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Questions and Answers
What is a common treatment intervention for a patient with GERD?
What is a common treatment intervention for a patient with GERD?
Which factor is NOT a risk factor for otitis media?
Which factor is NOT a risk factor for otitis media?
What symptom indicates a child may have epiglottitis?
What symptom indicates a child may have epiglottitis?
What is a key characteristic of diaper dermatitis that suggests it may be due to a yeast infection?
What is a key characteristic of diaper dermatitis that suggests it may be due to a yeast infection?
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In cases of poisoning, what is an essential first step for care?
In cases of poisoning, what is an essential first step for care?
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What is the expected weight change for a newborn during the first two weeks of life?
What is the expected weight change for a newborn during the first two weeks of life?
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Which factor is NOT a risk for neonatal jaundice?
Which factor is NOT a risk for neonatal jaundice?
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What is the condition most likely to require a surgical intervention in infants?
What is the condition most likely to require a surgical intervention in infants?
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Which of the following statements about safe sleep practices to reduce SIDS is false?
Which of the following statements about safe sleep practices to reduce SIDS is false?
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Which of the following milestones is correctly matched with its expected age of achievement?
Which of the following milestones is correctly matched with its expected age of achievement?
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What is the primary treatment method for Duchenne Muscular Dystrophy?
What is the primary treatment method for Duchenne Muscular Dystrophy?
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Which complication is most concerning in cases of sickle cell anemia?
Which complication is most concerning in cases of sickle cell anemia?
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What is NOT a symptom of measles?
What is NOT a symptom of measles?
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For a child with severe dehydration due to diarrhea and vomiting, the fluid replacement should be calculated at what rate?
For a child with severe dehydration due to diarrhea and vomiting, the fluid replacement should be calculated at what rate?
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What is the common first symptom of diabetes type 1 in children?
What is the common first symptom of diabetes type 1 in children?
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Study Notes
Pediatric Nursing Considerations
- Hospitalization stressors are a significant factor for families.
- Family-centered care is crucial to understand family dynamics.
- Atraumatic care is essential to prepare patients for unfamiliar treatments or procedures
- Developmentally appropriate communication with children and families is key.
- Anticipatory guidance is important for children and families regarding growth and development, diseases, procedures, and surgeries.
- Prioritizing nursing interventions related to mortality and morbidity across different age groups is vital.
- Birth to 1 month: congenital abnormalities
- First year: Sudden Infant Death Syndrome (SIDS), childhood accidents
- Adolescents: Accidents, homicide, suicide (male adolescents at higher risk than females).
Newborns
- Growth and development: Weight loss initially, then regain by 2 weeks, doubles at 6 months, and triples by 1 year.
- Milestones include rolling, lifting head, sitting, and pincer grasp.
- Neonatal respiratory distress syndrome is related to lack of pulmonary surfactant.
- Risk factors for newborn jaundice include bruising, early delivery, poor feeding, and sibling history of jaundice.
- Prevent Jaundice with frequent feedings.
- Congenital hip dysplasia is a concern, especially for breech births.
- Newborn screenings typically include CHD, hearing, metabolic, and jaundice testing.
- Cleft lip and cleft palate require careful monitoring of feeding and weight gain.
- Neonatal hypoglycemia is associated with factors such as small gestational age (SGA), prematurity, large for gestational age (LGA), gestational diabetes mellitus (GDM), and perinatal stress.
- Apgar scores are used to assess vital signs at one and five minutes. A score of 7 or more is considered normal.
- Sepsis, Chorioamnionitis (chorio), premature rupture of membranes (PROM) are potential risks
- Meconium passage within the first 24 hours of birth is normal, delayed or absent passage should trigger further investigation of Hirschsprung's disease, cystic fibrosis, and imperforate anus.
Infants
- Safe sleep practices include supine positioning, preventing overheating, and avoiding objects in the crib.
- Plagiocephaly is a concern that can be prevented with changing positions.
- Pyloric stenosis is a condition requiring surgery, characterized by projectile vomiting
- Vaccination schedules include Hep B for newborns.
- Influenza vaccination is annually recommended but recommended age is 12 months.
- Hydrocephalus is characterized by bulging fontanels and dilated scalp veins.
- Tracheoesophageal fistula: feeding difficulties and respiratory concerns, often requiring surgery
- GERD: Frequent feedings and upright positioning are essential as needed.
- Hirschsprung's disease involves absence of nerves (no ganglion cells) in the bowel and leads to constipation and vomiting.
- Diaper dermatitis is characterized by satellite lesions-yeast infection is common. Monitor mouth for thrush.
Childhood Conditions
- Otitis media, risk factors, smoking, cleft palate, day care attendance.
- Bronchiolitis/RSV symptoms: monitor frequently to prevent risks of respiratory distress syndrome, nasal flaring, retractions, grunting, and rapid breathing.
- Airway obstruction, inability to speak, difficulty breathing.
- Poisoning issues-immediate medical attention & contact with poison control.
- Reye syndrome– avoid aspirin.
- Allergic reactions– epinephrine preparation.
- Epiglottitis– do not swab throat; urgent medical attention.
- Scabies and lice: contagious infections needing treatment for patient and their home environment.
- Burns: Degrees of burns, essential treatment measures include pain control, maintaining homeostasis, monitoring thermoregulation, and replacing fluids and electrolytes.
- Eczema/Dermatitis, treat dryness/infections with frequent baths, mild soaps and emollient.
- Head injury: frequent monitoring, assessing Glasgow Coma Scale, and addressing possible increased intracranial pressure (ICP).
Childhood Conditions (cont'd)
- Seizures, various types (generalized, complex partial, absence).
- Shingles – painful rash along dermatomes
- Diabetes Type 1 – rapid onset characterised by increased thirst, frequent urination, weight loss, and increased appetite.
- Scoliosis – if indicated bracing for 23 hours of the day
- Sickle cell anemia – inherited hemoglobin disorder; concerned for stroke.
- Osteomyelitis – bone infection with fever and bone pain, requiring IV antibiotics.
- Measles, symptoms (Koplik spots, rash, fever, cough, inflamed eyes, runny nose).
- Group A strep, symptoms (sore throat, fever, vomiting, rash)
- Appendicitis - acute abdominal pain, guarding, fever, vomiting increased white blood cell count (WBC)
Childhood Conditions (cont'd)
- Duchenne muscular dystrophy: progressive muscle weakness evident in preschool years.
- Leukemia - unrestricted proliferation of immature blood cells
- Hemophilia - deficiency of a clotting factor.
- Dehydration – weight loss of 10%, requires immediate IV replacement; increase of 1.5X for maintenance
- UTIs: frequent urination, pain, abdominal pain, fever, enuresis. Treatment includes adequate fluid intake prevention of constipation.
- Hypospadias – surgical repair.
- Following kidney transplant: monitor for signs of rejection, increased blood pressure.
- Nephrotic syndrome: weight gain, facial edema, irritability, decreased output.
Fractures
- fractures occur; torn blood vessels and blood clots, pain, swelling, deformity, decreased movement, change in sensation, color change, altered pulse/quality are symptoms.
- Initial management: immobilize, apply ice, loosen restrictive clothing, maintain NPO status, assess neurovascular status, and elevation.
- Simple vs. Compound fractures and education on cast care
- 5 Ps to assess ischemia (pain, pallor, pulse, paralysis, paresthesia).
Cardiac
- Congenital heart defects: increased risk for babies exposed to rubella during pregnancy.
- Coarctation of the aorta: lower blood pressure in the legs compared to arms
- Tetralogy of Fallot (a congenital heart defect)– Tet spells, squatting.
- Kawasaki disease: inflammatory condition with symptoms of fever, rash, and inflammation of the blood vessels.
- Cardiac catheterization post-procedure care – assessing for complications and maintaining patient stability.
- Digoxin administration: considerations related to missed doses.
Advocate and Educate
- Terminally ill patients: support families, provide pain relief and symptom relief, improving communication.
- Children with disabilities: promote independence and safe choices.
- Parental experience when dealing with chronic diseases – common: shock, denial.
- Child abuse: nurses are mandatory reporters.
- Shaken Baby Syndrome: prevention education.
Autism and Down Syndrome
- Autism Spectrum Disorder (ASD) – neurodevelopmental disorders, difficulties with social communication and unusual restricted behaviors, there is a genetic link of recurrence for the affected child.
- Down Syndrome: physical characteristics – protruding abdomen, broad short feet and hands, hypotonia, and developmental level-based activities.
- Increased risk of leukemia with Down syndrome, particularly in older women.
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Description
Explore vital aspects of pediatric nursing through this quiz, focusing on hospitalization stressors, family-centered care, and the importance of communication with children and families. Understand the developmental milestones and nursing interventions necessary for various age groups, from newborns to adolescents.
