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Terms in this set (87)
Position for infant with epidural hematoma? What should you watch for?
Head elevated in midline position
S/s of brainstem herniation?
Cushing Triad (hypertension, bradycardia, decreased respiration)
Avoid with epidural hematoma? Implement?
Avoid suction and implement seizure precaution
How to secure car seat/system? Harness placement? Angle? Avoid?
Secure with anchors and tethers/LATCH system, harness at or above shoulders, 45 degree angle, avoid padding under infant or in car seat
Normal expecting after appendicitis? (peristalsis, WBC, drainage)
absent peristalsis, WBC above 10k, clear to green tinged drainage from NG
Abnormals after appendicitis? (drainage, stool)
Purulent drainage from NG and passage of dark red stool (Meckel diverticulum)
Before lumbar puncture? Position after and duration? Encourage after procedure? Monitoring?
Apply topical analgesic 1 hour before, position in prone or flat in bed for 12 hour, drink extra fluids after, no need for any monitoring
Can toddlers understand right from wrong? What anxiety can they develop?
Yes, they begin to; and acute separation anxiety
Digoxin education device wise? Oral car? dosing?
Use the device that comes with it, brush the child's teeth after, do not repeat dose if missed or if child vomits
Cannot receive MMR vaccine if? (3)
Neomycin, eggs, gelatin
Apply when child is having a tonic-clonic?
Position in the post-ictal period?
Post-ictal period eating/drinking?
When protective reflexes have returned
2 week old assessment: scrotal area and skin growths?
excoriated scrotal area and multiple hemangioma not normal
Mattress for juvenile idiopathic arthritis? Education?
Firm, and educate not to nap during day because of stiffness
How to describe time to a preschooler?
Relate it to their routine
Which children can you use the numeric pain scale with? CRIES? Non-Communicating?
5 and older for numeric, CRIES for infants, non-communicating for cognitive impairment
Bacterial meningitis precautions? Increased concentration of what in spinal fluid?
Droplet until 24 hours after therapy. Protein
Early signs of septic shock? Late signs?
Fever and chills early, low HR and BP late
Signs of high ICP? (GI, BP, behavior, HR)
Forceful vomiting, hypertension, decreased attention span, and bradycardia
Sunscreen for infants under 6 months? Clothes for sun exposure? Reapply every?
Apply sunscreen to small areas for infants, wear tight weaved cotton, reapply every 2-3 hours
When is the best time to give eye drops/ointment? Do you have to wait between?
Night time because it can make vision blurry. You have to wait 3 minutes
Most popular med for nephrotic syndrome in kids??
Moderate-severe dehydration symptom in infants x2?
No tears and cap refill greater than 2
Normal specific gravity? Normal sodium?
Specific gravity and sodium with diabetes insidious?
Decreased specific gravity, so below 1.01, and increased sodium, so above 145
When will the type 1 diabetes child get insulin? What should they eat if their sugar is low? What should they do when they are sick?
30 minutes before eating, carb snack, increase fluids
Signs of celiac disease in stool and weight
Steattorhea and weight loss
Food to recommend with celiac?
Pyloric stenosis characteristic symptom, appetite, and area affected?
Projectile vomiting, increased hunger, and olive shaped mass in the upper right quadrant.
If you're potty training a kid with a cognitive impairment, why is it important not to play music or TV during?
You don't want any other stimuli to distract them.
What could you use to clean cheiloplasty sutures and when? What should you educate the parent to report after a procedure like this? What should you avoid? Should you apply anything and if so, for how long? x2
Use sterile water or diluted hydrogen peroxide following feedings, educate the parent to report frequent swallowing because it could indicate bleeding, avoid putting anything in their mouth, apply antibiotic ointment for three days, apply petroleum jelly for several weeks
If your child has a superficial burn, what should you apply, cover it with, and not apply?
Apply antimicrobial ointment, apply fine mesh gauze that restricts movement and is clean/dry, don't apply ice
If your child has a partial thickness burn, what should you clean it with and apply?
Clean with mild soap and water and apply antibiotic ointment.
What might a child with a severe burn require?
They might require NG decompression
Apnea alternating with shallow breaths
Apnea alternating with hyperventilation
Food with high iron?
Cystic fibrosis patient fat intake? What should you do if they have steattorhea?
Above average, 35-45%. Give pancreatic enzymes.
Test for sickle disease? Positive requires?
Fingerstick sickle tubidity. If positive, do hemoglobin electrophoresis to distinguish genetic trait
What is the Allen test and when is it used?
It's before arterial puncture, test for adequate circulation by checking cap refill
What age group plays patty cake?
What can recurrent UTI indicate?
What two things can indicate physical neglect (fat, hygiene)
Low fat or poor hygiene
If you have osteomyelitis, can you walk and move around? How long for abx?
No weight bearing for weeks/months. At least 4 weeks of abx
SIADH: urine output, sodium, and osmolality
Decreased urine output, sodium below 135, and low osmolality
SIADH: concentration of urine and specific gravity of urine?
high concentration of urine since there isn't a lot, and higher than 1.01 specific gravity
Cognitive and pulses with SIADH?
confusion and bounding pulses
Two symptoms you wouldn't expect that occur with a child who has pneumonia?
diarrhea and abdominal distention
when should a child have intelligible speech and what if they don't?
By 24 months. Refer if not
When should a child have the startle response and what if they don't?
Anytime under 4 months. Refer if not
What behavior in a preschooler would indicate the need to get their hearing checked?
When should an infant make babbling sounds and what if they aren't?
8 months. If they aren't, refer.
What vocab should a child have at 18 months? What if they don't?
10 words. If they don't, refer.
Good toy for preschooler? Toddler ?
Large piece puzzle. Puppet for toddler.
What is sodium polystyrene sulfonate enema used for? How does it work?
Treat hyperkalemia. Exchanges sodium ions for potassium ions
Adverse effects of sodium polystyrene sulfonate enema?
Adverse effects are diarrhea and fluid/electrolyte imbalance
How should you position a child having an anaphylactic reaction?
What should you do if epinephrine doesn't work the first time? Where should you store it? When can't you use it?
Give again if it doesn't work the first time. Store it in a dark room. don't use if its miscolored
What should BUN be if patient isn't dehydrated and doesn't have a kidney issue?
Less than 25
What should you do before treating a child for a wound?
What should you do following treatment of a wound x2?
Apply antibiotic ointment and mesh gauze
If a patient has spastic (pyramidal) cerebral palsy, what reflex will be present? What symptom will they have specifically, and then what other general things should you expect x3?
Babinski will still be present. They will have ankle clonus, and they will have tremors/spasticity/contractures.
If your patient has non spastic (dyskinetic) cerebral palsy?
Bad movements of the face and extremities
To confirm peripheral edema? Central edema?
Palpate dorsum of feet. Central edema would be periorbital swelling .
What should you educate about long acting salmeterol? How often should asthma kids get PFTs?
Take salmeterol with a corticosteroid. get PFTs every 12-24 months.
Describe peak expiratory flow meter
3 times, 30 seconds apart, take the best one.
What outside activity should asthma kids not be around? What should be done in the house? What med should be avoided? What two things are recommended for the house and what isn't?
Don't be around mowing grass, mop (don't sweep) once a week, avoid cough suppressant, use air conditioning and dehumidifier, don't use humidifier.
If a child comes in with epiglottis, what should you prepare them for?
Prepare them for nasotracheal intubation.
If a child has a Wilm's tumor, what do you want to avoid? What should you monitor? What should you do post op?
Don't palpate their abdomen. Monitor their play because they have a high risk for injury. Post-op, monitor bowel sounds to make sure there is no obstruction.
In nephrotic syndrome kids, what statement could indicate effective prednisone use?
"im super hungry"
When your kid has athlete's foot, what shoes do you want them to wear and which ones can't they wear?
Wear sandals, no plastic shoes
What position should you place a preschooler in for immunizations and why? What needle should you use to minimize pain?
Upright to decrease anxiety. Use a 24 G.
What should you do before giving Nystatin? Can you mix it?
Shake. You cannot mix it with food
KAWASKI DISEASE: temp, tongue, lips, edema, redness/dryness, HR, enlargement
Fever for more than 4 days, strawberry tongue, oral mucosa edema and pharynx, redness/dryness of conjunctive (xeroplathamia), tachycardia with a gallop rhythm, and enlargement of lymph nodes
How do you treat diaper dermatitis?
What to educate parents and child to expect after first chemo treatment?
A child's parent comes in saying their chemo has caused the child to be tired, vomit, and lose weight to the point of anorexia. What do you say?
This is expected
what should you do for your immunocompromised patient's visitors?
Screen for infection
What should remain normal even for a kid in a cast x2?
Extended cap refill and inability to move toes
What is expected of a limb in a cast? x2
Pink toes and dependent swelling
What kind of cooling measures should you not take for a child? x2
don't use a cooling blanket or tepid bath
DKA leads to?
DKA symptoms as far as respirations? Flail chest respirations?
DKA causes high respirations, flail chest causes paradoxic hyperventilation
Where should you place pulse ox for an infant and an older child?
infant on toe, older child on finger
Normal creatinine? What is considered oliguria?
0.8-1.2. Oliguria is less than 20 ml/hr
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