-
Faces pain scale and poker chip scale can be utilized by child of _____ age and older
preschool
-
Numeric pain scale can be used by children _____ years of age and older
9
-
A nonverbal child can be assessed using the _____ pain assessment tool.
FLACC- facial expression, leg movement, activity, cry, adn consolability
-
Which age is distraction as a non-pharmacologic pain management tool used for?
toddlers and preschoolers- books, music, television, bubble blowing
-
Which age is guided imagery as a non-pharmacologic pain management tool used for?
school age and adolescents
-
What is the youngest age a PCA pump is used?
5
-
When does birth length double?
4 years
-
When does the child sit unsupported?
8 months
-
When does a child achieve 50% of adult height?
2 years
-
When deos a child throw a ball overhand?
18 months
-
When does a child speak two to three word sentences?
2 years
-
when does a child use scissors?
4 years
-
When does a child tie his or her shoe?
5 years
-
When does the fine pincer grasp appear?
10-12 months
-
What toys are appropriate for an infant?
mobiles, rattles, squeaking toys, picture books, balls, colored blocks, and activity boxes
-
What toys are appropriate for a toddler (1-3 years)?
board and mallet, push-pull toys, toy telephones, stuffed animals, and storybooks
-
What toys are appropriate for a preschool child (3-5 years)?
coloring books, puzzles, cutting and pasting, dolls, building blocks, clay, and toys that allow prescholer to work out hospitalization experiences
-
How much weight and height does a preschooler gain per year (3-5)?
Each year child gains 5 pounds and grows 2 1/2 to 3 inches
-
How much weight and height does a school age child gain each year?
4-6 pounds and about 2 inches in height each year
-
What toys are appropriate for a school age child (6-12)?
board games, card games, and hobbies, such as stamp collecting, puzzles, and video games
-
Which age child fears body mutilation?
Preschoolers (3-5 years)
-
What is contraindication to MMR?
History of anaphylactic reaction to eggs or neomycin
-
What is contraindication to DTaP?
history or reactions, seizures, neurologic symptoms after previous vaccine, or systemic allergic reactions
-
Which two vaccines must be given together or >30 days apart
MMR and Varicella
-
What are some foods high in Iron?
- Infant rice cereal, liver, beef, pork, eggs
- Iron fortified formula, infant high-protein cereal
-
If child is severely dehydrated, what IV solution will be prescribed?
Isotonic- Normal saline/ lactated ringers
-
What are the 3 classic signs and symptoms of measles?
- Photophobia
- Confluent rash that begins on the face and spreads downward
- Koplik sports on the buccal mucosa
-
What are some food sources high in vitamin A?
- Liver
- Sweet potatoes
- Carrots
- Spinach
- Peaches
- Apricots
-
How can the nurse best evaluate the adequacy of fluid replacement in children?
Urine output!
-
What nutritional support should be provided for a child with cystic fibrosis?
Pancreatic enzyme replacement, fat-soluble vitamins, and a moderate to low carb, high protein, moderate to high fat diet
-
List 7 signs of respiratory distress in a pediatric client
Restlessness, tachycardia, tachypnea, diaphoresis, flaring nostrils, retractions, and grunting
-
What should families be taught about administration of digoxin?
- Administer on a regular basis; do not skip or make up for missed doses
- Give 1 hour before or 2 hours after meals. Do not mix with formula or food
- Take child's pulse prior to administration and know when to call providor
- Keep in safe place (locked cabinet)
-
What is the therapeutic blood level for digoxin?
0.8 - 2.0 ng/ml
-
What are the four defects associated with tetralogy of Fallot?
- VSD
- Overriding aorta
- pulmonary stenosis
- Right ventricular hypertrophy
-
Describe nursing interventions to reduce the workload of the heart (CHF treatment)
- Give small, frequent feedings or gavage feedings
- Plan frequent rest periods
- Maintain a neutral thermal environment
- Organize activities to disturb child only as indicated
-
What medications are used to treat rheumatic fever?
- Penicillin
- Erythromycin
- Aspirin
-
Feed infant or child with cerebal palsy using nursing interventions aimed at preventing aspiration. How should the child be positioned?
Position child upright and support the lower jaw
-
Every child who has spina bifida should be screened for what?
Latex allergies
-
What are the signs of shock? signs of increased ICP?
- Shock: increased pulse, decreased bp
- Increased ICP: decreased pulse, increased bp
-
What is a common medicine prescribed to decrease cerebral edema?
Mannitol (osmitrol)- monitor for hypokalemia & hyponatremia
-
What is the most common presenting symptom of a brain tumor?
Headache upon awakening
-
How is the child usually positioned after brain tumor surgery?
Lie flat- may turn to either side.
-
What are two nursing priorities for a newborn with myelomeningocele?
Prevention of infection of the sac and monitoring for hydrocephalus
-
What is Gower's sign?
Gower's sign is an indicator of muscular dystrophy; to stand, the child has to "walk" hands up legs
-
What is the first sign of renal failure?
Decreased urinary output
-
What causes Acute glomerulonephritis (AGN)?
- Streptococcal infection
- - (edema on face)
-
What is the priority nursing intervention with a wilms tumor?
No abdominal palpation!!!!
-
When is surgery usually performed for hypospadias?
Before preschool years, to allow for achievement of sexual identity, to avoid castration anxiety, and to facilitate toilet training
-
Compare the signs and symptoms of acute glomerulonephritis (AGN) with those of nephrosis
- AGN: gross hematuria, recent strep infection, HTN, and mild edema
- Nephrosis: severe edema, massive proteinuria, frothy-appearing urine, anorexia
-
What occurs before acute glomerulonephritis?
Beta-hemolytic strep infection
-
Compare the dietary interventions for AGN and nephrosis
- AGN: low sodium diet with no added salt
- Nephrosis: high-protein, low-salt diet
-
Describe safe monitoring of prednisone administration and withdrawal
- Long term prednisone should be given every other day (to avoid growth failure)
- Signs of edema, mood changes, and GI distress should be noted and reported
- Drug should be tapered, not discontinued suddenly
-
Describe feeding technique for a child with cleft lip or palate
Use lambs nipple or prosthesis. Feed child upright, with frequent bubbling
-
List the signs and symptoms of esophageal atresia with TEF:
Choking, coughing, cyanosis, and excess salivation
-
What nursing actions are initiated for the newborn with suspected esophageal atresia with TEF?
Maintain NPO immediately, and suction secretions
-
Describe why a barium enema is used to treat intussusception
A barium enema reduces the telescoping of the intestine through hydrostatic pressure without surgical intervention
-
What are the signs of anorectal malformation?
A newborn that does not pass meconium within 24 hours; meconium appearing through a fistula or in the urine; an unusual appearing anal dimple
-
When is iron deficiency anemia commonly seen?
6-24 months old
-
What do you need to teach the family about administration of Iron?
- Give on empty stomach
- Give with citrus juice (vitaminc C)
- Use dropper or straw to avoid discoloring of teeth
- Stools will become tarry
- Iron can be fatal in severe overdose (keep away from other children)
- Do not give with any dairy products!
-
What are some dietarty sources of iron?
- meat
- green, leafy vegetables
- fish
- liver
- whole grains
- legumes
- for infants: iron fortified cereals and formula
-
What is given to clients with sickle cell anemia?
Folic acid- orally to stimulate RBC synthesis
-
What is the genetic transmission pattern of hemophilia?
X-linked recessive chromosomal disorder transmitted by the mother and expressed in male children (25% of having child with hemophilia with each pregnancy)
-
Describe the sequence of events in a vaso-occlusive crisis in sickle cell anemia
A vaso-occlusive crisis is caused by the clumping of red blood cells, which blocks small blood vessels; therefore, the cells cannot get through the capillaries, causing pain and tissue and organ ischemia. Lowered oxygen tension affects the HgbS, which causes sickling of the cells
-
What should families and clients do to avoid triggering sickling episodes?
- Keep child well hydrated
- Avoid known sources of infections
- Avoid high altititudes
- Avoid strenuous exercise
-
Nursing interventions and medical treatments for a child with leukemia are based on what three physiologic problems?
- Anemia (decreased erythrocytes)
- Infection (neutropenia)
- Bleeding thrombocytopenia (decerased platelets)
-
What foods are high in phenylalanine? low in phenlalanine?
- High: high protein foods, such as meat, milk, dairy products, and eggs; and nutrasweet (aspartame)
- Low: vegetables, fruits, juices, cereals, breads, and starches
-
What IV is given to the child in ketoacidosis?
Regular insulin IV in normal saline
-
What are the symptoms of congenital hypothyroidism in early infancy?
- Large, protruding tongue
- Coarse hair
- Lethargy
- Sleepiness
- Constipation
-
What are the outcomes of untreated congenital hypothyroidism?
Mental retardation and growth failure
-
What are two formula's prescirbed for infants with PKU?
Lofenalac and Phenex-1
-
Differentiate signs of hypoglycemia and hyperglycemia:
- Hypoglycemia: tremors, sweating, headache, hunger, nausea, lethargy, confusion, slurred speech, anxiety, tingling around mouth, nightmares
- Hyperglycemia: polydipsia, polyuria, polyphagia, blurred vision, weakness, weight loss, and syncope
-
Describe developmental factors that would impact the school-age child with diabetes
Need to be like peers; assuming responsibility for own care; modification of diet; snacks and exercise in school
-
What is compartment syndrome?
Damage to nerve and vasculature of an extremity due to compression
-
What are the signs and symptoms of compartment syndrome?
- Abnormal neurovascular assessment
- Cold extremity
- Severe pain
- Inability to move the extremity
- Poor capillary refill
-
How is skeletal traction applied?
Skeletal traction is maintained by pins or wires applied to the distal fragment of the fracture
-
What are the s & s of congenital dislocated hip in infants?
- Unequal skin folds of the buttocks
- Ortolani sign
- Limited abduction of the affected hip
- Unequal leg lengths
|
|
