Ch. 33
This non-invasive method is used to evaluate a child’s oxygen saturation, where values above 97% on room air are considered normal, and values at or below ____% may indicate hypoxemia. It’s often used alongside pain assessment to monitor overall patient status.
What is pulse oximetry? And what is 92%
In infants, this enzyme activity is variable for the first 3 months of life as the gastrointestinal system matures. Medications requiring specific enzymes for dissolution and absorption might not be converted to a suitable form for intestinal action. Additionally, infants up to 8 months of age tend to have prolonged gastric motility, less acidic gastric secretions, and intermittent, unpredictable gastric emptying.
What is pancreatic enzyme activity?
This pain scale is used for infants from 0-6 months of age,.
What is the CRIES pain scale?
This condition in children can cause symptoms such as dry mouth, dark urine, decreased urination, irritability, drowsiness, and in severe cases, rapid breathing, fast heart rate, and sunken eyes. It often results from inadequate fluid intake, diarrhea, vomiting, or excessive sweating, and requires prompt rehydration to prevent serious complications.
What is dehydration.
This relatively mild systemic disease in children is characterized by an intense, fiery red, edematous rash on the cheeks, giving the appearance of a “slapped cheek.” Despite the rash, the child typically appears well.
What is fifth disease (erythema infectiosum)?
This superficial, grating sound is coarse and low-pitched, often heard during both inspiration and expiration.
What is a pleural friction rub?
Caused when pleurae become inflamed and lose their normal lubricating fluid. Their opposing roughened pleural surfaces rub together during respiration. This sound is heard best in the anterolateral wall, where lung mobility is greatest.
These seven principles ensure the safe and effective administration of medications to children, including verifying the correct patient, medication, dose, time, route, reason, and documentation.
What are the 7 rights of medication administration?
This pain scale is used for children 3 years and older, while the numeric rating scale is used for children 9 years and older.
What is the FACES pain scale
This type of fluid loss can be perceived by the senses and measured, such as through urine, sweat, and feces. In contrast, this other type of fluid loss occurs through evaporation from the skin and respiratory tract and cannot be directly measured.
What are sensible and insensible fluid losses?
This syndrome, caused by Coxsackievirus, is characterized by inflammation and lesions in the mouth, on the palms of the hands, and on the soles of the feet, along with mild fever. Some children may also have small lesions on the buttocks. If lesions are widespread in the oropharynx, the child may refuse to eat or drink, increasing the risk of dehydration in very young children.
What is hand, foot, and mouth disease?
This approach in performing physical assessments in infants and young children involves completing tasks such as to pulses and respirations first, then progressing to more active assessments to increase cooperation.
What is the “quiet to active approach”?
When caring for a child with an IV catheter, the nurse should assess and document the site at least every hour, specifically looking for signs and symptoms of these three complications.
What are infiltration, phlebitis, and infection?
These interventions are commonly used to soothe and comfort newborns, including techniques such as swaddling, kangaroo care, breastfeeding, sucrose, and white noise.
What are nonpharmacologic interventions for newborns?
This level of dehydration in infants is classified by a 5-10% loss of body weight and can present with symptoms such as dry mouth, decreased urination, and irritability. It requires prompt rehydration to prevent progression to severe dehydration.
what is moderate dehydration.
When caring for a child with pertussis, nursing interventions include maintaining airway patency, auscultating lung sounds, assessing respiratory patterns, and monitoring for signs of complications. Nurses should also educate about proper coughing techniques, promote effective coughing, encourage fluid intake, administer prescribed medications, and provide chest physiotherapy as needed.
What are nursing interventions for pertussis? (whopping cough)
This assessment involves checking for an abnormal lateral curvature of the spine, often performed by having the child bend forward at the waist while the examiner looks for asymmetry in the rib cage, hips, shoulder, and/ or spine.
What is a scoliosis assessment?
According to the CDC, the preferred injection site for infants and toddlers is this muscle.
What is the vastus lateralis?
These higher-pitched crying, fist clenching, grimacing, wrinkling of the forehead, increases in blood pressure, heart rate, and respiratory rate, and decreases in arterial oxygen saturation, are also associated with?
What are the signs and symptoms of pain in neonates?
This level of dehydration in infants is characterized by a 15% loss of body weight, leading to symptoms such as hypotension, impaired perfusion, and potential shock. In adolescents, it corresponds to a 7-9% loss of body weight.
What is severe dehydration? Needs to be admitted for IV fluids.
This virus may cause Koplik spots, which appear 1-4 days before the onset of a deep-red macular rash that begins on the face and neck and spreads down to the trunk and lower extremities
What is the measles virus?
According to AAP guidelines, children should start having their blood pressure checked at this age during routine well-check appointments.
What is age 3.
The appropriate-size cuff must be used to obtain an accurate BP. The cuff bladder length must encircle 80% to 100% of the arm Cuffs that are too small will cause falsely elevated values; those that are too large will cause inaccurate low values
According to the CDC, the preferred injection site for children aged 3 to 18 years for immunizations.
What is the deltoid.
This topical anesthetic cream contains lidocaine and prilocaine and is used to numb the skin before medical procedures such as needle insertions, vaccinations, and minor surgeries.
What is EMLA cream?
This condition can result from diarrhea in children, leading to a loss of bicarbonate and an increased risk for metabolic acidosis.
What is the effect of diarrhea on bicarbonate levels and metabolic acidosis?
This bacterial illness, caused by Group A streptococcus, is characterized by a bright red rash that feels like sandpaper, a high fever, and a “strawberry tongue.” It most commonly affects children between 5 and 15 years of age and was once considered a serious childhood illness before the advent of antibiotics.
What is Scarlet Fever?
The entire course of antibiotic therapy, usually 10 days, must be completed to destroy all bacteria and decrease the risk of complications. Stopping antibiotics early can lead to bacterial resistance
For a 3-year-old child, the normal range for heart rate is 80 to 120 beats per minute, respiratory rate is 20 to 25 breaths per minute, and blood pressure is typically 90/50.
What are the normal vital signs for a 3-year-old?
These drugs are often preferred for treating bone and inflammatory pain associated with bone injuries, arthritis-like conditions, and certain types of cancer. However, they should not be given to infants under 6 months of age, and caution is advised for dehydrated children due to the risk of acute kidney injury. Prolonged use can cause peptic ulcers.
What are NSAIDs (Nonsteroidal Anti-Inflammatory Drugs)?
In pediatric patients, vital signs should be taken every 2 to 4 hours, and pain assessments should be conducted every 1 to 4 hours and with any bolus dose to evaluate the effectiveness of this therapy. Most hospitals allow children as young as 5 years old to use this method, where the patient controls the infusion of the bolus. Essential equipment includes oxygen, a bag-valve-mask device, and IV naloxone (Narcan), which reverses opioid-related analgesia and respiratory depression. Two registered nurses must check the medication bag or syringe before hanging.
What is Patient-Controlled Analgesia (PCA) therapy?
This solution, made of water, sugar, and electrolytes like potassium and sodium, is used to treat dehydration caused by conditions such as diarrhea and vomiting. It helps replenish the body’s fluid levels and is suitable for people of all ages, including infants and children.
What is oral rehydration solution (ORS)?
This serious medical condition occurs in newborns younger than 28 days old and is characterized by a life-threatening response to an infection. It can be caused by bacterial, viral, fungal, or parasitic infections, with symptoms including fever or low temperature, fast or slow heart rate, and difficulty feeding. Early diagnosis and treatment with antibiotics are crucial to prevent severe complications.
What is neonatal sepsis?
This set of physical and behavioral indicators may suggest a child is experiencing abuse. It includes wearing clothes inappropriate for the weather, poor hygiene like matted hair and dirty fingernails, fearful or anxious facial expressions, distorted body image, and unusual speech patterns such as one-syllable answers or seeking approval before responding.
What are potential indicators of child abuse?
According to agency policy and ISMP guidelines, a second nurse must verify medications such as insulin, opioids, anticoagulants, chemotherapeutic agents, and IV solutions like potassium chloride and hypertonic dextrose before administration to ensure patient safety.
What are high-alert medications requiring a second nurse check?
When prescribed to children, these medications may cause side effects such as nausea, vomiting, constipation, pruritus, dizziness, confusion, mood changes, sedation, respiratory depression, and even dependence—requiring careful monitoring and education for families.
What are the potential side effects of opioid analgesics in children?
This treatment is indicated for children experiencing diarrhea, vomiting, or any degree of dehydration. It helps restore fluid and electrolyte balance safely and effectively, often without the need for IV therapy.
What is oral rehydration therapy?
This sexually transmitted infection is the most prevalent in the U.S., affecting over 20% of sexually active adolescents and young adults. It can also be passed from mother to infant during birth, potentially causing neonatal eye infections and pneumonia. The USPSTF recommends routine screening for all sexually active females under age 25.
What is chlamydia?
When inspecting the skin of _________children, these color changes may indicate underlying conditions: erythema appears dusky red or violet, cyanosis may look black or dusky, and jaundice presents as a diffuse ________ of the skin.
What are signs of skin conditions in dark-skinned children?
To ensure accurate dosing and communication, children should be weighed in this unit upon admission, and it should be used consistently in prescriptions and medical records.
What are kilograms (kg)?
This theory-based approach to pediatric pain assessment emphasizes using tools to document pain levels, observing behavioral signs like grimacing or guarding, and recognizing that physiologic changes may reflect fear or anxiety rather than sustained pain.
What is a comprehensive pain assessment in children?
This metabolic condition can result from diarrhea due to the loss of bicarbonate in the stool, leading to an imbalance in the body’s acid-base levels.
What is metabolic acidosis?
Some sexually transmitted diseases like gonorrhea, chlamydia, and syphilis can be cured with medication, while others such as herpes, genital warts, and HIV can only be managed. This practice remains the only 100% effective method to prevent both pregnancy and STD transmission.
What is abstinence?
These discontinuous, high-pitched, short, popping sounds are heard during inspiration and are not cleared by coughing. Often associated with fluid in the airways, they can be simulated by rolling a strand of hair between your fingers near your ear.
What are crackles (rales or crepitations)?
Late inspiratory crackles occur with restrictive disease: pneumonia, congestive heart failure, and interstitial fibrosis.
Early inspiratory crackles occur with obstructive disease: chronic bronchitis and asthma.
To reduce the risk of dosing errors, hospitals should limit the number of concentrations and dose strengths of these medications, which include insulin, opioids, and chemotherapeutic agents.
What are high-alert medications?
This pain rating scale, translated into over 60 languages, helps children from diverse backgrounds express their pain. Its creators also developed a mnemonic—QUEST—to guide pain assessment: question the child, use pain rating tools, evaluate behavior, sensitize parents, and take action.
What is the Wong–Baker FACES Pain Rating Scale and the QUEST mnemonic?
Nursing care for a child experiencing this symptom includes observing and reporting episodes, assessing for dehydration, implementing measures to reduce it, recording accurate intake and output, evaluating therapy effectiveness, and preventing aspiration.
What is vomiting?
This vaccine is recommended for both girls and boys starting at age 11 or 12 (but can begin as early as age 9) to protect against infections that can lead to cervical, anal, and throat cancers, as well as genital warts. It is most effective when given before exposure to the virus.
What is the HPV vaccine?
This high-pitched, musical squeaking sound is often heard during expiration but may also occur during inspiration. It’s caused by narrowing of the air passages due to fluid, swelling, spasm, or tumors, and its character may change after coughing.
What is a wheeze?
Example heard during Obstructive lung disease such as asthma.
When sending a child home with an oral antibiotic solution, nurses should educate parents to give the medication exactly as prescribed, complete the full course even if symptoms improve, avoid using leftover antibiotics, and report if symptoms persist after treatment—helping prevent resistance and ensure full recovery.
What are key parent education points for antibiotic compliance in children?
This route of analgesic administration is often avoided in children due to fear of pain, limited suitable injection sites, risk of tissue injury, fluctuating absorption, shorter duration of action, and contraindications in children with bleeding disorders.
What are the disadvantages of intramuscular analgesics in children?
Parent teaching, no urination for over 6 hours, crying without tears, a sunken fontanel, changes in behavior or mental status, severe or bloody diarrhea lasting more than 24 hours, intense abdominal cramps, or a fever over 39°C (102°F).
What are signs that require immediate medical attention in a child?
Nursing care for a child with this viral illness includes prolonged rest, hydration, avoiding contact sports to protect an enlarged spleen, managing sore throat symptoms with soothing liquids, and preparing the family for a slow recovery with possible school accommodations.
What is infectious mononucleosis (Epstein–Barr virus)?