Which of these is done first during a pediatric emergency situation with a new or unknown patient:
Take VS
Put line in
Take weight
First is take weight, second is to put in a line
This tool is a color coded system that helps clinicians decide what doses of medications to administer and what size medical equipment is needed. These recommendations are based an the infant or child’s estimated height and weight.
Broselow Tape: The color coded system is present on the actual tape along with all of the charts and other medical material that comes in the complete system.
T or F: Children can become addicted to pain meds given in the hospital
False
Match when to use pain scales:
1. Newborn up to 6 weeks
2. Infants and non-verbal patients
3. 3 years and older
4. Knows Numbers
a. FACES
b. NRS
c. FLACC
d. NIPS
1. d (NIPS - neonatal infant pain scale)
2. c (FLACC - Face, legs, activity, cry, consolobility)
3. a (FACES)
d. b (NRS)
Which pain med to give with surgeries?
Toridol
T or F: dorsoglueteal injections are contraindicated with infants
True
T or F: For children UNDER three years old, you pull UP on their ears when giving otic meds.
False: You pull down for children under three, and up for >3 y/o
During postoperative care, what is the FIRST sign that something is wrong?
Behavior change
This is a bacterial skin infection. It causes red sores that can break open, ooze fluid, and develop a yellow-brown crust. These sores can occur anywhere on the body.
It is the most common skin infection in children.
Impetigo
This is a long - lasting (chronic) skin condition that causes intense itching and then a red, raised rash.
Atopic Dermatitis
This skin infection is a superficial fungal infection. It is acquired from vaginal birth, breast infection from mom, or unclean bottles and/or pacifiers.
It shows as white curd like lesions in mouth/tongue.
OTC antiseborrherics containing sulfur/salicylic is used to treat what?
Cradle Cap
What is another term for lice?
Pediculosis
This highly contagious skin infection is caused by straph/strep bacteria. It is a spread of infection d/t poor hygiene.
What is the topical ointment used for it?
Impetigo: Bactroban (topical) for 7-10 days
How are scabies treated?
Scabicide lotion applied for 4-8 hours then washed off
Which antiviral is used to treat Herpes Simplex?
Acycovir
What advice should the nurse offer a parent about reducing a child's fever?
C.
Which food is best mixed with medication for an infant?
A. Pudding
List interventions and teaching for Impetigo
Impetigo: a secondary skin infection, that is contagious by close contact. It can also spread to other body parts of the child.
Interventions include:
* topical and PO abx of Mupirocin (Bactroban); lasts 7-10 days
* wash lesions with warm soapy water, take off crusts
* Teach good handwashing
* Child should not attend school for 24 hours after starting tx
How will you encourage a child with Herpes simple virus (HSV) to drink fluids?
Offer ice pops, noncitrus juices, milk, and noncarbonated or "flattened" soft drinks.
These will reduce irritation d/t extreme discomfort when swallowing.
What is the differnce between Tinea capitis and corporis? The tx?
Tinea Skin infection caused by fungi. It can affect skin, nails, and hair.
Capitis tx must penetrate hair follicles, and topical therapy alone isn't effective. PO griseofulvin is given daily for 6 weeks.
Corporis is effective usually with local treatment, like Lotrimin or miconazole, twice daily for 4 weeks.
Griseofulvin, tx for Tinea capitis, is insoluble in water, so absorption is increased if taken with ____ or with ____.
high-fat meal or milk
What is another term for eczema? List therapeutic management.
Control itching with antihistamines (worsse at night)
moisturize skin
prevent secondary infection
remove allergens and irritants.
Explain the "wet" or "dry" approach for atopic dermatitis (eczema)
Refers to proper skin hydration
Dry: depends on avoiding bathing and the liberal use of emollients on dry skin
Wet: more popular; permits bathing for limited period of time, and use of wet compresses and occlusive creams and ointments.
In humid climates, bathing should be infreuent, and only lukewarm water, with mild nonperfumed soap.
Avoid things that can cause skin dryness: lotions with alcohol
What is another term for Cradle cap?
What ages will you normally see it and when will it disappear by?
What are its characteristics?
List interventions to manage it.
Why shouldn't ointments be used in affected areas?
Seborrheic dermatitis: chronic inflammatory skin condition seen in infants (first 2-3 weeks on the scalp, usually disappears by 12 months
Characteristics: nonpruritis, oily, yellow scales that block sweat and sebaceous glands, causing retained secretions and inflammation in affected areas.
**Seborrheic dermatitis: confluent erhythema commonly present in the diaper and around the umbilicus**
Interventions: relieve itching
Prevent infection
ID and remove offending substances
Cool compresses and tepid oatmeal baths (aveeno) for itching
Topical steroid creams and antihistamines
Cool rooms (heat makes itch worse)
Ointments should not be appkied to inflamed areas because they retain moisture.
What is another term for a lice infestation? List interventions for killing active lice and nits
Pediculosis: daily removal of nits with a nit comb
OTC (RID, NIX) kwell is stronger but more toxic
List manifestations of Herpes Simplex Virus.
Explain antiviral tx
Pain and tenderness in the affected area
Vesicles erupt, rupture, and then ulcerate over the course of 1-7 days.
Virus sheds for 2-3 weeks
Antiviral: Acyclovir is used
neonates are treated with parenteral acyclovir and a topical opthalmic
Adolescents treated for 10 days with PO antivirals.
What is the primary and alternative tx for Scabies?
How long should it be applied for on the patient's skin? How soon to do a retreatment?
Primary: permethrin (Elimite)
Secondary: lindane cream (Kwell)
**lindane can cause neurotoxicity for children <2 y/o or in pregnant women**
Med should remain on child for 8-14 hours, so it should be applied before bed, and washed off int he morning.
Retreatment is usually recommended in 1 week after initial application.
T or F: topical medications on pediatric patients will absorb slower
False
List interventions for oral candidiasis (thrush) and candidal diaper
Oral nystatin suspension q6h until 3-4 days after symptoms disappeared.
Pacifiers, nipples, and bottles should be thoroughly cleaned to decrease chance
Diaper: apply nystatin or clotrimazole, then leaving diaper area exposed to air to reduce moisture that facilitates fungal growth.
why do you not want to mix medications with rice cereal to administer to an infant at the hospital?
You don't want to associate a med with a normal part of their diet; give with pudding
