Fluid/Electrolyte
Clinical s/s of mild, moderate and severe dehydration
Mild: increased thirst, dry MM
Severe: Rapid pulse, rapid/shallow breathing, decreased skin turgor
Teaching for parents of a child with enuresis
restrict evening fluids, abstain from sugary drinks, possible medication, voiding right before bed
s/s of gastroesophageal reflux in an infant
vomiting, arching back, failure to thrive
Education for infection prevention in a child who is on chemo treatment
hand washing, avoiding sick people and crowds
Symptoms of DKA
Hyperglycemia, fruity breath, ketones in urine, kussmal breathing, lethargy
Nursing interventions for an infant diagnosed with spina bifida cystica
apply sterile,moist dressing
educate family on surgical repair
Frequent neuro assessments
Home education on cast care
Elevate to prevent swelling
avoid getting wet, unless a waterproof cast
Do not put anything down the cast
When should a child be switched over to po fluid rehydration?
moderate dehydration, no vomiting, decrease or no diarrhea, desire to take po
Steps to obtaining a urine sample via a UA bag
Wash the area, dry the area, apply the urine bag attempting a good seal, once there is urine remove the bag, label and send urine to lab
Education for parents of a reflux baby to help reduce vomiting
Small/more frequent feeds in upright position
Frequent burping
Thicken feeds
What chromosomal disorder is at highest risk for cancer?
Down Syndrome
Treatment of a child admitted with DKA
Obtain urine sample, start PIV (anticipate insulin drip), check blood glucose every 15 min while on insulin drip, NPO, VS Q1, Neuro checks Q4, blood gas
Home education for a baby with VP shunt
Infection precautions, signs of malfunction (bulging fontanel, irritability, vomiting, headache), if signs of malfunction go to ER
Treatment and education for Duchenne Muscular Dystrophy
steroids, ROM, remain active, encourage genetic testing for females
What fluid is best to give a child with diarrhea?
Oral rehydration fluid such as pedialyte
Diet for a child with acute glomerulonephritis
low sodium, fluid restricted
When would you notify provider prior to surgery for intussusception?
if patient passes a BM
Priority action for a cancer child that is suffering from nausea and vomiting
Give medication as ordered and document response
What topics should be included in endocrine education?
Metabolism, energy use, growth and dev, fluid and electrolytes, stress, sexual reproduction
Risk factors for febrile seizures
genetic predisposition, viral illness
What members of the healthcare team are expected to participate for a child with CP?
Pt, caregivers, speech, OT
What is the most common cause of water intoxication?
Inappropriately prepared formula
What do you expect to see in the urine of a child with acute glomerulonephritis?
Protein
Interventions for Hirschprung disease prior to surgery
empty bowel, IVF, consent, abdominal circumference
Symptoms of ALL
wounds not healing, bruising, complaints of bone and joint pain
How frequently should a type 1 diabetic check blood sugars?
before meals
Risk for Reye syndrome
Use of aspirin during a viral illness
Best way to improve mobility in a child with CP
passive ROM
Nursing priority prior to giving MIVF with K+
evaluate electrolytes and urine output
What are signs indicating a UTI in a pediatric patient?
fever, hematuria, foul smelling urine, leukocytosis, positive urine culture, vomiting,lethargy
What foreign bodies that are ingested are considered surgical emergencies?
magnets, button battery
What tests can you anticipate in a child with symptoms of ALL?
CBC, CT, Urine
Teaching for a new type 1 diabetic
check glucose before taking insulin, contact provider for hyperglycemia, check glucose more often when sick, know s/s of hypo/hyperglycemia
Priority nursing action for a child brought in for concussion
ABCs, neuro assessment
Education for parents with an infant in pavlik harness
No lotion/powder, massage under straps, check skin frequently for irritation
Name 3 things that require an increase in fluid requirements?
fever, tachypnea, vomiting, diarrhea, shock
What is the preferred method to collect urine in a pediatric patient?
clean catch
What is the pathophysiology of hirschsprung disease and assessment findings?
Absence of ganglion cells
abdominal mass, unable to pass stool, visible peristalsis
What lab would you expect to evaluate for a child with cancer who has sustained unexplained bruising?
Platelets
How to administer growth hormone
subcutaneous, 90-degree angle, At bedtime
s/s and priority nursing interventions of increased ICP
altered LOC, bradycardia, seizures, posturing
elevate HOB, hyperoxygenation, diuretics, surgery
Symptoms and treatment of congenital hip dysplasia
asymmetric gluteal and thigh folds, on leg longer, positive otolani test
pavlik harness
Name one thing that requires a decrease in fluid requirements
heart failure, increased ICP, renal failure
Most common pathogen to cause UTI in a pediatric patient?
E. coli
Gold standard diagnostic test for Hirschsprung disease
Rectal biopsy
Symptoms of tumor lysis syndrome
flank pain, lethargy, n/v, oliguria, pruritis, tetany, altered LOC
Symptoms and priority nursing action of suspected growth hormone deficiency
small for age
endocrine studies, xray, monitor growth curve
Priority assessment in a child who has experienced a near drowning
ABCs, Neuro, Temp regulation
Serial casting followed by a brace is the primary treatment for what orthopedic disorder?
Clubfoot
Water intoxication can lead to what disorder?
Seizures due to decrease in sodium
Nursing management in a child that has acute poststreptococcal glomerulonephritis
Daily weights, I&O, daily abdominal girth, low sodium diet
Symptoms of Meckel Diverticulum
bloody, painless bowel movements
Vaccine concerns with a child receiving chemo
vaccines given 2 weeks before or during chemo are considered inactive. Child should be revaccinated 3 months after chemo has stopped
Treatment for pituitary hyperfunction
surgical removal of tumor, radiation
Symptoms and Nursing interventions for meningitis
fever, irritability, bulging fontanelle, poor feeding
Droplet isolation, Tylenol prn, Neuro assessment, IV abx for bacterial, no abx for viral
Medications and priority assessment for a child with JRA
NSAIDs, Antirheumatic drugs, Biologic agents, Steroids
Priority assessment: signs of bone marrow suppression and infection, liver function if on metotrexate
What is the most frequent cause of hypovolemic shock in children?
blood loss
Characteristics of nephrotic syndrome
proteinuria, hypoalbuminemia, hyperlipidemia, facial edema, urinary protein loss
Signs and symptoms of pyloric stenosis
nonbilious projectile emesis, visible peristalsis, failure to thrive, dehydration, metabolic alkalosis, abdominal distention, constant hunger
S/s, testing and precautions with Wilms tumor
hematuria, non tender abdominal mass, hypertension
CBC, CT, UA
do not push/rub abdomen or flank
Define precocious puberty
Sexual development before age 9 in boys or before age 8 in girls
Gold standard test to diagnose epilepsy
EEG
Appropriate education to give a parent of a child with CP that has difficulty eating
frequent, small meals
Priority management of shock
Oxygenation and ventilatory support
Symptoms of DI in the newborn
vomiting, fever, failure to thrive, hypernatremia
Symptom triad for intussusception
sudden onset abdominal pain, sausage like abdominal mass, bloody stools
expected lab values post chemo
decrease in platelets, leukocytes, erythrocytes
Education topics to discuss with a family of a child with chronic hormone imbalance
metabolism, energy, growth and development, fluid and electrolytes, stress, sexual health
s/s of concussion
headache, periods of confusion or amnesia, difficulty concentrating
Assessment findings associated with compartment syndrome and priority nursing action
increased pain, numbness and tingling
priority action: call the provider