Neurosensory!!
S&S of ICP (early & late)
Early: changes in LOC, irritability, headache, vomiting, blurred/double vision, dizziness, decreased pulse and respirations, increased BP, decreased or unequal pupil reaction, seizure activity
Late: Lowered LOC, decreased motor & sensory responses, bradycardia, irregular respirations, Cheyne-Stokes respirations, decerebrate or decorticate posturing, fixed/dilated pupils
Omphalocele: saline-soaked gauze & sterile dressing
Gastroschisis: silo or bowel bag
Urine output for infants, children, & adolescents
infant: 1-3 mL/kg/hr
child: 0.5-1 mL/kg/hr
adolescent: 40-80 mL/hr
Family teaching for Osteogenesis Imperfecta
No contact sports
Non-weight bearing, low-impact activities
parents should lift infant from under the hips when changing diapers
parents should lift infant by the trunk when picking up
Sign specific to muscular dystrophy
VP shunt pre and postop care
Preop: frequent turning, IV antibiotics, acetazolamide & furosemide (to decrease CSF production), head circumference, baseline abdominal circumference
Postop: neuro assessments, head circumference, fontanel assessment, KEEP FLAT (supine), assess for peritonitis & paralytic ileus
-NO CONTACT SPORTS
The voluntary or involuntary passage of stool; Usually associated with constipation (retentive); Underwear soiling is the most common manifestation?
Encopresis
bladder exstrophy nursing management
supine position, keep bladder moist (plastic wrap or sterile bag), barrier cream to skin, no tub baths, change diapers immediately
S&S of DDH (developmental dysplasia of the hip)
positive Ortolani (most important test) & Barlow test
Trendelenburg gait
Uneven skin folds on legs
Difference in leg lengths (Galeazzi sign)
Limited hip movement w abduction
first sign of botulism
constipation
Signs associated w meningitis
Kernig & Brudzinski
S&S of Esophageal Atresia & Tracheoesophageal Fistulas
Three Cās: Cyanosis, coughing, and choking
copious/frothy bubbles of mucus in the mouth and nose, drooling, abdominal distension, rattling respirations
Medications for enuresis
spinal fusion post op care & education
log roll technique, turn every 2 hours, flat right after surgery
types of cerebral palsy & what they look like
Spastic: stiff muscles (most common)
Dyskinetic: Muscles alternate between high and low tone, rapid jerky movement
Ataxic: difficulty with coordination & steady gait
Mixed: combination of more than 1 type
A lumbar puncture is performed on a child suspected to have bacterial meningitis, and cerebrospinal fluid (CSF) is obtained for analysis. The nurse reviews the results of the CSF analysis and determines that which results would verify the diagnosis?
Cloudy CSF, elevated protein, and decreased glucose levels
List two nursing interventions to consider with post-op cleft lip repair
Keep patient supine
Utilize restraints to immobilize elbows
Promote skin-to-skin with parents as tolerated
Specialized nipples when they can start to feed
Monitor site for s&s of infection
Medications for Nephrotic syndrome
Corticosteroids (1st line); immunosuppressants; diuretics; ACE inhibitors; IV albumin; cytotoxic agents
The nurse is assisting a primary health care provider (PHCP) during the examination of an infant with developmental hip dysplasia. The PHCP performs the Ortolani maneuver. The nurse determines that the infant exhibits a positive response to this maneuver if which finding is noted?
A palpable click during abduction of the affected hip
Types of Spina Bifida & What they look like
Spina bifida occulta: no obvious protrusion. Hair tuft in area of defect
Spina bifida with meningocele: protrusion that contains only the meninges
Spina bifida with myelomeningocele: protrusion that contains meninges and spinal cord
The nurse is reviewing the record of a child with increased intracranial pressure and notes that the child has exhibited signs of decerebrate posturing. On assessment of the child, the nurse expects to note which characteristic of this type of posturing?
Rigid extension and pronation of the arms and legs
The nurse is caring for a school-age client who had an appendectomy after a ruptured appendix. Which orders does the nurse anticipate for this client? Select all that apply.
1. Antibiotics
2. Clear liquid diet
3. NG tube
4. Vital signs every 4 hours
5. Frequent monitoring of bowel sounds
1, 3, 4, 5
Antibiotics, an NG tube, vital signs every 4 hours, and frequent monitoring of bowel sounds are appropriate interventions following a ruptured appendix. The client is NPO until bowel sounds return
Hemolytic-Uremic Syndrome (HUS) is characterized by
hemolytic anemia, thrombocytopenia, and acute renal failure
Legg-Calve-Perthes Disease stages
avascular necrosis
fragmentation/resorption
reossification
healing
Guillain-Barre syndrome vs. Botulism
How does it progress? How do you get it? How is it diagnosed?
Guillain-Barre: ascending bilaterally; after a viral or bacterial infection; diagnosed by lumbar puncture (increased protein, negative bacterial and viral cultures)
Botulism: Descending bilaterally; honey or construction sites; diagnosed by history and stool culture