Growth and Development
What is something you could recommend a parent to give their child who is reluctant to sleep on their own or in their own room?
A flashlight or night light. Most younger children have a fear of the dark so illuminating their room could be a safe intervention
What are the 2 live vaccines in pediatrics and what is significant about them?
Varicella and MMR
Must be at least 1 year of age before they can receive live vaccines.
Other contraindications would be an allergy to the vaccine or immunocompromised. A fever is not a contraindication!
When assessing the respiratory rate on a child what are some things to consider?
Count respirations for a full minute (respirations are irregular in infants, that's why we count for a full minute)
You can count by auscultating or by watching the abdomen rise and fall
If respiratory rate is in a normal range and there are no signs of distress you will continue to monitor and continue with the remaining vitals
What is one intervention that is important when treating a patient in a sickle cell crisis and why?
IV or oral hydration. Fluids help in reducing the sickled cells from sticking or clumping together.
What preventable maternal condition increases the risk for a newborn to have a congenital heart defect?
Rubella
While the mother should not receive the MMR during pregnancy, she should have the immunization prior to getting pregnant to reduce the risk of the baby being born with a congenital heart defect
A child who is previously potty trained becomes ill and has to be hospitalized. When in the hospital the child has to wear pull ups because they are wetting the bed. This is an anticipated response we call what?
Regression
Often times kids will regress due to stress, illness, or change in their routine.
We recommend parents not to bottle prop for feeding due to the increased risk for what concern?
Dental Caries
Epiglottitis is a severe respiratory condition that can be avoided by the use of what vaccination?
The HIB vaccine
What is the pathophysiology of the pain someone in a sickle cell crisis endures?
The pain in a sickle cell crisis comes from the sickled cells occluding the vessels and causing ischemia..this causes extreme pain
What are the 4 defects that must be present to be diagnosed as Tetralogy of Fallot?
Think POVRT (sounds like Poverty)
P-ulmonary Stenosis
O-verriding Aorta
V-entricular Septal Defect (VSD)
R-ight Ventricular Hypertrophy
T-etralogy of Fallot
Due to the defects there is not enough oxygenated blood to keep up with the child's metabolic demands
A 9-month-old child is dropped off at daycare and cries hysterically why the parents leave. This is an example of what?
Separation Anxiety. Children between 8-14 months of age can have this and become upset when the parents leave
What are some of the Key Points to SAFE SLEEP?
Baby should be in a crib or bassinet alone, on their back, nothing loose in the crib (no bumper pads, stuffed animals, toys, or loose blankets) They can have a pacifier as this has shown in studies to decrease the risks of SIDS.
What are some key manifestations of Epiglottitis?
Tripod Position
Drooling
Air Hungry
Anxious or Restless
Remember, nothing in the mouth to assess, try to keep the child calm, and most importantly think AIRWAY Interventions!
C-Section Delivery
No Breastfeeding
Antiretrovirals
Kawasaki Disease is an autoimmune response that affects the cardiovascular system but the cause is unknown. What is one diagnostic tool that is used when diagnosing this disease?
CRASH and BURN
Which Pain Scale is appropriate for a newborn infant?
NIPS (Neonatal Infant Pain Scale)
The FLACC, FACES, and OUCHER scale are for toddlers, preschoolers and adolescents
You are assessing an infant who is admitted for dehydration after having a stomach virus for the past few days. When assessing the fontanelle, you would anticipate seeing what?
A sunken fontanelle. A sunken fontanelle can indicate dehydration. While a "bulging" fontanelle can indicate an increase of intercranial pressure (ICP) usually due from trauma or meningitis.
What is one way Cystic Fibrosis is diagnosed and what medication is essential for a cystic fibrosis patient?
Diagnosed with a Sweat Chloride Test
The skin is salty, it affects multiple systems not just the lungs, and Pancreatic Enzymes have to be given with meals to help with the digestion of fats
You are assessing patient labs and find your patient's CBC resulted with a significantly low platelet count (thrombocytopenia). What is the biggest risk for your patient?
Risk for bleeding, bleeding precautions should be started
You are assessing a infant newborn after delivery. Upon auscultation of the infant's heart, you hear a "machinery" like murmur. You recognize this type of murmur with what Congenital Heart Defect?
Patent Ductus Arteriosus (PDA)
A health risk assessment is what level of prevention?
Secondary.
Primary=Vaccines
Secondary= Screenings/Health Risk Assessment
Tertiary=The patient has the disease, but we make interventions (like referrals) to prevent other comorbidities from happening
What OTC medication is safe for pediatrics if dose correctly?
Acetaminophen "TYLENOL"
We don't have parents give Aspirin
We don't have parents give Ibuprofen until around 6 months of age
When caring for a post tonsillectomy patient what is a critical thing to monitor as the nurse?
Post Op Bleeding, usually this will present as frequent swallowing. If the child is frequently swallowing alert the physician immediately. Keep child prone or lateral. Avoid foods that are hot or warm in temperature, dairy products, or citrus like foods.
What are risk factors for a sickle cell crisis?
Lack of adequate oxygenation
Stress
Cold Exposure
Illness
What are the 3 stages of Kawasaki and what is significant with each stage?
Acute: CRASH and BURN symptoms occur
Subacute: Coronary Artery Aneurysms
Convalescent: Beau Lines