other resp. infections
Important identifiable risk factors for otitis media
Family socioeconomic status and extent of exposure to other children
Dealing with two patients, one is in for a cold, the other is in for a chronic illness, who is priority?
Pt. with chronic illness
2 swallowing/aspiration risks and what they are at risk for
1. Fluoride level in water, mom consumes water, baby may produce teeth in utero = need to get extracted, at risk for aspiration
2. Vomiting in large amounts, projectile = pyloric stenosis, bilious green = instestinal obstruction/malrotation of bowel
Doctor orders Amoxil for a child that weighs 63 lbs. The safe dosage range for this medication is 50 mg/kg/day every 8 hours. What is the safe dose for this child per dose?
477.3 mg/dose
Which action would the nurse take when caring for a child diagnoses with pulmonary edema?
Monitor pulse oximetry
Population at risk for aspiration pneumonia that's a common concern
Infants with reflux
Name an intervention for parents experiencing a lot of emotions through end-of-life process
Allow parents to go through the grieving process for the loss of an expected child
Car seat recommendations
Infant car seat (rear-facing only) is the most recommended up until child is 1, switch to a convertible seat (rear-facing and forward-facing) but use as rear until child is 2/feet can touch the back of the seat.
Doctor orders Zofran 2 mg for a child that weighs 13.6 kg. The safe dosage range of this drug is 0.15 mg/kg. Is this a safe dose?
Yes this is a safe dose
Clinical features used to classify asthma severity
Lung function, Frequency of symptoms, Frequency of rescue medication, and continual symptoms throughout the day.
Initial warning and progressive signs of RSV
Initial
Rhinorrhea
Pharyngitis
Coughing, sneezing
Wheezing
Possible ear or eye drainage
Intermittent fever
With progression of illness
Increased coughing and wheezing
Fever
Tachypnea and retractions
Refusal to nurse or bottle-feed
Copious secretions
How much information should you give family about what you've done?
Lay out what you have done, interventions tried, progression of illness, unlikelihood of improvement, and reality of death = closure
How to approach the "No!" phase
This is normal, try giving them options to minimize the risk of answering yes/no questions
Decide for them if no continues, discourage always saying no if the behavior continues for every question asked.
Ignore negative behavior
Doctor orders Zithromax for a child that weighs 82 lbs. The safe dose range for this medication is 10-12 mg/kg/day. What is the maximum safe daily dose for this child?
47.3 mg/day
Life-threatening condition that could occur from aggressive chemotherapy
Tumor Lysis Syndrome (rapid cell death)
First line of treatment for strep, what treatment to avoid.
Oral amoxicillin
IM penicillin = painful
Name the type of environment you should provide for patient about to pass.
Create a quiet & peaceful environment, allow personal items in the bed, stay in the room or nearby, let them be in the room as long as they need to
Too much laying on the back (safe sleep) can cause:
Plagiocephaly - tummy time is important
Doctor orders 300 mg of Zmax once a day for a child that weighs 72 lbs. The safe dose range for this medication is 10-12 mg/kg/day. Is this a safe dose for this patient?
No, this is not a safe dose. A safe dose is 327.3-392.7 mg/day
Difference between chemotherapy and radiation & how they manifest
Chemotherapy (chemicals are cytotoxic = kill cells with high proliferation but has a lot of side effects from parts with high turnover (hair, GI tract skin))
Radiation (targeted or total body for stem cell transplant) - S/S: N/v, anorexia, ulcers, diarrhea, alopecia, skin desquamation, mucositis
Name 5 signs of respiratory distress
Restlessness
Dyspnea
Cyanosis
Pulmonary edema
Respiratory arrest
Present during prayer? Why or why not?
It’s okay to be present in the room while praying = meaningful to family, be involved where you can, ask about religion and culture for end-of-life
When should lead tests be done?
Lead checks 1-2 years, before kindergarten (venous, capillary samples - stick finger, clean skin well to get an accurate value or it will appear more elevated)
**Levels 5 and higher should be investigated for potential sources (like water in the home) and retested in 1 month to assess**
Doctor orders an IV drip of Dopamine for a child that weighs 78 lbs. The safe dosage range for this medication is 5-20 mcg/kg/min. What is the safe dosage range for this child?
177.3-709.1 mcg/min
Conditions that may increase the risk for cancer (4)
Exposure to radiation/chemotherapy before
Epstein-Barr (mono) can increase risk for cancer (burkitt lymphoma, hodgkin lymphoma)
HPV: cervical, testicular, ora/esophageal cancers
Genetic Conditions (downs): at risk for leukemia, heart defects