PEDS
What are some rules of pediatric medication administration?
Remember 2 nurses check dosage for safety reason
Creative ways to encourage children to take meds – for example, offer an ice pop prior to administering a med that doesn’t taste good. (numbing, takes away from nasty med)
Never call meds candy.
How do we measure I/O for an infant?
Weighing diapers 1g = 1ml (dry diaper vs we diaper)
Count wet diapers
Number of diapers should equal days of life ex. 3 days old= 3 wet diapers
Baby first stool (meconium) within the first 24-48 hours
What are Signs of sickle cell disease with vaso-occlusive crisis?
Pain, Rise in altitude can increase/make worse crisis
What is the medication Ferrous Sulfate used for?
prescribed to prevent or treat iron deficiency anemia
For best absorption, take medication 1 hour before or 2 hours after a meal
Increase absorption if taken with OJ
If gastric irritation occurs can be taken with food
Stool may appear dark green or black
May stain the teeth. ALWAYS USE A STRAW
Constipation is a s/e, drink adequate amounts of fluid
Sources of iron:
Lean red meats, poultry→ heme
Iron-fortified cereals, green leafy vegetables, dried fruits→ non heme
What is Placenta abruption and its signs and symptoms?
S/S: pain, quick and swift. NO VAGINAL EXAMS R/T BLEEDING.
placenta separates from the inner wall of the uterus before birth.
D/C teaching following a bilateral myringotomy (eustachian tubes) with tubes
Tubes fall out on their own
Education: do not be alarmed if they fall out
What is the most common childhood cancer?
Wilms tumor
Signs of patent ductus ateriousus
PDA is a defect that occurs when the fetal shunt between the pulmonary artery and the aorta does not close. Causing increased blood flow to the lungs in a left-right shunting pattern.
S/S include Fluctuating 02 Sats and BP, Systolic heart murmur (machine hum), Wide pulse pressure, Bounding pulses, Active chest wall to the left of sternum above the heart.
Why would we give Rho(D) immune globulin to mom?
revent sensitization to the Rh factor in an Rh neg woman w/ Rh+ infant. Administered IM.
Nursing considerations: antibody screening
Baby: receives weekly antibody test.
What is placenta prev and what are the signs and symptoms?
occurs when a baby's placentapartially or totally covers the mother's cervix — the outlet for the uterus.
S/S: painless bleeding. NO VAGINAL EXAMS
Explain how you would care for an infant with RSV
Respiratory syncytial virus
Test all kids coming into the ER
Isolation room, on contact and droplet precautions
What causes fatigue in the infant with Tetralogy of Fallot pg. 570-571
improper tissue perfusion
Tetralogy of Fallout: includes a set of 4 defects that result in mixed blood flow throughout the newborn’s CV system. Life threatening condition that requires a series of surgical repairs and can be Dxed by ECG or cardiac cath. 4 defects include ventricular septal defects (VSD), pulmonary stenosis, overriding aorta, and R ventricular hypertrophy.
S/S include prominent heart murmur, Growth retardation/FTT, Polycythemia and clotting disorders, Cyanosis (not related to 02)
Causes: congenital heart defects
What are signs of pyloric stenosis?
GI issue where the pyloric valve closes and nothing can get through
S/S: Projectile vomiting, always hungry , can't keep anything down, on exam olive shaped mass evident during palpation, visible peristaltic waves on the infant’s abdomen.
Why do we give Vitamin K (Phytonadine) to a newborn baby?
fat-soluble vitamin that promotes blood clotting and is generally synthesized by microorganisms in the intestines r/t the sterile gut.
Administered via IM in the vastus lateralis muscle
Give 0.5-1mg IM to prevent neonatal hemorrhage
Vit. k deficiency bleeding can occur in newborns up to 6 months old
If a breastfeeding mom has sore nipples now can we educate her to reduce symptoms?
Make sure the baby is latched on properly
Keep the nipples covered
Wear a bra
Teach how to get the baby off the nipple
Alternate breasts during each feeding
Don't let the child sleep too much
Use of breast milk or lanolin on the nipples
Explain care of a child with eczema
Prevent secondary infections from persistent scratching, cut fingernails short.
Shower or bathe a child after they sweat then use emollient cream or lotion that is good for sensitive skin.
Avoid bubble bath concentrates or oils
Use small amount of steroid cream to affected areas
Use immunomodulators as Rxed (topical cyclosporin, methotrexate, interferon gamma, IV immunoglobulins.
Avoid contact with wool or synthetic fabrics. Use Cotton
Avoid harsh or fragrant soaps; Use Hypoallergenic soaps
Avoid wearing tight clothing
Prevent access to rash
Never scrub the inflamed site or washing in hot water.
Oatmeal bath, sensitive skin soaps, cool compresses, foods could be a issue.
Post op care of Hirschsprung's disease pg. 626
POST OP Care: Monitor for bleeding, edema, unusual drainage, fever, or any unexpected alteration in skin integrity, Provide meticulous skin care, ABT, pain control, and teaching/support for the family, After the return of bowel sounds and passage of confirmed passing of gas, introduce feedings slowly and monitor for tolerance.
Teach the parent that the colostomy is temporary and will be reversed once the baby’s bowel has had time to rest
What are signs of lead poisoning?
Irritability, developmental delay, not eating, wt loss, abdominal pain, seizures,
Metallic taste in mouth, GI upset, Decreased urine output, alteration in thinking, “personality change”, black/blue discoloration along the gums, Paresthesias or abnormal sensations.
What is oxytocin used for?
pituitary hormone secreted into the bloodstream to cause uterine contractions to go back to normal size after birth.
Used to slow/ control uterine bleeding in the 3rd and 4th stage of labor
Aka Pitocin
Prostaglandins → cervical softening and increased uterine contractions.
Oxytocin and Prostaglandin are the contraction hormones
Dilute 10-40 units in 1L of fluid and infuse at a rate of 20-40milliunits/min
What is pathological jaundice?
ABO incompatibility (when people have one blood type and receive blood from someone with a different blood type)
Usually occurs within the first 24 hours
Mom is A baby is B+
Explain a cyanotic heart defect.
A group of heart malformations or lesions that have R> L blood flow shunts. Blood flows abnormally which perfuses the pulmonary circulation to L side of heart and systemic circulatory system. They all produce some level of cyanosis.
Characteristics of cyanotic heart defects: defects that mix oxygenated and deoxygenated blood, Infant that is ductal dependent, Low pulmonary blood flow, or high pulmonary blood flow.
Includes: Transposition of the great arteries, Tetralogy of Fallout, Hypoplastic left heart syndrome (HLHS), Tricuspid Atresia
How would you care for a child with bacterial meningitis?
Dxed by CBC,CSF culture, and blood culture and start ordered ABT immediately. Corticosteroids may also be administered to prevent cerebral edema, and anticonvulsants.
Considerations: Keep IV patent , symptom management, and fluids as needed.
Maintain strict airborne/contact isolation left in place for 24-48 hrs until after the ABT Tx is begun,
Monitor for increasing ICP and Head circumference
Post op care for a child with cleft lip
Maintain an airway free of secretions and monitor for edema or any narrowing that could lead to airway compromise. Assess for distress, cyanosis, tachycardia, or restlessness.
Monitor for infections: DO NOT TAKE ORAL TEMP, to prevent tissue damage
Treat pain promptly and thoroughly reevaluate at regular intervals and provide distraction/diversion.
Try not to put anything in the baby’s mouth, soft restraints may be placed on the child to keep hands out of the mouth.
Antibiotic cream that can be placed in the baby's mouth to prevent infection
Why would we give the Gardisil Vaccine?
given to prevent HPV which is associated with certain types of cancers
Recommended for both boys at and girls around age 11
3 doses, initial, then the 2nd dose at 2 months and the 3rd dose at 6 months
What are Signs of preeclampsia?
Constant headache
High blood pressure
Double vision
Becomes eclampsia when a seizure occurs