Unit 1
A toddler has to receive a shot, he is experiencing extreme anxiety. How can you involve the parent in this process to decrease anxiety?
Let the child sit on the parent's lap
What are classic signs and symptoms of dehydration in children? (Give me at least 5)
weight loss, rapid pulse, hypotension, decreased cap refill, decreased urinary output, decreased skin turgor, dry mucosa, absence of tears, sunken fontanelles, decreased wet diapers/decreased urinary output.
What is the nurse's first action for a child experiencing a tet spell?
Knee-to-chest position; common with tetralogy of fallot (VSD, pulmonary stenosis, overriding aorta, right ventricular hypertrophy)
What is the most common cause of speech delay?
Hearing impairment
A child with hemophilia falls and scrapes her knee. Her parents immediately apply pressure to the site and cold therapy. An injection of factor ____ is necessary in this situation as well.
Factor 8 (clotting factor missing in kids with hemophilia)
What is Cyclic Sorrow?
Grief that recurs at predictable time during the child's life, especially during times of unmet or delayed developmental milestones.
What is the biggest complication/risk for a child with tracheoesophageal fistula?
Aspiration!
CMs: coughing, choking, cyanosis
What are the signs of Respiratory distress infants? (4)
RR greater than 60 (normal= 30-60), muscular retractions, audible wheezing, nasal falring.
What is the definition of Munchausen by proxy?
Fabricating or inducing illness in another person because it allows perpetrator to gain attention and self-esteem from others
The nurse receives an order to baclofen via pump. What does the nurse anticipate this medication and route is being for?
Muscle relaxant used for cerebral palsy
How should assessment procedures be done for a child?
from least to most invasive!
A child is n your unit with a know Wilm's Tumor in the abdomen. The new resident asks the nurse if she is able to palpate the mass for further education. How should the nurse respond.
NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO
What are the definitions for the following types of Juvenile Rheumatoid Arthritis?
-Pauciarticular, Polyarticular, Systemic onset
-Pauci: 4 or less joints affected
-Poly: 5 or more joint affected
-Systemic: variable arthritis
What are nursing considerations for osteogenesis imperfecta?
"Brittle Bone Disorder"
Carful handling (scoop rather than hold by armpits; educate no contact sports
A child with Beta Thalassemia is experiencing high levels of iron in the blood, what medication does the nurse anticipate giving?
Desferal (chelation therapy to remove iron from the body caused by excess RBC breakdown)
What are the 3 principles of Atraumatic Care?
2. Promote a sense of control
3. Prevent or minimize bodily injury and pain
A child is recently found to have scabies. The nurse should instruct the parents that along with the child, these people also need to be treated...
ANYONE who had close contact with the child needs to be treated
Tell me the difference between Hodgkin and Non-Hodgkin lymphoma and which is harder to treat.
Hodgkin: nodular, Reed-Sternberg cells present.
Non-Hodgkin: diffuse/systemic, harder to treat
What are the two main complications with shunts for hydrocephalus?
Shunt malfunction; infection
(used to drain excess CSF from the head)
What is Phenytoin used for and what is a serious adverse effect?
Use: anticonvulsant commonly used to prevent seizures with epilepsy.
A/E: causes skin to slough at the IV site
What are the Erikson Stages for each age group? (need all 5)
Infant: Trust vs. Mistrust
Toddler: Autonomy vs. Shame and Doubt
Preschoolers: Initiative vs. Guilt
School-Aged: Industry vs. Inferiority
Adolescents: Identity vs. Role Confusion
A child presents with new found enuresis, polydipsia, and polyuria. The doctor orders for the patient to be NPO until results come back, should the nurse question this order? If yes, why?
YES. These are signs of Diabetes Insipidus, a child with DI should never be NPO without IV fluids running!
What are the priority interventions for a child in sickle cell crisis (give me 3)
-Oxygen
-IV fluids
-Pain management (morphine around the clock)
-Rest (decrease oxygen demand)
Give me 3 s/s of increased ICP from each category.
-Early:
-Late:
-Infant:
Early: Headache, vision changes (diplopia), N/V, dizziness, vertigo, pupils not equal or not normally reactive, sunset eyes, seizures, slight change in LOC or vital signs
Late: Significant decrease in LOC, increased SBP, widened pulse pressure, bradycardia, irregular respirations, fixed dilated pupils
Infant: Bulging fontanel Wide sutures, increased OFC, Dilated scalp veins, High-pitched cat-like cry
A child has Hypopituitarism and is receiving growth hormone therapy. The educating the parents, the nurse explains that this medications is given how... (route and how often)
SQ injection every night