Neonatal Abstinence Syndrome (NAS) PDF

Infant neonatal abstinence syndrome (NAS) Jaundice HYPERBILIRUBINEMIA: AN EXCESSIVE LEVEL OF...

Infant neonatal abstinence syndrome (NAS) Jaundice HYPERBILIRUBINEMIA: AN EXCESSIVE LEVEL OF ACCUMULATED BILIRUBIN IN THE BLOOD AND IS CHARACTERIZED BY JAUNDICE, OR ICTERUS, A YELLOWISH DISCOLORATION OF THE SKIN AND OTHER ORGANS. An infant with severe jaundice/ hyperbilirubinemia is at risk for developing → encephalitis Choking - If child seems to be choking, open mouth and Herpes simplex virus check if you notice anything blocking their airway. s/s: presents normally @ 1 week, with fever, vesicular - If not, turn baby facing down on forearm rash, and poor feeding, lethargy. and give 5 black blows. ( check hairline if there is a rash. ) - Turn back around and give 5 abdominal thrusts. - If not breathing, begin CPR. CPR If find a child/baby unconscious and unresponsive no one near by, what should you do? → start CPR, for 2 minutes then → call 911 check response by tapping foot Open airway and assess breathing If not breathing start CPR Call 911, ask for help 30 compressions 2 rescue breaths Continue until help arrives  Pain FLACC score, stands for? Where do we give vaccines? Where do we NOT give vaccines? We GIVE vaccines on the lateral side of thigh. We DO NOT GIVE vaccines on the buttocks (dorsal gluteal), it does not have the best absorption. Developmental stages Adolescents are trying to develop what ? an identity Toddler  💪 Respiratory Asthma Cystic fibrosis Emergent interventions asthma: Albuterol, oxygen, iv access pancreatic enzymes High protein, high calorie Small frequent meals Chest physiotherapy Muscle / skeletal Fracture Pulmonary embolism s/s: dyspnea & chest pain, ect. Most likely to occur in long bone fractures (femur!!) Casting Tx club foot: serial casting and possible surgery  ⬇ ⬆ ⬇ Cardiac ➸ Coarctation of the aorta Localized narrowing near the insertion of the ductus arteriosus resulting in increased pressure proximal to the defect and decreased pressure distal to the defect. What are symptoms? → beat red Bounding pulses up top, poor pulse No pulse Cold, pale Blue ➸ Tetralogy of fallot * ➸ Patent ductus arteriosus (PDA) Blue or pink baby? → pink Which way blood flowing? → Failure of the fetal ductus arteriosus to close in the first weeks of life. Allows blood to flow from the higher pressure aorta to the lower pressure pulmonary artery, causing left to right shunt What complications, continues to go on, what problems? → respiratory ➸ PDA Why do surgery for PDA? What complication? Pulmonary congestion!!!!  🍓 Blood · Kawasakis disease Complication of Kawasaki ? aneurysm Sickle cell anemia Gastointestinal (GI) Hirchsprungs disease Lack of peristalsis in the large intestine and the accumulation of bowel contents leading to abdominal distention large intestine missing ganglion cells Pyloric stenosis Patho: the circular muscle of the pylorus thickens and results in hypertrophy Signs/ symptoms: nonbilious projective vomit Visible peristalsis Failure to thrive in infant who is “always hungry” Dehydration Weight loss  Genito urinary (GU) Prevention of post steptoccocal glomerular nephritis? take full course of antibiotics to help prevent spread Endocrine Hypo pituitary, when are they given it and how much ? once daily and at night DKA Tx: Insulin & IV fluids Diabetes insipidus (DI) vs. SIADH ADH ADH Diagnosis: Dehydration Diagnosis: Fluid overload  🤕 🧠 🏈 Neuro Ventriculoperitoneal Shunt (VT) Sustains Concussion at practice. advise against playing → Vomiting, Headache, Irritability, Fever , again why? Redness along shunt line, Fluid around shunt → risk for future concussions valve, Change in LOC Shunt malfunction or infection requires immediate treatment Screening TBI ? Pupillometry and Glasgow coma scale (GCS) Glasgow coma scale Unconscious Child Airway, breathing, circulation Emergency management Seizure precautions Reduction of ICP get on the ground, Treatment of shock turn on side, Outcome nothing in mouth, Recovery clear area so can’t hit anything ↳ Increased intracranial pressure Closed head injury, findings showing increased ICP?  Total maintenance fluids Calculate child’s weight in kg Allow 100 ml/kg for first 10 kg body weight Allow 50 ml/kg for second 10 kg body weight Allow 20 ml/kg for remaining body weight Example: → practice yourself!! 21 kg 18 kg Other math practice: calculate dose per Kg per day If dose per day-divide by how many doses a day Dose over hand-given the dose, must calculate the amount to give based on availability Group project questions PKU 1. A nurse is educating the parents of a child with PKU. Which statement indicates the parents understand the dietary restrictions required for their child? A) "Our child can have milk and cheese in moderation." B) "We should avoid all high-protein foods like meat and eggs." C) "Our child needs a high-protein diet to build muscle." D) "We only need to restrict foods for the first two years of life." 2. True or False Newborn screening for PKU is not necessary in countries with low prevalence rates. 3. The nurse is providing education about the treatment options for PKU. Which statement by the parent requires further teaching? A) "We will need to monitor our child's phenylalanine levels regularly." B) "Kuvan might help our child tolerate more phenylalanine." C) "Dietary management is only needed for a few years." D) "Gene therapy is being researched, but the long-term effects are still unclear."  Juvenile arthritis Which of the following symptoms would the nurse most likely observe in a child with juvenile arthritis? a) Persistent fever and weight gain b) Joint stiffness and swelling, particularly in the morning c) Sudden weight loss and fatigue d) Muscle spasms and difficulty walking 2.Which diagnostic test would the nurse expect the healthcare provider to order for a patient suspected of having juvenile arthritis? a) MRI scan b) Liver function test c) Hemoglobin A1c d) Chest X-ray 3.The nurse is providing education to a family of a child newly diagnosed with juvenile arthritis. Which statement by the parents indicates a need for further education? a) "We will ensure our child takes medication as prescribed." b) "Physical therapy and regular exercise will be part of our routine." c) "We don’t need to worry about uveitis since our child doesn't have eye symptoms." d) "We will monitor for signs of joint stiffness, especially in the morning." Neuroblastoma What is the most common presenting symptom of neuroblastoma in a child? a) Persistent cough b) Abdominal mass c) Frequent urination D) skin rash 2. A child with neuroblastoma is receiving chemotherapy. Which of the following nursing interventions is most important? a) Encouraging physical activity b) Monitoring for signs of infection c) Restricting fluid intake d) Administering pain medication as needed 3. When educating parents about the signs of neuroblastoma relapse, which symptom should the nurse include? a) Increased appetite b) Bone pain c) Hyperactivity d) Hair loss  Scoliosis 1) Nursing care directed toward nonsurgical management in a teenager with scoliosis primarily includes: A.Promoting self-Esteem and positive body image. B.Preventing immobility. C.Promoting adequate nutrition. D.Preventing Infection 2) Diagnostic evaluation is important for early recognition of scoliosis. Which of the following is the correct procedure for a school nurse conducting this examination? A.View the child who is standing and walking fully clothed, to look for uneven hanging of clothing. B.View all children from the left and right side to look mainly for asymmetry of the hip height. C.Completely undress all children before the examination. D.View the child who is wearing underpant/shorts, from behind when the child bends forward at the waist. 3) Marilyn, age 12 years, has been diagnosed with scoliosis and placed in a thoracolumbosacral orthotic (TLSO) brace. Which of the following information provided by the nurse tp Marilyn is correct? A.“The brace will cure you curvature.” B.“The brace is an underarm brace made of plastic that will be molded and shaped to your body to prevent worsening of the curvature.” C.“The brace includes a neck ring to extend the neck.” D.“The brace will only be worn in bed, since it prevents walking because of the severity of the trunk bend.” Leukemia 1) The most common signs and symptoms of leukemia related to bone marrow involvement are which of the following? A. Petechiae, fever, fatigue B. Headache, papilledema, irritability C. Muscle wasting, weight loss, fatigue D. Decreased intracranial pressure, psychosis, confusion 2) What are the needs of the patient with acute lymphocytic leukemia? A. to a private room so she will not infect other patients and health care workers B. to a private room so she will not be infected by other patients and health care workers C. to a semiprivate room so she will have stimulation during her hospitalization D. to a semiprivate room so she will have the opportunity to express her feelings about her illness 3) The nurse analyzes the laboratory values of a child with leukemia who is receiving chemotherapy. The nurse notes that the platelet count is 20,000/ul. Based on the laboratory result, which intervention will the nurse document in the plan of care? A. Monitor closely for signs of infection B. Monitor the temperature every 4 hours C. Initiate protective isolation precautions D. Use soft small toothbrush for mouth care  Autism 1) A nurse is providing education about Autism Spectrum Disorder (ASD) to a parent support group. Which statement by the nurse is most accurate regarding the prevalence of ASD? a) ASD affects 1 in 100 children in the United States. b) ASD is equally common in boys and girls. c) About 1 in 36 children are identified with ASD. d) The prevalence of ASD has remained stable over the past two decades. 2) A nurse is assessing a 2-year-old child for potential signs of Autism Spectrum Disorder (ASD). Which of the following observations is MOST concerning for ASD? a) The child has occasional tantrums. b) The child does not respond to their name when called. c) The child is shy around strangers. d) The child has a favorite toy they like to play with. 3) A nurse notices that a 2-year-old child is not speaking and avoids eye contact. What should be the next step in assessing for ASD? a) Wait until the child is older to assess for developmental delays. b) Refer the child for an autism screening. c) Provide the family with information on speech therapy. d) Advise the parents to avoid overstimulation. Trisomy 21 (Down Syndrome) 1) A nurse is providing prenatal education to a couple expecting their first child. The mother’s prenatal screening results indicate a high risk for Down syndrome (Trisomy 21). Which of the following diagnostic tests would the nurse explain as providing a confirmatory diagnosis for this condition? A. Quad screen B. Non-invasive prenatal testing (NIPT) C. Chorionic villus sampling (CVS) D. Nuchal translucency ultrasound 2) A nurse is providing discharge teaching to the parents of a child with Down syndrome. Which statement by the parents indicates a need for further education? A) "We will ensure our child has regular checkups for hearing and vision." B) "We will start early intervention programs to help with motor and speech development." C) "We don’t need to worry about heart problems since they don’t commonly occur in Down syndrome." D) "We will work with the school to ensure our child receives the support needed in the classroom." 3) The nurse is assessing a child with suspected trisomy 21. Which of the following findings would support this diagnosis? (Select all that apply.) 1.White spots on the iris (Brushfield spots) 2.Long neck and small jaw 3.Small ears and short neck 4.Short stature and poor muscle tone 5.High-pitched cry 6.Single crease across the palm of the hand