Where should you not administer any injections in, for infants and young children?
This is the IM site for infants (age birth-36 month)?
This site is a muscle located in the anterolateral aspect of middle or upper thigh?
What age group are IM injections, in the vastus lateralis done in?
Infants age birth- 36 month
Where is the preferred IM site for older toddlers, children, & adults?
IM injections in the deltoid process are preferred in what age group?
older toddlers, children, & adults
Where is the SubQ injection site for infants?
fatty area of the anterolateral thigh
Where is the preferred SubQ injection site for older toddlers, children, & adults?
fat part of outer aspect of upper arm
What do you do when doing a SubQ injection, to prevent from injecting into the muscle?
pinch up SQ tissue
multiple injections given in the same extremity, should be separated as far apart as possible, preferably at least ____-___?
1" - 1.5" apart minimum of 1"
The vastus lateralis is the preferred site for IM injections until the deltoid muscle has developed adequate mass, at approximately what age does this happen?
Antibodies from mom pass to baby, and provide limited protection, it decreases over several months after birth?
A childe develops their own antibodies through exposure to natural diseases & immunizations
What is the most common transmission of disease in children?
Fecal & respiratory route
How do immunizations work?
immunization introduces an antigen, the antigen triggers an immune response, then child produces antibodies against particular disease
This dose is 1:1000
how much epinephrine is safe to give?
0.01 ml/kg per dose; up to 0.5ml IM
how often can Epinephrine be administered?
can be repeated q 10-20min up to 3 doses
This should be done in children at the time of vaccine, with a history of seizures?
Give acetaminophen at time of vaccine, and q 4hrs for 24 hrs
When is a tetanus booster recommended?
after 5-10 years for contaminated wound or burn
Prior to the polio vaccine, allergies to ____, ____, & ____ should be asked about?
Neomycin, Streptomycin, Polymycin B
When giving the polio vaccine, you know the fluid should be what color?
Clear & Colorless
All doses of the polio vaccine must be given ______ apart?
Prior to MMR vaccine, you need to know child allergies to ____ & ____
neomycin & gelatin
After MMR vaccine, the child should be observed with _____ ____ for _____ minutes
College students need to have a 2nd dose of this?
Pregnancy should be avoided for _____ months after MMR vaccine is given?
If mother test positive for this, then the baby needs to get first dose of this, and when do they need it?
Hep B, within 12hours of birth
The dose series of Hep B is how many?
And if getting the series when can they, and when should they not get it?
-Series of 3 - Can get series any age - Should not have last dose before 6 months of age
Incomplete immunization series puts infants at risk for _____?
What is medical name for chicken pox?
What is mode of transmission for varicella?
What is period of communicability for varicella?
5 days before the onset of the rash till ALL lesions have crusted over
onset with fever, malaise, and headache, before eruption of skin rash begins as macule on erythematous base & progresses to a papule, then to a clear fluid filled vesicle, describe what disease?
What is this?
typically thick, bluish white to grayish black patch covering the tonsils?
What is transmission of Diptheria?
Contact or Droplet
What is period of communicability of Diptheria?
usually 2-4 wks or until 4 days after antibiotics are started
Endotoxins causing myocarditis & peripheral neuropathy, are complications of _____?
What medicine should be given for Diptheria?
Antibiotics & Antitoxins
What is mode of transmission for Fifth Disease?
When is the period of communicability highest for fifth disease?
Before the onset of the disease
This disease manifestations are described as fiery red rash on cheeks?
This rash usually occurs with fiery red rash on cheeks, will develop onto trunk, & extremities, but WILL NOT be on palm & Soles?
The agent of _____ is Morbillivirus?
What is mode of transmission for Measles?
Airborne, Droplet, Contact
Manifestations of _____ are typically, fever, conjunctivitis, cough, anorexia, Koplik spots on buccal mucosa, maculopapular rash on face, trunk, & limbs that do NOT blanch?
Measles have _____ Spots?
What are the Mumps?
Mode of transmission for Mumps is?
Typical manifestations for _____ are fever, headaches, earache, parotid gland swelling?
Parotid Glad Swelling is a typical manifestation of this?
Orchitis & Deafness are typical complications of this?
What is pertussis?
Mode of transmission for Pertussis?
The smaller the child, the greater risk for respiratory distress with this disease?
The manifestations of this are runny nose, fever, mild cough, that generally becomes worse at night?
What are the German Measles?
What is Rubella also known as?
What is mode of transmission for Rubella?
Droplet or Contact
This is usually a mild disease, but a major risk factor fetus if mother is infected in 1st trimester?
Mode of transmission for Strep Throat is?
Beefy red pharynx with exudate & tender cervical nodes, are typical manifestations of ____?
Mode of transmission for Scarlet Fever is___?
First 12-48 hrs, sandpaper rash appears, starting on neck & spreading to trunk & extremities, And classic strawberry tongue is seen on 4-5th day?
After 3-4 days, the rash begins to fade & tips of toes & fingers begin to peel, then 4-5 days later, classic strawberry tongue appears?
What are the diseases that are with streptococcus group A?
Strep Throat, Scarlet Fever, Impetigo
What is mode of transmission for Impetigo?
Contact with skin lesions
These lesions are honey colored crusted at te sire of open lesions?
What is the most common vectorborne illness in N. America?
A tick must feed for __ - __ hours to transmit lyme disease?
what should high fever associated with common diseases be treated with?
non-aspirin antipyretics, unless otherwise directed
what should be used to relief itching associated with common diseases?
antihistamines & oatmeal baths
Less than 37 completed weeks of pregnancy is considered?
What is considered preterm?
Less than 37 completed weeks
37 - 41 completed weeks of pregnancy Is considered?
Full term pregnancy is considered at?
37-41 completed weeks
greater than 42 weeks pregnancy is considered?
Post-term pregnancy is considered?
greater than 42 weeks.
Late preterm infants are being seen born, why??
Because of scheduled C-sections and Inductions
How are infants classified as (SGA) small gestational age?
below the 10th percentile for birth weight
SGA infants are more commonly seen in what situation?
mothers who smoke, or have high blood pressure
What is Intrauterine Growth Restriction (IUGR)?
Advanced gestation & limited fetal growth
These infants are more difficult to arouse to a quiet alert state and can have difficulty feeding?
Large for Gestational Age (LGA)
these infants have a birth weight at or above 90th percentile?
Large gestational age (LGA)
What is the most common metabolic disorder in infants?
When assessing / examining a baby or child, how should you assess?
ex, head to toe, feet to head, complex to simple, non-invasive to more invasive??
Non-invasive to more invasive
2 main risk factors for respiratory distress syndrome include?
prematurity & surfactant deficiency disease
respiratory distress is also known as _____ _____ ?
What is surfactant deficiency?
respiratory distress syndrome
What is transient tachypnea of the newborn?
Excess Fluid in the lungs
What is excess fluid in the lungs of a newborn?
The transient tachypnea newborn, may not have trouble breathing right after birth, but may begin to have difficulties shortly after, then clears completely within ___-____ hrs?
What does the nurse do for the infant who is suspected of having meconium aspiration syndrome?
suction from the airways of the infant before they draw their first breath
two types of hyperbilirubinemia, what are they and when do they appear?
Physiologic = appears AFTER 1st 24 hrs Pathologic = appears DURING 1st 24 hrs (WORSE)
This type of hyperbilirubinemia occurs AFTER the 1st-24hours?
This type of hyperbilirubinemia occurs DURING the 1st-24 hours?
This type of hyperbilirubinemia is considered the worse type of the two?
This type of hyperbilirubinemia is associated with hemolytic disease, RH & ABO incompatibility?
____ develop from the deposit of bilirubin in the skin?
What normally clears unconjugated (indirect) bilirubin in the utero?
Where is bilirubin excreted?
To prevent metabolic complications of hyperbilirubinemia, initiate early, ______ _____. Also administer ______ to all unsensitized mothers who are Rh negative after delivery of baby?
_____ should be initiated in infants who develop hyperbilirubinemia?
Hypoglycemia can indicate _____ in infants?
This chronic lung disease is usually caused by prematurity & they are on O2 for atleast 28 days, ______ _____ ventilation & O2 treatment, then infant can be gradually weaned.
Bronchopulmonary Dysplasia Positive Pressure
Birth of a child requiring NICU care elicits the _____ _____ in parents?
For supporting parents of newborn in NICU, the nurse should focus on the ____ of the infant.
In infants, the anterior fontanel is palpable until about _____?
In infants, the posterior fontanel is palpable until about _____?
In Children, their cardiac output id dependent, not _____ _____?
In children their ____ ____ is dependent, not stroke volume?
Children are susceptible to trauma due to poor protection of _____ & _____?
liver & spleen
Kidneys don't concentrate urine effectively in children until approximately ____ months?
Children have a faster respiratory rate until approximately age ____?
The _____ is the primary breathing muscle in children?
True / False
Adults bones are more soft and easily bent or fractured than children?
False - children's are more soft, easily bent until puberty
Children's muscles are approximately ____% of their weight?
Adults muscles are approximately ____ % of their weight?
When building rapport/ trust with children, _____ should be used cautiously in teens?
newborns & infants< 6 months old, how should they be assessed?
least invasive first to more invasive procedures last.
A head to toe sequence assessment starts at this age?
When assessing the ear, the auditory canal should be ____?
When assessing the ear, the tympanic membrane should be _____ & _____?
pearly grey & translucent
When assessing the heart, and auscultating cardiac sounds, the ____ is normal in children?
When assessing the abdomen, what is the order of assessment?
inspect, auscultate, percuss, palpate
What is the DDST? and what is it used for?
Denver Developmental Screening Test= used to screen development, not intelligence.
Eriksons - Trust VS. Mistrust - is what age?
Infants - Birth to 1yr
Eriksons - Autonomy VS. Shame & Doubt - is what age?
Toddlers - 1-3 yrs
Eriksons - Initiative VS. Guilt - is what age?
Pre-school - 3-6 yrs
Eriksons - Industry VS. Inferiority- is what age?
School age - 6-12 yrs
Eriksons- Identity VS. Role Confusion - is what age?
Adolescents - 12-18 yrs
Normal stressors for ____ include...
* Separation anxiety
* Stranger anxiety
* Painful, invasive procedures
* Sleep deprivation, sensory overload
Therapeutic play for infants include??
Mobiles, mirrors, music, cuddle r rock infant, lullabies, talking to infant
Normal stressors for ____ include..
* Separation Anxiety
* Loss of Self Control
* Painful, Invasive procedures
* Bodily injury, mutilation
* Fear of dark
When doing a procedure on a toddler, where should procedure take place?
In treatment room if possible
Therapeutic play for toddlers?
peek-a-boo familiar blanket, stuffed animal stories read to them dolls building blocks puzzles
Normal stressors for ___ include....
* Separation anxiety, fear of abandonment
* Loss of self control, bodily function
* Bodily injury, mutilation
* Painful, invasive procedure
* Fear of dark & monsters
When performing procedure on preschooler, where should it take place?
treatment room if possible
Therapeutic play for preschoolers?
playing with safe hospital equipment, crayons/book, puppets, magnet board, play dough
Normal stressors for _____ include...
* loss of control
* loss of privacy & control over bodily functions
* bodily injury
* separation from family & friends
* painful, invasive procedures
* fear of death
Normal stressors for ____ include....
* Loss of control
* Fear of altered body image, disfigurement,
* Fear of disability
* Fear of Death
* Separation from peers
* Loss of privacy & identity
What pain assessment scales are self reporting?
Faces & Oucher
What pain scales are used in non-verbal children?
NIPS & FLACC
What are the 5 rights of medcations?
Right - Patient Right - Drug Right - Dose Right - Route Right - Time
What is it when an infant has been on supplemental oxygen for at least 28 days after birth?
What does treatment of bronchopulmonary dysplasia, ventilation require?
If diagnosed with bronchopulmonary dysplasia, what can it lead to?
atelectasis & hyperexpansion
When does respiratory distress occur?
immediately after birth
What is excess fluid in the lungs of a newborn?
This type of newborn, may have more difficulty feeding & are more difficult to arouse to a quiet alert state
Large for Gestational Age
What is a well known condition that is associated with excessive fetal growth?
Birth trauma, resulting in shoulder dystocia is a common complication of?
An APGAR score of <7 is ?
An APGAR score of >7 is?
What is a normal lab result of bilirubin at birth in the infant?
After an infants delivery, their ____ must start to conjugate bilirubin?
In phototherapy, due to hyperbilirubinemia, what does the stool look like?
In neonatal sepsis, what is the most common sign?
In children under ____, they have a short, narrow trachea?
If a child is distressed, their ____ is not effectively expired?
Does dehydration hit children or adults sooner?
When doing a physical assessment on a child, what are the growth measurements recorded on plot growth chart?
Length, Height, Weight, Head Circumference.
The DDST test, screens children up to age 6, in 4 categories, what are they?
Personal-Social Fine Motor-Adaptive Language Gross Motor
The DDTS screens children, up to what age?
What is nitric oxide used for?
used for meconium aspiration syndrome
What is surfactant used for?
replacement therapy for RDS & meconium aspiration syndrome. it improves oxygenation & decreases the incidence of air leaks. It decreases the need for ventilator support
what is lidocaine used for?
local anesthesia for painful procedures