All about the newborn
Within what timeframes should a newborn have the first void and first stool, and what is the first stool called?
24 hours for urine
24-48 hours for meconium
What pediatric group experiences food jags and physiologic anorexia?
Toddlers
Food jags are when toddlers want to eat the same food over and over for a period of time
Physiologic anorexia means toddlers naturally eat less because growth slows after infancy, so parents should offer small nutritious meals/snacks without forcing food
Toddler food safety focuses on preventing choking
What condition in pregancy causes pruritic white discharge?
Candiasisis (yeast infection)
A child is being evaluated for cystic fibrosis. Which test result supports the diagnosis?
Chloride sweat test
What is the priority intervention for a newborn who is gagging and cyanotic?
What are the two newborn meds called and what does each prevent?
Vitamin K - prevention of bleeding
Erythromycin - prevention of ophthalmia neonatrum from gonorrhea/chlamydia
An infant has Tetralogy of Fallot. What is the priority intervention when experiencing a cyanotic spell?
Bring knees to chest
A newly postpartm mom has saturated a peripad within 15 minutes. Name the number one cause of postpartum hemorrhage and the number one priority.
Boggy uterus
Massage the fungus
What are the two common meds prescribed to pediatric patients with Graves disease, and what does each do?
1) Propranolol: treats tachycardia
2) Methimazole or PTU: blocks thyroid hormone production
Name the type of play toddlers most often engage in
A newborn girl has a small amount of blood-tinged vaginal discharge. What is this called?
Pseudomenstruation
Which cardiac disorder involves higher blood pressures and pulses in the upper extremities, and weak or absent pulses and decreased blood pressures in the lower extremities?
Coarctation of the aorta
Name 2 nonpharmacologic interventions for labor pain
Effleurage
Deep, slow, controlled pattern breathing
Counter pressure
A 32-year-old had a vaginal delivery of a healthy boy this morning. She is rubella nonimmune and blood type B-. What teaching should the PN perform?
Avoid pregnancy for 1 month after rubella vaccine and administering rhogam within 72 hours of delivery.
What is a common cause of conductive hearing loss in children?
Recurrent ear infections
Where should a newborn receive an IM injection, and what is the max volume?
Vastus lateralis, 1 mL
Pyloric stenosis, keep NPO
What kind of diet is a laboring mom usually prescribed and why?
Clear/ice chips due to aspiration risk if a c-section is needed
Name 3 ways to protect the suture line of an infant with cleft rip repair
1) elbow restraints to avoid rubbing incision
2) avoid pressure by placing infant side-lying or on back
3) no pacifiers or straws
Name 2 teaching points for an infant using a Pavlik harness for developmental hip dysplasia
1. Keep it on all the time unless otherwise directed
2. No lotion under the staps/check for skin breakdown
3. Hips should be flexed and infant should be able to freely kick feet
4. Report skin redness, breakdown, swelling, etc
5. Keep diaper under straps/don't remove straps for diaper changes
What teaching should be performed in regards to the changes in breastmilk after delivery?
Starts with colostrum days 1-3: gold color and high in protein, few drops at a time, full of antibodies - baby doesn't need much
Transitional milk days 3-5: lightens, may be bluish white
Mature milk: days 5-7 and there on out, continuously changes, higher in fat and changes based on baby's needs
What are the top 3 priority nursing interventions for a child experiencing a sickle cell vaso-occlusive crisis?
1. IV fluids
2. Pain Management
3. Oxygen
Explain the difference in assessment findings between placenta previa and placental abruption, and one intervention for each.
1) previa: bright red painless bleeding; no vaginal exams; c-section delivery
2) abruption: dark red bleeding with severe abdominal pain and fetal distress; immediate delivery, O2, pitocin off, lay on left side
A child has high fever, drooling, muffled voice, difficulty swallowing, and is sitting upright/tripod position. What condition is the child most likely experiencing, and should the PN do?
Epiglottitis; keep upright and calm; no throat inspection
What are 3 signs of transplant rejection in pediatric patients?
Fever, decreased urine output and edema, pain over the graft site, fatigue