Ch.49
Answer: This characteristic of pediatric skin makes it more vulnerable to irritants and infections, necessitating careful monitoring even for minor abrasions.
Question: What is thinner skin?
Answer: This device is used in complex fractures to lengthen bones and helps stabilize fractures or displaced vertebrae in the cervical and thoracic areas. It is crucial to perform neurological checks when using this device.
Question: What is a Pediatric Halo Traction External Fixation Device?
What are some Nursing interventions?
Clue: This rare condition, characterized by excessive urination and extreme thirst, is caused by the body's inability to properly balance fluid levels due to issues with antidiuretic hormone (ADH).
Answer: What is Diabetes Insipidus (DI)?
NI?
TX?
Clue: In managing this condition in children, it is crucial to perform neurological and LOC assessments, monitor vital signs, maintain the head of the bed at a 30-to-45-degree angle, and avoid neck or hip flexion. Other important steps include monitoring pupil size, measuring head circumference daily, and having emergency equipment available.
Answer: What is increased intracranial pressure (ICP)?
Answer: This condition requires immediate medical attention. Initial treatment includes stabilizing the patient, administering activated charcoal if within one hour of ingestion, and providing N-acetylcysteine (NAC) either orally or intravenously to prevent liver damage. Supportive care such as intravenous fluids and anti-nausea medication may also be necessary.
Question: What is the treatment for acetaminophen overdose in pediatrics?
Answer: These flat, gray-green or blue lesions are present at birth and are most commonly found on the lumbosacral regions or buttocks, resembling bruises but are benign and typically fade by the age of 4 to 5 years.
Question: What are Mongolian spots?
Answer: This bone infection can result from direct entry through an open fracture, injury to surrounding soft tissues like cellulitis, external fixation devices, and skeletal traction. In infants, its manifestations can be vague and nonspecific, including symptoms such as fever, irritability, lethargy, and feeding difficulties.
Question: What is osteomyelitis?
Treatment:
NI
Clue: This autoimmune disorder is characterized by symptoms such as goiter, increased appetite, weight loss, nervousness, diarrhea, increased perspiration, heat intolerance, increased heart rate, muscle weakness, palpitations, tremors, exophthalmos, poor attention span, and behavior or school problems.
Answer: What is Graves' disease?
NI?
TX?
Clue: This type of abnormal posturing involves flexion of the upper extremities and extension of the lower extremities, indicating injury to the cerebral hemispheres?
Answer: What are decorticate posturing?
Both types of posturing are serious and require immediate medical attention.
Answer: These are the most common causes of cardiopulmonary arrest in children.
Question: What are the factors leading to shock and respiratory failure in children?
Key factors to assess include respiratory rate and effort, skin color, and response to the environment.
Answer: This condition involves nits visible and attached to hair shafts near the scalp, causing severe itching and scattered lesions, and is effectively treated with permethrin 1% (Nix).
Question: What is pediculosis capitis (head lice)?
Answer: This chronic condition in children causes persistent joint inflammation, leading to symptoms such as pain, swelling, and stiffness. It often requires a combination of medication, physical therapy, and lifestyle adjustments to manage.
Question: What is juvenile idiopathic arthritis?
What are some types of activities a child should participate in?
What Medications would be prescribed?
Clue: This autoimmune condition in children is characterized by the body's inability to produce insulin, leading to symptoms such as increased thirst, frequent urination, extreme hunger, and unintentional weight loss.
Answer: What is Type 1 diabetes?
Teaching?
Treatment?
NI?
Clue 2: This type of abnormal posturing involves extension of the upper extremities with internal rotation of the upper arm and wrist, indicating damage to the brainstem areas such as the pons, midbrain, or diencephalon.
Answer: What is decerebrate posturing?
Both types of posturing are serious and require immediate medical attention.
Answer: This condition is a leading cause of injury-related death in the United States. Assessment includes identifying the substance ingested, the amount ingested, the approximate time of ingestion, changes in the child’s condition, and any treatment administered at home. Diagnostic evaluation involves toxicology of urine, serum, and stomach, glucose level checks, X-rays and blood gases if hypoventilation is present, and liver enzymes and kidney function tests. It can cause unusual neurological signs, neuropathy, anemia, and cognitive delays. Blood lead levels should be tested, and chelation therapy is used to remove lead.
Question: What is lead poisoning?
Answer: This lotion should be kept on for 8 to 12 hours, followed by bathing, and infants should be clothed during treatment to prevent them from licking their skin.
Question: What is permethrin (Elimite) lotion?
Answer: This congenital condition is characterized by one or both feet being twisted out of shape or position. Treatment often involves stretching, casting, and sometimes surgery to correct the deformity.
Question: What is clubfoot?
Why would Casting be done before surgery?
Clue: This life-threatening complication of diabetes is characterized by symptoms such as excessive thirst, frequent urination, nausea, vomiting, abdominal pain, dehydration, Kussmaul respirations, fruity-scented breath, and lethargy.
Answer: What is Diabetic Ketoacidosis (DKA)?
Treatment?
NI?
Clue: During a seizure at home or at school, it is advised to place the child on their side in a lateral position, avoid restraining them, and loosen clothing around their neck.
Answer: What are the steps to take during a seizure?
Answer: This type of shock involves an abnormality in blood flow or the inability of the body to maintain vascular tone through vasoconstriction. It can be caused by anaphylaxis, spinal cord injury, or drug intoxication. Symptoms may include extremities that are warm to the touch, tachycardia, tachypnea, and early signs of hyperthermia or hypothermia.
Question: What is distributive shock?
NI?
Tx?
Answer: This condition, caused by the Sarcoptes scabiei mite, spreads through close personal contact and causes intense nighttime itching, with burrows, papules, vesicles, and nodules being common symptoms.
Question: What is scabies?
Answer: This device is used to treat developmental dysplasia of the hip (DDH) in infants. It holds the baby's hips in a position that allows the hip joint to develop properly. Parents are taught how to apply and adjust the harness to ensure it remains effective.
Question: What is a Pavlik harness?
What are some nursing considerations for preventing skin breakdown?
Clue: This condition in infants is characterized by signs such as skin mottling, a large anterior fontanel, a large tongue, hypotonia, slow reflexes, a distended abdomen, prolonged jaundice, lethargy, constipation, feeding problems, coldness to touch, umbilical hernia, hoarse cry, and excessive sleeping.
Answer: What is congenital hypothyroidism?
NI?
TX?
Clue: These congenital neural tube defects are classified by incomplete closure of the vertebrae and can manifest as spina bifida occulta or spina bifida cystica, often identified by a small tuft of hair or dimple in the lower lumbar sacral area.
Answer: What are neural tube defects (NTDs)?
Answer: This type of shock is the most common cause of decreased circulating blood or fluid volume. Symptoms may include dry mucous membranes, depressed fontanel, cold/clammy skin, poor skin turgor, low urine output, and delayed capillary refill. Hypotension is a late sign of this condition.
Question: What is hypovolemic shock?
NI?
TX?
Answer: This disorder of sebaceous hair follicles affects 80% of adolescents and includes symptoms such as closed papules, pustules, whiteheads, blackheads, nodules, and cysts. Treatment goals include preventing scarring and promoting a positive self-image.
Question: What is acne?
Answer: This type of injury involves damage to muscles, ligaments, or tendons, often resulting from a fall, twist, or blow. Common symptoms include pain, swelling, and bruising. Treatment typically includes rest, ice, compression, and elevation (RICE).
Question: What is a soft tissue injury?
Clue: This condition, caused by the thyroid gland not producing enough hormones, can lead to symptoms such as fatigue, weight gain, increased sensitivity to cold, constipation, dry skin, and depression.
Answer: What is hypothyroidism?
NI?
TX?
Clue: Treatment for this condition may include surgery to repair the spinal defect, managing complications such as hydrocephalus with a shunt, and using assistive devices like braces or wheelchairs to aid mobility.
Answer: What is the treatment for neural tube defects (NTDs)?
•Increased risk for latex allergy
•Lifelong management of neuro, orthopedic
and urinary problems
•Bowel and bladder problems exist in 75% of
children with spina bifida
Answer: This condition occurs when the body overheats and can't cool itself, often due to excessive sweating and dehydration. Symptoms include heavy sweating, dizziness, nausea, headache, weakness, and an elevated heart rate. Treatment involves moving to a cooler place, drinking fluids, removing tight clothing, and applying cool compresses. If symptoms do not improve within an hour, seek medical help.
Question: What is heat exhaustion?
Compare Heat cramps, Heat Exhaustion, and Heat Stroke.
Answer: This term describes a burn pattern with a sharp line dividing burned skin from unburned skin, typically resulting from immersion in hot water.
Question: What is the "stocking" or "glove" appearance?
Answer: These types of fractures in infants are rare due to the cartilaginous nature of their skeletons and often result from significant trauma during birth or nonaccidental trauma. Spiral fractures in young children, especially those not yet walking, can be highly suspicious for child abuse.
Question: What are fractures in infants and spiral fractures in children as a result of child abuse?
Also, bruising at different stages of healing.
Clue: This chronic condition is characterized by high levels of sugar in the blood due to insulin resistance and relative lack of insulin. Common symptoms include increased thirst, frequent urination, fatigue, and unexplained weight loss.
Answer: What is Type 2 Diabetes Mellitus?
NI?
Teaching?
TX?
Clue: This chronic, nonprogressive disorder of posture and movement in children is characterized by difficulty controlling muscles and may include comorbidities such as cognitive impairment, hearing and speech impairment, visual impairment, and seizures. Manifestations include persistence of primitive reflexes, delayed gross motor development, abnormal muscle tone, gait disturbances, and speech/swallowing impairments.
Answer: What is Cerebral Palsy (CP)?
TX?
Teaching?
Answer: This condition can cause immediate symptoms such as drooling, dysphagia, pain, vomiting, and sometimes bleeding in the mouth, throat, chest, or abdomen. Treatment includes avoiding gastric emptying, providing supportive care, and possibly diluting the substance with milk or water if ingestion was recent. Severe cases may require antibiotics and surgery for esophageal or gastric perforation.
Question: What are the symptoms and treatments for ingesting an acidic substance?
Answer: These burns affect only the outer layer of skin, causing redness, minor swelling, and pain, and typically heal within a few days without scarring.
Question: What are first-degree burns?
Answer: Signs of this condition include severe pain, often unrelieved by analgesics, and signs of neurovascular impairment. If extending the fingers or wiggling the toes produces pain, and/or the quality of the radial or pedal pulse is poor to absent, it is crucial to notify the physician immediately.
Question: What are the signs of compartment syndrome?
Clue: For children with this condition, balancing meals and snacks with insulin action is crucial to avoid hyperglycemia or hypoglycemia. Adherence to a consistent daily schedule of food intake and insulin injections helps achieve metabolic control.
Answer: What is Type 1 Diabetes Mellitus (DMI)?
Clue: This medical device, often used to treat hydrocephalus in children, involves a long plastic tube that drains excess cerebrospinal fluid from the brain to the peritoneal cavity, helping to relieve pressure on the brain.
Answer: What is a ventriculoperitoneal (VP) shunt?
NI?
Answer: This part of the trauma assessment involves obtaining a history of the injury, using trauma scoring to objectively measure the severity, and assessing for child abuse. Indicators of abuse include a history inconsistent with physical findings, activities leading to trauma that seem inconsistent with the child's age or development, delays in seeking treatment, a history of other emergency department visits, fractures in various stages of healing, patterns of injury caused by specific objects (such as cigarette burns or belt marks), and injuries rarely found in children when the history does not match the injury (such as long bone or rib fractures).
Question: What is the secondary survey in pediatric trauma assessment?
Answer: This chart is used to calculate the total body surface area burned (TBSA) in children and corrects for the age of the child.
Question: What is the Lund and Browder chart?
Answer: Nursing interventions for this condition include performing frequent neurovascular checks, administering prescribed analgesics, and educating the patient and family about the signs and symptoms. Loosening restrictive dressings or casts and preparing for potential fasciotomy are also crucial.
Question: What are nursing interventions for compartment syndrome?
Clue 1: This condition in children can result from too much insulin, missed meals, or excessive exercise, leading to symptoms like shakiness, dizziness, sweating, and irritability.
Answer: What is hypoglycemia?
NI?
Treatments?
Teaching?
Answer: This procedure involves measuring cerebrospinal fluid (CSF) pressure and obtaining a specimen by inserting a needle into the subarachnoid space between the L3 and L4 or L4 and L5 vertebrae. It is used to identify hemorrhage or infections. Nursing care includes obtaining signed consent, instructing the child to lay on their side with knees up to the chest, ensuring the child lies flat after the procedure, encouraging fluids, and using a topical anesthetic at the insertion site.
Question: What is a lumbar puncture?
Risks?
Teaching?
Answer: For children over one-year-old, this maneuver involves standing behind the child, placing your fists between the navel and the bottom of the breastbone, and giving quick inward and upward thrusts. For infants under one-year-old, it involves a combination of back slaps and chest thrusts to clear the airway.
Question: What is the Heimlich maneuver?
Answer: This first-line pharmacologic approach for certain pediatric conditions involves administering oral propranolol at a dose of 2 to 3 mg/kg/day, divided into three doses, with heart rate and blood pressure monitored 1 to 2 hours after each dose.
Question: What is the treatment protocol for oral propranolol in children?
Clue: This assessment method for evaluating a child's limb injury involves checking for Pain, Pallor, Paresthesia, Paralysis, and Pulselessness.
Answer: What are the Five Ps?
The three A's— Agitation, Anxiety, and Analgesia—are all part of a neurovascular assessment of children with fractures or soft tissue injuries.
Clue: Children with this condition must follow a strict diet low in phenylalanine, avoiding high-protein foods such as meat, dairy, and nuts, to prevent intellectual disability and other complications.
Answer: What is Phenylketonuria (PKU)?
Teaching?
Answer: This imaging procedure provides horizontal and vertical cross-sectional images of the brain to identify abnormal tissues and structures such as brain tumors, bleeding, or fractures. Nursing responsibilities include inserting an IV and notifying the radiologist of any dye allergies.
Question: What is a CT scan?
Answer: This involves limited assessment and intervention for airway and breathing, using a towel roll to help open the airway and provide slight neck extension for neonates and infants. For obstructed airway management, infants are placed in a downward-facing position with five back blows alternating with five compressions, while older children receive the Heimlich maneuver. Cardiopulmonary resuscitation follows the CAB (circulation, airway, breathing) sequence, with compressions at a rate of 100 per minute and a depth of one-third of the chest. The ratio is 30:2 for one rescuer and 15:2 for two rescuers from neonates to puberty onset, and 30:2 for one or two rescuers for adolescents. If IV access is unsuccessful, intraosseous (I/O) access is used. Automatic external defibrillation (AED) and vagal maneuvers, such as ice water to the face, are used for symptomatic tachycardia and arrhythmias.
Question: What are the key components of pediatric emergency care for airway and breathing, cardiopulmonary resuscitation, and circulation?
Answer: This condition initially appears as a vesicle or pustule that ruptures to become erosion with an overlay of honey-colored crust. Children with this condition should not attend school or daycare for 24 hours after beginning treatment.
Question: What is crusted impetigo?
Treatment?
Exclusion guidelines?
Clue: This type of traction is noninvasive and generally well tolerated by patients, while its counterpart involves the insertion of metal pins into the bone for more stable immobilization.
Answer: What are Skin Traction and Skeletal Traction?
Nursing intervention?
Assessment:
*If a child has skeletal traction: Pin site care daily
Clue: This hormone, produced by the pancreas, is essential for regulating blood sugar levels by allowing glucose to enter cells. It is often administered as a treatment for both Type 1 and Type 2 diabetes.
Answer: What is insulin?
Answer: Common triggers for these severe headaches in teenagers include lack of sleep, skipping meals, stress, weather changes, bright lights, loud noises, and strong odors
Question: What are migraine headaches?
Answer: This condition involves a severe injury or illness threatening a child's health or could cause permanent harm. Common emergencies include breathing trouble, upset stomachs, injuries, infections, and exposure to environmental dangers like drowning or poisons. Immediate medical attention is crucial to prevent long-term damage.
Question: What are common pediatric emergencies?
Answer: Parents of an infant with this condition should be taught to swab oral nystatin suspension onto the infant’s gums, tongue, and buccal mucosa. It should be applied after feedings to increase its contact time with the mucous membranes.
Question: What is thrush (oral candidiasis)?
Clue: This form of Muscular Dystrophy, characterized by progressive muscle atrophy and weakness, typically begins in early childhood and often leads to loss of walking ability by ages 9 to 12.
Answer: What is Duchenne Muscular Dystrophy (DMD)?
Treatment plan?
Clue: Children with this condition can safely participate in sports and exercise, which helps improve insulin sensitivity and maintain healthy blood sugar levels. However, they need to monitor their blood sugar levels closely and adjust their insulin and diet accordingly.
Answer: What is Type 1 Diabetes?
Answer: This life-threatening condition requires immediate medical attention. Initial treatment involves stabilizing the patient and administering diazepam (Valium), lorazepam (Ativan), or midazolam (Versed) intravenously. If IV access cannot be obtained, medication can be given orally or rectally. A dose of the child’s usual antiepileptic should be given. If the seizure continues, a second dose of benzodiazepine should be administered. Fosphenytoin (Cerebyx) or phenobarbital may be given IV as a second round of drugs if diazepam or lorazepam does not stop the seizures. The intramuscular route is not used due to unpredictable absorption. Third round medications include valproate (Depakote) and levetiracetam (Keppra). Prioritization involves rapid identification, prompt medication administration, and continuous monitoring.
Question: What is status epilepticus?
This nursing course includes maternal newborn care and pediatric care; it may be your favorite class.
What is N 226:)