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Galen College of Nursing Pediatrics Exam 2
Galen College of Nursing Pediatrics Exam 2 Final
Terms in this set (75)
Most common post op complication of tonsillectomy?
Risk time for hemorrhage after tonsillectomy?
10 days to 2 weeks post op
Signs and symptoms of hemorrhage after tonsillectomy?
restlessness, swallowing frequently, low BP (late sign)
How should child lay post op to prevent hemorrhage from tonsillectomy?
side lying or on abdomen
What should the child avoid after a tonsillectomy post op?
coughing or blowing nose
How should xrays be taken to see the section of the lung behind the heart (lingual)?
Why are lateral xrays needed to view the lingual area?
a common site for pneumonia
If a child is "barking" and has hoarseness and inspiratory stridor what might they have?
What does inspiratory stridor sound like?
If stridor reduces in a child previously showing stridor, what can that mean?
blockage and imminent respiratory failure
Do not put anything in the __________ of a child with acute epiglottitis.
Croup symptoms, Inflammation mucosa lining larynx & trachea causing narrowing airway-subglottic area narrowest part causes respiratory acidosis
Diagnosis of Asthma is
peak expiratory flow (PEF)
Treatment of Asthma is
beta agonists such as albuterol to relieve bronchospasms
Preventing chronic problems with Asthma treatment
anti imflammatories such as corticosteroids
treatment for an emergency with Asthma attack
repeat dose q15min twice, on 3rd dose call ambulance
Parents need education about beta agonists, what should a nurse advise?
don't give them around the clock, they should be prn, do not abuse
Common side effects of beta agonists
What is Cystic Fibrosis?
Sludge, or increased viscosity of mucous, a build up of thick, sticky mucus in the lungs
What diet should a patient with cystic fibrosis eat?
high protein, high calorie
Signs and symptoms of Increased Intracranial pressure
High pitched cry, difficult to soothe, tense and bulging fontanels, cranial sutures separated, setting sun eyes, distended scalp veins, headache, vomiting, seizures, diplopia, irritability/restlessness, drowsiness, indifference, decrease in physical activity & motor skills, complaints of fatigue, somnolence, weight loss
Late signs of increased ICP
decreased LOC, decreased motor response to command, decreased sensory response to painful stimuli, loss of PERRLA, palliledema
Decorticate positioning is a dysfunction of what?
Decerebrate positioning is a dysfunction of what?
Reflex due to cerebral ischemia that causes an increase in blood pressure, decrease in pulse rate, and changes in breathing patterns.
What is Myelomeningocele?
the most common form of spina bifida in which the bones of the spine do not completely form, resulting in an incomplete spinal canal, causing the spinal cord and meninges to stick out of the childs back
What should be done for Myelomeningocele?
4x4 soaked in normal saline placed over "sac", normal saline drip over 4x4 to prevent rupture until surgery
Main prevention for Spina Bifida (Myelomeningocele)?
Folic acid early in pregnancy
Diagnostic indication for Neuroblastoma is?
High catecholamines in 24 hour urine collection
Malignant childhood tumor originating in cells of the nervous system.
tumor arising from a developing retinal cell (a congenital, malignant tumor)
aka cat's eye reflex; yellowish white reflex seen in the pupil because of a Retinoblastoma tumor behind the lens
Inflammation of the membranes covering the brain and spinal cord; caused by bacteria (e.g., meningococcus); symptoms include nasopharyngeal catarrh, headache, convulsions, vomiting, and stiff neck.
Definitive diagnostic test for bacterial meningitis is
Lumbar puncture with decreased glucose, increased protein, increased WBC's
Treatment for Bacterial Meningitis
Give antibiotic immediately, do not wait for C&S
A brain inflammation that occurs in children following a viral infection, usually the flu or chickenpox. It is characterized by vomiting and lethargy and may lead to coma and death.
What should be monitored with Reye's syndrome to watch for possible cerebral edema?
Infantile seizures are usually associated with some degree of _________________.
There are no ____- ____ ____ in infantile spasms
What should be done for pediatric seizures?
side lying to keep airway patent, document exact length of seizure and any precipitating factors, do not put anything in the mouth
How many concussions with in several months lead to permanent brain injury?
Signs and symptoms of cerebral palsy
poor head control after 3 months, unable to sit without support at age 8 months, clenched fists after age 3 mths
dexedrine, adderall, ritalin
Side effects of ADHD medications
insomnia, anorexia, weight loss, hypertension, may suppress growth over long term
5 p's of fracture
pain, pulse, pallor, paresthesia, paralysis distal to point of fracture
How do you handle a fresh cast?
with palms of hands, not fingertips
begin IV antibiotics before C&S is done
infection of bone and bone marrow causing inflammation
protein - milkshake
Developmental dysplasia of the hip
A genetic condition in which the head of the femur dislocates from the acetabulum of the pelvis.
The limb on the affected side of DDH is _________.
What two tests will be positive with DDH?
Ortolani test and Barlow test
-hip abduction w/a resulting clunk as the head relocates into the joint
Detection of unstabloe hip by adduction and extension of hip. The "feel" of dislocation is felt as femur leaves acetabulum
Signs of DDH
restricted abduction of hip on affected side, shortened limb, unequal gluteal folds when infant prone, positive ortolani and barlow
What can juvenile Rheumatoid arthritis lead to?
iridocyclitis and uveitis (blindness)
Juvenile Rheumatoid arthritis
an autoimmune disorder that affects children aged 16 or less with symptoms that include stiffness, pin, joint swelling, skin rash, fever, slowed growth, and fatigue
inflammation of the iris and ciliary body of the eye
inflammation of the uvea of the eye
What is the best therapy for JRA?
moist heat, warm baths
occurs most often in femur, tibia, humerus during growth spurt of teen-age males and may metastasize to lungs
What should a nurse prepare for with a patient with osteogenic sarcoma?
possible amputation and phantom limb pain
If a child is exhibiting incontinence with frequency & foul-smelling urine, they should be evaluated for
Nephrotic syndrome definition
condition in which very high levels of protein are lost in the urine and abnormally low levels of protein are present in the blood
Nephrotic syndrome includes:
proteinuria, hypoabumenia, hyperlipidemia, edema, massive urinary protein loss
How is Nephrotic syndrome diagnosed?
urine test shows 3+ protein
Treatment for neprhotic syndrome?
low salt diet, fluid restriction, prednisone is drug of choice
malignant kidney tumor found most often in children
Do not __________ the abdoment with Wilm's tumor.
Wilm's tumor post op instructions should include?
no contact sports
Signs of smoke inhalation
trunk circumferential burns, edema of face and neck, singed hair, soot in mouth, hoarseness
Fluid therapy for burns
1/2 in first 8 hours, 1/4 in second 8 hours, 1/4 in third 8 hours
Urinary output should be
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