Peds E2 Quizlet TW PDF

Oxygen induced carbon dioxide necrosis ? = Oxygen-induced carbon dioxide narcosis happens when too much oxygen causes someone with a chronic lung disease to stop breathing enough, leading to a dangerous buildup of carbon dioxide in the blood. Oxygen Therapy for kiddos Least Invasive to Most Invasiv...

Oxygen induced carbon dioxide necrosis ? = Oxygen-induced carbon dioxide narcosis happens when too much oxygen causes someone with a chronic lung disease to stop breathing enough, leading to a dangerous buildup of carbon dioxide in the blood. Oxygen Therapy for kiddos Least Invasive to Most Invasive ? = High Flow Oxygen ( Most Invasive) Binasal Canula Mask Blow-by (Least Invasive) Pulse Ox (Monitoring Oxygen Therapy) Where do we put the probe? What percent does it read up to? What is it synchronized with? ? = -We put the probe on the big toe or around the foot. Cover up with a sock as they get older and start messing with things. -It does not read above 100% -Synchronized with heartbeat- treat the patient not the machine End-Tidal Carbon Dioxide Monitoring What does it do? What's the normal range? Why do we use them? ? = -Measures the exhaled carbon dioxide non invasively -Normal: 30 to 43 -Why do we use them? Asthma patients, intubation, etc. Helps see if patient is blowing off CO2 properly or if they are retaining it (we don't want them to retain it). Postural Drainage & Chest Physical Therapy What does it do? ? = Helps MOVE mucus, Encourage clients to cough or huff forcefully, Use of chest physical therapy HELPS postural drainage Postural Drainage & Chest Physical Therapy when to do it? ? = Perform before meals or 1- 1.5 hours after eating (don't want them to vomit or aspirate) Suctioning what's the proper way to do it? ? = Proper way to suction: one nurse holds baby's head, the other instills saline into one Nare and lightly suctions. Then let baby recover for a minute. Proceed with the other nostril. When do we suction? ? = Before feeding and before bedtime (so the baby can eat and sleep without a stuffy nose.) General Care: What are signs of Respiratory deterioration? ? = Stridor, grunting, nasal flaring, increased use of accessory muscles, increased WOB What's normal temp? and what temp is considered fever? ? = Normal temp is about 98.6°F (37°C) Fever starts at 100.4°F (38°C) What ages can receive Ibuprofen? ? = ibuprofen 6 months and older Topical vapor rubs are for clients older than? ? = older than 2 years old Peak Flow Monitor Green, Yellow, Red Zone Meaning? ? = -Green zone=__GOOD/Doing Well___ - Yellow zone= _CAUTION/Getting Worse_. If in the yellow zone after several measure of peak flow, use an inhaled SABA - Red Zone=__*DANGER*/Medical Alert__. Take an inhaled SABA right away, call your HCP and ask what to do, or go directly to the ED HOW TO USE A PEAK FLOW METER Steps? ? = 1) move the indicator to the bottom of the numbered scale 2) stand up 3) take a deep breath, filling your lungs completely 4) place the mouthpiece in your mouth and close your lips around it but do not put your tongue in the hole 5) blow out as hard and fast as you can in a single blow Write down the number you get.But if you cough or make a mistake do not write down the number. Perform the action again Repeat steps 1 through 5 two more times.Write down the best of the 3 blows in your asthma diary Therapeutic Management (oral rehydration therapy) for mild to moderate what can we give? ? = Oral Replacement Solution/Pedialyte, Gatorade, etc. Therapeutic Management (oral rehydration therapy) Parenteral fluid (severe) what do we give? ? = Isotonic - LR or 0.9% NS (no D5W during early phase esp. during DKA) ▪ 20ml/kg bolus over 5 to 20 minute & can repeat then maintenance ▪ Potassium is withheld until kidney function improves (greater than 100ml/day) ▪ Acid-base status is improved via the administration of fluid or indirectly through improved renal function Water intoxication watch for what CNS symptoms ? = Be careful - watch for CNS symptoms(confusion or seizures) Most can be prevented via education Acute streptococcal pharyngitis symptoms? ? = -Sudden onset of sore throat ▪ Difficulty swallowing ▪ Fever (often high) ▪ Headache ▪ Abdominal pain (especially children) ▪ Nausea or vomiting ▪ Swollen lymph nodes in the neck -Red and swollen tonsils, sometimes with white patches or streaks of pus -Petechiae on the soft palate -Swollen uvula Absence of cough (differentiating factor from viral sore throat) Therapeutic Management for Acute streptococcal pharyngitis? ? = Antibiotics: -First-line Treatment: Penicillin or Amoxicillin (for strep throat). -Alternatives: Cephalexin (for those allergic to penicillin) or Clindamycin. -Duration: Typically 10 days for oral antibiotics. Acute streptococcal pharyngitis Symptomatic Relief: Pain management: ? = - Acetaminophen or ibuprofen for pain and fever. -Throat soothing: Warm saltwater gargles, throat lozenges, or sprays. Acute streptococcal pharyngitis Hydration ? = Encourage adequate fluid intake to prevent dehydration. Acute streptococcal pharyngitis Isolation: ? = Patients are usually contagious until 24 hours after starting antibiotics. Acute streptococcal pharyngitis Follow-Up: ? = Reassessment after 48-72 hours to ensure resolution of symptoms. Acute streptococcal pharyngitis Assessment: ? = -Monitor vital signs, especially temperature and heart rate. -Assess throat for signs of swelling, redness, and exudate. -Monitor for signs of dehydration, especially in children. Acute streptococcal pharyngitis Education: ? = -Teach about the importance of completing the full course of antibiotics. -Educate on symptoms to monitor for potential complications (e.g., rheumatic fever, post- streptococcal glomerulonephritis). Acute streptococcal pharyngitis Comfort Measures: ? = -Provide comfort measures, such as warm compresses to the throat and soothing foods. -Encourage rest and quiet activities. Acute streptococcal pharyngitis Infection Control: ? = -Implement standard precautions to prevent the spread of infection. -Instruct the patient on hand hygiene and avoiding close contact with others until no longer contagious. Acute streptococcal pharyngitis Support: ? = Provide emotional support and reassurance, especially for children experiencing pain and anxiety related to their illness. Tonsillitis - tonsillectomy What is my main worry? ? = Bleeding/Hemorrhage. The 1st risk of bleeding is in the first 24 hours and the second risk is within the first 7 days. Pt education is crucial. Tonsillitis - tonsillectomy How am I going to handle it? ? = PREVENTION: Soft diet No red foods Cold fluids Maintain the airway Assess for continuous or repetitive swallowing or vomiting of blood. If you see signs of hemorrhage, keep patient on their side, elevate HOB, suction LIS buccally (nothing deep) page surgeon immediately. Educate caregivers on PREVENTION and signs of hemorrhage. Tonsillitis - tonsillectomy what should be worried about? ? = Also worried about dehydration risk. (patient might not want to drink much because their throat hurts.) Acute epiglottitis How will my patient present? ? = Drooling, dysphonia (muffled voice), and dysphagia (trouble swallowing) Pt might also be in tripod positioning. Maintain that airway. Acute epiglottitis What is my main worry? ? = Patient's airway. Acute epiglottitis What am I going to do about it? ? = -Call Respiratory and HCP. -Maintain the patient's position. -DO NOT examine the throat or use an oral thermometer (prevent laryngospasm). -Prep for emergency intubation or tracheostomy. -Patient education: Hib vaccine to prevent, respiratory distress, and watch for drooling, tripoding, etc. Acute laryngotracheobronchitis (Croup) How will my patient present? ? = -barking cough -hoarseness -inspiratory stridor -low grade fever. -Symptoms are often worse at night and may improve with cool air or mist. -Symptoms get worse at about 5-7 days and then improve. Acute laryngotracheobronchitis (Croup) Therapeutic Management ? = -hydration -fever control -reducing inflammation -cool mist/air -maintain airway Acute laryngotracheobronchitis (Croup) Nursing Care: ? = -Assess for stridor, -respiratory distress, -hydration, -administer cool mist, -corticosteroids as ordered, and racemic epinephrine through a nebulizer mist for severe stridor if ordered in the ER (monitor because this can cause rebound constriction), positioning. Caregiver education on respiratory distress S/S such as stridor, nasal flaring, accessory muscle use, head bobbling, etc, refusing to eat and drink, etc. Acute spasmodic laryngitis How Will My Patient Present? ? = Symptoms: -Sudden onset of a barking cough. -Stridor (a high-pitched wheezing sound) when breathing in. -Hoarseness. Difficulty breathing, especially at night. Fever (often mild). Restlessness or irritability. Signs are usually worse at night and may improve during the day. Possible signs of respiratory distress (e.g., retractions, increased respiratory rate). Acute spasmodic laryngitis Therapeutic Management Medications: ? = Corticosteroids (e.g., dexamethasone) to reduce airway inflammation. Nebulized epinephrine for severe cases to relieve stridor. Acute spasmodic laryngitis Therapeutic Management Supportive Care: ? = -Encourage calmness to reduce anxiety. - Humidified air (using a humidifier or steam from a hot shower). - Ensure hydration, preferably with clear fluids. Acute spasmodic laryngitis Observation: ? = Monitor for worsening respiratory distress or inability to maintain oxygen saturation. Acute spasmodic laryngitis Nursing Care Assessment: ? = Regularly monitor respiratory status (e.g., breathing patterns, stridor, oxygen saturation). Observe for signs of respiratory distress. Acute spasmodic laryngitis Education: ? = Educate caregivers about recognizing signs of worsening condition and when to seek emergency care. Acute spasmodic laryngitis Comfort Measures: ? = -Provide reassurance and a calm environment - Encourage fluid intake and soft foods if tolerated. Acute spasmodic laryngitis Infection Control: ? = Follow standard precautions to prevent the spread of infections. Respiratory syncytial virus and bronchiolitis How Will My Patient Present? ? = Symptoms: -Nasal congestion and runny nose. -Cough that may become more severe. -Wheezing and difficulty breathing. -Fever, often mild to moderate. -Irritability or fussiness in infants. -Respiratory distress: increased work of breathing, retractions, and nasal flaring. Cyanosis (in severe cases). Respiratory syncytial virus and bronchiolitis Supportive Care: ? = -Hydration: Ensure adequate fluid intake to prevent dehydration. -Nasal suctioning: To clear mucus and improve breathing. -Humidified air: To ease breathing. Respiratory syncytial virus and bronchiolitis Medications: ? = -Bronchodilators: May be used in some cases (not universally effective). -Corticosteroids: Considered in severe cases with wheezing. -Ribavirin: An antiviral that may be used in high-risk patients, though its use is limited. Respiratory syncytial virus and bronchiolitis Hospitalization: ? = May be required for severe cases with significant respiratory distress, oxygen support, or feeding difficulties. Respiratory syncytial virus and bronchiolitis Assessment: ? = -Monitor respiratory status (e.g., respiratory rate, oxygen saturation, work of breathing). -Assess hydration status and fluid intake. Respiratory syncytial virus and bronchiolitis Education: ? = Inform caregivers about RSV, its transmission, and when to seek medical attention. Respiratory syncytial virus and bronchiolitis Comfort Measures: ? = -Provide comfort and reassurance to both child and caregivers. -Administer medications as prescribed. Respiratory syncytial virus and bronchiolitis Infection Control: ? = Practice strict hand hygiene and use of personal protective equipment (PPE) to prevent the spread of RSV. Asthma How Will My Patient Present? Signs and Symptoms? ? = Symptoms: -Wheezing (a high-pitched whistling sound when breathing). -Coughing, especially at night or early morning. -Shortness of breath or difficulty breathing. -Chest tightness or pressure. Signs: -Increased respiratory rate. -Use of accessory muscles for breathing. -Possible prolonged expiration phase. Asthma Medications: ? = -Quick-relief (rescue) inhalers: Short-acting beta-agonists (e.g., albuterol) for immediate symptom relief. -Long-term control medications: Inhaled corticosteroids, leukotriene modifiers, or long- acting beta-agonists. Asthma Monitoring: ? = Use of a peak flow meter to monitor lung function and recognize worsening asthma. Asthma Action Plan: ? = Develop a written asthma action plan for managing symptoms and recognizing triggers. Asthma Assessment: ? = -Regularly monitor respiratory status (e.g., wheezing, oxygen saturation). -Assess triggers and identify factors contributing to exacerbations. Asthma Education: ? = -Teach proper inhaler technique and adherence to medication regimens. - Educate about avoiding known triggers (e.g., allergens, smoke, exercise). Asthma Support: ? = -Provide emotional support and reassurance to patients and families. -Encourage regular follow-up with healthcare providers. Asthma Crisis Management: ? = -Be prepared to act in case of an asthma attack, including administering rescue medications and contacting emergency services if necessary. Cystic fibrosis What does my client look like? ? = -Chronic cough -wheezing, -recurrent lung infections -Malabsorption -failure to thrive -clubbing of the fingernail - barrel chest later on in life -electrolyte imbalances -salty-tasting skin -meconium presence in ileus in newborns. Cystic Fibrosis Therapeutic Management: ? = hydration, nutrition, infection control, hand hygiene, medication adherence, daily chest PT, pancreatic enzymes every time they eat (even a snack) Cystic Fibrous Nursing Care ? = hospitalized stressor management, hydration, nutrition, oxygenation, chest PT daily routine, airway clearance, administer bronchodilators, hand hygiene, infection risk, mucolytics, high calorie, high protein diet. Iron deficiency What is it? ? = Lack of RBC production due to iron deficiency in the blood. Therefore, the body's organs don't get enough oxygen. Iron deficiency What does my client look like? ? = Pale, irritable, fatigue, lethargic in severe cases, behavioral changes Iron def Therapeutic management: ? = limit cows' milk to 16-24oz per day, iron supplements with Vit C, increase dietary iron, protect teeth if using the liquid supplement by using an oral syringe. Better to give iron on an empty stomach. Only give with food to decrease GI upset, something high in vit C like juice or an orange. Can do IV or deep IM if oral supplementation does not work. Iron deficiency Nursing role: ? = -Educate patient/care give stool darkening being normal. -Educate on proper storage of iron due to risk of toxicity/overdose. -Educate on how to handle the medication and best ways to take it. -Educate on dietary sources such as leafy greens and red meats. -Stools will darken and H/H will improve if compliant. -Symptoms will improve if compliant. -Most are not treated in the hospital. Sickle cell what is it? ? = Genetic condition where red blood cells are shaped like sickles instead of round, which causes them to get stuck in blood vessels, blocking blood flow. The sickled cells also break down faster, leading to lower red blood cell counts. Sickle cell The Vaso occlusive crisis (VOC) ? = preferably called a "painful episode," is characterized by ischemia causing mild to severe pain that may last from minutes to days or longer. Dactylitis (swelling in hands and feet) is often the first painful manifestation of VOC in children, usually occurring from 6 months to 2 years old. Sickle cell Sequestration crisis ? = is a pooling of a large amount of blood, usually in the spleen and infrequently in the liver, that causes a decreased blood volume and may ultimately cause shock(hypovolemic) Sickle cell Aplastic crisis ? = is diminished RBC production, usually triggered by viral infection that may result in profound anemia. Will affect oxygenation due to low production of RBCs. Sickle cell Hyper hemolytic crisis ? = is an accelerated rate of RBC destruction characterized by anemia, jaundice, and reticulocytosis. Sickle cell Acute Chest Syndrome: ? = when a pt has pulmonary infiltrates that look a lot like pneumonia, and it causes extreme chest pain for the patient. Sickle cell Therapeutic management ? = Pain control, oxygenation, hydration, prophylactic antibiotics, vaccines, blood transfusions in severe cases, hydroxyurea prescription to reduce crises. Sickle cell The main objectives are to provide ? = (1) rest to minimize energy expenditure and to improve oxygen use; (2) hydration through oral and IV therapy; (3) electrolyte replacement because hypoxia results in metabolic acidosis, which also promotes sickling; (4) analgesia for the severe pain from Vaso occlusion; (5) blood replacement to treat progressing severe anemia; and (6) antibiotic therapy to treat any existing infection. - Don't forget to prioritize on what's best to do first. Hemophilia What is it? ? = A genetic disorder where the blood doesn't clot properly because it's missing a special protein needed for clotting. Hemophilia What does my client look like? ? = -Bleeding -Bruising -Petechiae -Swollen joints and pain -Hematomas Hemophilia Therapeutic management ? = -Replace missing clotting factors (VIII or IX) -Avoid NSAIDS and activities that risk bleeding, -RICE -Education on safe activities and injury prevention. Hemophilia Nursing role ? = -Monitor for bleeding: assess for any signs of bleeding (gums, nose, joints); chest for bruising and hematuria. -Administer factor replacement therapy: give clotting factors via IV promptly when needed - Educate on bleeding prevention: avoid contact sports & NSAIDS. Wear protective gear. Electric razors instead of handheld or straight. Soft bristle brushes. Caution with nail clippers. -RICE for joint bleeds. -Be cautious with IM injections. If you can give SQ then do that. -Start IVs only if needed. Epistaxis What is it? ? = Blood vessels inside the nares bleed due to trauma, dry air, allergies, foreign body, clotting disorders. Epistaxis What does my client look like? ? = -Anxiety in patient or caregiver, nasal bleeding (duh), possible snycope Epistaxis Therapeutic management ? = -Lean forward, pinch the bridge of the noes, and apply ice -Humidify air and use nasal saline to prevent dryness -Educate on nose picking and refraining from blowing nose. -Seeking medical care if prolonged or recurrent bleeding. Epistaxis Nursing role ? = Patient education, positioning, and therapeutic communication. -Calm & reassure the child to reduce anxiety and prevent worsening bleeding. -Position properly to prevent swallowing blood or aspiration. -Monitor for underlying issues and prevent future bleeds. Immune thrombocytopenic purpura (ITP) what is it ? ? = Low platelets.Typically seen in patients diagnosed with viral illness 3-4 weeks prior. Immune thrombocytopenic purpura (ITP) What does my client look like? ? = Easy bruising , petechiae, mucosal bleeding, low platelet count Immune thrombocytopenic purpura (ITP) herapeutic management ? = -Prednisone, - IV IG, -antiplatelet, -antibody D (given over a shorter amount of time and it protects the platelet from the antibody breaking it down) Immune thrombocytopenic purpura (ITP) Nursing role ? = Monitor platelet counts and bleeding. Corticosteroids and IVIG. Educate on contact sports,aspirin, and risk of bleeding. Platelet transfusions only in life-threatening bleeding. Leukemia (Acute lymphoblastic leukemia) Chemotherapy ? = can be the primary form of treatment or maybe an adjunct therapy. **Not selectively cytotoxic for malignant cells **Vesicants. Chemo will attack all cells, even the healthy ones. Especially the fast-growing ones such as hair, skin, nails, and GI tract. Leukemia (Acute lymphoblastic leukemia) Biologic Therapy ? = made from living organisms A good example is immunotherapy (simulates the immune response). Boosts your natural immunity. Leukemia (Acute lymphoblastic leukemia) Hematopoietic Stem Cell Transplant (HSCT) ? = Replaces stem cells in children who take high doses of chemo/radiation or to replace dysfunctional bone marrow. **Remember stems cells can be donated or retained and then stored from the patient. **Huge process!!! (wiping them clean and then transplanting stem cells into them, hoping their body takes it to start producing healthy cells instead of cancerous cells.) Leukemia (Acute lymphoblastic leukemia) Common Acute Side Effects of Treatment: ? = - Infection - **fever with absolute neutrophil count lower than 500/mm3- we have a problem!!! -Hemorrhage - Administration of platelets and prevention is the key -Anemia - Administration PRBC **best to let the child self-regulate activity -Nausea & vomiting - Jump on it before it starts! Numerous drugs can be used (serotonin receptor blockers, antihistamine) -Mucosal ulceration - Ulcers along the track **be careful with viscous lidocaine *soft, bland diets - Neurologic problems - constipation **opioids can cause further problems, foot drop, jaw pain (gum will help) -Hemorrhagic cystitis - increase fluid intake (either IV or oral) & freq. voiding, administration of chemo early in the day (this is so that the chemo does not sit in the GU system overnight) -Alopecia - hair loss - educate your client and family about options -Steroid effects - physical changes and alterations in body image Acute Lymphoblastic Leukemia (ALL) Clinical Manifestations: ? = -Huge /extreme!! (a common cold does not go away to pale and lifeless) **found by accident - **Anemia, infection, bleeding - reason for S & S Acute Lymphoblastic Leukemia (ALL) How is it diagnosed? ? = Peripheral blood smear that contains leukemic blasts in combo with low blood counts.*Definitive - bone marrow and then LP to test CNS involvement▪ Then clinical staging and prognosisis determined▪ Staging - Immunophenotyping▪ Prognosis (table 25.3) - do not memorize, just look at how the prognosis is determined.(Tests like immunophenotyping help determine the type and severity of the leukemia and predict how well the patient might respond to treatment.) Acute Lymphoblastic Leukemia (ALL) Therapeutic Management: ? = 3 phases: remission induction, consolidation/intensification, and maintenance. Chemo, radiation, chemo with stem cell transplant, & targeted therapy (use of antibodies) Treatment started immediately!! Complete remission is determined by blood/bone marrow counts- less than 5% blast cells in the bone marrow & no leukemia in extramedullary sites Acute Lymphoblastic Leukemia (ALL) Nursing Care: ? = Very supportive -Lots of teaching to caregivers and client (level is determined by clients age) -Depends on treatment regimen - Side effects of the drugs being give Immunizations start @ ? = birth or within 2 weeks of birth Immunizations DTap/DTP to Tdap ? = given at 11-12 years of age Flu shots start at , watch for what allergy? ? = start @ 6 months, watch for egg allergy (children 6months to 8yrs old needs two dose) Hib is for what? ? = bacterial meningitis & epiglottitis Meningococcal can be given as early as when but who is it reserved for? ? = can be given as early as 2 months but typically reserved for adolescents Immunizations Hep B is given when? ? = 1st immunization - given before the baby leaves the hospital (What happens if mom is Hep B+?) ? = Follow-Up: The baby will continue the Hep B vaccine series (3 doses total) on the regular schedule. After the series is completed, the baby will have a blood test to confirm: They are immune to Hep B. They did not contract the virus from the mother. Attenuated live virus what's the four? ? = -MMR - Varicella - Nasal flu - Rotavirus - oral and give at 2 months of age (Mike,Very, Nice,Really) Attenuated live virus not given until when? ? = Generally, not given until ages 12-15 months Immunization Reactions ? = -Educate the caregiver - vaccine information statement (VIS) -Reactions are usually at injection site -Think about proper places to administer Extra ingredients - Increase the effectiveness - Hypersensitivity (eggs and yeast) - Neomycin allergy Immunizations contraindications? ? = -severe febrile illness -Live virus vaccines - altered immune system & exposure to recent acquired passive immunity -Pregnancy - MMR -Breast feeding - You are good to go! -Anaphylactic reaction Immunizations What is the Nurse's Role? ? = -Education - Vaccine Information Sheet (VIS) -Be open and nonjudgmental -Proper administration & storage -Think about pain control Acetaminophen, EMLA cream -Assess for contraindications and prior reactions and pregnancy Immunization Priorities: ? = -Ensure up-to-date immunizations for children per CDC guidelines. -Recognize and respond quickly to symptoms of communicable diseases. -Educate families about the importance of vaccines in preventing disease. Immunization Interventions: ? = -Administer vaccines according to the child's age and immunization schedule. -Observe for adverse reactions post-vaccination and manage mild side effects. -Isolate children with contagious diseases to prevent the spread in healthcare and community settings. Immunizations Patient Education: ? = -Educate families on vaccine schedules, safety, and common myths about vaccines. -Discuss basic hygiene practices to prevent communicable diseases (e.g., handwashing). -Inform caregivers on recognizing symptoms of communicable diseases and when to seek care. Autism is no scientific evidence to date that ASD is linked to ? ? = MMR or Tdap vaccines There is a high re-occurrence in families if ? ? = there is one child already diagnosed Autism Clinical Manifestations ? = -Core deficits - **social interactions, **communications, and behavior -GI issues (usually constipation) -Children can present differently -Manifestations can range from mild to severe (self-abuse) -Cognitive impairment -Many children with ASD excel in particular areas (art, music, memory, and math) -Communication delay (Red flag if children are not babbling or gesturing by 12 months, single words by 16 months, & 2-word phrases by 24 months - immediate hearing and language evaluation) -Autism regression -Early diagnosis is the KEY: Symptoms can be greatly improved and, in some cases, overcome Some require adult supervision their whole life Autism Nursing Care ? = Provide a highly structured environment and understand they are typically involved in intensive behavior modification programs.ASD is associated in multiple comorbidities If hospitalized (autism child)- the caregivers should stay ? ? = With child as much as possible Nursing Care for autism child in hospital? ? = -Utilizing a private room -Decrease stimulation -Lessen physical contact -Suggest comfort items from home -Watch their eating habits -Careful when administering medications -Communicate on their level-brief and concrete Autism Nursing Care Priorities? ? = -Establish a safe, structured environment. -Build a trusting relationship with the child and family. -Maintain consistent routines to reduce anxiety and improve engagement. Autism Nursing interventions? ? = -Use clear, simple communication and visual aids (e.g., pictures, symbols). -Engage in play therapy to encourage social and communication skills. -Provide sensory-friendly spaces to prevent overstimulation. -Collaborate with occupational and speech therapists as needed. Autism Patient Education? ? = -Educate families on the importance of routine and structure. -Offer guidance on behavior management and sensory sensitivities. -Provide resources for therapy options, community support, and educational programs Autism Family Support? ? = -Education is KEY -Refer to national support groups -Encourage the caregiver to be an active participant in the child's care -As the child ages - long-term placement facility ADHD Attention-deficit/hyperactive disorder (pg. 439) ? = -Developmentally inappropriate degrees of inattention, impulsiveness, & hyperactivity -Usually evokes negative attention from others -Early identification is important - can significantly interfere with the normal course of emotional and psychologic development. -Increased risk of developing other cognitive issues/disorders ADHD Attention-deficit/hyperactive disorder Clinical Manifestations ? = -Motor activity and developmentally inappropriate inattention, impulsiveness, & hyperactivity. They Have ranges in symptoms -Diagnosis is made utilizing both the DSM-5 and individual accounts (parents, teachers) -Based on the types of symptoms different kinds of ADHD can occur (over a 6 months' time frame): Inattentive presentation (too much inattentive and no hyperactive impulsivity), Hyperactive-impulsive (too much hyperactivity -impulsivity but not inattention) ADHD Attention-deficit/hyperactive disorder Diagnostic Evaluation ? = Will need a complete and thorough multidisciplinary evaluation of the child. A very thorough physical and mental health check-up! ADHD Attention-deficit/hyperactive disorder Therapeutic Management ? = -Depends on the age of the child and the severity of symptoms. #1 choice is behavioral therapy -Other treatment options are: family education & counseling, medications, proper classroom placement, environmental manipulation, and possible psychotherapy ADHD Attention-deficit/hyperactive disorder Behavioral Therapy ? = Prevention of undesirable behavior -The caregivers learn new contingencies, reward systems, & parenting skills, and age- appropriate consequences. Requires lots of time and effort -Social skills and developing a skill (skill-building) ADHD Pharmacology Therapy choice of medication is based on ? = age of the child ADHD #1 med choice? ? = Methylphenidate (1st choice) ADHD Child taking stimulants should be carefully monitored for: ? = -Appetite loss (weight loss) -Abdominalpain -HA -Sleep disturbance -Growth velocity -Cardiac (BP) Adhd stimulants are contraindicated ? = in children with tic-like behaviors or a family history of Tourette ADHD Environment Manipulation? ? = -Consistency -Working on organizational skills -Making more appropriate choices -Taking responsibility for their actions -Decreasing distraction when completing tasks -The biggest take away is help the child cope with deficits, succeed all while emphasizing strengths ADHD classroom Lots of things the school system(s) need to consider: ? = -Verbal and visual instructions -Teach academic subjects in the morning -Give more time to complete assignments -Give frequent breaks -If a learning disability exist-special training classes ADHD nursing care? ? = -We serve as the "middle person" between the educational world and the healthcare world -Concepts we help with: -Medication education (for example loss of appetite and reducing sleeplessness) -Addiction potential - usually very low because the effect of the drug is opposite that produced in normal individuals. Education in general Nursing Care Priorities? ? = -Provide a safe, structured environment to minimize distractions. -Assist with organization and routine to support attention and focus. -Monitor for side effects of medications, if prescribed (e.g., stimulants). ADHD inteventions? ? = -Encourage the use of visual schedules, timers, and checklists. -Promote positive reinforcement for appropriate behavior. -Limit overstimulation and offer frequent breaks during tasks. -Collaborate with teachers and families to create consistent behavior strategies. ADHD Patient Education: ? = -Teach families about ADHD and realistic expectations for behavior. -Explain medication side effects, dosing schedules, and follow-up needs. -Provide resources on behavior management, support groups, and school accommodations (504 Plan or IEP). Maltreatment what are the types of child neglect? ? = Physical, Emotional, Psychological maltreatment Maltreatment Physical Abuse is what? ? = -The deliberate infliction of physical injury on a child, usually by the child's caregiver -Abusive head trauma (example - shaken baby syndrome) Factors predisposing to physical abuse: -Parental, Child, Environmental Maltreatment Sexual Abuse ? = Define as the employment, use, persuasion, inducement, enticement, or coercion of an child to engage in, or assist any other person to engage in, sexually explicit conduct or any simulation of such conduct. Sexual Abuse Types ? = -Incest -Molestation - Exhibitionis - Child pornography -Child prostitution -Pedophilia Maltreatment Priorities: ? = -Ensure the child's immediate safety and provide a non- judgmental, supportive environment. -Assess for signs of physical, emotional, or sexual abuse and neglect. -Report suspected maltreatment to appropriate authorities as mandated by law. Maltreatment Interventions? ? = -Document findings carefully, using objective language. -Involve social services and mental health professionals to support the child and family. -Provide trauma-informed care, focusing on trust-building and emotional support. -Use play therapy or child life specialists to facilitate emotional expression. Maltreatment Patient Education: ? = -Educate families on positive parenting and stress management. -Provide information on support services like counseling, housing, or food assistance if needed. -Encourage family therapy when appropriate to address family dynamics and healing. Precocious Puberty what is it? ? = Hypothalamic gonadotropin-releasing hormone (GnRH) - imbalance in reproductive hormones. Develop secondary sexual characteristics way too early. It can result from various causes, including hormonal imbalances, tumors, or central nervous system disorders. Precocious Puberty Treatment - ? = -luteinizing hormone-releasing hormone (Lupron Depot) -GnRH analog (GnRHa histrelin implant - suppresses LH and testosterone for 1-2 years) -Treatment is stop once patient reaches appropriate age - allows natural puberty to take over Precocious Puberty Signs and Symptoms Girls ? = -Breast development -Menstruation (menarche) -Pubic or underarm hair growth -Growth spurts Precocious Puberty Signs and Symptoms Boys: ? = -Enlargement of the testes -Penis enlargement -Pubic or underarm hair growth -Facial hair growth and deepening voice Precocious Puberty Assessment: ? = -Conduct a thorough physical assessment, including growth charts to monitor height and weight. -Gather a detailed health history to identify any underlying conditions or family history of early puberty. -Monitor psychosocial development and emotional well-being, as early maturation can lead to social and emotional challenges. Precocious Puberty Education: ? = -Educate the patient and family about precocious puberty, its potential causes, and implications. -Discuss normal growth and development milestones to provide context and reassurance. -Inform about the importance of adherence to treatment plans if prescribed. Precocious Puberty Support ? = -Provide emotional support and counseling to address concerns about early maturation, self- image, and peer relationships. -Encourage open communication with the child and family regarding feelings and experiences related to puberty. Precocious Puberty Medication Administration: ? = -Administer medications as prescribed (e.g., GnRH agonists) to help manage symptoms and delay further progression of puberty. -Educate the family about medication side effects and the importance of regular follow-up appointments. Precocious Puberty Coordination of Care: ? = -Collaborate with pediatric endocrinologists, psychologists, and other healthcare professionals involved in the child's care. -Ensure regular follow-up appointments to monitor growth and response to treatment. Precocious Puberty Monitoring and Evaluation: ? = -Regularly assess the effectiveness of interventions and the child's emotional well-being. -Adjust care plans based on the child's needs and any changes in condition. Juvenile hypothyroidism If not detected? ? = the child can develop unreversible neurocognitive dysfunctions Juvenile hypothyroidism Treatment is? ? = levothyroxine (oral) levothyroxine (oral) what happens if they vomit? ? = if they vomit within 1 hr. of admin, can repeat dose. Dosed in mcg. Juvenile hypothyroidism Signs and Symptoms ? = Growth and Development:Delayed growth and short stature.Delayed puberty. Physical Symptoms: Fatigue and lethargy, Weight gain despite a normal or decreased appetite, Cold intolerance. Decreased temperature regulation.Dry skin and hair loss.,Constipation.,Hoarseness or a deepened voice. Cognitive and Emotional Symptoms: Sluggishness or decreased energy. Difficulty concentrating and learning problems. Depression or mood changes. Juvenile hypothyroidism Diagnosis ? = Clinical Evaluation: History and physical examination to assess growth, development, and symptoms. Juvenile hypothyroidism Medication: ? = Levothyroxine: Synthetic thyroid hormone replacement is the primary treatment. It must be taken daily, and dosages are adjusted based on regular monitoring of TSH and T4 levels. Juvenile hypothyroidism Monitoring: ? = -Regular follow-up appointments to monitor hormone levels and adjust medication dosages as the child grows. -Monitor growth and developmental milestones to ensure appropriate progress. Juvenile hypothyroidism Education: ? = -Educate the patient and family about the condition, its management, and the importance of adherence to medication regimens. -Discuss potential side effects of medications and signs of over-treatment (e.g., increased heart rate, anxiety). Juvenile hypothyroidism Assessment: ? = -Monitor growth parameters (height, weight) and developmental milestones. -Assess for symptoms of hypothyroidism and any changes in condition or medication side effects. Juvenile hypothyroidism Education: ? = -Teach families about the nature of hypothyroidism and its treatment. -Instruct on proper medication administration and the importance of consistent timing (e.g., on an empty stomach). Typically in a pill form. For Peds can dissolve into milk or fluid. Juvenile hypothyroidism Support: ? = -Provide emotional support and resources for coping with chronic illness. -Encourage a supportive environment for learning and development. Juvenile hypothyroidism Coordination of Care: ? = -Collaborate with healthcare providers, including pediatric endocrinologists, dietitians, and school personnel for holistic management. -Facilitate communication among caregivers, teachers, and healthcare providers regarding the child's needs. Diabetes Type I **Kid specific - honeymoon phase? ? = when the kid is first diagnosed, some eyelet cells still produce some insulin, but not enough to maintain glycemic control. As the disease progresses, sugars continue to rise. Type 1 diabetes is? ? = is a chronic autoimmune condition that results in the destruction of insulin-producing beta cells in the pancreas (eyelet cells), leading to absolute insulin deficiency. It typically manifests in childhood or adolescence, although it can occur at any age. Diabetes Type I Causes? ? = -Autoimmune Reaction: The immune system mistakenly attacks and destroys insulin-producing beta cells. -Genetic Factors: Family history may increase the risk. -Environmental Triggers: Viral infections or other environmental factors may contribute to the onset. Kid specific - honeymoon phase meaning? ? = when the kid is first diagnosed, some eyelet cells still produce some insulin, but not enough to maintain glycemic control. As the disease progresses, sugars continue to rise. Diabetes Type I Signs and Symptoms ? = -Increased thirst (polydipsia). -Frequent urination (polyuria). -Unexplained weight loss. -Extreme hunger (polyphagia -Fatigue or weakness. -Blurred vision. Dawn Phenomenon: Increased blood sugar levels in the early morning hours due to hormonal changes. Diabetic Ketoacidosis (DKA): A serious complication that can present with abdominal pain, vomiting, rapid breathing, fruity-smelling breath, and altered mental status. (caused by stress, illness, etc.) Diabetes Type I Diagnosis Laboratory Tests: ? = -Fasting blood glucose level of 126 mg/dL (7.0 mmol/L) or higher. o Random blood glucose level of 200 mg/dL (11.1 mmol/L) or higher with classic symptoms. o Hemoglobin A1c level of 6.5% or higher. o Urine tests for ketones or glucose may also be performed. Diabetes Type I Insulin Therapy: Lifelong insulin therapy is ? ? = Necessary Diabetes Type I Blood Glucose Monitoring? ? = -Frequent monitoring of blood glucose levels (at least 4 times a day -Use of continuous glucose monitoring (CGM) systems may be recommended. Diabetes Type I Dietary Management: ? = -Carbohydrate counting and balanced meal planning are essential. Hydration is key. -Education on healthy food choices and understanding how food affects blood glucose levels. Diabetes Type I Physical Activity ? = Encourage regular physical activity as part of a healthy lifestyle, with consideration of its impact on blood glucose levels. Diabetes Type I Emergency Management: ? = -Educate about recognizing and treating hypoglycemia (low blood sugar) with quick-acting glucose sources. -Understanding signs and management of DKA. Diabetes Type I Assessment: ? = -Monitor vital signs, blood glucose levels, and symptoms of hyperglycemia or hypoglycemia. -Regularly assess growth and development in relation to diabetes management. Diabetes Type I Education? ? = -Teach the child and family about diabetes management, including insulin administration, blood glucose monitoring, and dietary management. -Educate on the importance of regular follow-ups and lab tests (e.g., A1c levels). Diabetes Type I Support? ? = -Provide emotional support and counseling, as managing a chronic condition can be challenging for children and families. -Encourage participation in diabetes education programs or support groups. Diabetes Type I Coordination of Care? ? = -Collaborate with a multidisciplinary team, including endocrinologists, dietitians, and diabetes educators. -Facilitate communication between home and school regarding the child's needs and management plan. Diabetes Type I Crisis Management? ? = Be prepared to respond to hypoglycemic episodes or DKA, ensuring families know how to manage these situations at home. Diabetes Type II is a? ? = metabolic disorder characterized by insulin resistance and relative insulin deficiency. While it has historically been more common in adults, the incidence of type 2 diabetes in children and adolescents has been increasing, largely due to rising obesity rates and lifestyle factors. Diabetes Type II causes? ? = -Insulin Resistance: The body's cells become less responsive to insulin, leading to higher blood glucose levels. -Genetic Factors: Family history of diabetes can increase risk. -Obesity: Excess body fat, particularly abdominal fat, is a significant risk factor. -Sedentary Lifestyle: Lack of physical activity contributes to the development of obesity and insulin resistance. -Dietary Factors: Poor dietary choices, including high consumption of sugary and processed foods. Diabetes Type II Classic Symptoms: ? = -Increased thirst (polydipsia). -Frequent urination (polyuria). -Fatigue or Lethargy -Blurred vision. -Unexplained weight loss or weight gain (more common with obesity). Acanthosis Nigricans: Dark, velvety patches of skin, often seen on the neck or armpits, indicating insulin resistance. Diabetes Type II ? = -Fasting blood glucose level of 126 mg/dL (7.0 mmol/L) or higher. o Random blood glucose level of 200 mg/dL (11.1 mmol/L) or higher with classic symptoms. o Hemoglobin A1c level of 6.5% or higher. o Oral glucose tolerance test (OGTT) may also be performed. Diabetes Type II Lifestyle Modifications diet ? = Emphasize a balanced diet rich in whole grains, fruits, vegetables, lean proteins, and healthy fats. Limit sugar-sweetened beverages and processed foods. Diabetes Type II Physical Activity: ? = Encourage at least 60 minutes of moderate to vigorous physical activity most days of the week. Diabetes Type II Weight Management: ? = Support gradual weight loss or weight maintenance in overweight or obese children to improve insulin sensitivity. Diabetes Type II Medication: ? = Metformin: The first-line oral medication used to improve insulin sensitivity and reduce hepatic glucose production. Only one currently FDA approved for peds. Black Box warning for lactic acidosis. Other medications may be considered depending on individual needs and circumstances. Diabetes Type II Monitoring: ? = -Regular monitoring of blood glucose levels. -Routine follow-up appointments to assess metabolic control and adjust management as needed. Diabetes Type II Education ? = Educate the child and family about diabetes, its management, and the importance of healthy lifestyle choices. Least invasive first. Diet and Exercise before meds. Diabetes Type II Assessment: ? = -Monitor vital signs, weight, and blood glucose levels. -Assess for signs of complications, including diabetic ketoacidosis (DKA) or hyperglycemic hyperosmolar state (HHS). Diabetes Type II Education: ? = -Teach the child and family about T2D, including the role of diet, exercise, and medication management. -Provide information on recognizing and managing hypoglycemia and hyperglycemia. Diabetes Type II Support: ? = -Offer emotional support and resources for managing a chronic condition. -Encourage family involvement in lifestyle changes to support the child. Diabetes Type II Coordination of Care: ? = -Collaborate with a multidisciplinary team, including dietitians, diabetes educators, and mental health professionals, to provide comprehensive care. -Facilitate communication between the school and healthcare providers regarding the child's management plan. Diabetes Type II Crisis Management: ? = -Be prepared to respond to emergencies related to blood glucose levels and educate the family on appropriate actions in case of severe hypo- or hyperglycemia. Cerebral Palsy patho? ? = -A non-progressive neurological disorder resulting from brain injury or malformation that occurs while the brain is developing (before, during, or after birth). -Causes vary but can include prenatal hypoxia, infection, or traumatic birth injury. Cerebral Palsy Clinical Manifestations: ? = -Varies by type but may include abnormal muscle tone (hypertonia or hypotonia), delayed motor development, poor coordination, and involuntary movements. -Commonly accompanied by sensory, speech, and cognitive impairments. Cerebral Palsy Priorities: ? = -Promote mobility, prevent contractures, and maintain optimal physical function. -Monitor for associated complications (seizures, aspiration). Cerebral Palsy Nursing Interventions: ? = -Implement physical and occupational therapy exercises. o -Provide adaptive devices as needed (wheelchairs, braces). o Administer muscle relaxants (e.g., baclofen) or anticonvulsants for seizure management Cerebral Palsy Enhancing Mobility: ? = -Perform range of motion (ROM) exercises to prevent contractures. -Collaborate with physical and occupational therapists for individualized exercise programs. -Use splints, braces, or orthotic devices as prescribed to maintain alignment and support mobility. Cerebral Palsy Preventing Aspiration ? ? = -Position child upright during and after meals. -Use adaptive feeding techniques, such as thickening liquids or using specialized utensils. -Monitor for signs of aspiration (e.g., coughing, choking, drooling). Cerebral Palsy Promoting Communication and Socialization: ? = -Encourage the use of alternative communication methods if needed (e.g., sign language, communication boards). Work with a speech therapist to enhance language and communication skills. -Engage the child in social activities suitable for their developmental level. Cerebral Palsy Monitoring for Seizures: ? = -Assess for signs of seizure activity and have emergency medications available. -Educate caregivers on seizure precautions and management. Maintain a seizure log to track frequency and triggers. Cerebral Palsy ain and Comfort Management: ? = -Administer muscle relaxants, analgesics, or antispasmodics as prescribed. -Use non-pharmacological methods (e.g., massage, warm baths) to relieve discomfort. -Regularly assess pain and muscle tone. Cerebral Palsy Patient Education: ? = -Teach families exercises and stretches. -Provide information on the importance of regular follow-ups with a multidisciplinary team. -Educate on potential complications (e.g., aspiration, skin breakdown). Increased Intracranial Pressure (ICP) Pathophysiology ? ? = -Increased pressure within the skull caused by an imbalance between brain tissue, cerebrospinal fluid (CSF), and blood volume. -Causes can include head trauma, hydrocephalus, tumors, or infections. Increased Intracranial Pressure (ICP) Clinical Manifestations? ? = -Infants: Bulging fontanel, high-pitched cry, irritability. Wong box 27.1 pg 883 -Children: Headache, nausea/vomiting, blurred vision, lethargy, altered level of consciousness, and possible Cushing's triad (hypertension, bradycardia, irregular respiration). Increased Intracranial Pressure (ICP) Priorities: ? = -Immediate assessment and intervention to prevent brain herniation. -Monitor neurological status frequently. Increased Intracranial Pressure (ICP) Nursing Interventions: ? = -Elevate the head of the bed to 30 degrees. -Avoid activities that increase ICP (e.g., coughing, straining). -Administer medications as prescribed (e.g., osmotic diuretics like mannitol, corticosteroids). Increased Intracranial Pressure (ICP) Positioning and Environmental Adjustments: ? = -keep the head of the bed elevated at 30 degrees to promote venous drainage. -Minimize environmental stimuli, such as noise and light, to reduce stress. -Avoid activities that increase ICP, like straining, coughing, or vigorous suctioning. Increased Intracranial Pressure (ICP) Monitoring Neurological Status: ? = -Perform frequent neurological checks, including Glasgow Coma Scale assessment. -Observe for early signs of increased ICP, such as altered pupil response, irritability, or decreased alertness. -Monitor vital signs closely, looking for Cushing's triad (bradycardia, hypertension, irregular breathing). Increased Intracranial Pressure (ICP) Fluid Management: ? = -Administer IV fluids cautiously to avoid overhydration, which can exacerbate ICP. -Monitor intake and output strictly. -Restrict fluids if prescribed and monitor for electrolyte imbalances. Increased Intracranial Pressure (ICP) Administering Medications: ? = -ive osmotic diuretics (e.g., mannitol) as ordered to reduce cerebral edema. -Administer corticosteroids if prescribed to decrease inflammation. -Monitor for medication side effects, including electrolyte imbalances. Increased Intracranial Pressure (ICP) Preventing Secondary Injury: ? = -Maintain a calm environment,minimizing stimuli. Increased Intracranial Pressure (ICP) Patient Education: ? = -Teach parents signs of increased ICP. -Educate on head injury prevention. -Stress the importance of follow-up appointments if chronic conditions are present. Meningitis pathology? ? = -Inflammation of the meninges (protective membranes covering the brain and spinal cord), typically due to bacterial or viral infection. -Bacterial meningitis is a medical emergency and can cause severe complications. Meningitis Clinical Manifestations: ? = -Infants: Poor feeding, lethargy, bulging fontanel. -Children: Fever, severe headache, stiff neck, photophobia, altered mental status, positive Brudzinski's and Kernig's signs. Meningitis Priorities: ? = -Rapid initiation of antibiotic therapy if bacterial. -Monitor for complications (seizures, increased ICP, shock). Meningitis Nursing Interventions: ? = o Implement droplet precautions if bacterial. o Administer prescribed antibiotics or antiviral medications. o Monitor neurological status and fluid balance closely. Meningitis Infection Control: ? = -Place the child on droplet precautions if bacterial meningitis is suspected. -Ensure proper hand hygiene and instruct family members on infection control practices. -imit visitors to reduce the risk of additional infections. Meningitis Frequent Monitoring of Neurological Status: ? = -Assess for changes in consciousness, pupil response, and motor function regularly. -Observe for signs of increased ICP and prepare to intervene if symptoms worsen. -Monitor for seizure activity and ensure safety measures are in place. Meningitis Supportive Care for Fever and Pain: ? = -Administer antipyretics for fever control and analgesics as prescribed. -Implement cooling measures, such as cool compresses and tepid baths. -Ensure the child is comfortable with low lighting and minimal noise. Meningitis Hydration and Electrolyte Balance: ? = -Administer IV fluids and monitor for signs of dehydration or fluid overload. -Monitor electrolyte levels regularly, especially sodium. -Restrict fluids as prescribed if there is risk of cerebral edema Meningitis Preventing Complications and Long-term Effects: ? = -Educate family about signs of complications, such as hearing loss or developmental delays. -Arrange follow-up care, including auditory and neurological assessments post-infection. Provide referrals to specialists if necessary (e.g., neurologist, audiologist). Meningitis Patient Education: ? = -Educate on vaccination for meningitis prevention (e.g., Hib, meningococcal vaccines). -Inform parents about signs of meningitis and when to seek emergency care. -Provide information on the importance of completing the full antibiotic course. Spina Bifida Pathophysiology: ? = -A congenital defect where there is incomplete closure of the neural tube during embryonic development, leading to protrusion of the spinal cord and/or meninges. -Can range from mild (spina bifida occulta) to severe (myelomeningocele). Spina Bifida Clinical Manifestations: ? = Varies by severity; may include visible sac-like protrusion on the back, sensory and motor impairment below the lesion, hydrocephalus, and bladder/bowel dysfunction. Spina Bifida Priorities: ? = -Prevent infection, especially in cases with open lesions. -Manage and monitor for hydrocephalus and neurological deficits. Spina Bifida Nursing Interventions: ? = -Cover open lesions with sterile, moist dressings until surgery. o Position infant prone to prevent pressure on the defect. o Collaborate with a multidisciplinary team (e.g., urology, physical therapy) Spina Bifida Protecting the Sac/Lesion: ? = -Cover the lesion with sterile, moist non- adherent dressing. -Avoid pressure on the sac by positioning the infant prone or on the side. -Monitor the dressing frequently for signs of leakage or infectio Spina Bifida Monitoring for Hydrocephalus: ? = -Measure head circumference daily to monitor for hydrocephalus. ▪ Observe for signs of increased ICP (e.g., irritability, vomiting, bulging fontanel). ▪ Collaborate with the healthcare team for potential surgical interventions if hydrocephalus is present. Spina Bifida Promoting Skin Integrity: ? = Position child carefully to prevent pressure ulcers, especially in paralyzed areas. ▪ Perform frequent skin assessments and provide appropriate padding. ▪ Educate parents on techniques to maintain skin integrity. Spina Bifida Bladder and Bowel Management: ? = -Implement a bowel regimen to prevent constipation (e.g., high fiber diet, stool softeners if prescribed). ▪ Teach intermittent catheterization if needed for bladder management. ▪ Encourage parents to monitor for signs of urinary tract infections. Spina Bifida Promoting Mobility and Independence: ? = -Collaborate with physical and occupational therapists to enhance motor skills. ▪ Provide assistive devices as needed (e.g., walkers, braces). ▪ Encourage age-appropriate independence in self-care activities. Spina Bifida Patient Education: ? = -Educate parents on signs of infection and hydrocephalus. o Teach range of motion exercises to prevent contractures. o Inform about bladder and bowel care if needed. Seizures Pathophysiology: ? = -Sudden, uncontrolled electrical disturbances in the brain. -Can be caused by various factors, including genetic conditions, infections, and head trauma. Seizures Clinical Manifestations: ? = Symptoms may include muscle stiffening, jerking movements, loss of consciousness, or focal signs (e.g., twitching, strange sensations). Seizures Priorities: ? = -Ensure safety during seizures to prevent injury. -Monitor airway and breathing. Seizures Nursing Interventions: ? = -Place child on side during a seizure to maintain airway. o Do not restrain the child or put anything in their mouth. o Administer anticonvulsants as prescribed and monitor drug levels. Seizures Ensuring Safety During a Seizure: ? = -Position the child on their side to maintain airway patency. ▪ Do not restrain the child or put anything in their mouth. ▪ Clear the area to prevent injury and provide a safe environment. Seizures Seizure Monitoring and Documentation: ? = -Document seizure duration, type, and any precipitating factors. ▪ Monitor postictal period and assess for any neurological changes. ▪ Maintain a seizure log for tracking and evaluation. Seizures Administering Anticonvulsants: ? = -Administer prescribed medications, such as phenobarbital or phenytoin. -Monitor therapeutic drug levels and observe for side effects. -Educate parents on the importance of medication adherence. Seizures Family Education and Support: ? = -Teach caregivers seizure first aid and when to seek emergency care. -Provide information on seizure triggers (e.g., lack of sleep, stress). -Encourage participation in support groups for families of children with epilepsy. Seizures Patient Education: ? = -Teach parents seizure first aid and when to seek emergency care. o Educate on seizure triggers and how to avoid them.o Emphasize adherence to medication regimen. Reye's Syndrome Pathophysiology: ? = A rare but serious condition causing brain and liver damage, often associated with the use of aspirin in children following viral illnesses. Leads to encephalopathy and hepatic dysfunction. Reye's Syndrome Clinical Manifestations: ? = -Initial signs include vomiting, lethargy, and irritability. o Progresses to confusion, seizures, and coma in severe cases. Reye's Syndrome Priorities: ? = -Early identification and treatment to prevent progression. o Monitor neurological status and liver function. Reye's Syndrome Nursing Interventions: ? = -Provide supportive care, monitoring for increased ICP. -Manage fluid and electrolyte balance to prevent cerebral edema. o Administer medications to decrease ammonia levels (e.g., lactulose). Reye's Syndrome Monitoring for Increased ICP: ? = -Perform frequent neurological assessments for changes in level of consciousness or signs of increased ICP. -Monitor for signs of worsening encephalopathy (e.g., confusion, seizures). -Elevate the head of the bed to reduce ICP if not contraindicated. Reye's Syndrome Fluid and Electrolyte Management: ? = -Administer IV fluids carefully, monitoring for fluid overload or dehydration. -Assess electrolyte levels and monitor for imbalances. -Avoid giving medications metabolized by the liver unless prescribed. Reye's Syndrome Administering Medications to Manage Ammonia Levels: ? = -Administer lactulose as prescribed to help lower blood ammonia. -Monitor for medication side effects, such as abdominal cramping or diarrhea. -Monitor liver function tests and report abnormalities. Reye's Syndrome Preventing Infection and Promoting Rest: ? = -Keep the environment calm and restful to minimize stress. -Limit visitors and noise to avoid overstimulation. -Supportive care to prevent additional infections due to the weakened immune system. Reye's Syndrome Family Education: ? = -Educate on the importance of avoiding aspirin in children. ▪ Teach parents to recognize early signs of Reye's syndrome. ▪ Discuss the need for follow-up care, especially if liver function was affected. Reye's Syndrome Patient Education: ? = -Educate on avoiding aspirin in children, especially during viral infections. o Inform parents of early signs of Reye's syndrome. o Stress the importance of regular follow-ups if liver function is impaired.