Exam 2 Review: Pediatric Health Theory & Application PDF

lOMoARcPSD|40142722 Exam 2 Review Modules 3, 4, 5 Pediatric Health Theory & Application (Arizona College of Nursing) Scan to open on Studocu Studocu is not sponsored or endorsed by any college or university Downloaded by...

lOMoARcPSD|40142722 Exam 2 Review Modules 3, 4, 5 Pediatric Health Theory & Application (Arizona College of Nursing) Scan to open on Studocu Studocu is not sponsored or endorsed by any college or university Downloaded by James Jonez ([email protected])  lOMoARcPSD|40142722 Modules 3, 4, and 5 Review 1.) Med Math IV fluid maintenance 100 mL/kg/hr for the first 10 kg 50 mL/kg/hr for the next 10 kg 20 mL/kg/hr for every kg over 20 kg Calculate the following IV fluid maintenance: 1.) Child weighing 6 kg = 600 ml / 25 ml/hr 2.) Child weighing 20 kg = 1500 ml / 62.5 ml/hr 3.) Child weighing 15 kg = 1250 ml / 52.08 ml/hr 4.) Child weighing 4 kg = 400 ml / 16.6 ml/hr Hourly rate: divide by 24 hrs. Review your pediatric med math packet for dosage calculations. 2.) What is Munchausen by Proxy? (pg. 318) o (also known as factitious disorder imposed on another DSM-5) is when the caregiver, usually the mother attempts to make the child appear ill o May put blood in child’s urine, stool, or vomitus, or report made up symptoms to health care providers o Child should be put in the room with a camera so that the caregiver’s actions can be monitored 3.) Autism Spectrum Disorder – how do we care for children with this disorder?  Consistency, consistency, consistency  Positive reinforcement  Remain calm and patient  Introduce new situations slowly and prepare the child 4.) What is the definition of Oppositional Defiant Disorder? o Argumentative, disobedient, hates rules, stubborn, provokes others, angry (especially at authority), temper tantrums last hours, touchy, easily annoyed o Characterized by a persistent pattern of disobedience, argumentativeness, angry outbursts, low tolerance for frustration and tendency to blame other for misfortune Downloaded by James Jonez ([email protected])  lOMoARcPSD|40142722 5.) What is medical abuse? (pg. 27) o Also referred to as “pediatric condition falsification” o When the child is needlessly exposed to diagnostic therapeutic interventions for symptoms or conditions that have been exaggerated, totally fabricated or purposefully induced o May have multiple physicians 6.) Medications and treatments used to treat ADD and ADHD.  Methylphenidate  Dextroamphetamine  Psychostimulants that work to increase the dopamine and norepinephrine levels. (Both medications listed above)  Medications are used to treat the disorder and should be continued per physician’s orders.  Do not abruptly discontinue; serotonin discontinuation syndrome can be result of an abrupt withdrawal which can be fatal  LIFELONG MEDICATIONS AND AS PT. GETS OLDER MAY NEED ADJUSMENTS. * 7.) Signs of child abuse  Patterns from cords, rope, hands, wire  Bruising in different phases of healing  Bruising on non-ambulatory children  Bed wetting  Developmental delays 8.) Anorexia and depression – what should the nurse be looking for?  Health issues as a result of anorexia:  Anemia  Heart problems  Bone loss  GI problems 9.) ADHD/Bullying/Suicidal ideation – when to worry.  Children or adolescent statements regarding harm to self or others. States indicating that a child/adolescent is unhappy at school – ask open ended questions to determine why? Downloaded by James Jonez ([email protected])  lOMoARcPSD|40142722 10.) What do you see in children with attachment disorder? (pg. 303) o Severe colic and difficulty feeding resulting in failure to weight gain o Detached and difficulty being comforted o Difficulty in social situations o Failure to thrive o Anxiety o Reactive attachment disorder (characterized by the failure of a child younger than the age of 5 years to initiate or respond appropriately to caregivers and or social situations. As a result, caregivers then disregard the child’s physical and or emotional needs. 11.) What is the MacDonald Triad?  Pyromania (setting things on fire; indicates internal anger)  Cruelty to animals  Enuresis (bed wetting) 12.) Stress and coping in adolescents, what is the concern?  Child may no longer find excitement in things they once did. What is causing the change? Dig deep to investigate the cause, is it bullying, difficulties at home, etc.? 13.) Cystic Fibrosis – How is it diagnosed?  Sweat test 14.) Otitis media – what is the nurse concerned about? (pg. 191)  Otitis media with and without effusion o WITH: collection of non-infected fluid in the middle ear space o WITHOUT:  What is the treatment for OM with effusion? o Antibiotics o Topical antibiotics o Analgesics, antipyretics, adequate hydration.  What would the nurse be concerned about with OM with effusion? o Loss of hearing with fluid build up 15.) Priority assessments – what patient do I see first? o ABCs are always first 16.) MDI – read chapter 16 in your ATI book regarding use. Downloaded by James Jonez ([email protected])  lOMoARcPSD|40142722 o Remove cap from inhaler o Shake inhale 5-6 times o Attach spacer (to facilitate proper inhalation of medication) o Hold inhaler with mouthpiece at the bottom o Hold inhaler with the thumb near the mouthpiece and index and middle fingers at the top o Form seal around the MDI and take a deep breath and exhale o Press inhaler and being a slow deep breath that last 3-5 secs to facilitate delivery to air passages o Hold breath for approx. 5-10 secs o If additional puff is needed wait at least 1 min between puffs 16.) Epiglottitis – What are the 4 D’s? NEVER Examine the child’s throat when epiglottitis is suspected. Downloaded by James Jonez ([email protected])  lOMoARcPSD|40142722 17.) Features of Down’s Syndrome. 18.) What is a common side effect of taking antibiotics?  Risk of candida due to antibiotics disrupting the normal balance of bacteria.  Yeast infection: thrush (use Nystatin to treat) 19.) Interventions for respiratory infections? o Rest o Fluids o Medications (Tylenol) o Suction o HOB elevated 20.) What is trisomy 21?  Genetic disorder that results in extra genetic material from chromosome 211 21.) Asthma – signs and symptoms, interventions (pg. 206) o S/S: o SOB o Airway obstruction o Wheezing o Prolonged expiration o Nasal flaring o Retractions Downloaded by James Jonez ([email protected])  lOMoARcPSD|40142722 o Interventions: o Bronchodilators o Steroids 22.) STI’s and risky behaviors  Sexual activity at an early age and with many different partners.  Oral/anal sex does not protect from STI’s. 23.) Peak Meter Flow – What is it and what does it tell us? o Portable handheld device measures ability to push air out of the lungs o Measures how much maximum airflow out of your lungs 24.) Hypospadias  Condition where the urethra is on the underside of the penis instead of being properly located on the tip.  Requires surgery to correct the flow of urine (age for surgical repair is 6-12 months)  25.) What does ground glass indicate on a chest x-ray? o Pneumonia o Respiratory distress 26.) Emergency department priority patients o Resp. distress o Shock o Appendicitis o RSV o Cyanosis 27.) Croup – how do we treat? Downloaded by James Jonez ([email protected])  lOMoARcPSD|40142722 o Inflammation in upper airways o Let it run its course and treat symptoms o Cool mist o Antipyretics 28.) RSV and bronchiolitis o Acute inflammation of the bronchi and usually caused by virus o Suction o Humidification o I&Os 29.) Infant cyanosis o Medical emergency o Give O2, resuscitative equipment 30.) What are the signs and symptoms of testicular torsion? (pg. 421) o Internal twisting of the testicles o Most commonly affects adolescent boys ages 12 to 18 o S/S: o Sudden severe pain in scrotum lower abdomen, and groin area o Swelling and slightly elevated o N/V o Discoloration o Surgical emergency within 6 hours of onset of symptoms to preserve testes 31.) Uncircumcised males – what are common problems?  Cleanliness of foreskin  Do not force the foreskin back as it may cause swelling to the penis not allowing the foreskin to be placed back in pre-retracted position.  In most cases the foreskin will expand with age. 32.) Syphilis – Why are we concerned? o Neurological issues o Stillbirth o Prematurity o Rash o Congestion and chronic rhinitis 33.) Turner’s syndrome – signs and symptoms and how is puberty affected? What would be the treatment if puberty is affected? (pg. 427) Downloaded by James Jonez ([email protected])  lOMoARcPSD|40142722 o Lose an entire X chromosome o Only affects girls o S/S: o Prematurity o Feeding difficulties, with spitting, emesis, and difficulty latching on o Gastroesophageal reflux and failure to thrive o Treatment: o Hormones: estrogen 34.) FASD – what do infants struggle with?  FASD infants struggle to suck, swallow and breath all at the same time 35.) Inguinal hernia’s – what are they and what causes them? o Protrusion of contents through a defect or opening through intra-abdominal contents o Causes: o Weak abdominal wall o Straining o Pressure o Lifting o 36.) Opportunities for education in pediatrics.  Pay close attention to what parents/caregivers are verbalizing, as this may need follow up education from the nurse. An example would be: My child no longer needs the medication because they feel better. 37.) When should steroids be used and for what conditions?  Steroids are often prescribed to decrease inflammation. An example would be in a child with asthma that is not fully responding to nebulizers. Downloaded by James Jonez ([email protected])  lOMoARcPSD|40142722 38.) Varicocele – what is it and when do we intervene? o Painless collection of dilated and twisted veins in scrotum o Only need surgery when caused pain or swelling o S/S: o May be asymptomatic o Dull ache or fullness of the scrotum 39.) 40.) Epispadias o When the bladder is on the outside of the body and must be surgically repaired o Require surgery during the first year of life o When surgery is done make sure bladder is covered and kept moist o Downloaded by James Jonez ([email protected])  lOMoARcPSD|40142722 o QUESTIONS: The nurse should assess a child that had a tonsillectomy for: Frequent swallowing A parent of a toddler calls the nurse asking about croup, what is a distinguishing manifestation of spasmodic croup: barking cough 9-year-old girl diagnosed with cystic fibrosis which of the following must the nurse keep in mind when developing a care plan for this child: pulmonary secretions are abnormally thick  DO NOT WANT TO GIVE THEM ZYRTEC OR MEDS TO DRY UP SECRETIONS Veronica’s parents were told that their daughter needs Ribavirin, this drug is used to treat which of the following: RSV Fred is a 12-year-old boy diagnosed with pneumococcal pneumonia which of the following would the nurse expect to assess: chest pain When planning care for a 4-month-old child admitted for resp. distress caused by RSV and bronchiolitis it is essential to include which of the following: Ensure adequate hydration A humidified atmosphere is recommended for a child with an upper respiratory tract infection because: soothes inflamed mucous membranes An appropriate nursing intervention when caring for a child with pneumonia is which of the following: monitor resp. status frequently Which statement accurately expresses the genetic implications of cystic fibrosis: if it is present in a child both parents are carriers of the defective gene What behavioral factors cause adolescents to be at a higher risk of STIs SATA: multiple partners, new partners, partners with multiple other partners, inconsistent use of condoms What is the purpose of a peak flow meter: to measure the ability of the lungs to push air out What test confirms cystic fibrosis: Sweat test What are the characteristics of a hydrocele SATA: Scrotum is fluid filled, in most cases resolves by 1 year of age Downloaded by James Jonez ([email protected])  lOMoARcPSD|40142722 Downloaded by James Jonez ([email protected])