Term
|
Definition
-Interruption of stimulation
-Interruption of regular routine
-Unfamiliar environment
Interruption of mother-child relationship = SEPARATION
Treatment:
-Human contact when mom not available
-Soothing stimulation
-Security measures from home
-Reassure parents role as caregivers |
|
|
Term
|
Definition
Major fear = SEPARATION
-May view hospitalization as a loss of love
-May regress to more infant behavior
Treatment:
-Encourage caregiver to assure of their return & DO SO
-Provide for play activity - in play room if possible
-Reassure parents regression is temporary |
|
|
Term
|
Definition
Primary issue = BODY MUTILATION
May blame self or others for hospitalization
Loss of control May show:
*Tantrums
*Clinging
*Withdrawal
Treatment:
-Reassure child as not cause of illness
-Preparation for any procedure
-Medical play
-Encourage expressive play |
|
|
Term
| HOSPITALIZED SCHOOL AGE CHILD |
|
Definition
Major issue = CONTROL
-Loss of contact with peers
-Interruption of school routine
Treatment:
-Give opportunities for choices
-Tell OK to cry
-Encourage visits from friends
-Provide play opportunities for expression of feelings |
|
|
Term
|
Definition
Primary issue = BODY IMAGE
-Privacy important
-Often rebels from authority figures
-Separates from family - wants to be treated as adult.
Treatment:
-Allow to participate in treatment. decisions
-Respect privacy & confidentially
-Phone @ bedside |
|
|
Term
|
Definition
*Behaviors typically arise between ages 3 -5
*Diagnosis currently established on basis of self-reports, parent reports, & teacher reports
coupled with psych assessments.
S/S:
-Fidgets & squirms in seat
-Easily distracted by internal &/or external stimuli
-Difficulty awaiting turns in games or group situations
-Often blurts out answers to questions before questions completed
-Often shifts from one uncompleted activity to another
-Talks excessively
-Interrupts or intrudes on others
-Has difficulty organizing tasks & activities
-Loses things necessary for tasks or activities
-Does not seem to listen when spoken to directly
-Is “on the go” or acts as if “driven by a motor”
-Has difficulty playing in leisure activities quietly
-Diminished sense of time
-Displays all emotions publicly |
|
|
Term
|
Definition
-PSYCHOSTIMULANTS such as Ritalin
-ANTIDEPRESSANTS for some
-Training parents & teachers in more effective methods for managing the behavioral problems .
*Making consequences of actions more frequent & immediate
*Increasing the external use of prompts & cues about rules & time intervals
*Anticipating events for the kids
*Breaking tasks down into smaller, more immediate steps
*Using artificial immediate rewards
***** structure and limits very important**** |
|
|
Term
|
Definition
-Elevated blood lead levels > 10
-Lead is absorbed into the bones, where it can collect for a lifetime.
-Can affect anyone, but children ages 6 & younger greatest risk. r/t hands in mouth.
-Diets deficient in iron & calcium & high in fats increase the exposure risk for kids living in leaded environments.
-Fetus can get transplacentally
-A poison that affects virtually every system in body
*RBCs
*Kidneys
*Reproductive organs
*The brain
Lead can permanently damage children leading to:
*Nervous system & kidney damage
*Learning disabilities, ADD, & decreased intelligence
*Speech, language & behavior problems
*Poor muscle coordination
*decreased muscle & bone growth
*Hearing damage
*Anemia |
|
|
Term
| SOURCES OF LEAD POISONING |
|
Definition
-Peeling or chipping paint in homes built before 1978
-Dust from sanding or removing old paint & wallpaper
-Soil near a major highway or industry that uses lead, or around an older home with chipping outside paint
-Old water pipes made of lead or newer fixtures that contain lead solder
-Food grown in contaminated soil
-Bullets & batteries
-Hobbies that use lead such as making ceramics, stained glass or pottery
-Food stored in some glazed pottery & ceramicware, or stored in open cans
-Home or folk remedies like greta, azarcon & pay-loo-ah |
|
|
Term
|
Definition
Children with elevated blood levels often exhibit only subtle symptoms or sometimes no symptoms.
Some S&S:
*Persistent tiredness or hyperactivity
*Irritability
*Loss of appetite
*Reduced attention span
*Difficulty sleeping
*Constipation
*Wt. Loss
*can only be determined by blood test* |
|
|
Term
| LEAD POISONING TREATMENTS |
|
Definition
-Removing source of lead
-Improving nutrition: Calcium, phosphorus,& vit. D aid lead excretion.
-Using chelation therapy, EDTA w/ BAL, IM x5 days: A substance that bonds with the lead and the lead isolated in bone and is then excreted by the kidney |
|
|
Term
|
Definition
-Defined as the sudden death of an infant under age 1 yr that remains unexplained after a thorough case investigation.
-Occurs most freq. between 2 - 4 mo. of life
-Occurs most frequently in winter months.
-Clinical findings:
*Silent death
*Disheveled bed
*Frothy, blood-tinged fluid fills mouth & nostrils
*Diaper wet & full of stool
*Hands may be clutching sheets |
|
|
Term
|
Definition
Significant association with:
*Infants sleeping in prone position
*Infants sleeping on soft bedding
*Overheating during sleep
**If known history of SIDS, newborn sent home on a CAM & parents knowing CPR **
-More common in:
*Infants with ALTEs requiring CPR or vigorous stimulation
*Low birth-wt
*Lower socio-economic groups
*Infants with CNS disturbance & respiratory disorders. |
|
|
Term
|
Definition
-Anticipate parents will feel a combination of guilt, anger, & emotional
*RN offer calm, caring support
-Questioning must NOT imply negligence or any involvement with death
-Allow parents time to think before they answer questions
-If SIDS suspected, tell parents & inform that nothing they could have done could have prevented situation
-Provide a quiet room & have someone remain with family
-Assist family in calling support people
RN accompany Dr. when info given to parents
-Give parents opportunity to say “goodbye” to infant:
*Quiet room
*Rocking chair
*Dim lights
-Follow-up in the home
-Refer family to local SIDS program for information, support & counseling |
|
|
Term
|
Definition
-Nonaccidental trauma in the < than 2 yr. old population
-Form of child abuse caused by vigorous shaking as the the infant is held by the extremities or shoulders
Injury leads to:
*Whiplash-induced intracranial & intraocular bleeding
*Life threatening brain swelling
*Subdural hematoma
*Subarachnoid bleeding
Recent studies strongly indicate that shaking alone cannot cause the life threatening injuries, but that most shaken babies, after shaking, are then thrown down.
*Skull fracture & more severe injuries than occur.
-Usually provoked by infant’s uncontrollable crying |
|
|
Term
| S/S: SHAKEN BABY SYNDROME |
|
Definition
Various S&S:
*Irritability
*Coma
*Retinal Hemorrhage
*Seizures
*Posturing
*Resp. distress
*Full/tense fontanel (R/T increased ICP & decreased LOC)
Stories from family:
*Infant fell off couch, bed, changing table, etc
***These types of falls can not cause the types of injuries seen in SBS*** |
|
|
Term
| MANAGEMENT OF SHAKEN BABY SYNDROME |
|
Definition
Management of care involves:
*Maintain ventilation
*Maintain oxygenation
*Maintain perfusion
*Monitor & manage increased ICP
*Emergency surgery to evacuate intracranial hematomas
*Monitor LOC ( is infant’s most sensitive indicator of neuro status)
*Report suspected child abuse to a child protection agency |
|
|
Term
| COMPLICATIONS OF SHAKEN BABY SYNDROME |
|
Definition
Possible results of SBS:
*Blindness or eye trauma
*Brain damage
*Death
*Delay in normal development
*Fractures or dislocations
*Hydrocephalus
*Impaired motor & sensory skills
*Mild to severe retardation
*Seizures
*Spinal injury, paralysis, or spasticity |
|
|
Term
|
Definition
-Frequently performed to obtain cerebral spinal fluid
-RN assists by:
*Positioning: side-lying or sitting
*Restraining
*Monitoring the child
**EMLA** a local anesthetic cream can be used 1 hr prior to procedure.
-Post-LP headache may occur R/T postural changes.
*Less severe when flat
*Seen less frequently in young children than adults
-Post procedure monitor for :
*Headache
*Fever
*CSF leakage @ puncture site
**During procedure monitor Respiratory status. Risk of airway obstruction R/T neck flexion** |
|
|
Term
|
Definition
-Transmission:
*Direct contact, droplet, airborne, and contaminated objects
*Usually late winter - early spring
-Incubation:
*2 - 3 weeks, usually 13 - 17 days
-Communicability:
*1 day before eruption of lesions to 6 days after first crop of vesicles when crust have formed. |
|
|
Term
|
Definition
-S&S:
*Slight fever, malaise, anorexia first 24 hours
*Rash very itchy & begins as macule & rapidly progresses to papule, vesicle, pustula, to crust
*All stages present at the same time
*Irritability from itching
*Lymphadenopathy
-Distribution:
*Centripetal, spreading to the face and proximal extremities but sparse on distal limbs and less on areas not exposed to the heat |
|
|
Term
|
Definition
-Treatment:
*Antiviral agent Acyclovir(Zovirax)- decreases # of lesions.
*Varicella-zoster immune globulin (VZIG) after exposure in high risk children
*Antihistamines to relieve itching
*Skin care to prevent secondary bacterial infection.
-Complications:
*Secondary bacterial infections
*Encephalitis
*Varicella pneumonia
*Reye’s syndrome- no aspirin to children |
|
|
Term
| NURSING CARE: CHICKEN POX |
|
Definition
-Nursing:
*Strict Contact isolation in hospital (gown, gloves, & mask )
*Isolate children at home until vesicles have dried
*Isolate high risk children from infected children
*Keep cool
*Administer topical lotions
*Keep fingernails short and clean
*Benedryl or Atarax for itching
*Avoid use of aspirin- Causes Reye's syndrome.
-Prevention:
*Primary immunization
*VZIG = Varicella zoster immune globulin |
|
|
Term
|
Definition
-Source:
*Airborne particles
*Infectious droplets
-Transmission:
*Direct contact with droplets of infected person or airborne particles
*Winter-Spring season
-Incubation:
*10 - 20 days
-Communicability:
*From 4 days before to 5 days after rash appears. |
|
|
Term
|
Definition
-S&S:
*Prodromal: fever, malaise, followed in 24 hrs. by coryza, cough, conjunctivitis, *Koplik spots*, symptoms increase in severity until 2nd day after rash appears when they begin to subside.
*Rash: appears 3-4 day, begins as maculopapular red eruption on face and gradually spreads downward, more severe at early stage, brownish after 3-4 days.
*Anorexia
*Malaise
*Lymphadenopathy |
|
|
Term
| TREATMENT: MEASLES - RUBEOLA |
|
Definition
Treatment:
*Droplet isolation in hosp.
*Bed rest
*Antipyretics
Complications:
*Otitis media
*Pneumonia
*Bronchiolitis
*Encephalitis |
|
|
Term
| NURSING CARE: MEASLES - RUBEOLA |
|
Definition
Nursing:
*Isolation until the 5th day of the rash
*Respiratory precautions in the hospital
*Provide quiet activity
*Dim lights if photosensitive
*No aspirin- causes Reye's syndrome
Prevention:
*MMR (SC) primary immunizations- 12-15 mo & 4-6 yr
Is a live vaccine produced by chick embryo cell culture. If allergy to eggs, give killed measles vaccine. |
|
|
Term
|
Definition
Transmission:
*Direct contact with or droplet spread from infected person.
Incubation:
*14 - 21 days
Communicability
*Most immediately before and after swelling begins
*Winter -Spring season |
|
|
Term
|
Definition
S&S:
*Prodromal: fever, headache, malaise, anorexia, earache that is aggravated by chewing
*Parotitis: by 3rd day parotid gland enlarges and reaches maximum size 1-3 days
*Unilateral or bilateral
*Pain
*Submaxillary and sublingual infection
Generally affects salivary glands,
( Parotid ) but can involve other organs |
|
|
Term
|
Definition
Treatment:
*Analgesics for pain
*Antipyretics for fever
Complications:
Deafness
*Encephalitis
*Myocarditis
*Arthritis
*Orchitis- swelling of testicles
*Sterility |
|
|
Term
|
Definition
Nursing:
*Isolate during communicability
*Respiratory precaution if in the hospital
*Bed rest until swelling subsides
*Analgesics for pain
*Encourage fluids and soft foods
*Apply hot/cold compresses to the neck
Prevention:
MMR (SC) primary immunizations- 12-15 mo & 4-6 yr |
|
|
Term
| PERTUSSIS - WHOOPING COUGH |
|
Definition
Transmission:
*Direct contact or droplet spread from infected person; indirect contact with freshly contaminated articles
*Infants do not get maternal immunity to & are very susceptible
Incubation:
*10 days
Has 3 stages:
*Catarrhal - 1-2 wks (most infectious time)
*Paroxysmal - 2-4 wks
*Convalescent - 1-2 wks |
|
|
Term
| S/S: PERTUSSIS - WHOOPING COUGH |
|
Definition
Catarrhal:
*Sym. of URI:
-Coryza
-Sneezing
-Cough
-Low-grade fever
Paroxysmal:
*Cough
-Most often @ night
-Short, rapid followed by sudden inspiration assoc. with “whoop”
-Vomiting freq. after attack
Convalescent:
*Episodes decrease in severity & freq.
*Cough may last for several mo. |
|
|
Term
TREATMENT:
PERTUSSIS - WHOOPING COUGH |
|
Definition
Treatment:
*Abx. = Erythromycin drug of choice
*Pertussis-immune globulin
*Hospitalization for infants
*Fluid administration if dehydrated
*Humidity & O2
Complications:
*Pneumonia
***Otitis media***
*Hemorrhage - subarachnoid, subconjunctival, *epistaxis
*weight loss and dehydration
*Hernia
*Prolapsed rectum |
|
|
Term
| NURSING CARE: PERTUSSIS - WHOOPING COUGH |
|
Definition
Nursing:
*Isolation*** - if hospitalized, institute Droplet isolation
*Provide restful environment and reduce factors that *promote paroxysm
*Keep occupied during day
*Encourage fluids
*Provide high humidity
*O2
*Suction to prevent choking on secretions
*Observe for signs of airway obstruction
*Cultures****
Prevention:
*DPT (IM) primary immunization
-No DPT after 6 yr
-Use DTaP for #4 and 5
-Give Tdap for 11-18 year olds for vaccine*
-Tdap as a single booster dose for 19-64 year olds, then continue Td every 5-10 years* |
|
|
Term
|
Definition
Source:
*Nasopharyngeal secretions of person with apparent or inapparent infection; virus also present in blood, stool and urine
Transmission:
*Airborne or by direct contact
*Season = winter to spring
*Usually a mild disease for kids and adults
Incubation:
*14 - 21 days
Communicability:
*7 days before to about 5 days after appearance of rash
****can be in congenital form**** |
|
|
Term
| S/S: RUBELLA - GERMAN MEASLES |
|
Definition
S&S:
*Prodromal - absent in children, present in adults and adolescents; consist of low grade fever, headache, malaise, anorexia, mild conjunctivitis, coryza, sore throat, cough and lymphadenopathy; lasts for 1 - 5 days subsides 1 day after appearance of rash
*Rash - first appears on the face and rapidly spreads downward to neck, arms, trunk and legs; by end of the first day body is covered with a discrete, rose-colored maculopapular exanthema; disappears in the same order as it began and is usually gone by the third day.
*Occasionally low-grade fever
*Headache
*Malaise
*Lymphadenopathy |
|
|
Term
| TREATMENT: RUBELLA - GERMAN MEASLES |
|
Definition
Treatment:
*No treatment necessary other than antipyretics and analgesics
Complications:
*Rare - arthritis, encephalitis, purpura
*Most benign of all childhood communicable diseases
*Greatest danger is teratogenic effect on fetus. |
|
|
Term
| NURSING CARE: RUBELLA - GERMAN MEASLES |
|
Definition
Nursing:
*Reassure parents
*Comfort measure as necessary
*Isolate from pregnant woman
Prevention:
*MMR (SC) primary immunizations -12-15 mo & 4-6 yr |
|
|
Term
|
Definition
Source:
-Soil, dust, and the intestinal tract of humans and animals, especially herbivorous animals.
Transmission:
-Enter by way of a wounds, particularly a puncture wound, burn or crushed area. They may enter through a very minor, unnoticed break in the skin. In the newborn infection may occur through the umbilical cord.
Incubation:
-3 days - 3 weeks but generally averages 8 days
Communicability:
-Months when persons are more involved in outdoor activities. Substance abusers are susceptible from poor injection technique and the use of heroin |
|
|
Term
|
Definition
S/S:
-Initial - progressive stiffness and tenderness of muscles in neck, jaw; difficulty in opening mouth; sardonic smile caused by facial muscle spasm
-Progressive - opisthotonos, boardlike rigidity of abdominal and limb muscles, difficulty swallowing, high sensitivity to external stimuli, trigger paroxysmal muscular contractions that last seconds to minutes, contractions recur with increased frequency until almost continuous, laryngospasm and tetany of respiratory muscles, accumulated secretions,respiratory arrest, atelectasis, pneumonia.
-Rapid pulse
-Sweating
-Anxious expression
-Fever usually absent or only mild |
|
|
Term
| TREATMENT: TETANUS - LOCKJAW |
|
Definition
Treatment:
-Tetanus toxoid or tetanus antitoxin
-Tetanus immune globulin to the unprotected or inadequately immunized child.
-Close and constant observation for monitoring and respiratory status
-Quiet environment
*Adequate fluid intake
*Antibiotics
*Wound care
*Sedatives or muscle relaxants
*Seizure meds (valium) |
|
|
Term
| NURSING CARE: TETANUS - LOCKJAW |
|
Definition
Nursing:
-Control or eliminate stimulation from sound, light and touch
-Administer medications as prescribed
-Monitor vital signs
-Documentation of location and extent of muscle spasms as well as the severity
-Assess respiratory status
-Monitor oxygen saturation
-Maintain hydration and nutrition
-Calm and reassuring manner
Prevention:
-DPT or DTaP (up to age 6 yrs., Td after) (IM) primary immunizations (one dose of Tdap after 19 as a booster) |
|
|
Term
|
Definition
-Most common during hot, humid months
-Toddlers and preschoolers most
-Incubation = 3 - 5 days
-Communicable from outbreak until lesion healed - very contagious.
-Immunity: None
Lesions usually around mouth and nose:
*Superficial
*Starts as small red macules that become vesicles that rupture and release serous fluid
*Secondary lesions are thick, honey-colored crusts
*Lesions are pruritic
*Resolve in 12 - 14 days
*Can result in rheumatic fever. |
|
|
Term
|
Definition
Treatment:
-Lesions washed and crusts removed 2 - 3xday
-Antibiotic ointment applied to area after washing ( Bactroban, Neosporin, etc)
-Erythromycin or Penicillin po x 10 - 14days
-Child stay at home until on antibiotic x 24h
**Good handwashing and careful hygiene by entire family, lysol and no scratching**
Complications: RF or PSAGN |
|
|
Term
| PEDICULOSIS CAPITIS: Head Lice |
|
Definition
-A blood sucking organism
-Needs 5 meals a day ( your blood)
-Female lays eggs at night at hair shaft close to skin
-Eggs - NITS - hatch in approx 1 week
-Nits look like dandruff but don’t brush out
-Major problem with school age kids
Treatment:
*Various shampoos
*Read directions carefully.
*Use fine-toothed comb after shampoo to remove nits
*Wash linens, combs, etc. in hot water and pediculoside
Some schools require kids be nit-free before reentry
Thorough housecleaning necessary to remove lice and nits
Recheck after 7 - 10 days |
|
|
Term
|
Definition
-Universally present in temperate climate zones
-Transmission favored in crowded conditions:
*Classrooms
*Daycare centers
-Eggs are ingested or inhaled - the eggs float in the air
-Eggs hatch in upper intestine,worms migrate to cecal area.
-Movement of worms on skin & mucous membrane causes intense itching
-Eggs can persist in environment for 2-3 wks & contaminate everything they contact. |
|
|
Term
|
Definition
-Intense perianal itching (principal sym)
-General irritability
-Restlessness
-Poor sleep
-Bed-wetting
-Distractibility & short attention span
-Infection in vagina & urethra in girls
*Identification of worms using flashlight 2-3 hr after child asleep or tape test using clear tape pressed against perianal area upon waking & before BM.* |
|
|
Term
|
Definition
Drug therapy:
-Taken by all members of family R/T ease of transmission
-Usually a 1 time dose with a repeat dose in 2 weeks
-Drugs are considered safe with few side effects
*Vermox (mebendazole)- drug of choice |
|
|
Term
|
Definition
Pathogens spread to meninges from:
-Upper Respiratory Infection
-Lymphatic drainage from sinuses or mastoid area
-Direct introduction
*Most common between 1 month and 5 years of age*
Leads to:
*Elevated WBC
*Inflammation of meninges
*Exudate over meninges
*Purulent material distributed throughout brain and spinal cord
*Increased Intra Cranial Pressure
***Hemophilus influenza type B most common cause***
**Respiratory isolation for at least 24 hours after start of treatment**
***Vaccination is HIB*** |
|
|
Term
|
Definition
Outcome can be:
-Rapid, fulminating, and fatal
-Full recovery ( need rapid diagnosis and treatment )
-Result in Neurologic sequelae
*Mental retardation
*Seizures
*Learning problems
*Hearing impairment
*Hydrocephalus |
|
|
Term
|
Definition
-May be insidious or sudden
-In Newborn vague with S&S of:
*Poor suck
*Weak cry
*Lethargy
*Apnea
*Bulging fontanel
-Headache ( from increased ICP )
-Seizures
-Stiff neck
-Increasing irritability
-Purple rash with meningococcal |
|
|
Term
|
Definition
-Cerebral Spinal Fluid exam by lumbar puncture Gross appearance:
*Turbid = bacteria
*Clear = virus
-WBC increased
-Protein increased
-Glucose decreased(bacteria have fed on)
Gram stain:
*Positive for bacteria
*Absence = viral |
|
|
Term
|
Definition
-Prevent spread of infection = respiratory isolation 24 - 72 hrs
-Provide and maintain IV route for 10 – 14days of antibiotic
*Ampicillin
*Ceflosporins
*Aminoglycosides
-Assess neurologic status with neuro checks- LOC
-Maintenance of ventilation
-Control fever (Tylenol)
-Observe for S&S of increasing ICP
-Maintain optimal hydration and nutrition
-Assess for complications:
*Visual, hearing or speech problems
*Brain abscess (Temp will increase and stay up)
*Hydrocephalus (increasing head circumference)
*Seizures |
|
|
Term
|
Definition
-Most common cause of emergency surgery in school age and adolescent
-S&S:
*Anorexia
*N&V
*Diarrhea or constipation
*Pain: **McBurneys point**, RLQ
*Fever
-SUDDEN PAIN RELIEF FOLLOWED BY AN INCREASE IN PAIN MAY INDICATE RUPTURE. |
|
|
Term
|
Definition
-Etiology: basically unknown
ACNE TREATMENT:
*Topical tretinoin ( Retin-A)
*Topical benzoyl peroxide
*Topical antibiotics
*PO antibiotics
*Oral Contraceptive pills for girls
*Isotretinoin ( Accutane )
Keep face clean, hair pushed back and frequent shampooing.
No picking or squeezing. |
|
|
Term
|
Definition
Incubation period: 10 days - 6 weeks
Communicable: During acute illness
Transmission: Saliva
Chief complaint often inability to maintain usual level of activity
Assessment:
*Malaise
*Sore throat
*Fever
*Lymphadenopathy
*Spleen may be enlarged |
|
|
Term
|
Definition
**REST**
Mild analgesic
Regulate activities to own tolerance
If spleen enlarged, activities that could cause a blow to abdomen avoided
Increase fluids
Diet tolerable for sore throat
Acute symptoms last 7 - 10 days
Advise family to seek medical evaluation for the following:
*Breathing becomes difficult
*Abdominal pain develops
*Sore throat pain is so severe that can’t eat or drink |
|
|
Term
|
Definition
An inflammatory autoimmune disease that affects connective tissue of:
*Heart
*Joints
*Subcutaneous tissue
*Central Nervous System
Major complication: Rheumatic heart disease.. scarring of mitral valve.
Diagnosis:
-2 major manifestations
or
-1 major and 2 minor manifestations
--Rheumatic Fever is a Complication of Impetigo-- |
|
|
Term
| RHEUMATIC FEVER MANIFESTATIONS |
|
Definition
MAJOR MANIFESTATIONS:
-Carditis
-Polyarthritis
-Chorea- involuntary movements
-Subcutaneous nodules
-Erythema marginatum - on trunk
MINOR MANIFESTATIONS:
Arthralgia
Previous Rheumatic Fever history
Fever
Increased ESR
Presence of C-reactive protein
Prolonged P-R interval on ECG
Increased ASO titer ( tells recent strep infection )
History recent strep infection |
|
|
Term
| RHEUMATIC FEVER TREATMENTS |
|
Definition
Antibiotic therapy to eradicate strep and protect from recurrence. ***PENICILLIN***
****Culture nasopharynx before treatment****
May have life-long prophylactic antibiotic with invasive procedures
Bedrest to decrease workload of heart if carditis present
ASA(Aspirin) to decrease inflammatory process in joints
Help child cope with confinement according to developmental age |
|
|
Term
|
Definition
A type of pruritic eczema that usually begins during infancy and is associated with allergy with a hereditary tendency.
Common condition 2 mo - 5 yrs
Usually starts in infancy and clears by 3 yrs
Characterized by a variety of types of pruritic lesions. |
|
|
Term
|
Definition
HYDRATION OF SKIN
CONTROLLING PRURITIS AND PREVENTING SECONDARY INFECTION
*Short, clean nails
*Antihistamines to decrease itching
ELIMINATE ALLERGENS
*Eggs, soy, cow’s milk, peanuts, and wheat common offenders |
|
|
Term
| NURSING CARE DURING SEIZURE |
|
Definition
-Turn child onto side
-Do not try to restrain
-Do not put anything into the mouth
-Allow child to drool
Call Dr if any of following occurs:
*Sz lasts > 3 min
*Another sz occurs
*Child’s neck is stiff
*Child delirious or difficult to awaken after Sz
*****Remain with during seizure*****
Chart and describe all movement:
-Site of commencement
-Twitching or jerking movements
-Part of body involved
Chart and describe the face:
-Any color change: pallor, cyanosis, flushing
-Perspiration
-Mouth: teeth clenched, tongue bitten, frothing, blood
Chart and describe the eyes:
-Position : straight ahead, deviation up, out or down
-Pupils
Chart and describe the respiratory effort:
-Presence and length of apnea
-Presence of stritor
Chart and describe any involuntary urination or defecation
Observe, describe, and chart afterward:
-State of consciousness
-Motor ability
-Speech : any changes
-Sensations
*Promote rest after attack
*Reduce anxiety |
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Term
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Definition
-A disease that affects ALL organs of the body, but most LETHALLY the LIVER AND BRAIN.
-Occurs as a child is recovering from a recent viral illness.
-*****Potential link between aspirin given during viral illness and development of Reye Syndrome******
Clinical manifestations:
*History of viral illness 4 - 7d prior to onset of sym.
*Malaise
*Nausea
*Vomiting
*Progressive neurologic deterioration
If suspected perform liver tests: SGOT & SGPT
Nursing care delivered in ICU
Not infectious
Therapy aimed at:
-Supporting respiratory function
-Controlling hypoglycemia
-Reducing brain edema |
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Term
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Definition
Also called CRACKLES
The sound of air passing through fluid in alveoli
Crackling sound - like crinkling of tissue paper
Can have a popping or bubbling sound
Usually do NOT clear with coughing
Typically on inspiration
Found anywhere in lungs |
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Term
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Definition
Also called GURGLES
The sound of air passing through fluid in major airways (bronchi)
Loud, snoring sound
May be able to clear with coughing
Of lg. airways |
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Term
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Definition
Sound of air being pushed from narrowed bronchioles
Usually on expiration
Whistling sound
Heard anywhere in lungs
Sound may change with coughing |
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Term
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Definition
Sound of air being pulled past a NARROWED LARYNX on inspiration.
A crowing rooster sound
Most marked when in a supine position
May be on expiration or on both inspiration & expiration
Needs immediate attention!! |
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Term
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Definition
-Mainly used to determine acid-base balance
-Measures blood’s O2 content
-Helps determine effectiveness of ventilation
-Most definite study to determine decrease Hb in blood
-Arterial blood sample most accurate
-Sample should be put on ice |
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Term
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Definition
-Non-invasive use of pulse oximeter (POx)
-Measures O2 saturation of arterial blood (SaO2)
-Probe has sensors positioned opposite ea. other |
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Term
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Definition
-Measures sweat electrolyte conc. for diagnosis of cystic fibrosis.
-Sweating is stimulated on forearm with a sm. electrical current & pilocarpine.
-Sweat sample collected on gauze and amount of sodium & chloride is measured.
-N = < 40 mEq/L |
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Term
| RESPIRATORY THERAPEUTIC MODALITIES |
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Definition
-Increase oral fluids
-Expectorants
-Humidification
*Vaporizers - cool
*Nebulizers
*Mist tent
-Coughing |
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Term
| ASTHMA- Reactive Airway Disease (RAD) |
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Definition
-An intermittent, reversible, diffuse airway obstruction of bronchi and bronchioles.
*Complex inflammatory process that leads to airway resistance
*Over time, airway tissue damage
Involves 3 basic processes:****
-Constriction of bronchial smooth muscle (SPASMS)
-Excess MUCUS production
-Mucosal EDEMA
Is a Type 1 Hypersensitivity over-reaction of immune system to an antigen |
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Term
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Definition
-Wheezing (Air rushing over sm airways)
-Dyspnea
-Retractions (Use of accessory muscles of resp.)
-Tachypnea
-Tachycardia
-Prolonged expiration
-Chest tightness
-BS coarse with crackles throughout lungs
-Tri-pod position (Hunched over “sitting position” with arms braced)
-Cough
-Increased temp*****
-Sym often worse @ bedtime R/T increased narrowing of airways & pooling of secretions |
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Term
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Definition
-Bronchodilators:
*Aminophylline (Usually IV) Theophylline
*Beta 2- Adrenergic Agonists- Albuterol
*Long-acting Beta2 agonists
*terbutaline (Brethine, Bricanyl)
*Corticosteroids- prednisone or solu-medrol
* Keep calm, humidified O2, hydration, expectorants and high fowlers position. |
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Term
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Definition
-Used to relax bronchial smooth muscle, decrease airway reactivity, and inhibit mast cell degranulation.
-Can be given IV or po (aerosol adm. ineffective)
-Therapeutic serum concentration = 10 - 20 ug/ml
Side Effects:
*GI distress ( may need antacid )
*Nervousness
*Insommia (Kids are “hyper”)
*Irritability
*HA
*Anorexia
*N&V
*Diuresis (need to void more freq.)
Adverse effects= TOXICITY. Give valium for overdose:
*Dysrhythmias
*Seizures
*Decreased BP
*Increased P |
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Term
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Definition
Diagnostic test: = Quantitative sweat chloride test. If > 50 - 60 test considered +
S/S:
-Meconium ileus of NB = earliest
-Steatorrhea = excess fat in stools R/T malabsorption syndrome - STINK !!!!!!
-Failure to grow & thrive (FTT)
-Freq. pneumonia R/T abnormal respiratory mucus
-Wt. loss even with increased appetite
-Poor absorption of fat sol. vits = A D E K****
-Most males sterile R/T blockage of vas deferens
-Dev. of emphysema and atelectasis R/T increasingly obstructed airways with mucus
-Digital clubbing
-Protruberant abd., barrel chest, wasted buttocks, and thin extremities
-Thin & underweight, but usually normal height
-Abnormally high conc. Na & Cl in sweat |
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Term
| CYSTIC FIBROSIS MANAGEMENT |
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Definition
-Humidified O2
-Antimicrobial agents
-Chest physiotherapy qid
-Aerosol therapy
-Expectorants
-Bronchodilators
-Mucolytic agents
-Pancreatic enzyme replacement with each meal and snack****
-Diet: Increased calorie, Increased protein and decreased fat |
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Term
| Erickson Stages of Development |
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Definition
Birth to 18 months : Trust vs. Mistrust-Children develop a sense of trust when caregivers provide reliabilty, care, and affection. A lack of this will lead to mistrust.
2 to 3 years : Autonomy vs. Shame and Doubt: Children need to develop a sense of personal control over physical skills and a sense of independence. Success leads to feelings of autonomy, failure results in feelings of shame and doubt
3 to 5 years : Initiative vs. Guilt : Children need to begin asserting control and power over the environment. Success in this stage leads to a sense of purpose. Children who try to exert too much power experience disapproval, resulting in a sense of guilt.
6 to 11 years : Industry vs. Inferiority : Children need to cope with new social and academic demands. Success leads to a sense of competence, while failure results in feelings of inferiority.
12 to 18 years : Identity vs. Role Confusion : Teens need to develop a sense of self and personal identity. Success leads to an ability to stay true to yourself, while failure leads to role confusion and a weak sense of self. |
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Term
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Definition
Term used to describe a group of conditions char. by:
-Stridor
-Harsh cough
-Hoarseness
-Respiratory distress
Each type named according to area involved:
-Epiglottitis
-LTB
-Spasmodic croup
-Acute tracheitis
All involve swelling or obstruction of larynx |
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Term
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Definition
An obstructive narrowing of the LARYNX
Causes:
-Viral - Usually mild URI
-Seems to be hereditary predisposition
-Emotional
S&S:
-STRIDOR - inspiratory
-Suddenly awakens @ night
-Harsh cough
-Dyspnea and hoarseness
-Little or no fever
Treatment:
-Mist
-Keep hydrated afterwards
-If sym. persist or increase, bring to ER |
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Term
| LTB: Acute laryngotracheobronchitis |
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Definition
An acute infection of:
-Larynx
-Trachea
-Bronchi
Most common in infant and toddler age
Clinical manifestations:
-Often @ night and may be preceded by several days of URI
-Sudden onset of harsh, metallic cough (sounds like a seal !)
-Inspiratory stridor R/T laryngospasm
-Hoarseness
-Retractions
-Restlessness
-Fever
-Sym. worse @ night & better in day
LTB: NURSING CARE
*Maintain Airway- O2, mist, epi, tach set, keep calm.
*Maintain Fluid Balance
*Relieve Fear & Anxiety |
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Term
| Cardinal signs of Resp. distress |
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Definition
Restlessness
Increase in resp. effort
Tachypnea
Tachycardia
Diaphoresis
*****do pulse ox***** |
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Term
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Definition
Bacterial form of croup
S&S : SUDDEN with rapid progression:
-High fever
-Sore throat - severe
-Dysphagia (difficulty swallowing)
-Mouth open & drooling
-Respiratory distress- stridor
-tripod position
Treatment:
-intubation
-abx
-cool mist |
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Term
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Definition
Inflammation of lung alveoli.
S&S:
-Fever
-Productive cough
-Dyspnea
-Retractions
-Tachycardia
-Malaise
-Crackles in lungs
-Decreased breath sounds
-Chest pain (older kids)
Treatment:
-Abx
-O2
-Chest physiotherapy
-Increased fluids |
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Term
| RESPIRATORY SYNCYTIAL VIRUS |
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Definition
RSV: Inflammation of bronchioles and small bronchi.
S&S:
-Often follows URI
-Increased P and R
-Low O2 saturation
-Dyspnea
-Fever
-Apneic spells- often 1st sign
-Wheezing
-Poor feeding
-Lethergy
Diagnosis:
Nasal wash with RSV kit- suction both nares after instillation of saline.
*****HAND WASHING******
RSV: PREVENTIVE AGENTS
*RespiGam
****Synagis (Palivizumab)-given monthly IM injections during RSV season (fall to spring)*** |
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Term
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Definition
Inflammation of the pharynx & surrounding lymphoid tissue.
Tonsillitis usually present with pharyngitis
S&S:
-Gradual or abrupt onset
-Sore throat
-Erythema & inflammation of pharynx & tonsils
-Cervical lymph nodes may be swollen
-Fever, low or high
Diagnosis:
-Throat culture
-Rapid strep test
Treatment:
-Pain relief with acetaminophen or ibuprofen
-Cool, bland liquids
-Activity as tol
-Abx. only for those who test positive to Streptococcal infection. (penn) |
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Term
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Definition
Often occurs with pharyngitis. S/S are the same.
Palatine tonsils:
-May enlarge & meet in midline (kissing tonsils) & obstruct passage of air or food
-Difficulty swallowing & breathing
Adenoids:
-Difficulty breathing thru nose R/T enlargement
Treatment:
-Abx if strep. Supportive if viral
-T&A only for multiple severe strep infections or abscess formation |
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Term
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Definition
-Position prone or on side
-Observe for freq. swallowing- can indicate bleeding
-VS q15m 1st hr, q1h x 4hr, then q4h
-Suction equipment available
-If bleeding occurs, turn on side and call Dr.
-Initially may vomit 1-2x of old, brownish bld swallowed in OR
**No red liquids**
**No OJ, grapefruit or tomato juices**
Avoid rough, scratchy, citrus or spicy foods x 3wks
Halitosis common x 14 days
-Anticipate earache and slight fever after procedure. Call Dr if persistent
-Keep away from crowds for 2wks
-May return to school as directed by Dr. -usually 10 days
-Follow-up appointment |
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Term
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Definition
An obstruction of air flow R/T a blockage by a foreign object in the trachea
-Either partial or complete obstruction
-Remains in trachea or goes down to main bronchus
Is an ACUTE situation
Treatment = HEIMLICH MANEUVER IF:
-Can’t speak
-Becomes cyanotic
-Collapses |
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Term
|
Definition
***Vasoocclusive and causes tissue hypoxia***
Nursing Care:
-Hydration 2-3 time maintenance****
-Electrolyte replacement
-Pain med
-IV morphine drip in hospital
-Bed rest
-Antibiotics if infection present
-O2*****
-O2 monitoring (POx)
-Transfusion of packed cells if severe anemia
-Stool softeners ( R/T narcotics)
Complications:
-Pain******
-Infection r/t damaged spleen
-Chest syndrome
-Aplastic crisis
-Splenic sequestration
-Stroke
-Liver disease
-Priapism
-Bedwetting |
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Term
|
Definition
| Children play independently but among other children. They play beside each other but not with. |
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Term
|
Definition
-Persistent "no"
-****Give the child options****
-Avoid asking questions. |
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Term
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Definition
| Incubation period is the time elapsed between exposure to a pathogenic organism and when symptoms and signs are first apparent. |
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Term
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Definition
| the time during which a disease process has begun but is not yet clinically manifest. |
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Term
| BRONCHIOPULMONARY DYSPLASIA |
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Definition
-Affects newborns who have experienced respiratory failure or who have been O2 dependent for more than 28 days.
-X-ray shows area of overinflation and atelectasis.
S/S:
*tachypnea
*tachycardia
*retractions
*nasal flaring
*labored breathing
*crackles and decreased air movement
*expiratory weezing
Interventions:
*monitor airway and cardiopulmonary function
*O2
*fluid restriction
*meds- surfactant, diuretics, corticosteroids and bronchodilators. |
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Term
|
Definition
-Inflammation of trachea and bronchi
-Usually occurs with URI
S/S:
*fever
*dry hacking nonproductive cough that is worse at night and becomes productive in 2-3 days.
Treatments:
*cool humidified air
*increased fluids
*antipyretics
*couch supressant
****commonly caused by RSV**** |
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Term
| PIAGET STAGES OF DEVELOPMENT |
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Definition
Sensorimotor: 0 - 2 yrs. Object Permanence Blanket & Ball Study
Preoperational: 2 - 7 yrs. Egocentrism
Three Mountains
Concrete Operational: 7 – 11 yrs. Conservation Conservation of Number
Formal Operational: 11yrs+ Manipulate ideas in head, e.g. Abstract Reasoning
Pendulum Task |
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Term
|
Definition
Temperature:
-Birth to 1 year (axillary) – 36.5 to 37.2 ° C (97.7 to 98.9° F)
-1 to 12 years (oral) – 36.7 to 37.7° C (98.1 to 99.9° F)
-12 years and older (oral) – 36.6 to 36.7° C (97.8 to 98.0° F)
Pulse:
-1 week to 3 months – 100 to 220/min
-3 months to 2 years – 80 to 150/min
-2 to 12 years – 70 to 110/min
-12 years and older – 50 to 90/min
Respirations:
-Newborn to 1 year – 30/min
-1 to 2 years – 25 to 30/min
-2 to 6 years – 21 to 24/min
-6 to 12 years – 19 to 21/min
-12 years and older – 16 to 18/min
Blood Pressure:
◯◯ Age, height, and gender all influence blood pressure readings. Readings should be
compared with standard measurements |
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Term
|
Definition
-Behaviors in a child with pain can vary from immobility and stillness to restlessness
and constant mobility.
-Changes in blood pressure, pulse, and respiratory rate are temporary physiologic
changes associated with the pain. Initially, elevated vital signs will return to normal
despite the persistence of pain.
-Children from 3 to 7 years of age may comprehend how to use a pain rating scale,
and self-report using pain scales may be useful with children over 7 years of age.
-Prior experiences can increase or decrease sensitivity depending on whether or not
adequate relief was obtained, especially in older children and adolescents.
-Family and friends may decrease sensitivity to pain by staying with the child. |
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Term
|
Definition
|
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Term
| PEDI DRUGS USED FOR SURGERY |
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Definition
Goals for pre-op meds:
1. anxiety reduction
2. amnesia
3. sedation
4. antiemetic
5. reduction of secretions
Versed- pre-op sedative
Fentanyl
Nitrous oxide via mask |
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