Podcast
Questions and Answers
Which congenital heart defect is most commonly associated with cyanotic congenital heart diseases?
Which congenital heart defect is most commonly associated with cyanotic congenital heart diseases?
What is a common requirement for many gastrointestinal defects that affect nutrition and digestion?
What is a common requirement for many gastrointestinal defects that affect nutrition and digestion?
What is the optimal age range for repairing a cleft palate?
What is the optimal age range for repairing a cleft palate?
Which of the following is NOT a characteristic of congenital gastrointestinal defects?
Which of the following is NOT a characteristic of congenital gastrointestinal defects?
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Which condition involves the need for surgery to ensure proper speech development?
Which condition involves the need for surgery to ensure proper speech development?
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Which of the following best describes congenital disorders?
Which of the following best describes congenital disorders?
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What is a common diagnostic tool used to identify CNS defects during pregnancy?
What is a common diagnostic tool used to identify CNS defects during pregnancy?
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Which symptom can be a clinical manifestation of spina bifida?
Which symptom can be a clinical manifestation of spina bifida?
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What are examples of specialists involved in the treatment of spina bifida?
What are examples of specialists involved in the treatment of spina bifida?
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What factor contributes to congenital malformations?
What factor contributes to congenital malformations?
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What is a key nursing intervention for newborns diagnosed with myelomeningocele?
What is a key nursing intervention for newborns diagnosed with myelomeningocele?
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When should screening tests for CNS abnormalities be performed during pregnancy?
When should screening tests for CNS abnormalities be performed during pregnancy?
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What does elevated maternal alpha-fetoprotein levels indicate?
What does elevated maternal alpha-fetoprotein levels indicate?
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What is the primary treatment for esophageal atresia (EA) and tracheoesophageal fistula?
What is the primary treatment for esophageal atresia (EA) and tracheoesophageal fistula?
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What is an important nursing care consideration for a newborn with imperforate anus?
What is an important nursing care consideration for a newborn with imperforate anus?
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What is the surgical requirement for an omphalocele at birth?
What is the surgical requirement for an omphalocele at birth?
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In which situation is surgery required to prevent complications for an umbilical hernia?
In which situation is surgery required to prevent complications for an umbilical hernia?
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What clinical manifestation is associated with a diaphragmatic hernia?
What clinical manifestation is associated with a diaphragmatic hernia?
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What is the greatest concern when treating a newborn with a diaphragmatic hernia?
What is the greatest concern when treating a newborn with a diaphragmatic hernia?
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What is the risk associated with an inguinal hernia in males?
What is the risk associated with an inguinal hernia in males?
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What is a common misconception about umbilical hernias?
What is a common misconception about umbilical hernias?
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What is the initial step taken for an infant with a defect at birth?
What is the initial step taken for an infant with a defect at birth?
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What anatomical location is associated with hypospadias?
What anatomical location is associated with hypospadias?
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Which is NOT a treatment option for congenital talipes equinovarus?
Which is NOT a treatment option for congenital talipes equinovarus?
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What does the Ortolani sign indicate during a hip examination?
What does the Ortolani sign indicate during a hip examination?
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What is the recommended long-term treatment for developmental dysplasia of the hip in an infant?
What is the recommended long-term treatment for developmental dysplasia of the hip in an infant?
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Which method is classified as a nonsurgical treatment for clubfoot?
Which method is classified as a nonsurgical treatment for clubfoot?
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What is a common clinical manifestation of developmental dysplasia of the hip?
What is a common clinical manifestation of developmental dysplasia of the hip?
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In which condition should circumcision be avoided due to its potential use in surgical repair?
In which condition should circumcision be avoided due to its potential use in surgical repair?
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What is the primary treatment for a child experiencing status epilepticus?
What is the primary treatment for a child experiencing status epilepticus?
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Which type of meningitis is typically caused by enteroviruses?
Which type of meningitis is typically caused by enteroviruses?
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What symptom is typically associated with meningococcal meningitis?
What symptom is typically associated with meningococcal meningitis?
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Which of the following is NOT a common cause of cerebral palsy?
Which of the following is NOT a common cause of cerebral palsy?
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Which of the following clinical manifestations may be present in children with meningitis?
Which of the following clinical manifestations may be present in children with meningitis?
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What type of cerebral palsy is characterized by constant, slow, writhing movements?
What type of cerebral palsy is characterized by constant, slow, writhing movements?
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What is the most common method for diagnosing meningitis?
What is the most common method for diagnosing meningitis?
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What precaution is necessary for a patient suspected of having bacterial meningitis?
What precaution is necessary for a patient suspected of having bacterial meningitis?
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Which medication is often administered to manage muscle spasticity in cerebral palsy?
Which medication is often administered to manage muscle spasticity in cerebral palsy?
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Which type of cerebral palsy is characterized by poor coordination and balance?
Which type of cerebral palsy is characterized by poor coordination and balance?
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What is a key preventive measure to reduce the risk of cerebral palsy?
What is a key preventive measure to reduce the risk of cerebral palsy?
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What is a common clinical manifestation in infants with meningitis?
What is a common clinical manifestation in infants with meningitis?
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Which is NOT a consequence of untreated bacterial meningitis?
Which is NOT a consequence of untreated bacterial meningitis?
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What is a notable feature of the mixed type of cerebral palsy?
What is a notable feature of the mixed type of cerebral palsy?
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How does vision impact a child's growth and development milestones?
How does vision impact a child's growth and development milestones?
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What is a common characteristic of conductive hearing loss?
What is a common characteristic of conductive hearing loss?
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Which of the following is true regarding sensorineural hearing loss?
Which of the following is true regarding sensorineural hearing loss?
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What distinguishes mixed hearing loss from other types?
What distinguishes mixed hearing loss from other types?
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Which of the following reactions is commonly associated with hearing impairment?
Which of the following reactions is commonly associated with hearing impairment?
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How should a child with suspected hearing difficulties be diagnosed?
How should a child with suspected hearing difficulties be diagnosed?
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What is a primary treatment approach for children with hearing loss?
What is a primary treatment approach for children with hearing loss?
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What clinical manifestation might indicate otitis media in younger children?
What clinical manifestation might indicate otitis media in younger children?
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Which diagnostic method is used to confirm otitis media?
Which diagnostic method is used to confirm otitis media?
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What is a common treatment for chronic cases of otitis media?
What is a common treatment for chronic cases of otitis media?
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What role does caregiver presence play in the nursing care of a child with hearing impairment?
What role does caregiver presence play in the nursing care of a child with hearing impairment?
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What should nurses do when communicating with a child who has hearing impairment?
What should nurses do when communicating with a child who has hearing impairment?
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Which factor may contribute to a child experiencing sensorineural hearing loss?
Which factor may contribute to a child experiencing sensorineural hearing loss?
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Study Notes
Pediatric Nursing Day 2
- Topics covered: Newborn at Risk: Congenital Disorders, The Child with Sensory/Neurologic Disorder
- Focus on congenital disorders and their nursing implications
Congenital Disorders
- Malformations or anomalies
- Inborn errors of metabolism
- Hereditary disorders or chromosomal abnormalities
- Crisis for parents and family, experience grief
- Immediate or early surgery may be required
- Continuous, skilled observation and nursing care required
Congenital Malformations
- Caused by genetic or environmental factors
- Include defects of central nervous, cardiovascular, gastrointestinal, genitourinary, and skeletal systems
- Some apparent at birth, others only after complete physical examination
- Large percentage of health problems seen in newborns and children
Central Nervous System Defects #1
- Spina bifida (occulta, meningomyelocele, mylomeningocele)
- Diagnosed between 13 and 15 weeks gestation
- Diagnosis made from clinical observation and examination (MRI, ultrasonography, CT, myelography)
- Treatment depends on extent; surgical repair, therapy, and highly skilled nursing care required
- Specialists: neurologists, neurosurgeons, orthopedic specialists, pediatricians, urologists, physical therapists
Central Nervous System Defects #2
- Spina bifida (cont.)
- Clinical manifestations: asymptomatic with no problems or with serious paralysis, depending on the type
- Diagnosis: elevated maternal alpha-fetoprotein (AFP) levels followed by ultrasound showing incomplete neural tube; elevated AFP in maternal serum or amniotic fluid indicates a probability of CNS abnormalities
Central Nervous System Defects #3
- Spina bifida (cont.)
- Diagnosis (cont.): tests between 13 and 15 weeks gestation, clinical observation, examination, MRI, ultrasonography, CT, myelography
- Treatment: depends on extent, surgical repair, therapy, highly skilled nursing care. Specialists include neurologists, neurosurgeons, orthopedic specialists, pediatricians, urologists, physical therapists
Question #1
- Correct answer: a. Family teaching
- Rationale: Provide family with information about the defect, proposed surgery, and follow-up care. Reassure families. Information should be repeated and given in small segments.
Hydrocephalus
- Noncommunicating hydrocephalus: obstruction prevents CSF from passing between ventricles and spinal cord
- Communicating hydrocephalus: absorption of CSF is defective
- Clinical manifestations: rapid head growth, widening cranial sutures, anterior fontanelle becomes tense and bulging, skull enlarges, scalp shiny, veins dilate, heavy head, difficulty raising/turning head, increasing helplessness, increased intracranial pressure.
- Setting-sun sign (sunset eyes)
- Diagnosis: CT and MRI, echoencephalography, and ventriculography
- Treatment: surgical intervention, ventriculoperitoneal shunting
Cardiovascular System Defects: Congenital Heart Disease #1
- Development of the heart begins in the third to eighth week of gestation.
- Circulation is unique, bypassing the lungs, circulating through the placenta.
- Ductus arteriosus, foramen ovale, ductus venosus close after birth.
- Pressure changes in heart from right side to left side.
- Abnormalities can occur.
Cardiovascular System Defects: Congenital Heart Disease #2
- Common types of congenital heart defects are traditionally described as cyanotic or acyanotic conditions.
- Current classifications are based on blood flow characteristics (increased pulmonary blood flow, obstruction of blood flow, decreased pulmonary blood flow, mixed blood flow).
Cardiovascular System Defects: Congenital Heart Disease #3
- Ventricular septal defect: most common intracardiac defect with an abnormal opening in the septum between two ventricles, allowing blood to pass directly between left and right ventricles.
- Corrected by surgery.
Cardiovascular System Defects: Congenital Heart Disease #4
- Atrial septal defect: an abnormal opening between right and left atria.
- Corrected by surgery.
Cardiovascular System Defects: Congenital Heart Disease #5
- Patent ductus arteriosus: the ductus arteriosus allows blood to bypass the lungs after delivery. If remains open, shunts blood from aorta to pulmonary artery.
- Corrected by medication or surgery (indomethacin).
Cardiovascular System Defects: Congenital Heart Disease #6
- Coarctation of the aorta: constriction or narrowing of the aortic arch.
- Can lead to hypertension and congestive heart failure.
- Surgical correction is necessary.
Cardiovascular System Defects: Congenital Heart Disease #7
- Tetralogy of Fallot: consists of pulmonary stenosis, ventricular septal defect, overriding aorta, and right ventricular hypertrophy.
- Causes cyanosis.
- Severity depends on the degree of defect.
- Surgical correction of defects.
Cardiovascular System Defects: Congenital Heart Disease #8
- Transposition of the great arteries: aorta arises from the right ventricle instead of the left, and the pulmonary artery arises from the left ventricle instead of the right.
- Newborns are usually cyanotic from birth.
- Advancements in diagnosis and treatment have increased survival rates.
Cardiovascular System Defects: Congenital Heart Disease #9
- Risk factors: preterm newborn, maternal alcoholism, smoking, ingestion of certain drugs during pregnancy, maternal diabetes, advanced maternal age, rubella in first trimester, maternal malnutrition, heredity of offspring of mothers with congenital heart anomalies, previous siblings with congenital heart abnormality.
- Clinical manifestations: cyanosis, murmur, feeding difficulties, tiring easily with feeding, failure to thrive or grow.
Cardiovascular System Defects: Congenital Heart Disease #10
- Treatment and nursing care: improved techniques, earlier surgery to improve outcomes and prevent complications like congestive heart failure (CHF), care at home before surgery, support for family.
- Various responses may be seen from family.
Cardiovascular System Defects: Congenital Heart Disease #11
- Treatment (cont.): cardiac catheterization, preoperative preparation: teaching essential, describe equipment, tour of facility, appropriate teaching for postoperative tasks and allow time to practice.
- Cardiac surgery, type depends on the situation, induced hypothermia. Postoperative care with tasks depending on procedure, education, goals, and plans
Question #2
- Correct answer: d. Tetralogy of Fallot
- Rationale: Tetralogy of Fallot is a fairly common congenital heart defect, involved in 50-70% of all cyanotic congenital heart diseases.
Gastrointestinal System Defects #1
- Most are apparent at birth or shortly thereafter.
- Results from interruption of embryonic growth at a crucial stage.
- Many interfere with nutrition and digestion.
- Often require immediate surgical intervention.
Gastrointestinal System Defects #2
- Cleft lip and cleft palate
- Clinical manifestations: images shown of the defect.
Gastrointestinal System Defects #3
- Cleft lip and cleft palate (cont.)
- Diagnosis: physical appearance confirms.
- Treatment: surgery, timing of surgery varies among surgeons and extent of deformity, repair needed to ensure intelligible speech, proper nutrition. May need several surgeries to correct, depending on extent of deformity.
Question #3
- Correct answer: True
- Rationale: The optimal time for cleft palate repair is considered to be between 6 months and 5 years of age.
Gastrointestinal System Defects #4
- Esophageal atresia and tracheoesophageal fistula (EA/TEF)
- Clinical manifestations: coughing, choking, cyanosis. Blind pouch of esophagus, trachea, distal portion of esophagus.
Gastrointestinal System Defects #5
- Esophageal atresia (EA)/tracheoesophageal fistula (TEF) (cont.)
- Treatment and nursing care: surgery (may be done in stages), prevention of mucus aspiration and respiratory distress, IV fluids for hydration, total parenteral nutrition (TPN), gastrostomy tube and drainage of proximal esophageal pouch.
Gastrointestinal System Defects #6
- Imperforate anus
- Clinical manifestations: Images shown of the defect.
Gastrointestinal System Defects #7
- Imperforate anus (cont.)
- Treatment: surgery, extent and type depends on defect, may need colostomy.
- Nursing care: family education for colostomy care.
Gastrointestinal System Defects #8
- Hernias — Diaphragmatic hernia
- Hernia of diaphragm, abdominal organs into left chest.
- Pushes heart to right, compresses left lung.
- Requires surgery to repair.
- Outcome of surgery depends on degree of pulmonary development.
Gastrointestinal System Defects #9
- Hernias (cont.) — Omphalocele
- Rare; usually detected on ultrasound.
- At birth, cover with moistened gauze and plastic wrap.
- Surgical repair necessary.
Gastrointestinal System Defects #10
- Hernias (cont.) — Umbilical hernia
- Incomplete closure of umbilical cord.
- Largely a cosmetic problem.
- Bowel strangulation is possible but rare.
- Surgery necessary if it does not close.
Gastrointestinal System Defects #11
- Hernias(cont.) — Inguinal hernia
- Primarily in males
- Intestine slips into scrotal sac
- Surgery required to prevent strangulation of intestine
Question #4
- Correct answer: b. Covered with gauze moistened in sterile saline.
- Rationale: At birth, the defect is covered with gauze moistened in sterile saline. This is to prevent heat loss and is done immediately
Genitourinary Tract Defects #1
- Hypospadias: urethra terminates on the ventral surface of the penis instead of at the tip.
- Epispadias: urethra is on the dorsal surface of the penis.
- Treatment: surgical repair, may be done as outpatient surgery, avoid circumcision if foreskin is used in repair. May need repair of other defects.
Skeletal System Defects #1
- Congenital talipes equinovarus (clubfoot)
- Can be noted in utero on ultrasound.
- Most common congenital foot deformity.
- Clinical manifestation
Skeletal System Defects #2
- Congenital talipes equinovarus (clubfoot)(cont.)
- Treatment: nonsurgical (Ponseti method); use of plastic splint or cast. Casts changed frequently until radiographic evidence of correction.
- Surgical, if no response to nonsurgical treatment; denis-brown method.
Skeletal System Defects #3
- Developmental dysplasia of the hip (DDH)
- Clinical manifestations: Barlow test, Ortolani sign (or click) to check for dislocation
Skeletal System Defects #4
- Developmental dysplasia of the hip (cont.)
- Treatment: use of 2-3 diapers to maintain constant flexion/abduction (4-8 weeks). Use of brace, traction (if severe), or cast (spica cast). Long-term Pavlik harness (ages 1-6 months), surgery (18 months or older).
Question #5
- Correct answer: c. Congenital hip dysplasia.
- Rationale: Ortolani maneuver is a test used to diagnose congenital hip dysplasia. Expert examiners check for an audible click when assessing the neonatal hip using the Barlow sign and Ortolani maneuver.
Inborn Errors of Metabolism #1
- Hereditary disorders that affect metabolism.
- Nursing care involves accurate observation of manifestations for prompt diagnosis and initiation of treatment.
- Reinforcing family teaching is vital.
- Dietary guidelines, information about the disorder, genetic counseling, long-term care for chronically ill children.
Inborn Errors of Metabolism #2
- Phenylketonuria (PKU): recessive hereditary defect of metabolism, causing severe intellectual disability if untreated.
- Clinical manifestations: frequent vomiting, aggressive, hyperactive, severe, progressive mental disability, convulsions, eczema, and musty urine smell.
- Diagnosis: Guthrie inhibition assay test after ingestion of protein (48-72 hours). Normal range for blood levels of phenylalanine (2-10 mg/dL).
Inborn Errors of Metabolism #3
- Phenylketonuria (PKU) cont.
- Treatment: formula low in phenylalanine, diet low in phenylalanine (most grains, meat, fish, dairy products, eggs, nuts, and legumes). Sapropterin dihydrochloride (Kuvan)- medication to breakdown excess phenylalanine in the blood.
Inborn Errors of Metabolism #4
- Galactosemia: recessive hereditary metabolic disorder; enzyme necessary to convert galactose into glucose is missing.
- Clinical manifestations: early feeding difficulties, vomiting, diarrhea, dehydration, weight loss, jaundice.
- Treatment/Nursing: galactose omitted from diet, special formula, lactose-free diet.
Inborn Errors of Metabolism #5
- Congenital hypothyroidism
- Associated with either congenital absence of thyroid gland or inability of gland to secrete thyroid hormone
- Clinical manifestations: signs/symptoms (6 weeks): depressed nasal bridge, large tongue, puffy eyes, short/thick neck, hoarse cry, dry/cold skin, slow bone development, chronic constipation, and enlarged abdomen. Lack or low muscle tone (hypo-tonia)
Inborn Errors of Metabolism #6
- Congenital hypothyroidism (cont.)
- Image of a child.
Inborn Errors of Metabolism #7
- Congenital hypothyroidism (cont.)
- Diagnosis: routine test for triiodothyronine (T3) and thyroxine (T4) levels.
- Treatment and nursing care: replacement of thyroid hormone, monitor blood levels, early infancy treatment prevents intellectual disability and slow growth. Lifelong therapy is required.
Inborn Errors of Metabolism #8
- Maple syrup urine disease (MSUD)
- Inborn error of metabolism, branched-chain amino acids; autosomal recessive, often fatal.
- Clinical manifestations: early infancy, feeding problems, seizures, spasticity, opisthotonos, urine with distinct maple syrup odor; blood tests.
- Treatment/Nursing: dietary - low in branched-chain amino acids, immediate treatment vital.
Chromosomal Abnormalities #1
- Often evident at birth.
- Commonly cause physical and cognitive challenges throughout life.
- Most common: nondisjunction abnormalities (chromosomal division uneven, may have one extra or missing one.)
Chromosomal Abnormalities #2
- Down syndrome (most common)
- May also have trisomy 21.
- Higher risk for women 35+.
- Prenatal screening varies by trimester, blood tests and ultrasound.
- Second trimester screening: "quad test" (AFP , unconjugated estriol, inhibin-A, hCG levels) are used to assess for higher risk for Down syndrome.
Chromosomal Abnormalities #3
- Down syndrome (cont.)
- Clinical manifestations include: brachycephaly, short stature, upward/outward slanted eyes, epicanthic fold, short/flattened bridge of nose, thick/fissured protruding tongue, dry/cracked/fissured skin, mottled, small hands, short broad fingers, curved fifth finger, wide space between first and second toes, lax muscle tone, heart/eye anomalies, greater susceptibility to leukemia.
Chromosomal Abnormalities #4
- Down syndrome (cont.)
- Treatment/Nursing Care: physical characteristics determine care, respiratory difficulties, late motor development, GI issues, congenital heart defects, vision/hearing problems, difficulty eating. Family needs strong support and education. Intervention programs are available. Decisions may be difficult.
Chromosomal Abnormalities #5
- Turner syndrome
- Having one less X chromosome
- Characteristics: short stature, low-set ears, broad-based/short neck, low-set hairline on neck, broad chest, increased angle of the arms, hand/feet edema.
- Females do not develop secondary sex characteristics.
- Normal intelligence, but may have visual-spatial concerns, learning disabilities, problems with social interaction, lack physical coordination.
- Treatment: growth hormones.
Chromosomal Abnormalities #6
- Klinefelter syndrome
- Extra X chromosome. Characteristics not evident until puberty. Most common in males.
- Characteristics: atypical physical sexual development; behavioral issues; difficulty with memory and processing; often of normal intelligence.
- Treatment: testosterone hormone replacement in early teens.
Nursing Process
- Assessment: data collection
- Nursing care focus
- Goal
- Implementations
- Evaluation of goal/desired outcome.
Question #6
- False— chromosomal abnormalities result from extra or missing chromosomes or from a structural rearrangement, not always a lack of chromosomes.
The Nervous System
- Communication network of body
- Central nervous system: brain, spinal cord
- Peripheral nervous system: nerves throughout body
- Cerebrospinal fluid: in brain and spinal cord, cushioning/protective mechanism
- Nerve impulses: activate, coordinate, integrate, control all bodily functions
- Autonomic nervous system: regulates involuntary functions.
- System immature; growth and development occurs, gross and fine motor skills develop.
Sensory Organs #1
- Eyes: detect light, stimuli from the environment, produce/transmit nerve impulses to brain. Brain interpretation results as "seeing".
- By 2 months: focus and follow objects.
- By 7 months: depth perception matures. Visual acuity: usually between 20/100 and 20/400 until 5 years old; most have 20/20 by then.
Sensory Organs #2
- Ears: organ of hearing, equilibrium, balance. External, middle, inner ear, tympanic membrane, Eustachian tube. First hearing screening before newborn discharge.
Sensory Organs #3, #4, #5, #6
- These sections are about descriptions and differences of the Eustachian tube between a child and adult; vision impairment classifications (sighted with eye problems, partially sighted, legally blind); types (refractive error, partial sight, blindness); clinical manifestations (squinting, frowning, tearing, eye rubbing, Snellen eye chart); treatment and education; and nursing care (needs of children). Different eye conditions, including cataracts, glaucoma, strabismus, eye injuries/foreign objects, eye infections (hordeolum/sty, conjunctivitis) are covered, and the treatment for them and their care considerations are outlined. Also, the nursing care for children undergoing eyes surgery is covered.
Hearing Impairment #1
- Hearing loss is a prevalent disability in the US. Development can be moderately to severely impaired. Hearing loss ranges from mild (hard of hearing) to profound (deaf.)
- Hard of hearing: can learn speech/language by imitating sounds. Deaf: no hearing ability
Hearing Impairment #2
- Conductive hearing loss: middle ear structures cannot carry sound waves to the inner ear. Often results from chronic serous otitis media or other infections. Hearing levels can fluctuate, a damaged eardrum/ossicles can cause conductive hearing loss.. Seldom complete. Can be treated.
Hearing Impairment #3
- Sensorineural hearing loss: damage, disease, or disorder affecting the nerve endings of the inner ear/nerve pathways.
- Causes: Hereditary/congenital, certain drugs.
- Generally severe and unresponsive to medical treatment.
Hearing Impairment #4
- Mixed hearing loss: combination of conductive and sensorineural hearing impairments.
- Conduction level determines how well child hears.
Hearing Impairment #5, #6, #7, #8
- Clinical manifestations. Diagnosis. Treatment/education, hearing loss classifications (mild, moderate, severe, profound, central auditory processing disorder). Diagnosis in soundproof room, speech reception/discrimination tests; hearing aids/cochlear implants; communication; specialized care. Nursing care; patient needs.
Otitis Media #1
- One of the most common infectious diseases in children. Related to the eustachian tube. Haemophilus influenzae and streptococcus pneumoniae are causes. Immunizations have lessened the incidence. Symptoms: restless, shaking head, ear pulling, decreased activity, pain, fever, possible vomiting/diarrhea.
Otitis Media #2
- Diagnosis: otoscopic exam. Shows bright red, bulging eardrum; spontaneous rupture may occur followed by purulent drainage.
- Treatment/Nursing Care: acute cases: antibiotics, analgesics, antipyretics; chronic cases: prophylactic course of antibiotics, myringotomy with tubes. Possible complications: mastoiditis. Teach prevention, care if infected.
Insertion of Foreign Bodies Into the Ear or Nose
- Toddlers/Preschoolers may insert objects into ears/nose.
- Ear removal: irrigation, forceps.
- Nose removal: healthcare professional uses speculum. Risk of infection if object remains.
Reye Syndrome #1
- Usually occurs after a viral illness (upper respiratory infection or varicella). Aspirin use has been implicated as a contributing factor. The American Academy of Pediatrics (AAP) recommends that aspirin or aspirin-containing products NOT be given to children during viral infections. Characterized by acute encephalopathy and fatty degeneration of the liver and other abdominal organs.
Reye Syndrome #2
- Clinical manifestations: appear 3-5 days after illness, severe to moderate vomiting, irritability, lethargy, confusion, disorientation.
- Need for immediate intervention for: seizures, coma, respiratory arrest.
- Diagnosis: history of viral illness, liver function tests, biopsy, lumbar punctures, coagulation studies, blood glucose, elevated ammonia levels, and/or hypoglycemia (low blood glucose). Delayed PTT
Reye Syndrome #3
- Treatment: ICU care.
- Nursing care: careful observation, intake and output, monitor blood glucose levels/bleeding time.
- Care for family, support, education.
Acute or Nonrecurrent Seizures #1, #2, #3, #4, #5, #6, #7, #8, #9, #10, #11
- These sections cover the different types of seizures; seizure disorders classifications, primary idiopathic, secondary resulting from infection/head trauma etc.; clinical manifestations, diagnosis, treatment and nursing care for each.
Question #3
- Correct answer: d. IV Diazepam
- Rationale: Status epilepticus is an emergency, requiring immediate treatment. Diazepam/lorazepam (rectal or IV) used for quick treatment.
Meningitis #1, #2, #3, #4, #5, #6,
- These sections cover the different types of Meningitis; clinical manifestations of viral and bacterial meningitis (onset gradual or abrupt, fever, bulging fontanels, poor sucking and feeding, lethargy, irritability, headache, nuchal rigidity, opisthotonos, etc.); Kernig and Brudzinski signs; diagnosis (lumbar puncture, WBC count, spinal tap); appropriate isolation precautions, antibiotic/steroid therapy; possible complications including deafness, intellectual disability, seizures, hydrocephalus, and paralysis).
Cerebral Palsy #1, #2, #3, #4, #5, #6, #7, #8, #9, #10, #11, #12, #13 --
- These sections cover causes (prenatal, perinatal, postnatal); prevention; clinical manifestations (different types of CP, like spastic, athetoid, ataxic); diagnosis (family history, physical characteristics, developmental delays, screenings, MRI/cranial ultrasound, assessment); treatments/special aids (braces, orthopedic management, biomedical engineering, physical therapy); nursing care (interviewing/assessing child/family, support, education). Different types/characteristics of CP (like spastic, athetoid, ataxic, and mixed) are covered.
Question #4
- Correct answer: True
- Rationale: Moderate technology has greatly improved the lives of children with Cerebral Palsy by providing a wide range of assistive devices.
Intellectual Disability #1, #2, #3, #4, #5 --
- These sections cover the nature and causes of intellectual disability (significant limitations on intellectual functioning, IQ of 70 or lower, and concurrent adaptive behavior deficits); causes (prenatal, perinatal, and postnatal); clinical manifestations of different severities (mild, moderate, severe, profound); diagnosis; methods of treatment/education (new teaching techniques, family support, early intervention).
Brain Tumors #1, #2, #3 --
- These sections cover the nature and causes of brain tumors (benign or malignant; second most common cancer in children/adolescents; cause often unknown), clinical manifestations/diagnosis (in infants/children/adolescents; subtle/nonspecific symptoms vary by age, location), and treatment/nursing care (surgery, radiation, chemotherapy).
Head Trauma #1, #2 --
- Broad definition, including injuries to scalp, skull, and/or brain. Use of the Glasgow Coma Scale to evaluate severity. Various types of head injuries (falls, child abuse, bike accidents, sports injuries). Significant issues like hemorrhage, hypoxia, cerebral edema, IICP, retinal hemorrhages, shaken baby syndrome.
Drowning --
- Second leading cause of accidental death in toddlers and older adolescents.
- Causes, especially with infants/toddlers in bathtubs. Supervision is stressed to prevent drowning injuries to young children. CPR is stressed as immediate treatment, until the victim is transported for professional medical care.
References
- A reference citation is given, and it is for the appropriate text.
Studying That Suits You
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Description
Test your knowledge on congenital heart and gastrointestinal defects, as well as related treatment and diagnostic approaches. This quiz covers various aspects of congenital disorders, including symptoms, age for surgical interventions, and specialist involvement. Perfect for anyone studying pediatric medicine or nursing!
