Cardiac
pre procedure Cardiac Catheterization
assessment, VS, mark pulses, educate developmentally
Infant with S&S of UTI--collect specimen with U bag or straight cath
straight cath if need culture
diagnosis of Hodgkin Lymphoma
lymphnode biopsy with + Reed Sternberg cells
Infant Fluid Imbalance affects this electrolyte
Sodium with risk of seizure
Most common time for infant to experience constipation
changing type of feeding--breastfeeding to formula
Diet for Acute Glomerulonephritis
low sodium, low protein
newborn RR 32--normal or abnormal
normal
Labs if suspect urosepsis
Lactic acid, WBC, UA/culture
when is closure of PDA and management
closes in 1st week or use indomethacin
Nursing consideration for chronic renal failure with FTT
monitor diet of high calories, high protein
management Thrombocytopenia
Avoid unnecessary punctures, cold, pressure, platelets, no rectal temperature, no ASA
What is Hourly urine output formula
1-2 ml/kg
Risk if swallow battery or magnet
necrosis
Interventions to prevent a UTI
avoid holding, no tight pants/diapers, wipe front to back, good fluid intake, good toileting
When to hold digoxin
<90bpm in infants or <70bpm in children
Iron Deficiency Anemia
Low RBCs, H&H; Elevation of total iron-binding capacity
post op Cardiac Catheterization complications
site bleeding, Pulseless Extremity, Dysrhythmia
Infant with HF and history of edema
daily weights
Meds for sickle cell
Hydroxyurea, opioids--morphine/hydromorphone
Why children more at risk for electrolyte imbalance
Greater Body surface area, •Higher metabolic rate, •Immature kidneys
What foods to avoid with Diarrhea
BRAT diet (bananas, rice, applesauce, toast)
How to collect specimen if suspect systemic infection from urologic source
straight cath
3 yr old female BP 84/42--normal or abnormal
hypotensive, abnormal
Digoxin Therapeutic levels
0.5–2 ng/mL
Management of VSD
If no spontaneous closure 1 year then cardiac cath or surgery
Endocarditis possible new murmur
Obtain a EKG
What need before blood transfusion
type/cross, consent, VS, Y tubing, NS
ways to assess edema
daily weights, Lower extremity pitting edema, abd girth measurement for ascites
This can be a cause if failure to pass meconium w/in 24-48 hours
Hirschsprung disease
Manifestations include Oliguria, periorbital edema, HTN, Hematuria, Proteinuria
Acute Glomerulonephritis
Toddler with HF, pulse 168 & irregular--type of med needed
tachycardic needs Beta Blocker
Labs with chronic renal failure (no values)
low RBCs, Hyperkalemia, hypovolemia, Hyperphosphatemia, Hypocalcemia, low pH
BP greater on upper extremity than lower extremity
Coarctation of Aorta
Priority checks post op Cardiac Catheterization
VS, pulses, dressing
Thalassemia treatment
blood transfusions, deferoxamine, deferasirox, vitamin C
Classic “Shocky” patient
•Cool, clammy, diaphoretic, pale
Education on Celiac Disease diet
•No gluten – Wheat, rye, barley, oats
Education of taking antibiotics
compliance, brush teeth after taking at night, can crush meds, mix with soft food
18 month infant with iron deficiency anemia and pulse 155 RR 40
abnormal--tachycardia, tachypnea
urine specific gravity 0.025--hydrated or dehydrated
dehydrated
management of Kawasaki Disease
aspirin, IVIG, Lip balm, cool compress, mouth care, loose clothes, soft food
Tetralogy of Fallot --Hypercyanotic spells
knee chest
How to administer iron supplementation
liquid or tablet, water or juice, no milk, give with straw or syringe
Stop the burn
Remove heat source! Run under cool water, remove clothing, remove jewelry
Causes of colic
feeding too quickly, overfeeding, swallowing excessive air, improper technique (position/burping), emotional stress, milk allergy
Manifestations include Proteinuria, Hypoalbuminemia, ascites, edema, hyponatremia, Hyperlipidemia
Nephrotic Syndrome
12 year old male with sickle cell--BP 82/49 pulse 128--normal or abnormal
abnormal--anemia, sepsis
sickle cell vasoocclusive crisis
elevated reticulocyte count, bilirubin, WBC, decreased Hgb
Post GABHS infection with manifestations of carditis, endocarditis, joint pain
Rheumatic Fever
sickle cell Vasocclusive Crisis--IV fluids, IV abx, pain medication
IV fluids
signs of cerebral and GI bleeding
cerebral, headache, slurred speech, loss of consciousness; GI, black tarry stools
what is the Parkland formula
fluid replacement in a 24 hour period post burn
Treatment for Encopresis
Manage constipation, bowel training
Source of Hemolytic–Uremic Syndrome
under cooked meat, unpasteurized apple juice, public pools
8 yr old pulse 82 RR 20--normal or abnormal
normal
Acute Appendicitis
elevated WBC, CRP
educate child on dressing changes
use doll to show process, picture books, videos, reward systems
Acute renal failure with oliguria, dehydration--most immediate risk
hyperkalemia, abnormal EKG
treatment for Von Willebrand Disease
Infusion of von Willebrand protein concentrate
Pain management post burn
IV or IN Fentanyl
nursing care of Cleft Palate
upright position, special bottle, burp frequently
Most common cause of Acute Renal Failure
severe dehydration
5 yr female BP 126/82--normal or abnormal
abnormal, HTN
Leukopenia labs
Low ANC <500/mm3; WBC < 3
Progressive with S&S faint pulse, hypotension, tachycardia, poor feeding, exercise intolerance
Aortic Stenosis
post cardiac surgery prevent hyperkalemia
antibiotic prophylaxis
Education on Henoch Schönlein Purpura
Only temporary and wear long pants, sleeves
burn degree with charring and limited movement
4th degree
What is McBurney's point and Rovsing sign
•RLQ pain at McBurney’s point; rebound tenderness
•Rovsing sign – tenderness in RLQ during palpation of other quadrants
Chronic Renal failure manifestations
edema, HTN, hypovolemia, Hyperkalemia, Acidosis, anemia, ´Increased phosphorus
infant RR 38--normal or abnormal
abnormal
diagnosis of hemophilia
Amniocentesis, decr. Factor VIII or IX, prolonged PTT
HF Pathophysiology of right vs left
•Right-sided failure
•Reduced function à peripheral edema
•Left-sided failure
•Increased pressure; lung congestion
management of gastroschisis
cover with sterile, moist dressing, warmer, IV fluids
sickle cell risk complications/risks
Acute Chest syndrome, Pn, thrombus, Splenic sequestration, anemia, sepsis
Which degree of burn counts towards TBSA
2nd, 3rd, 4th
currant red jelly-like stools, abdominal palpable sausage shaped mass
Intussusception
UTI manifestations infant --2 yr
Lethargy, poor feed, irritable, V, D
1 yr male BP 82/43, P 156, RR 32--normal or abnormal
abnormal
Idiopathic Thrombocytopenic Purpura labs
PLT <20,000