Growth & Development
What is the role of a child life specialist (CLS)?
used in acute settings to work with families and children. They use creative therapeutic and play activities to foster growth and development, decrease fear and anxiety, and educate about the healthcare process
What is vaccine hesitancy, and why is it such a big deal?
Vaccine hesitancy is when we reach herd immunity and have a decrease in vaccine-preventable diseases. This comes with decreased fear and vaccines being perceived as unimportant, which gives room for people to have more concerns and refuse vaccines, causing a decrease in vaccinations. This causes the re-emergence of vaccine-preventable diseases. This is a big deal because certain populations cannot receive live vaccines and are immunocomprimised regardless, they are more susceptible and can be killed due to this.
What is the treatment of lead poisoning and how does it work?
Chelating agents bind to lead and remove it from the system.
Stridor: high-pitched whistling during inspiration indicates airway obstruction
Crackles: fine or coarse due to fluid in the lungs
Wheezes: high-pitched whistling due to narrowing of the airways
Rhonchi: low-pitched snoring due to secretions in the large airways
What is cystic fibrosis? How do we diagnose it?
Cystic fibrosis is an exocrine gland dysfunction causing thick secretions. This causes decreased chloride secretion, decreased water flow across cells, and an increase in sodium absorption. To diagnose CF, the sweat chloride test is used, and a value of > 60 meq/l is dx
Infant nutrition: breast milk or formula for how long? When to introduce cow's milk? important information regarding food allergies? What supplements are needed during this period?
Breast milk or formula for the first 6 months, then introduce solids w/, cows' milk can be introduced after 1 year. If solids are introduced too early, there is an increase of allegries, at 6 months, is when you should begin introducing solids, and some supplements needed are iron and flurioide
What are live vaccines? Who should/shouldn't receive them, and what the specific live vaccines discussed are.
Live vaccines are weakened forms of a virus or bacteria that induce a strong, long-lasting immune response. Those who should not receive live vaccines are immunocompromised individuals, pregnant people, those with allergies to the vaccine or any specific ingredient in it, and anyone with severe febrile illness. The live vaccines discussed are the MMR (measles, mumps, and rubella), RotaTeq (rotavirus), Varivax (varicella-zoster or chicken pox), and one version of the seasonal influenza Flumist.
What factor causes hemophilia A? How can we treat it? How does hemophilia get passed down? Lastly, what is hemophilia???
Factor 8 causes hemophilia A. It is treated by injecting factor 8, an antihemophilic factor called bioclate. Hemophilia is passed down through X-linked chromosomes; the mother (XX) is a carrier of the disease, but the son (XY) has that one X, causing hemophilia to be dx. Hemophilia is a clotting disorder.
A 5-year-old child is brought to the emergency department with a high fever, sore throat, drooling, and difficulty swallowing. The child is sitting upright, leaning forward, and has inspiratory stridor. What do we suspect and what are we focusing on as a nurse? What is a big no-no?
Acute epiglottitis: inflamamtiona nd edema of the epiglottis causing severe respiratory distress. As a nurse, we must focus on reducing anxiety, positioning for comfort, cool humidified oxygen, IV fluids, corticosteroids, and abx/prepping for respiratory emergency. NOOOO, examining the throat with any tools can cause immediate closure
A nurse is caring for an infant hospitalized with respiratory syncytial virus (RSV). Which nursing interventions are appropriate?
Select all that apply.
A. Place the infant on contact and droplet precautions
B. Suction nasal secretions as needed
C. Encourage small, frequent feedings
D. Administer antibiotics as prescribed
E. Monitor oxygen saturation continuously
F. Restrict visitors with cold-like symptoms
A spreads through direct contact and respiratory droplets
B thick secretions obstructs airway
C small feeds reduce fatigue and aspiration risk due to tachypnea
E hypoxia is a common complication
F: Preventing exposure reduces transmission
What are the leading causes of infant, Toddler, preschooler, and school-age injuries and deaths?
Accidental injuries regarding cars/street safety, water (drowning), burns, ingestion/poisoning, falls, and suffocation/safe sleep
A 6-year-old child is brought to the clinic with a low-grade fever, mild headache, and a bright red rash on both cheeks described by the parent as a “slapped-cheek” appearance. A lacy, pink rash is also noted on the trunk and extremities. What disease is this? How is it transmitted, and how do we treat it?
Fifth disease, aka erythema infectiosum. This is transmitted through bodily fluids such as blood and respiratory secretions, and it is a viral infection, meaning we need to let it run its course and offer tx of symptoms.
Which neoplastic disease has the rarest chance of metastizing to other parts of the body? Explain the etiology of this disease. As nurses, what is something we need to be mindful of?
Nephroblastoma, aka wilms tumor. This is a malignant renal and solid intra-abdominal tumor, often unilateral. Nurses should not perform deep palpation on the abdomen due to the potential dissemination of cancer cells to other distant sites, causing metastasis.
What is strabismus? Explain the difference between exotropia vs esotropia and symptoms and treatment.
Strabismus is the misalignment of the eyes. Exotropia is when the eyes turn outward, and esotropia is when the eyes turn inward. Symptoms of strabismus are a noticeable misalignment, a complaint of blurry vision, and the child adjusting their head to focus on objects. Treatment includes patching the eye, corrective lenses, and eye muscle surgery.
What are some signs of post op hemorrhage regarding children who have undergone a tonsilectomy? What type of shock are we most concerned with this?
increased pulse, pallor, frequent swallowing, frequent throat clearing, restlessness, vomiting bright red blood, decreased BP. Concern for hypovolemic shock.
What are Jean Piagets cogntive development stages, ages, and descriptions of the stages?
4 months - 24 months: sensorimotor stage (object permanence)
2-7 yrs: preoperational stage: (magical thinking, imaginary friends, egocentric)
7-11 yrs: concrete operational stage: (organize facts about the world to use in problem-solving
10-20 yrs: formal operational stage: (abstract thinking; scientific reasoning)
What bacteria cause serious infections such as meningitis, epiglottitis, pneumonia, septic arthritis, and sepsis? What is the vaccine called, and what is the vaccine schedule?
Haemophilus infleunza type B, the vaccine is called Hib, and the schedule depends on the brand.
3 dose series: 2 months, 4 months, and between 12-15 months
4 dose seriesL 2 months, 4 months, 6 months, and between 12-15 months
A nurse is caring for a patient admitted with an acute sickle cell pain crisis. Which nursing interventions are appropriate for managing this condition? Select all that apply.
A. administer IV opioids as prescribed for severe pain
B. Encourage oral and IV fluid intake
C. Apply cold compresses
D. administer oxygen as ordered
E. Encourage ambulation
A. Sickle cell crisis can be very painful, and for severe pain, opioids like morphine help.
B. Fluid should be encouraged and increased; this causes hemodilution and decreases the viscosity of the blood.
D. Oxygen is given to help decrease hypoxia
What is the difference between AOM acute otitis media and OME otitis media with effusion?
AOM may be a viral or bacterial infection of fluid in the middle ear, causing fever and pain. OME is fluid in the middle ear without signs and symptoms of infection, often feels full behind the ear, or has a popping sensation. OME can cause hearing loss.
This surgical incision of the eardrum alleviates pain and provides pressure-equalizing tubes to go into the tympanic membrane to facilitate drainage of fluid in the middle ear to aid in hearing. What procedure is this?
Mryingtomy performed by an ENT specialist.
What are Erik Erikson's psychosocial development stages, including specific ages and descriptions of the stages?
birth - 1 yr Infant: trust vs mistrust (I cry, you come help me, and I trust you)
1-3 yrs Toddler: autonomy vs shame and doubt (I can do it myself! or child pours milk, it spills, and parent yells "you're too little, you made a mess."
3-6 yrs Preschooler: initiative vs guilt (Child picks out an outfit, but is met with critism causes guilt and humiliation.)
6-12 yrs school-age: industry vs inferiority (child works hard on a project, but the topic is incorrect, resulting in a zero from the teacher; feels inferior and like a failure)
12-20 yrs adolescent: identity vs role confusion (teenager learns they like to play instruments. join a band, and further their education in school to become a music teacher, vs a teenager who changes their personality, clothing, style, and beliefs based on the friend group they are with due to a lack of "core" self.)
A 5-year-old child is brought into the ER. The parents claim their daughter has excessive coughing that results in redness in the face. The cough sounds like a seal, and they noticed excessive saliva. What disease is this? What vaccine helps prevent this, and what is the schedule for that vaccine? What is the treatment plan for this disease?
Pertussis or whooping cough. The vaccine that prevents this is DTaP or TdaP.
DTaP: less than 7 yrs of age: 2, 4, 6, 15-18 months and 4-6 yrs
TdaP: for adolescents 11-12 yrs
Nursing tx is high humidity, frequent suctioning, and maintaining hydration to thin secretions
What are the clinical signs of sickle cell crisis?
aplastic crisis: decreased RBC production causing anemia
hyperhemolytic crisis: increased RBC destruction causing anemia, jaundice and reticulocytosis
Acute chest syndrome: similar to pneumonia, causing chest pain, fever, cough, tachypnea, wheezing and hypoxia
Cerebrovascular accident: occluded blood vessels in the brain causing strokes and variable degrees of neurological impairment
What is the pathophysiology of asthma, and what are the acute complications that can occur?
Asthma causes airway hyperresposiveness aka bronchospasm, which then causes airway edema and bronchoconstriction, with increased mucus production plugging up the airways. Acute complications are status asthmaticus, which is when the asthma exacerbation is not getting any better despite therpeitc intevrentions possible elading to respiratory failure.
A nurse is providing discharge teaching to the parent of a child with persistent asthma. Which statements indicate the parent understands the pharmacologic management of asthma?
Select all that apply.
A. “My child should use the short-acting bronchodilator for quick relief of symptoms.”
B. “Inhaled corticosteroids should be taken daily to prevent asthma attacks.”
C. “Long-acting beta-agonists can be used alone for sudden asthma symptoms.”
D. “If my child uses a steroid inhaler, they should rinse their mouth after use.”
E. “Leukotriene modifiers help reduce airway inflammation.”
F. “We should stop controller medications when symptoms improve.”
A short-acting medication such as albuterol are rescue medication
B inhaled corticosteroids are first line controller therapy
D: Rinsing prevents thrush
E leukotriene modifiers decrease inflammation and bronchoconstriction