Fluid/Electrolyte
Clinical s/s of mild, moderate and severe dehydration
Mild:increased thirst
Mod:sunken eyes, tented skin turgor
Severe:Rapid pulse, rapid/shallow breathing
What should first be checked prior to giving a child fluids with potassium?
urine output
s/s of gastroesophageal reflux in an infant
vomiting, arching back, failure to thrive
What will a nurse monitor for a patient on methotrexate?
Signs of bone marrow suppression and infection
Symptoms of DKA
Hyperglycemia, fruity breath, ketones in urine, kussmal breathing, lethargy
Nursing interventions for an infant diagnosed with spina bifida cystica
apply sterile,moist dressing
educate family on surgical repair
Frequent neuro assessments
Home education on cast care
Elevate to prevent swelling
avoid getting wet, unless a waterproof cast
Do not put anything down the cast
When should a child be switched over to po fluid rehydration?
moderate dehydration, no vomiting, decrease or no diarrhea, desire to take po
Steps to obtaining a urine sample via a UA bag
Wash the area, dry the area, apply the urine bag attempting a good seal, once there is urine remove the bag, label and send urine to lab
Education for parents of a reflux baby to help reduce vomiting
Small/more frequent feeds in upright position
Frequent burping
Thicken feeds
What chromosomal disorder is at highest risk for cancer?
Down Syndrome
Treatment of a child admitted with DKA
Obtain urine sample, start PIV (anticipate insulin drip), check blood glucose every 15 min while on insulin drip, NPO, VS Q1, Neuro checks Q4, blood gas
Home education for a baby with VP shunt
Infection precautions, signs of malfunction
Home care for clavicle fracture
NSAIDs, neurovascular assessment, sling
What fluid is best to give a child with diarrhea?
Oral rehydration fluid such as pedialyte
Diet for a child with acute glomerulonephritis
low sodium, fluid restricted
When would you notify provider prior to surgery for intussusception?
if patient passes a BM
Priority action for a cancer child that is suffering from nausea and vomiting
Give medication as ordered and document response
What topics should be included in endocrine education?
Metabolism, energy use, growth and dev, fluid and electrolytes, stress, sexual reproduction
In a submersion injury what are the priority assessments?
ABC, Temperature regulation
What members of the healthcare team are expected to participate for a child with CP?
Pt, caregivers, speech, OT
What is the most common cause of water intoxication?
Inappropriately prepared formula
What do you expect to see in the urine of a child with acute glomerulonephritis?
Protein
Interventions for Hirschprung disease prior to surgery
enema, IVF, consent, abdominal circumference
Symptoms of ALL
wounds not healing, bruising, complaints of bone and joint pain
How frequently should a type 1 diabetic check blood sugars?
before meals
Risk for Reye syndrome
Use of aspirin during a viral illness
Best way to improve mobility in a child with CP
passive ROM
What is the correct order of emergency burn managemnent?
stop the burn, assess condition, cover the burn, reassurance
What are objective signs indicating a UTI in a pediatric patient?
fever, hematuria, foul smelling urine, leukocytosis, positive urine culture
What foreign bodies that are ingested are considered surgical emergencies?
magnets, button battery
What tests can you anticipate in a child with symptoms of ALL?
CBC, CT, Urine
How long will a type 1 diabetic require insulin?
for life
Priority nursing action for a child brought in for concussion
ABCs, neuro assessment
Education for parents with an infant in pavlik harness
No lotion/powder, massage under straps, check skin frequently for irritation
Name 3 things that require an increase in fluid requirements?
fever, tachypnea, vomiting, diarrhea, shock
What is the preferred method to collect urine in a pediatric patient?
clean catch
What is the pathophysiology of hirschsprung disease?
Absence of ganglion cells
What lab would you expect to evaluate for a child with cancer who has sustained unexplained bruising?
Platelets
When should growth hormone be administered?
At bedtime
Priority outcomes for an infant with meningitis
ABCs WNL, Neuro WNL, Resolution of fever within 24 hours
What is initial treatment for Developmental dysplasia of the hip?
Pavlik harness
Name one thing that requires a decrease in fluid requirements
heart failure, increased ICP, renal failure
Most common pathogen to cause UTI in a pediatric patient?
E. coli
Gold standard diagnostic test for Hirschsprung disease
Rectal biopsy
Symptoms of tumor lysis syndrome
flank pain, lethargy, n/v, oliguria, pruritis, tetany, altered LOC
What is considered the master gland?
anterior pituitary gland
Fever, petechial rash, and positive Kernig and Brudzinski sign is evidence of what disease process?
Meningitis
Serial casting followed by a brace is the primary treatment for what orthopedic disorder?
Clubfoot
Water intoxication can lead to what disorder?
Seizures due to decrease in sodium
Nursing management in a child that has acute poststreptococcal glomerulonephritis
Daily weights, I&O, daily abdominal girth, low sodium diet
Symptoms of Meckel Diverticulum
bloody, painless bowel movements
Vaccine concerns with a child receiving chemo
vaccines given 2 weeks before or during chemo are considered inactive. Child should be revaccinated 3 months after chemo has stopped
Treatment for pituitary hyperfunction
surgical removal of tumor, radiation
Nursing interventions for viral meningitis
Droplet isolation, Tylenol prn, Neuro assessment
What teaching should be involved with a teen that has newly been diagnosed with JRA?
NSAIDs, Antirheumatic drugs, Biologic agents, Steroids
What is the most frequent cause of hypovolemic shock in children?
blood loss
Characteristics of nephrotic syndrome
proteinuria, hypoalbuminemia, hyperlipidemia, facial edema, urinary protein loss
3 Signs and symptoms of pyloric stenosis
nonbilious projectile emesis, visible peristalsis, failure to thrive, dehydration, metabolic alkalosis
3 phases of chemo
induction, intensification, maintenance
Define precocious puberty
Sexual development before age 9 in boys or before age 8 in girls
Gold standard test to diagnose epilepsy
EEG
Appropriate education to give a parent of a child with CP that has difficulty eating
frequent, small meals
Priority management of shock
Oxygenation and ventilatory support
Symptoms of DI in the newborn
vomiting, fever, failure to thrive, hypernatremia
Symptom triad for intussusception
sudden onset abdominal pain, sausage like abdominal mass, bloody stools
expected lab values post chemo
decrease in platelets, leukocytes, erythrocytes
What labs are diagnostic of Graves Disease?
increase in T4 and T3, low TSH
What position should a child be placed in that has suffered a head trauma?
HOB at 30 degrees
What are the five Ps of assessing a fracture?
pain and point of tenderness, pulses, pallor, paresthesia, paralysis