Podcast
Questions and Answers
A child presents with persistent vomiting and diarrhea for 3 days. Which assessment finding would be MOST indicative of moderate dehydration?
A child presents with persistent vomiting and diarrhea for 3 days. Which assessment finding would be MOST indicative of moderate dehydration?
- Alert mental status with normal skin turgor.
- Normal capillary refill and moist mucous membranes.
- Sunken fontanelle, decreased urine output, and delayed capillary refill. (correct)
- Increased blood pressure and rapid heart rare.
An infant is admitted with severe burns covering 30% of their body. What is the priority nursing assessment related to fluid balance during the initial resuscitation phase?
An infant is admitted with severe burns covering 30% of their body. What is the priority nursing assessment related to fluid balance during the initial resuscitation phase?
- Evaluating hourly urine output and specific gravity. (correct)
- Checking skin turgor and mucous membrane moisture every 4 hours.
- Assessing the presence and extent of peripheral edema.
- Monitoring the frequency and characteristics of bowel sounds.
A child with type 1 diabetes is admitted for hyperglycemia and suspected diabetic ketoacidosis (DKA). Which assessment finding MOST strongly suggests the presence of a combined fluid and electrolyte imbalance?
A child with type 1 diabetes is admitted for hyperglycemia and suspected diabetic ketoacidosis (DKA). Which assessment finding MOST strongly suggests the presence of a combined fluid and electrolyte imbalance?
- Complaints of abdominal pain and increased appetite.
- Bradycardia and hypertension.
- Warm, flushed skin with increased skin turgor
- Deep and rapid respirations (Kussmaul breathing) with a fruity odor on the breath. (correct)
A nurse is assessing the pain level of a nonverbal 4-year-old child. Considering their developmental stage and limited communication abilities, which pain scale would be the MOST appropriate initial choice?
A nurse is assessing the pain level of a nonverbal 4-year-old child. Considering their developmental stage and limited communication abilities, which pain scale would be the MOST appropriate initial choice?
A toddler has been experiencing frequent episodes of diarrhea for the past 48 hours. The nurse is MOST concerned about which acid-base imbalance?
A toddler has been experiencing frequent episodes of diarrhea for the past 48 hours. The nurse is MOST concerned about which acid-base imbalance?
A nurse is caring for a preterm infant in the NICU and needs to assess the infant's pain level. Which pain assessment tool is specifically designed and validated for use in preterm neonates up to 6 weeks?
A nurse is caring for a preterm infant in the NICU and needs to assess the infant's pain level. Which pain assessment tool is specifically designed and validated for use in preterm neonates up to 6 weeks?
The nurse is caring for a child with renal insufficiency. What assessment finding requires immediate intervention?
The nurse is caring for a child with renal insufficiency. What assessment finding requires immediate intervention?
A 10-year-old child is admitted to the hospital. Which pain assessment tool is best suited for this child, considering their cognitive and emotional development?
A 10-year-old child is admitted to the hospital. Which pain assessment tool is best suited for this child, considering their cognitive and emotional development?
A 14-year-old adolescent is experiencing chronic pain. Considering their cognitive abilities and communication skills, which pain assessment tool would be MOST appropriate?
A 14-year-old adolescent is experiencing chronic pain. Considering their cognitive abilities and communication skills, which pain assessment tool would be MOST appropriate?
A child who primarily speaks Spanish is brought to the emergency department. To accurately assess their pain using the Oucher scale, what is the MOST important consideration?
A child who primarily speaks Spanish is brought to the emergency department. To accurately assess their pain using the Oucher scale, what is the MOST important consideration?
Which physiological response to pain in children could lead to an increased risk of infection and delayed wound healing?
Which physiological response to pain in children could lead to an increased risk of infection and delayed wound healing?
A child is post-operative and reluctant to move. Which behavioral manifestation of pain is the child demonstrating?
A child is post-operative and reluctant to move. Which behavioral manifestation of pain is the child demonstrating?
What is a common misconception about pain in infants and children that can negatively impact their care?
What is a common misconception about pain in infants and children that can negatively impact their care?
You administer pain medication to a child. After one hour, they still report a high level of pain. What should you do next?
You administer pain medication to a child. After one hour, they still report a high level of pain. What should you do next?
A nurse is caring for children from diverse cultural backgrounds. What should the nurse recognize about cultural influences on pain?
A nurse is caring for children from diverse cultural backgrounds. What should the nurse recognize about cultural influences on pain?
Considering cultural variations, which of the following might a nurse expect when assessing pain in a child of African American or Latino descent?
Considering cultural variations, which of the following might a nurse expect when assessing pain in a child of African American or Latino descent?
Which statement accurately reflects how previous experiences with pain affect a child's future pain responses?
Which statement accurately reflects how previous experiences with pain affect a child's future pain responses?
A preverbal infant is displaying jerky movements, knitted eyebrows, and closed eyes. Which of the following is the MOST likely interpretation of these signs?
A preverbal infant is displaying jerky movements, knitted eyebrows, and closed eyes. Which of the following is the MOST likely interpretation of these signs?
A child is prescribed an opioid for severe pain. Which of the following nursing interventions is most crucial to implement due to the common side effects of opioids?
A child is prescribed an opioid for severe pain. Which of the following nursing interventions is most crucial to implement due to the common side effects of opioids?
What is the youngest age a patient can begin using a PCA (Patient-Controlled Analgesia) pump?
What is the youngest age a patient can begin using a PCA (Patient-Controlled Analgesia) pump?
A nurse is caring for a child who is experiencing pain. Which non-pharmacological intervention would be most appropriate to delegate to a trained child life specialist?
A nurse is caring for a child who is experiencing pain. Which non-pharmacological intervention would be most appropriate to delegate to a trained child life specialist?
A child with a respiratory condition is displaying nasal flaring and retractions. What do these signs indicate?
A child with a respiratory condition is displaying nasal flaring and retractions. What do these signs indicate?
When using the nursing process (ADPIE) upon a child's arrival to the clinic, what is the nurse's priority?
When using the nursing process (ADPIE) upon a child's arrival to the clinic, what is the nurse's priority?
A nurse assesses a child with a respiratory condition and notes the child is sitting upright, leaning forward, and using accessory muscles to breathe. This is known as what position?
A nurse assesses a child with a respiratory condition and notes the child is sitting upright, leaning forward, and using accessory muscles to breathe. This is known as what position?
A child is receiving pain medication via an IV. What is the primary advantage of IV administration compared to oral administration in this scenario?
A child is receiving pain medication via an IV. What is the primary advantage of IV administration compared to oral administration in this scenario?
A nurse is assessing a child's cough. Which characteristic of the cough would most likely suggest the presence of croup?
A nurse is assessing a child's cough. Which characteristic of the cough would most likely suggest the presence of croup?
Chelation therapy assists in the treatment of lead poisoning by what mechanism?
Chelation therapy assists in the treatment of lead poisoning by what mechanism?
A child is brought to the emergency department suspected of acetaminophen ingestion. The parent reports finding an empty bottle but is unsure of the timing. Which of the following is the priority nursing intervention?
A child is brought to the emergency department suspected of acetaminophen ingestion. The parent reports finding an empty bottle but is unsure of the timing. Which of the following is the priority nursing intervention?
Which of the following physiological traits of a young child’s ear increases their susceptibility to middle ear infections?
Which of the following physiological traits of a young child’s ear increases their susceptibility to middle ear infections?
An infant is noted to be primarily a nasal breather. Up to what age is nasal breathing the primary mode of respiration in infants?
An infant is noted to be primarily a nasal breather. Up to what age is nasal breathing the primary mode of respiration in infants?
A child is diagnosed with astigmatism. How does this condition affect the child's vision?
A child is diagnosed with astigmatism. How does this condition affect the child's vision?
During a routine eye examination, a white reflex is noted in a child's eye when light is shined into it. This finding is most indicative of which condition?
During a routine eye examination, a white reflex is noted in a child's eye when light is shined into it. This finding is most indicative of which condition?
A swimmer is complaining of pain and discomfort in their ear. On examination, the healthcare provider notes redness and inflammation of the ear canal. Which condition is most likely causing these symptoms?
A swimmer is complaining of pain and discomfort in their ear. On examination, the healthcare provider notes redness and inflammation of the ear canal. Which condition is most likely causing these symptoms?
A child has difficulty hearing because of a condition that prevents sound from effectively reaching the middle ear. This type of hearing loss is classified as what?
A child has difficulty hearing because of a condition that prevents sound from effectively reaching the middle ear. This type of hearing loss is classified as what?
A 6-year-old child is diagnosed with esotropia. If left untreated, which secondary condition is MOST likely to develop?
A 6-year-old child is diagnosed with esotropia. If left untreated, which secondary condition is MOST likely to develop?
A child is diagnosed with infectious conjunctivitis. What is the MOST important teaching point to emphasize to the parents to prevent the spread of infection?
A child is diagnosed with infectious conjunctivitis. What is the MOST important teaching point to emphasize to the parents to prevent the spread of infection?
An infant at risk for Retinopathy of Prematurity (ROP) is undergoing regular eye exams. At which stage of ROP would laser therapy most likely be considered?
An infant at risk for Retinopathy of Prematurity (ROP) is undergoing regular eye exams. At which stage of ROP would laser therapy most likely be considered?
During a well-child visit, the mother of a 10-month-old expresses concern that her child does not turn their head towards sounds. What follow-up question is MOST important for the nurse to ask?
During a well-child visit, the mother of a 10-month-old expresses concern that her child does not turn their head towards sounds. What follow-up question is MOST important for the nurse to ask?
A 4-year-old child is suspected of having hearing loss. Which behavior, if observed by the nurse, would MOST likely support this diagnosis?
A 4-year-old child is suspected of having hearing loss. Which behavior, if observed by the nurse, would MOST likely support this diagnosis?
What is the MOST appropriate immediate intervention for a parent to perform after their child has suffered a tooth avulsion?
What is the MOST appropriate immediate intervention for a parent to perform after their child has suffered a tooth avulsion?
A child who had a tonsillectomy earlier today is restless and frequently swallowing. The MOST appropriate immediate nursing action is to:
A child who had a tonsillectomy earlier today is restless and frequently swallowing. The MOST appropriate immediate nursing action is to:
A child is diagnosed with bronchitis. What is a typical symptom the nurse would expect to find during the assessment?
A child is diagnosed with bronchitis. What is a typical symptom the nurse would expect to find during the assessment?
A child with a known hearing impairment is admitted to the hospital for an unrelated surgery. What nursing intervention would be MOST helpful in facilitating communication?
A child with a known hearing impairment is admitted to the hospital for an unrelated surgery. What nursing intervention would be MOST helpful in facilitating communication?
Which strategy is LEAST effective when communicating with a child who has a sight impairment?
Which strategy is LEAST effective when communicating with a child who has a sight impairment?
A child is diagnosed with sensorineural hearing loss. The nurse understands this condition involves impairment to which part of the ear?
A child is diagnosed with sensorineural hearing loss. The nurse understands this condition involves impairment to which part of the ear?
A child presents with symptoms indicative of sinusitis. Which symptom is MOST characteristic of this condition?
A child presents with symptoms indicative of sinusitis. Which symptom is MOST characteristic of this condition?
Following a tonsillectomy, a school-aged child refuses to drink fluids due to pain. What is the MOST appropriate initial nursing intervention?
Following a tonsillectomy, a school-aged child refuses to drink fluids due to pain. What is the MOST appropriate initial nursing intervention?
A nurse is teaching a parent about managing epistaxis in a child. Which instruction is MOST important to include?
A nurse is teaching a parent about managing epistaxis in a child. Which instruction is MOST important to include?
The FACES pain scale would be MOST appropriate for which patient?
The FACES pain scale would be MOST appropriate for which patient?
Flashcards
Fluid volume deficit causes
Fluid volume deficit causes
Common causes include vomiting and diarrhea. Others: NG suction, hemorrhage, burns, DM, wound drainage and renal issues.
Dehydration & Body Weight
Dehydration & Body Weight
Decreased weight compared to previous measurements, reflecting fluid loss.
Skin & Mucous Membrane Assessment
Skin & Mucous Membrane Assessment
Assess temperature, turgor, and moistness. Check oral mucous membranes and eyes for moisture and tears. Look for edema.
Cardio/Respiratory Assessment
Cardio/Respiratory Assessment
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GI System Assessment
GI System Assessment
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Physiological Pain Manifestations
Physiological Pain Manifestations
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Behavioral Pain Manifestations
Behavioral Pain Manifestations
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Pain in Children: Dispelling Myths
Pain in Children: Dispelling Myths
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Reasons for Underreporting Pain
Reasons for Underreporting Pain
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Cultural Influences on Pain
Cultural Influences on Pain
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Pain Perception by Ethnicity
Pain Perception by Ethnicity
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Individual Pain Responses
Individual Pain Responses
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Post-Medication Pain Management
Post-Medication Pain Management
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NIPS Pain Scale
NIPS Pain Scale
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FACES Pain Scale
FACES Pain Scale
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FLACC Pain Scale
FLACC Pain Scale
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Poker Chip Pain Scale
Poker Chip Pain Scale
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Visual Analog Scale (VAS)
Visual Analog Scale (VAS)
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Tylenol and NSAIDs
Tylenol and NSAIDs
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Morphine, Dilaudid, Codeine, Oxycodone
Morphine, Dilaudid, Codeine, Oxycodone
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Opioid Side Effects
Opioid Side Effects
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Opioid Administration Routes
Opioid Administration Routes
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PCA Pump
PCA Pump
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Non-Pharmacological Pain Management
Non-Pharmacological Pain Management
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Assessing Infant/Child Respiratory Rate
Assessing Infant/Child Respiratory Rate
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Position of comfort
Position of comfort
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Environmental Hazards
Environmental Hazards
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Chelation Therapy
Chelation Therapy
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Acetaminophen Overdose S/S
Acetaminophen Overdose S/S
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Aspirin Overdose S/S
Aspirin Overdose S/S
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Child's Eustachian Tube
Child's Eustachian Tube
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Infant Nasal Breathing
Infant Nasal Breathing
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Astigmatism
Astigmatism
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Retinoblastoma
Retinoblastoma
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Esotropia
Esotropia
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Exotropia
Exotropia
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Amblyopia (Lazy Eye)
Amblyopia (Lazy Eye)
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Infectious Conjunctivitis (Pink Eye)
Infectious Conjunctivitis (Pink Eye)
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Periorbital Cellulitis
Periorbital Cellulitis
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Retinopathy of Prematurity (ROP)
Retinopathy of Prematurity (ROP)
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Otitis Media
Otitis Media
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Conductive Hearing Loss
Conductive Hearing Loss
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Sensorineural Hearing Loss
Sensorineural Hearing Loss
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Epistaxis
Epistaxis
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Nasopharyngitis
Nasopharyngitis
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Sinusitis
Sinusitis
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Pharyngitis
Pharyngitis
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Bronchitis
Bronchitis
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Avulsion (Tooth)
Avulsion (Tooth)
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Study Notes
- The module 2 exam includes multiple choice, true/false, multiple answers, and short answer questions.
- It has 50 questions with a 75-minute time limit.
- Additional knowledge beyond the material may be needed.
- Analyze vital signs to differentiate between normal and abnormal, considering nursing interventions.
General Vital Signs and Guidelines
- Premature infants: Heart rate 110-170 beats/min, SBP 55-75 mmHg, DBP 35-45 mmHg, Respiratory rate 40-70 breaths/min.
- 0-3 months: Heart rate 110-160 beats/min, SBP 65-85 mmHg, DBP 45-55 mmHg, Respiratory rate 35-55 breaths/min.
- 3-6 months: Heart rate 110-160 beats/min, SBP 70-90 mmHg, DBP 50-65 mmHg, Respiratory rate 30-45 breaths/min.
- 6-12 months: Heart rate 90-160 beats/min, SBP 80-100 mmHg, DBP 55-65 mmHg, Respiratory rate 22-38 breaths/min.
- 1-3 years: Heart rate 80-150 beats/min, SBP 90-105 mmHg, DBP 55-70 mmHg, Respiratory rate 22-30 breaths/min.
- 3-6 years: Heart rate 70-120 beats/min, SBP 95-110 mmHg, DBP 60-75 mmHg, Respiratory rate 20-24 breaths/min.
- 6-12 years: Heart rate 60-110 beats/min, SBP 100-120 mmHg, DBP 60-75 mmHg, Respiratory rate 16-22 breaths/min.
- Over 12 years: Heart rate 60-100 beats/min, SBP 110-135 mmHg, DBP 65-85 mmHg, Respiratory rate 12-20 breaths/min.
- Newborn to 3 months heart rate: 82-205.
- 3 months to 2 years heart rate: 100-190.
- 2 to 10 years heart rate: 60-140.
- More than 10 years heart rate: 60-100.
- Respiratory rate for 1 day to 1 year: 30-60.
- Respiratory rate for 1-3 years: 24-40.
- Respiratory rate for 3-5 years: 22-34.
- Respiratory rate for 5-12 years: 18-30.
- Respiratory rate for 12 years and older: 12-18.
Fluid Balance
- Monitor fluid balance through Intake and Output (I&O).
- Infant urine output: 2-3 ml/kg/hr.
- Toddler urine output: 1-2 ml/kg/hr.
- Adolescent/School Age urine output: 0.5-1 ml/kg/hr.
- Daily maintenance fluid: 100 ml for 1-10 kg, 50 ml for 11-20 kg, and 20 ml for anything over 20 kg.
- Administer IV fluids as a bolus.
- Calculate pediatric weight-based medication dosages, ensuring they are within the safe range and adjusting by weight.
Fluid and Electrolytes
- Isotonic dehydration occurs when fluid loss isn't balanced by intake, and water/sodium loss are proportional, causing vomiting and diarrhea.
- Hyponatremic (hypotonic) dehydration involves greater sodium loss than water loss, leading to fluid shifts from extracellular to intracellular. Can stem from severe vomiting/diarrhea/burns/renal disease/IV fluids w/out electrolytes.
- Hypernatremic (hypertonic) dehydration is characterized by greater water loss than sodium loss, causing fluid shifts from intracellular to extracellular. Symptoms include neurologic issues due to diabetes insipidus or IV/tube feedings with high electrolytes.
- Elevated BUN, low serum bicarbonate, high urine specific gravity, skin turgor, urine color, and dry mucous membranes indicate clinical dehydration.
- Mild dehydration includes restlessness and thirst.
- Moderate dehydration involves irritability/lethargy, thirst, increased pulse, possibly low BP, poor skin turgor, dry mucous membranes, dark/decreased urine, delayed capillary refill (>2 sec), and changes in respiration/tears.
- Severe dehydration manifests as lethargy to coma, low/undetectable BP, weak/nonpalpable pulse, parched mucous membranes, absent urine.
- Overhydration causes too many fluids with electrolytes, too much water in formula, CHF, and chronic kidney failure.
- Treat overhydration by restricting water and giving diuretics.
- Vomiting and diarrhea are common risk factors for fluid/electrolyte imbalance, as are NG suction, hemorrhages, burns, type 1 diabetes, wound drainage, and renal insufficiency.
Fluid Assessment
- Assess body weight changes since the last measurement.
- Assess skin temperature, turgor, oral mucous membrane moisture, presence of tears, and edema.
- Evaluate cardiovascular and respiratory systems (pulse, BP, cap refill, RR).
- Assess GI system (N/V/diarrhea frequency and duration and eating/drinking habits).
- Evaluate urinary system (output, wet diapers, urine specific gravity).
- Assess the musculoskeletal system for muscle tone and symmetry.
- Assess the neurological system for alertness, LOC, and fontanelle appearance.
- Normal blood pH is 7.35-7.45 (acidic if lower).
Acid-Base Imbalances
- Respiratory acidosis: caused by hindered CO2 release, potentially from cardiac/respiratory arrest, decreased aeration, respiratory muscle injury, or head injury. Symptoms include CNS depression, confusion, lethargy, increased ICP, tachycardia, low BP, and decreased LOC.
- Respiratory alkalosis: caused by decreased CO2 and elevated pH, often due to hypoxia, asthma, sepsis, or hyperventilation. Symptoms include paresthesia.
- Metabolic acidosis: caused by imbalance in acid production/excretion or bicarbonate loss, results from DM, antifreeze ingestion, ASA, renal failure, diarrhea, or starvation. Increase in RR, Kussmaul's respirations.
- Metabolic alkalosis: caused by acid loss or excess bicarbonate, stemming from prolonged vomiting, NG suction, antacids, or diuretics.
- Hyponatremia symptoms: decreased consciousness, anorexia, N/V, headache, muscle weakness, agitation, lethargy, confusion, coma, seizures.
- Hyperkalemia symptoms: muscle dysfunction, GI hyperactivity, intestinal cramping, diarrhea.
- Hypokalemia symptoms: abdominal distention, constipation, cardiac arrhythmias, impaired respiratory muscles, polyuria.
- Hypercalcemia symptoms: constipation, anorexia, N/V, fatigue, skeletal muscle weakness, confusion, lethargy.
- Hypocalcemia symptoms: twitching, cramping, tingling, carpal/pedal spasms, seizures, cardiac arrhythmias.
Fluid Distribution
- Newborns: 75% water.
- Infants: 65% water.
- Children/adolescents: 50% water.
- Sensible fluid loss: measurable (urine, wound drainage).
- Insensible fluid loss: immeasurable (skin, respiratory tract).
Dehydration Stages
- Mild dehydration: 3-5% total weight loss, treat with oral rehydration (avoid sugary drinks).
- Moderate dehydration: 6-10% weight loss.
- Severe dehydration: over 10% weight loss, requires IV hydration (20 ml/kg/hr bolus over 20-30 min), check skin turgor, mucous membranes, I/Os, BP, weight.
- Normal output ranges: Infants: 2-3 ml/kg/hr, Toddlers: 1-2 ml/kg/hr, Adolescents: 0.5-1 ml/kg/hr.
- Overhydration symptoms: weight gain (0.5 lbs in 1 day), edema, tight clothes/shoes, bounding pulse, respiratory difficulty (dyspnea/orthopnea/crackles).
Pain
- Physiologic Pain Manifestations
- Respiratory: shallow breathing, poor lung expansion/cough.
- Neurologic: tachycardia, hypertension, sleep changes, irritability, perspiration.
- Metabolic: increased blood glucose, decreased insulin.
- Immune: high infection risk/delayed wound healing.
- GI: delayed function, anorexia, poor nutrition.
- Behavioral Pain Manifestations: Short attention span, posturing, drawing up knees, lethargy, withdrawal, quietness, sleep disturbances, depression, aggression, knitted eyebrows, squinting, closed eyes, crying, jerky movements, anxiety.
- Children do not have pain like adults, or that there are consequences to children from pain.
- Infants display behavioral/psychological cues, children remember painful experiences which can lead to stronger future reactions, children experiencing repeated pain tend to report higher levels, children may not complain due to vocab limitations, fear of doctor, or fear of more pain, the reaction, or bravery.
- After giving pain medicine, recheck levels afte 1 hour, distract if high.
Cultural Influences
- Children learn about pain expression through imitation.
- African Americans/Latinos perceive stronger pan.
- Each children is individualized to each past experience.
- Newborn pain assessment scales: NIPS (preterm-6 weeks), CRIES scale (preterm/full term ICU), N-PASS (neonates/infants).
- Preschooler pain assessment: Oucher (3-13 years, ethnicity-based pictures), FACES (3-7 years).
Pain Scales
- FLACC for nonverbal/sedated (3-18 years), based on face, legs, activity, cry, and consolability.
- Poker chip scale is used for older children to compare levels of pain (4-12 years). More chips = higher pain.
- Numerical ratings are not ideal for younger school age (7-9 years or higher).
- Visual Analog is a subjective evaluation best for 9-18 years.
- Pain rating scale for Newborn/Infant (0-1 years old): NIPS.
- Pain rating scale for Toddler (1-3 years old): FLACC, Oucher, FACES.
- Pain rating scale for Preschooler (3-6 years old): Oucher, FACES, FLACC, Poker chip.
- Pain rating scale for School Age(6-12 years old): FACES, Oucher, Poker chip, Visual Analogue
- Pain rating scale for Adolescent (12 or older): Oucher, FACES, , Numeric Pain Scale, word grapic
Pharmacological Methods for Pain
- Mild/moderate pain: non-opioids (Tylenol, NSAIDs).
- Moderate/Severe pain: Opioids (Morphine, Dilaudid, Codeine, Oxy).
- s/s from Opioids: sedation includes sedation, nausea/vomiting, urinary retention, itching, or respiratory depression, and constipation.
- Oral is prefereed(slower absorption) and IV(quicker absorption), Topical:EMLA
- Comfort measures, CBT: distraction, guided imagery, relaxation/breathing .
Respiratory Assessment
- Nursing priority upon patient arrival is ADPIE.
- Evaluate infant/child comfort by if lying down, sitting up, or tripod.
- Assess vital signs for rate/depth of respirations to see if tachypnea or assess pulse rate/rhythm.
- Lung Auscultation: are breath sounds bilateral or adventitious.
- Respiratory effort: stridor/wheezing, grunting, nasal flaring presents, retractions presents, accessory muscles being used, can the child say a full sentence and weak/strong cry.
- Assess color of the mucous membranes, nail beds, or skin.
- Evaluate the presence, type, and strength of cough.
- Track behavioral changes for irritability, restlessness, or responsiveness changes.
- Smaller/thinner bronchioles causeasthmatic attacks, children consume more O, children > 6 use diaphragm for breathing, causing retractions .
- Treatment: pulse ox, nasal suction elevation, tylenol/ibuproden, nasal wash, keep O (Iv/Po).
Respiratory Alterations
- Viral nasopharyngitis is a common cold.
- Bronchiolitis/RSV: Common less than 2 years where airway lining swells/ excessive mucus, gradual.
- Bronchiolitis/RSV Allows air in/ out , apnea , stridor, retraction, low grade fever,rales, Stacco cough, hypoxemia
- RSV Treatment: pulse ox, nasal suction, elevate HOB, Tylenol/Ibuprofen, nasal wash, humidified O2 (keep moist and soft), hydration (IV/PO). Don't recommend: Bronchodilators, ephrine and corticosteroids Not recommenced
- Nebulized Hypertonic Saline.
- Pneumonia: lower airway disorder w inflammation/infection of the bronchioles and alveolar spaces (bacterial is more severe viral.
- Pneumonia s/s: sough, tachypnea, diminished breathe sounds, nasal flaring, Irritability, cyanosis, fever
- Diagnosis :chest Xray , CBC, lytes, blood culture
- Preventative measures DEEP, and ambiton . Based on behavior,cardos vascular statues and respirator .
- LTB : Viral.
- S/S: croup dry, SEAL bark cuff , afebrile . THEray :oral, dexa methusone
- LTB. 6m-3y A VIVAL invasion of up are way. In inflammation S/S: barking crowing sounds/low gradre TREAtments hydration /oxygen. MEdications R, epi,albuterol.
- Bacterial trach : the life . ( 1m-13y)
- Engotti : Due to Hib vaccine.
- Rapid bacterial rate. 4 DS:
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