at vitals, what's most important |
|
Definition
| look at TRENDS, CHANGES are more important |
|
|
Term
| tachycardic, tachypnic, & hypertensive indicates (3) |
|
Definition
| fluid overload from IV, pain, or sepsis |
|
|
Term
| bradycardic, tachypnis, & hypotensive indicates |
|
Definition
|
|
Term
| greatest source of error & potential for harm in pediatric medications |
|
Definition
|
|
Term
| 8 strategies to reduce medication error |
|
Definition
| don't use memory, include child's weigh/age, calculated dose AGE mg/kg dose, legible print, no abbreviations, don't use zeros, bar coding, allergy documentaion & band |
|
|
Term
| 6 rights of medication administration |
|
Definition
| medication, dose, patient, route, time, documentation |
|
|
Term
|
Definition
| identify, situation, background, assessment, recommendation, questioning/clarifying |
|
|
Term
|
Definition
| we are responsible for professional, clear, and complete verbal and written communications |
|
|
Term
| 2 most important electrolyes |
|
Definition
|
|
Term
| presentation of hypernatremia (3) |
|
Definition
| seizures, altered mental state (agitation, frustration, etc.), low urine output |
|
|
Term
| cause of hypernatremia (5) |
|
Definition
| dehydration (from not enough feeding or too concentrated formula), developmental reasons, prolonges diarrhea/vomiting, tube feedings, crtain IV preparations |
|
|
Term
|
Definition
|
|
Term
| how often should babies have a wet diaper |
|
Definition
| 2-3 hours, less as they age |
|
|
Term
| nursing management of hypernatremia (5) |
|
Definition
| breastfeeding change, check Is/Os & weight, assess urine, assess/change saltiness of food or IV solution, hydrate or start IV if diarrhea/vomiting |
|
|
Term
|
Definition
| absent tears, low BP, hypernatremia, altered mental state (hard to console), low urine output, dry mucous membranes, pale, sunken eyes, floppy arms (poor tone), skin turger (brisk, not tented) |
|
|
Term
| assessment of dehydration (5) |
|
Definition
| parent interview, ABCs, listen to lungs, palpate fontanelle, check vitals |
|
|
Term
| interventions of dehydration (4) |
|
Definition
| check vitals, call doc, parent teaching on breastfeeding, give fluids |
|
|
Term
| milk allergy presentation |
|
Definition
| dehydration & blood stool |
|
|
Term
| where should we assess skin turger for babies and why |
|
Definition
|
|
Term
|
Definition
| why here, intake (what, when, how tolerating, output (when, where, quality) behavior, onset, duration, siblings sick, traveling, immunizations, past hospitalizations/surgeries, premature?, complicated birth? |
|
|
Term
| parents of an infant w/ slow weight gain want to feed baby highly concentrated formula. What's your response |
|
Definition
| can lead to dehydration cuz of high sodium content; let's discuss other strategies |
|
|
Term
| cause of hyponatremia (5) |
|
Definition
| D5W IV solution instead of NaCl, tap water enemas, diluting formula, excessive swallowing of pool/bath water, excessive sweating w/ incorrect fluid replacement (Marathon) |
|
|
Term
|
Definition
|
|
Term
| swimming safety considerations |
|
Definition
| diving can be dangerous if head/neck flexed; learn to swim w/ clothes on; trauma - flight or flight; chlorine intake |
|
|
Term
| hyponatremia interventions |
|
Definition
| stop the excess intake of water, replace sweat/fluid loss w/ appropriately; don't teach swimming until developmentally appropriate |
|
|
Term
|
Definition
| more related to muscle so has cardiac problems |
|
|
Term
| primary functions of potassium (2) |
|
Definition
| nerve transmission, muscle firing |
|
|
Term
| potassium is inside or outside cell? |
|
Definition
|
|
Term
| causes of hyperkalemia (6) |
|
Definition
| burns, trauma, blood transfusion, renal failure, IV fluids w/ K+ |
|
|
Term
|
Definition
|
|
Term
|
Definition
| wide QRS cuz resting state/repolarization too long --> tombston/high T wave (as high as QRS) |
|
|
Term
| symptoms of hyperkalemia (3) |
|
Definition
| palpitations, weakness, arrhythmias |
|
|
Term
| hyperkalemia interventions |
|
Definition
| D50 & insulin, assess cardiac status, stop giving K+ |
|
|
Term
| signs of hypokalemia from anorexia/EDNOS |
|
Definition
|
|
Term
| causes of hypokalemia (4) |
|
Definition
| diarrhea, wound drainage, eating disorders, renal disease |
|
|
Term
| symptoms of hypokalemia (3) |
|
Definition
| neurological changes, weakness, arrhythmias |
|
|
Term
| hypokalemia interventions (3) |
|
Definition
| slow replacement of K+, assess cardiac status, re-assess |
|
|
Term
| 10 differences between children and adults regarding electrolytes |
|
Definition
| higher water content; insensible loss from more body surface area; not regular food, can't communicate problem, less margin for error, can have lots of poop, breathes faster, higher metabolic rate, frequent fevers, fast growth / calcium metabolism, susceptible to controversial parent regimens |
|
|
Term
| symptoms of fluid overload (6) |
|
Definition
| crackling lung sounds, labored breathing, weight gain, hypertension, , slow bounding pulses, generalized edema |
|
|
Term
| major causes of edema/fluid overload (3) |
|
Definition
| IV fluid overload, CHF (right side), congential defect/brain defect that leads to drinking too much |
|
|
Term
| nursing management of edema (8) |
|
Definition
| daily weights, abdominal girth, assess for skin breakdown, urine specific gravity, fluid restriction?, electrolyte balance, check IV, neuro assessment |
|
|
Term
| why first time breast feeeders have a higher risk for dehydration |
|
Definition
| babies sleep too long and mom's forget to wake them up |
|
|
Term
| better way to say shortness of breath |
|
Definition
| increased work of breath evidenced by retractions |
|
|
Term
| better way to say test urine |
|
Definition
| obtain urine analysis and urine culture |
|
|
Term
| better way to say test blood |
|
Definition
|
|
Term
| nutrition physical assessment |
|
Definition
| examine extremities, physical development (Tanner stages), activity/alertness, medical devices or drugs that alter eating/appeitite), skin/hair/nails/nails/mucous membraines/abdomen/musculoskeletal |
|
|
Term
|
Definition
|
|
Term
| age can start fruits/veg/meat/eggs |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| why have to start fruit juice so late |
|
Definition
| too much sugar' they can't handle that much sugar |
|
|
Term
| why can't start whole milk |
|
Definition
| can't tolerate/digest it - can't break down an enzyme in cow milk so diarrhea & the milk doesn't have enough iron (milk anemia) |
|
|
Term
|
Definition
|
|
Term
| malnutrition effects on respiratory system |
|
Definition
| decreased diaphragmatic function |
|
|
Term
| indicator of health, well-being, and "thriving" |
|
Definition
|
|
Term
| history & assessment for nutrition specific to those under age 2 (5) |
|
Definition
| birth weight, length, head circumference, complications, gestational age |
|
|
Term
| history and assessment for nutrition specific to those over 2 |
|
Definition
|
|
Term
| history and assessment of nutrition for all age groups (7) |
|
Definition
| previous disease states, co-morbidities, hospitalizations, treatments/surgeries, developmental history, actives issues affecting nutrition, GI symptoms |
|
|
Term
|
Definition
| usual mode of intake (PO/enteral), age-appropriateness of foods/portions/textures, food allergies/interolerances/reactions, vitamin supplements, herbal/"natural" supplements |
|
|
Term
| alternative growth measures (4) |
|
Definition
| knee height, tibia length, ulnar length, arm span |
|
|
Term
| children born w/ imperforated anus often have what other associated anomaly |
|
Definition
|
|
Term
| priority order of interventions for 34 week neonate w/ gastroschisis (bowel protection, decompression, temp control) |
|
Definition
| bowel protection, temp control, decompression |
|
|
Term
| most common presentation for Meckel's Diverticulum |
|
Definition
|
|
Term
| typical pediatric patient w/ appendicitic present w/ (7) |
|
Definition
| fever, emesis, anorexia, periumbilical pain, RLQ pain, guarding, obturator & psoas signs |
|
|
Term
| most likely result of abdominal exam of a patient w/ intussusception |
|
Definition
| sausage shaped mass on the right side |
|
|
Term
| sugical treatment of choice for pyloric stenosis |
|
Definition
| pyloric resection or pyloromyotomy |
|
|
Term
| which standard postoperative nursing intervention would you NOT do for infants returning from surgery for Hirschsprung's Disease |
|
Definition
|
|
Term
|
Definition
| esophageal atresia w/ DISTAL TEF |
|
|
Term
| pts w/ celiac disease should avoid rice, corn, barley, or fruit? |
|
Definition
|
|
Term
| those w/ celiac disease need to have a gluten-free diet for how long? |
|
Definition
|
|
Term
| a hydrocele is distinguished from an inguinal hernia in that a hydrocele is |
|
Definition
| a collection of peritoneal fluid in the scrotal sac |
|
|
Term
| T or F? bilateral inguinal hernias are common in permature infants. |
|
Definition
|
|
Term
|
Definition
| gently stroking the medial thigh --> spermatic cord cremasteric muscle contraction and testicular movement |
|
|
Term
| time frame most advantageous to restoring viability of a torsed testicle |
|
Definition
| within 4-6 hours of injury |
|
|
Term
| Gi system of peds v. adult pts |
|
Definition
| faster peristalsis, small stomach, weaker ribs, no voluntary control over swllowing (until 6 weeks) |
|
|
Term
|
Definition
| just started absorption & excretion (used to use placenta), no voluntary control over swallowing (till 6 w), relaxed lower esophageal sphincter (so regugitation), digestion in duodenum, deficiency in enzy,es (so abdominal distension), immature liver function, bad at gluconeogenesis/protein-ketone formation/vitamin storage/deamination |
|
|
Term
| effects of infants having faster peristalsis |
|
Definition
| need more feeding cuz faster digestion |
|
|
Term
| effects of children having smaller stomachs |
|
Definition
| dehydrate easily & pee/poo a lot |
|
|
Term
| how to measure size of stomach |
|
Definition
| (2 + age in years) ounces --> example: 3 y/o = 5 oz. |
|
|
Term
|
Definition
| bladder, liver, small intestine, and spleen at higher risk for injury |
|
|
Term
| urinary catheters in pediatric pts |
|
Definition
| don't use in case of bladder injury |
|
|
Term
|
Definition
|
|
Term
| abdominal trauma - presentation |
|
Definition
pain (tachypnic & tachycardic)
behavior/neuro changes
low BP if injured spleen/bleeding
distension, hypo or no bowel sounds, guarding, soft, rebound tenderness |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| injured spleen presentation (3) |
|
Definition
| left flank pain, low BP, low HR |
|
|
Term
|
Definition
| filters blood and controls blood volume |
|
|
Term
| why give H2 blocker for abdominal trauma |
|
Definition
|
|
Term
| lap belt injury - which organs should we be worried about |
|
Definition
| liver, spleen, small intestines, bladder, pancreas |
|
|
Term
|
Definition
| take stuff out from stomach/perineum to see if there is blood/infection (diagnositc) or get infection screening and give antibiotics (therapeutic) |
|
|
Term
| abdominal trauma - diagnosing (4) |
|
Definition
| CT, ultrasound, MRI, peritoneal lavage |
|
|
Term
| abdominal trauma - interventions |
|
Definition
A - give oxygen
B - auscultate lungs everywhere
C - HR & BP
D - give analgesic
E - take blood for type&cross. Check hematocrit & hemoglobin
F - give fluids
G - do GI assessment. DON’T give NG tube. |
|
|
Term
|
Definition
| air collection in the pleural space between the lung and inside the chest wall from blunt/penetrating chest trauma - present w/ injuries that penetrate the parietal and visceral pleura |
|
|
Term
|
Definition
| low pitched, continuous, musical sounds that are similar to qheezes |
|
|
Term
| abdominal trauma, O2 sat = 88%, and barky spasmodic cough means…? |
|
Definition
| pneumothorax & possible injury to liver |
|
|
Term
| Meckel Diverticulum - hallmark |
|
Definition
| painless rectal bleeding in toddlers |
|
|
Term
| painless rectal bleeding in toddlers indicates |
|
Definition
|
|
Term
| Meckel's Diverticulum - pathophysiology |
|
Definition
| sac in intestines harbors gastric or pancreatic tissue --> acidic gastric cells causes ulceration by 1 or 2 y/o --> painless rectal bleeding W/O stool |
|
|
Term
| Meckel's Diverticulum - special peds consideration |
|
Definition
| may not be caught cuz toilet trained and no diapers |
|
|
Term
| Meckel's Diverticulum - presentation |
|
Definition
A & B - fine
C - tachycardic (if bleeding --> lower BP)
D - skin may be pale/anemic
E - low hematocrit, low hemoglobin
F & G - fine (no dehydration or guarding) |
|
|
Term
| Meckel's Diverticulum - interventions |
|
Definition
A - give oxygen (until sure Meckel's)
E - test CBC/WBC, aspirate/assess electrolytes, urine culture (virus or bacteria in urine?), assess poop for odor (infectious?), stool sample, type & screen
F - give fluids, monitor I/O
monitor for shock |
|
|
Term
| Meckel's Diverticulum - healthcare team |
|
Definition
|
|
Term
| Red Stool from Food - presentation |
|
Definition
| A-F fine, G has red stool; nothing wrong, but red blood (no tachycardia, pale, agitation) |
|
|
Term
| Red Stool from Food - Intervention |
|
Definition
| intake history from family!! Put in their chart for future, let them know for future |
|
|
Term
| common foods that cause red stool |
|
Definition
| beets, cranberry, artificial coloring |
|
|
Term
|
Definition
|
|
Term
|
Definition
| infection of appendix or obstruction leading to inflammation of appendix |
|
|
Term
| highest morbidity and mortality reason for children under 2 |
|
Definition
|
|
Term
| why is appendicitis the highest morbidity and mortality for children under 2a |
|
Definition
| can't express problem and pain |
|
|
Term
| appendicitis - classic symptoms |
|
Definition
| rebound tenderness, RLQ abdom pain, high WBC count, fever |
|
|
Term
| what happens after rupture of appendix |
|
Definition
| feels fine for a bit then septic |
|
|
Term
|
Definition
|
|
Term
| appendix & chron's disease |
|
Definition
| taking out appendix helps chron's disease since appendix helps immunity |
|
|
Term
| Appendicitis - Presentation |
|
Definition
A - shallow breaths & tachypnea (from pain & sepsis)
B - fine
C - high HR (from pain and sepsis) & high BP (from pain)
D- analgesic E - elevated WBC, blood culture for infection and right antibiotics pre/post surgery
F- IV cuz antibiotics prior to surgery
GI- guarding, rebound tenderness from the swollen and inflamed appendix, positive psoas major and obturator; maybe vomiting/diarrhea/constipation |
|
|
Term
| rebound tenderness - cause |
|
Definition
| occurs when peritoneum is irritated, inflamed, or infected (peritonitis); in appendicitis it is because the appendix is swollen and inflamed |
|
|
Term
|
Definition
| pain upon bending knee (patient lies down) |
|
|
Term
|
Definition
| pain upon rotating leg out when patient lying down w/ hips & knees flexed |
|
|
Term
| appendicitis - post surgery |
|
Definition
|
|
Term
| appendicitis - surgical procedure |
|
Definition
| laproscopic surgery w/ 3 incisions (camera, gives fluids, removal of things) |
|
|
Term
| appendicitis - reason for discomfort post surgery |
|
Definition
|
|
Term
| Appendicitis - Assessment |
|
Definition
D - detailed pain asessment (OLDCART)
B - assess anxiety & coping
G - abdominal assessment (palpate last to avoid causing pain)
temperature |
|
|
Term
| Appendicitis - Additional PostOp Assessment |
|
Definition
| fluid status, vitals, return of bowel function, wound site for infection |
|
|
Term
| appendicitis - interventions |
|
Definition
A- Supplemental oxygen
B - Auscultate lung, orientation, emotional support
C & D - analgesic & lie on right side
E - White blood cell count, hematocrit, hemoglobin
G - listen for bowel sound, movement
F - Minimum urine output: 1mL/kg/hour, give fluids & IV antibiotics (hydrate & monitor I/O)
monitor for infection symptoms
surgical site dressing change, antibiotics, edema, redness, pain, drainage |
|
|
Term
| severe appendicitis leads to |
|
Definition
|
|
Term
| Appendicitis Perforation - First Actions |
|
Definition
| call OR surgeon (ISBAR - tell vitals) |
|
|
Term
|
Definition
| inflammation of the abdominal lining and contents |
|
|
Term
|
Definition
| rigid belly (flat, hard, stomach) |
|
|
Term
|
Definition
| pelvic inflammatory disease (Can be from untreated STD) |
|
|
Term
|
Definition
| does NOT lead to PID & peritonitis in males, but CAN in women |
|
|
Term
|
Definition
| surgical irrigation w/ antibiotics - put a catheter in and wash them out w/ antibiotics up to 4x a day |
|
|
Term
| Peritonitis - why not IV antibiotics |
|
Definition
| blood does not circulate to peritineum well |
|
|
Term
|
Definition
A - tachypnic cuz VERY painful
B - shallow and rapid
C - hypertensive
D - N/A
E - high WBC
F - N/A
G - rebound tenderness, distended, guarding. hypoactive bowel sounds |
|
|
Term
| Peritonitis - Interventions |
|
Definition
| D only - fluids, analgesic, antibiotics |
|
|
Term
| Intussusception - Definition |
|
Definition
| prolapsing and invagination of SI which causes a painful mass |
|
|
Term
| Intussusception - Common location |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| red currant stool (mucous & blood), abdominal mass in RUQ, classic triad, intermittent bouts of belly pain |
|
|
Term
| Intussusception - Treatment |
|
Definition
| Therapeutic Barium Enema (interventional radiology) then Surgery (if 1st didn't work) |
|
|
Term
| Intussesception - classic triad |
|
Definition
| vomiting, bloody stools, colicky |
|
|
Term
|
Definition
| periods of crying/significant distress in otherwise well-fed, healthy baby |
|
|
Term
| Intussesception - Assessment |
|
Definition
A & B - fine
C - high BP, HR, and RR (from pain)
D - Dehydration, absence of tear, dry mucous membrane
E - Fine WBC and RBC; high sodium (breastfed, not eating)
F - calculate urine output and see if normal
G - guarding & distension, mass in URQ, vomiting |
|
|
Term
|
Definition
| put cather in, forcefully open up the bowel w/ air, then barium |
|
|
Term
| Intussesception - Interventions |
|
Definition
D- Pain Management have been intussuscepted for a long time)
E - CBC, stool culture, dehydration labs
G - listen for bowel sounds (movement to make sure there is no obstruction)
Let them know stool will be white and chalky for a few days
F - FLUID/ELECTROLYTE BALANCE MAINTENANCE/RESTORATION
CAN GO HOME |
|
|
Term
| Intussessception - Treatment if intussescepted for a long time |
|
Definition
|
|
Term
| Pyloric Stenosis - Hallmark |
|
Definition
| Projectile vomit at ~ 3 weeks |
|
|
Term
| Pyloric Stenosis - Definition |
|
Definition
| Narrowing of pyloric sphincter |
|
|
Term
| Pyloric Stenosis - Treatment |
|
Definition
|
|
Term
| Pyloric Stenosis - Puts pts at risk for |
|
Definition
| dehydration & hypernatremia |
|
|
Term
| Pyloric Stenosis - Worrisome Signs |
|
Definition
| vomiting/losing weight. Do NOT worry if patient is gaining weight |
|
|
Term
| Fluid maintenance - which weight do you use |
|
Definition
| CURRENT, NOT birthweight ever |
|
|
Term
| Pyloric Stenosis - Assessment |
|
Definition
| B - lethargic/irritable, D - jaundice, E - dehydrated (sunken fontanels, no tears), G - extra soft abdomen, olive-shaped mass to left region of belly, weight loss, hyperactive bowel sounds, bowel movements, peristaltic waves, vomiting |
|
|
Term
| Pyloric Stenosis - Interventions |
|
Definition
E - electrolytes for dehydration D - analgesic (pre & post op) but NO antibiotics (both regarding post-op)
F - IV fluids
G - Bowel sound |
|
|
Term
| Hirschsprung's Disease - Definition |
|
Definition
| congenital aganglionic megacolon (no nerves in portion of bowel) |
|
|
Term
| Hirschsprung's Disease - first meconium |
|
Definition
| tells many things such as presense of CF |
|
|
Term
| Hirschsprung's Disease - S&Sx |
|
Definition
| no meconium for 48 h, FTT, constipation |
|
|
Term
| Hirschsprung's Disease - Rx |
|
Definition
| bowel management, surgical removal, temporary colostomy (or ileostomy to bypass disease portion) |
|
|
Term
| Hirschsprung's Disease - complication |
|
Definition
| could develop toxic megacolon |
|
|
Term
| Hirschsprung's Disease - Assessment |
|
Definition
newborns - observe for meconium & abdominal distension & vomiting
older than newborns - failure to gain weight, malnutrition, consitpated, infrequent defacation w/ hard dry stools or pencil thin stools |
|
|
Term
| Esophageal Atresia - Tracheoesophageal Fistula |
|
Definition
| esophagus forms a pouch connected to trachea (90% of cases) |
|
|
Term
| Tracheoesophageal Fistula |
|
Definition
| failure of esophagus to developas a continuous tube, may end in a pouch, surgical emergency |
|
|
Term
| Esophageal Atresia - Symptoms |
|
Definition
| cough, choke, cyanotic (when eating) |
|
|
Term
|
Definition
| blind pouch v. pouch connected to something |
|
|
Term
| Esophageal Atresia & Tracheosophageal Fistula - Assessment |
|
Definition
| Excessive Drooling; cyanosis, choking, coughing (inability to handle secretions), potential aspiration (milk out of mouth & nose), feeding difficulties, risk for pneumonia, make sure airway is fine |
|
|
Term
| Esophageal Atresia & Tracheosophageal Fistula - Diagnosis |
|
Definition
| may be detected during prenatal ultrasound |
|
|
Term
|
Definition
|
|
Term
| Esophageal Atresia & Tracheosophageal Fistula - Pre- Op Interventions |
|
Definition
Maintain patent airway (suction available)
Head of bed raised (minimize aspiration)
Withhold oral feedings
administer maintenance IV & antibiotics
Clinical exam and nursing assessment - antibiotics |
|
|
Term
| Esophageal Atresia & Tracheosophageal Fistual - PostOp Interventions |
|
Definition
Total parenteral nutrition (TPN)
Measure gastrostomy output
Monitoring of feeding tolerance when oral feedings introduced |
|
|
Term
| Esophageal Atresia & Tracheosophageal Fistula - Signs |
|
Definition
| NG tube will be met w/ resistance; x-ray will show pouch |
|
|
Term
|
Definition
| vertebral (scoliosis), anal, cardiac murmur, TE fistula, radial (no radial bone & club finger) and renal (kidney issues) |
|
|
Term
| Imperforate Anus - definition |
|
Definition
|
|
Term
| Imperforate Anus - common second diagnosis |
|
Definition
|
|
Term
| Imperforate Anus - Assessment |
|
Definition
| ABC - fine; D - look at perineum, skin integrity, EF - fine, G - no meconium, abdominal guarding, distention, firm abdomen |
|
|
Term
|
Definition
|
|
Term
| Imperforate Anus - NonNursing Interventions |
|
Definition
| Ileostomy/Colostomy; vesicostomy (if bladder issues) |
|
|
Term
| Imperforate Anus - PostOp Interventions |
|
Definition
| E - electrolytes; D - skin assessment (skin care), pain; G - assessment of abdoment (bowel sounds, bowel management); F - give fluids until PO, I/Os, foley catheter |
|
|
Term
| Imperforate Anus - PreOp Interventions |
|
Definition
| IV fluids, NG decompression, monitor I/Os & VS, Skin Assessment & Assessment of Abdomen |
|
|
Term
|
Definition
| Intestinal wall or other abdominal organs in a sac, right through umbilicus |
|
|
Term
| Gastroschisis - definition |
|
Definition
| intestines stick out of umbilicus w/o sac |
|
|
Term
|
Definition
| necrotyzing enterocolitis: infection, inflammation, adhesion, necrosis of bowel; dehydration from fluid loss; hypothermia |
|
|
Term
| Abdominal Wall Defect - PreOp Interventions |
|
Definition
| protect GI from injur/infection, maintain temp, bowel decompression, resp support PRN, fluid/electrolute balance |
|
|
Term
| Abdominal Wall Defect - Treatment |
|
Definition
| replacement into a Silastic silo then close abdominal wall |
|
|
Term
| Abdominal Wall Defect - PostOp |
|
Definition
| pain mangement, prevent infection/antibiotivs, skin/wound care, monitor circulation to lower extremities and wound, respiratory support, fluid/electrolyte balance |
|
|
Term
| Cleft Lip/Palate - Assessment |
|
Definition
| palpate it! May result in feeding problems |
|
|
Term
| Cleft Lip/Palate - Feeding |
|
Definition
| PO (NG may be necessary), smaller volume but more frequent, head elevated, frequent burping, breastfeeding |
|
|
Term
| Cleft Lip/Palate - PreOp Interventions |
|
Definition
| reduce risk for aspiration, assess for resp distress, ensure adequate nutrition & growth, provide feeding training for parents, appropriate referrals |
|
|
Term
| Cleft Lip/Palate - PostOp Interventions |
|
Definition
| arm immobilizers, pain management, avoid crying |
|
|
Term
| Celiac Disease - Definition |
|
Definition
| intolerate to gluten/rice/wheat changes intestinal mucosa which leads to malabsorption |
|
|
Term
| Celiac Disease - hallmart |
|
Definition
| fatty, smelly stool, chronic diarrhea, growth impairment, abdominal distension |
|
|
Term
| Hemolytic Uremic Syndrome - classic symptoms |
|
Definition
| (1)hemolytic anemia causes (2)uremia and (3)thrombocytopenia |
|
|
Term
|
Definition
| anemia caused by destruction of RBC |
|
|
Term
|
Definition
| acute kidney/renal failure |
|
|
Term
|
Definition
|
|
Term
| Hemolytic Uremic Syndrome - Assessment |
|
Definition
| gastroenteritis, blood diarrhea, URI or UTI, hypertension, pallor, bruising, oliguria, fever |
|
|
Term
| Hemolytic Uremic Syndrome - Treatment |
|
Definition
| fluid restrictions, high cal/high carb/low protein/low sodium/low potassium diet, hemodialysis, transfusions of RBC & platelets, daily weights/labs/neuro assessment, assess swelling/edema/vomiting/headache |
|
|
Term
| Urinary Tract Infection - Infant presentation |
|
Definition
| irritability, failure to thrive, fussy, loss of appetite, colicky, vomiting/diarrhea, change in urine color |
|
|
Term
| Urinary Tract Infection - child presentation |
|
Definition
| wetting bed when previously not, change in urine colo, burning/pain w/ urination, frequent/urgent urination, fever, lower abdominal pain, bood in urine |
|
|
Term
| Urinary Tract Infection - Diagnosis |
|
Definition
| Urinalysis & Urine Culture (catheter catch more reliable than bag/clean catch) |
|
|
Term
|
Definition
| urethra opens to underside of penis |
|
|
Term
|
Definition
| accumulation of fluid around the testicle |
|
|
Term
| communicating v noncommunicating hydrocele |
|
Definition
| communicating - opening between abdominal cavity & scrotum |
|
|
Term
|
Definition
| protrusion of an organ or tissue through an abnormal opening |
|
|
Term
| Hernia & Communicating Hydrocele - Interventions |
|
Definition
| keep wounds dry & clean, stitches v mesh, dermabonds, no lotion to wound, frequent diaper changes, sponge baths, no lifting or straddling for 2 weeks |
|
|
Term
| Testicular Torsion - presentation |
|
Definition
|
|
Term
| Testicular Torsion - Reflex |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| catarrhal, paroxysmal, convalescent stage |
|
|
Term
|
Definition
| 7-10 days, incubation and communicable, infectious before symptoms start, possible fever |
|
|
Term
|
Definition
| 1-6 weeks, start coughing, antibiotics to prevent spread, infectious |
|
|
Term
|
Definition
| rest of 100 days, gradual recovery |
|
|
Term
|
Definition
| A - repiratory assessment (risk for apnea & resp arrest), D - comfort level, E - assess NG tube (can't eat cuz coughing), F - hydration and nutritional assessment, G - assess GI, in neg airflow isolation (drop & contact) |
|
|
Term
|
Definition
|
|
Term
| Pneumococcal Disease - Definition |
|
Definition
| Streptococcus pneumoniae infection; can be anywhere |
|
|
Term
| Pneumococcal Disease - Vaccine |
|
Definition
| sickle cell, cancer, and HIV pts get the stronger vaccine |
|
|
Term
| Pneumococcal Disease - Sickle Cell Concerns |
|
Definition
| spleen doesn't filter as well so can't fight off infection well |
|
|
Term
| Pneumococcal Disease - Presentation |
|
Definition
|
|
Term
| Pneumococcal Disease - Assessment |
|
Definition
| neurological (irritablity, fontanelle); respiratory (pneumonia; retractions; nasal flaring; O2 sat); pain; sensitivity to light; VS (febrile) |
|
|
Term
| Pneumococcal Disease - Interventions |
|
Definition
| chest xray; bacteriologic cultures of blood, spinal fluid, and other body fluids; home treatment if mild; antibiotics; encourage fluids |
|
|
Term
| Staphylococcal Infection - Where do you not want it |
|
Definition
|
|
Term
|
Definition
| Methicillin-resistant Staphylococcus aureus |
|
|
Term
| Staphylococcal Infection - Assessment |
|
Definition
| skin (esp wounds); respiratory; joint/bones; GI/GU (attention to catheters/tubes); vesiculars (puss? Diameter? Area? Tender? Odor? Fever?) |
|
|
Term
| Staphylococcal Infection - Interventions |
|
Definition
| hand hygiene; contact precautions; blood cultures; chest xray (in pneumonia); wound cultures; penicillin; rapid strep test |
|
|
Term
| Group A and B - Which Infection? |
|
Definition
|
|
Term
| Group A Streptococcal Infections |
|
Definition
| common so not reported, but can go to heart so must come back |
|
|
Term
| Group B Streptococcal Infection |
|
Definition
| culture mom before delivery. Normal in vagina, but don't want to give to baby |
|
|
Term
| Group A Streptococcal Infections - Complications |
|
Definition
| Aortic Valve Stenosis, Rheumatic fever, Renal failure |
|
|
Term
| Group A Streptococcal Infections - Treatment |
|
Definition
|
|
Term
| Negative Rapid Strep Test, but Positive Group A Streptococcal Culture |
|
Definition
| must come back even if feeling well cuz many complications |
|
|
Term
| Group A Streptococcal Infections - Assessment |
|
Definition
| Respiratory, throat, skin (sand paper rash, also check skin folds), lymph nodes, renal |
|
|
Term
| Group A Streptococcal Infections - Interventions |
|
Definition
| hand hygiene; standard and droplet precautions, strep test throat culture, antibiotics and ibuprofen, warm salt water gargle, compliance w/ antibiotics |
|
|
Term
| Meningococcemia - Effects |
|
Definition
| VERY infectious and abrupt. Lots of bleeding. Necrotic. Could lose a finger or limg or tip of nose, etc. DEVASTATING disease |
|
|
Term
| Meningococcemia - incubation |
|
Definition
|
|
Term
| Meningococcemia - Presentation |
|
Definition
| abrupt onset of fevers, chills, malaise, vomiting; neuroligic signs; rash (maculopapular then petechial then purpura then sepsis) |
|
|
Term
|
Definition
| a feeling of general discomfort or uneasiness, first indication of an infection or disease |
|
|
Term
| Meningococcemia - Complication |
|
Definition
| septic shock, sepsis until lose an extremity, death, seizures |
|
|
Term
| Meningococcemia - Neurologic signs |
|
Definition
| decreased mental status, seizures, coma, bulging fontanel, severe headache, stiff neck, sensitivity to bright lights, nuchal rigidity |
|
|
Term
| Meningococemia - Assessment |
|
Definition
| Cardiac, Repiratory, Neurological Status, Skin, Joints/ROM |
|
|
Term
| Meningococemia - Interventions |
|
Definition
| standard and droplet precaustions until 24h post antibiotics, prophylazis for adult contact, spinal tap (low glucose/high protein indicates meningitis! and also to rule out sepsis), give antibiotics |
|
|
Term
|
Definition
| spinal fluid blood count, blood cultures |
|
|
Term
|
Definition
| VERY & airborne (respiratory droplets) |
|
|
Term
| Measles - Incubation Period |
|
Definition
|
|
Term
| Measles - When Contagious |
|
Definition
| not contagious until presenting w/ symptoms |
|
|
Term
| Measles - Disease Process |
|
Definition
| incubation 3-12 days, infectious 10 days before onset of symptoms to 15 days after rash appears, symptoms first then maculopapular rash |
|
|
Term
| Measles - Presentation (3 Cs) |
|
Definition
| conjunctiitis, cough, coryza |
|
|
Term
|
Definition
| 3 Cs, maculopapular rash, koplik spots |
|
|
Term
|
Definition
| Skin, Respiratory, Neurological, GI, Family (for infection spread control) |
|
|
Term
|
Definition
| GI/Diarrhea, Pneumonia, Bronchitis, Encephalitis (convulsion, coma), Death |
|
|
Term
|
Definition
| airborne precausion (N95 respirator), hand hygiene, cool mist vaporizer, suction gently, antipyretics, cool liquid frequently, antibiotics only for secondary bacterial infections |
|
|
Term
|
Definition
| cant come out of isolation until EVERY lesion crusted over |
|
|
Term
|
Definition
| high fever, malise, anorexia, macular rash then pruritic vescular lesions, ulcerative lesions in mucous membranes, VERY ITCHY |
|
|
Term
| Varicella - Complications |
|
Definition
| pneumonia, cellulitis from itching |
|
|
Term
|
Definition
| skin, neurlogical status, respiratory |
|
|
Term
| Varicella - Interventions |
|
Definition
| tylenol or ibuprofen, oral antihistamines for relief of itching, trim fingernails/use soft cotton mittens, reassure child lesions will go away, IV acyclovir w/in 24h of rash |
|
|
Term
|
Definition
|
|
Term
| Varicella - When Contagious |
|
Definition
| 1-2 days before rash, to until all lesions crusted over |
|
|
Term
| Varicella - Rash Presentation |
|
Definition
| incubation 14-21 days, contagious 1-2 days before rash until all lesions crusted over, macular rash for a few hours then pruritic vescular lesions for 1-5 days, crusts 1-3 weeks |
|
|
Term
|
Definition
| nonverbal, experiecne more intense pain cuz less myelin sheeth |
|
|
Term
|
Definition
| pain perception can be inhibited or changed when a competing non-pain impulse is sent along the same nerve pathway; stimulation can cause closure of gate and decrease transmission of pain impulses to the brain |
|
|
Term
| Pain Scale - Premature to term |
|
Definition
| Premature Infant Pain Profile |
|
|
Term
| Pain Scale - Term to 7 y/o |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| Analogue Chromatic Continuous Scale |
|
|
Term
|
Definition
| Adolescent Pediatric Pain Tool |
|
|
Term
| Adolescent Pediatric Pain Tool Age |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| self report, parents, behavioral indicators, physiologic indicators |
|
|
Term
|
Definition
| Faces, Poker Chips, numeric rating |
|
|
Term
|
Definition
| neonatal infant pain scale - expression, cry, breathing, arm&leg movements, arousal state |
|
|
Term
|
Definition
| crying, requires O2, increased vital signs, expression, sleeplessness |
|
|
Term
|
Definition
| face, legs, activity, cry, consolability |
|
|
Term
| Post Sedation/Analgesia - Interventions |
|
Definition
| assess cardiovascular & respiratory function, assess arousability, assure adequate hydration, protect from injury (falls) |
|
|
Term
| Pain Behavioral Interventions - Diversional talk |
|
Definition
| develop imaginary game/trip, help pt imagine comfortable place, short statements of comfort/encouragement, riddles/jokes/humor |
|
|
Term
|
Definition
| allow child to sit up if possible, lying down is threatening |
|
|
Term
| Pain Behavioral Interventions - Comfort Measures |
|
Definition
| encourage parent/caregiver to be present, modify environment (dim lights/decrease noise/limit talking/play favorite music), use familiar objects (favorite tow/blanket/pacifier), comfort hold or positioning (sit on parent's lap) |
|
|
Term
| Pain Behavioral Interventions - Breathin techniques |
|
Definition
| blow bubbles, pinwheels, singing, inhale through nose/exhale through mouth together |
|
|
Term
| Pain Behavioral Intervention - Assorted Visuals |
|
Definition
| light up toys, popupbooks, movies, magic wands |
|
|
Term
| During Sedation/Analgesia - Interventions |
|
Definition
| monitor for respiratory depression, watch chest rise, SpO2, monitor patient tolerance, VS q15min |
|
|
Term
| Preprocedure considerations |
|
Definition
| topical agents, use of diversion, procedural medications, NPO status, avoid delays, create safe environment; sedation plan (what is required for procedure? Length of procedure? Painful procedure?), consider child's development & history, work w/ parents to help them help, prep pt (include expected sensation) |
|
|
Term
| If radius is halved, resistance increases ____ |
|
Definition
|
|
Term
| why do infants have inc RR |
|
Definition
| oxygen consumption of infant is twice that of an adult (by mass) |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| airway edema, constriction, obstruction of airflow |
|
|
Term
|
Definition
| identifiy and minimize trigger, education and monitor for syptoms of exacerbation, maintain regular levels of activity and exercise, early management when symptoms occur, asthma action plan |
|
|
Term
|
Definition
| beta 2 agonist that relaxes smooth muscle |
|
|
Term
| cycstic fibrosis affects which systems |
|
Definition
| respiratory, GI, integumentary, reproductive |
|
|
Term
| which infectious diseases have no vaccine |
|
Definition
|
|
Term
| considerations when removing gastric |
|
Definition
| removing electrolytes AND fluids so replace BOTH |
|
|
Term
|
Definition
| ease breathing cuz pushing up against diaphragm |
|
|
