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34 terms

Pediatrics-Common Dx and Nursing Care

Information extracted from N4502 Notes in preparation for exam 1.
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Epilepsy
D/O: More than 2 afebrile seizures w/o known cause
Epilepsy Dx work up
EEG sleep deprived, or long term monitoring, MRI, Surgical Evaluation
Epilepsy Nursing Care
Monitor for seizure activity
Ensure safe environment
Administer antiseizure medications
Sx of medication toxicity
Document S/Sx, duration, intervention and response to intervention.
Asthma triggers
Virus
Cold
Smoke
Exercise
Allergens
Asthma medications
Controller medications: Flovent, Pulmicort, Advair
Rescue Medications: Albuterol, Xopenex
Hospitalized: IV or oral corticosteroids
Asthma Nursing Care
Monitor Respiratory Rate, Breath Sounds, SaO2, Push Fluids, Manage Medications, Educate
Bronchiolitis S/Sx
Harsh congested cough, tachypnea, anorexia, N/V, Febrile
Bronchiolitis Dx Workup
Symptomatic, CXR
Bronchiolitis Tx
Albuterol via nebulizer
Sx treatment, comfort, humidity, fluids
Bronchiolitis Nursing Care
Contact & Droplet Precautions
Airway- O2, bulb syringe/suction
Hydration, I/O
Croup
Seal-like bark, expiratory stridor, Respiratory distress, retractions, hoarse, nasal flare.
Croup Nursing Care
Contact/Droplet Precautions
Pt. must wear mask outside of room.
ABCs
Croup Dx
characteristic cough
Neck x-ray
Croup Tx
Humidity
Steroids
Nebulizer
Fluids
Pneumonia Sx
Febrile
Cough
Tachypnea
Crackles
Retractions/Nasal Flare
Chest Pain
Anorexia
Abd Pain
Pneumonia Dx
CXR
Physical exam
CBC and cultures
Pneumonia Tx
Viral: supportive, hydration, respiratory support
Bacterial: Ab.s, Fluids, Respiratory support
Pneumonia Nursing Care
Isolation Precautions: organism specific
ABCs, IV access PRN, Ab's
Respiratory Synctial Virus RSV
Rhinorrhea
Pharyngitis
Cough/sneeze
Wheeze
Eye/ear Infxn
Febrile
Tachypnea/apnea
Retractions/Cyanosis
Listlessness
RSV Dx
Nasal RSV wash
Seasonal: Oct thru April
May progress to Pneumonia or Bronchiolitis if unDx.
RSV Tx
Fluids
Humidity
O2 PRN
Meds: albuterol/epinephrine/neb
Antivirals w/in 3 days of Dx: Ribavirin
Congestive Heart Failure
Back up of blood in venous system causes lack of O2 Blood to circulation.
Infant Sx: anorexia, malnutrition, tachypnea, diaphoresis.
Child Sx: Fatigue, SOB, Periorbital and Peripheral Edema, behind peers.
CHF Nursing Care
Limit Child's energy expenditure: group cares, limit feeding length, avoid stress.
Elevate HOB and reduce exposure to respiratory Infxn.
Small frequent feedings of High caloric formula/BF.
Proper wt gain before surgery
Cardiac medications require attention to fluid balance.
Gastroenteritis
Bacterial (Salmonella), or Rotavirus most common: foul odor of watery stools, Fluid deficit r/t V/D, Abd cramps, anorexia, febrile.
Gastroenteritis Nursing Care
Monitor I/O
Maintain Fluid status.
Skin care
Dietary mgmt.
Infxn control
GastroEsophogeal Reflux GER
Acid backup from stomach to esophagus.
Esophogeal inflammation/stricture
May lead to aspiration pneumonia.
May resolve w/age.
GER Nursing Care
Position
Med mgmt: Proton pump inhibitors (Prevacid)
UTI S/Sx
Cloudy, foul odor of urine.
Dysuria & Urgency.
Hematuria.
Lower ABD discomfort
Febrile
Infants:irritable, colic, vomiting.
UTI Dx
Urinalysis or Urine Culture before antibiotic Tx.
Voiding cystourethrography VCUG to detect reflux r/t repeat UTIs.
UTI Tx
Antibiotics: oral/IV for bladder infxn.
IV for kidney infxn.
Fluids and antispasmodics
Incomplete Fractures
Greenstick or Bend fractures
Complete Fractures
Transverse, Spiral, Oblique, Comminuted
May be open or closed.
Types of casts
Fiberglass is quick to dry, water resistant, lightweight, can Xray.
Plaster is heavier, dries slower, breathable, is less rigid.
Skin and pressure!
Neurovascular Checks: color, sensation, motion.
Sepsis Workup
Blood cultures: line or stick
Urine/sputum/throat/skin cultures
Prophylactic Antibiotics like ampicillin or gentamycin.
Monitor Pt closely.