Growth + Development
This age group can ride a tricycle, jump off a step, skip/hop, and use scissors. They are also magical thinkers. What are the 2 biggest concerns for this age group?
1.) Persistent Drooling by 3 years old
2. Separation anxiety at 5 y/o
When is Hepatitis B Vaccine given? (What age)
Birth, 2 months, 6 months
(4 got -> forgot hep B -> no Hep B at 4 months)
What is Aplastic Anemia? What are s/s? What is the treatment for it?
Aplastic Anemia is pancytopenia (low blood cells, low everything), seen as anemia (low RBC), neutropenia (low WBC), thrombocytopenia (Low platlets). This causes pallor/fatigue, fever/infection, and bleeding/brusing. These patients need a bone marrow transplant bc they need everything!
DKA: Diabetic Keto Acidosis
Pt gets infection and goes into DKA where body breaks down muscle instead of glucose
S/S: Fruity breath (ketones in lungs), Ketones in Urine, and blood glucose of 330+
TX: IV Insulin(regular), IVF, monitor glucose, monitor ketones in urine
What is an appropriate HR for an infant (1-12 months). When should CPR be started?
100-190 awake and 90-160 asleep
If lower than 60 bpm, start CPR immediately
Posterior Fontanelles closes first at 6-8 weeks
Anterior Fontanelle is larger and closes last at 12-18 months
This viral infection causes a RED LACY rash, low grade fever, and erythema which appears to be a "Slapped Cheek".
5ths Disease or Erythema Infectiosum
(5 fingers to slap cheek)
S/S: DROOLING and TRIPOD BREATHING
Nursing interventions: DO NOT STICK ANYTHING IN THEIR MOUTH: DO NOT TOUCH THEIR THROAT, this is a medical emergency, you must call doctor and call code
Acute Post Infectious Glomerulonephritis (APIG) is a complication of what and what are the s/s, complication risks, and treatment???
-s/s: protein and blood in urine, perioribital edema, HTN, and high potassium levels
-complications: HTN encephalopathy, SEIZURES, and HTN
- tx: nifedine, sodium polysulfate (to bring down K+), Lorazepam (seizures)
What is the treatment for burns?
Pain control, Hydration, and Prevent Infection
*good to check throat/resp if burn was due to fire
*NEVER APPLY ICE TO BURN
Autonomy vs Shame/Doubt
Ms Ducker allows Sally to wear mismatched socks to recess to build confidence in their independence.
VS Ms Dumbo scolded Sally for the mismatched socks and Sally was sad.
Before kindergarten, children 4-6 are recommended to get which vaccines.
'Very DIM' to leave home and start school
VAR, DTAP, IPV ("Polio"), MMR
Describe Croups clinical manifestations and nursing interventions
S/S: Audible STRIDOR, bark cough at night, and horsiness of voice
TX: Inhaled racemic epi neb (only given in hospitals)
Compare and Contrast Crohn's disease with Ulcerative Colitis
Crohns disease: occurs anywhere in GI tract, no blood, and is immune related (no cure)
Ulcerative colitis: occurs in large intestine, lots of blood (diarrhea etc), cured with surgery
What's the difference between secondary drowning and dry drowning?
Secondary Drowning is DELAYED drowning. This means water was inhaled and child had drowning s/s hours later (cough, choke, vomit, chest pain, dyspnea).
Dry drowning is when head is submerged in water. water is inhaled and trapped in airway DOES NOT REACH LUNGS (dry lungs)
Tx for both is early detection, o2, intubate, and supportive care measures
List the maturation of sexual development of males and females in order
Females: Breast, Public Hair, Axillary Hair, Menstruation
Males: Testicles, Pubic Hair, Penile Growth, Axillary Hair, Facial Hair, Voice 'drop'
This disease is a complication of STREP throat, s/s include STRAWBERRY TONGUE, SANDPAPER RASH, and scattered sunburn-like rash
Scarlet Fever
tx with antibiotics, must complete full antibiotic course!
Name the Acyanotic Defects, Cyanotic defects, and obstructive cardiac disorders.
Acyanotic: ASD, VSD, PDA
Cyanotic: TOF, TGA
Obstructive: COA, HLHS
Hip dysplasia is dx with what tests/ signs. Bonus if you can describe the tx options
DX: Otalani (abduct hip and palpate for click) and Barlow (adducting hip)
TX: Pavlik Harness for babies less than 6 months: hips are up and out (flex and abducted)*diaper changes are done in harness
Spica Cast from armpit to ankle *hygeine and fit 2 fingers
Treatment for Status Asthmaticus
Albuterol (for wheezing)
Corticosteriods (decrease inflammation)
IV mag sulfate (relax smooth muscles)
Name all the reflexes that disappear by 4-6 months! Bonus if you can explain them :)
Moro: "startle reflex"
Head lag
Rooting
Tonic neck: "fencing relex"
Tongue Extrustion
What vaccines are LIVE vaccines and who can you not give them to
Can't give live vaccines to babies under 1 y/o or Immune compromised pts (ex chemo pts) or pts on IVIG tx!
VAR: varicella "chicken pox"
MMR: Measles, Mumps, Rubella
*Important notes
Measles has 3 C's: cough, coryza/runny nose, and conjunctivitis
Rubella/German Measles is the most dangerous to Pregnant women!!!
In Acute Lymphoblastic Leukemia (ALL) what are complications of the disease and complications of the treatment therapy.
Complications of ALL: Pathologic fractures (bone breaking due to leukemia), Tumor Lysis Syndrome (tumor breaking and going into blood stream), and Metabolic Derangement (Increased uric acid, phosphate, calcium, and electorate imbalance)
Complication of ALL tx (chemo, steroids): Myelosuppression and neutropenia
a rise in ICP is shown as what signs/symptoms. What should the nurse do??
ICP: Cushings Triad: Increase BP, Decrease HR, and shallow respirations!
Nurse should increase HOB and give diuretic
4 y/o patient comes in with cyanosis, tripod breathing, nasal flaring, retractions, and a RR of 40. The ER triage nurse would put this patient at a level ____
level 1!
cyanosis is BIG RED FLAG! patient stats are high bc patient is trying to compensate their severe respiratory distress. This patent need IMMEDIATE LIFE SAVING MEASURES!