Pediatric Hesi Review

Pediatric Hesi Review What are 2 contraindications for giving a child a live vaccine?  Immunocompromised child; or in most cases, a child in the household with an immunocompromised individual. How should burns be assessed in the child? Modified Rule of Nines In children versus adults the Head and Neck are considered as one body part. This would give you 18% of the body and in adults it is only 9%. What early signs should the nurse assess when lead poisoning is suspected? Lead poisoning causes Anemia which gives you the following symptoms: Acute cramping, Abdominal pain, Vomiting, Constipation, Anorexia, Headache, Lethargy, Hyperactivity, Aggression, Impulsiveness, Decreased interest in play, Irritability, Short attention span List seven sign of respiratory distress in children. Restlessness, Tachycardia, Tachypnea, Diaphoresis, Flaring nostrils, Retractions, Grunting Respiratory Disorders What position would the child with epiglottitis assume to help them breathe better? The Tripod position – upright sitting, chin out and tongue protruding. Review of Neuromuscular Disorders What is a description of ‘scissoring’ in a child with cerebral palsy? In spastic CP, in infants; legs are extended and crossed over each other; feet are plantar flexed Cardiovascular Disorders What is the difference between a right-to-left shunt and a left-to right shunt in cardiac disease? What would cause an infant to have nasal flaring? Flaring nares is a sign of respiratory distress because infants are obligatory nose breathers. They do not know they can breathe through their mouths when the nose is stopped up. When a pediatric patient has an amputation what kind of teaching will the nurse do that is very important to the patient’s health? Teach them to inspect the stump for skin breakdown to prevent infection. What is ‘synagis’ and why is it given? That is called the RSV ‘vaccine’. Not really a vaccine but a preventative given IM once a month during RSV season from Fall thru Spring, to children at risk: • Premature • Chronic illness • Disabilities When should solid food be offered to a baby? When they can to turn their head and open their mouth when the spoon comes toward their mouth. Textbook would say 4 to 6 months of age and then only one new food at the time to make sure they are not allergic. When and why would a Lyme test be done on a child? Lyme test is done by drawing blood to detect the bacteria Borrelia burgdorferi after getting bitten by ticks. This is usually best done after 1 or 2 weeks of exposure. What test is done to detect cystic fibrosis in children? A ‘sweat chloride test’ is done if the PKU or metabolic screening is positive or there is a meconium ileus in the newborn or when the infant has other signs when these things are not done or noticed; skin tastes extremely salty when parents kiss the baby. What is cradle cap and how do you get rid of it on the infant? A skin condition on the infants scalp due to excessive sebum production. Characterized by patches of yellow or brownish scales on the top of the head. Use mineral oil to moisten and a fine-toothed comb or soft brush to remove the scales gently several times a day. What is Juvenile Idiopathic Arthritis (JIA) and how is it treated? JIA is diagnosed in pediatrics before age 16 if you have arthritis for six weeks or more, and the doctor rules out other conditions that cause arthritis. Treated with NSAID’s, steroids, and sometimes methotrexate. Aspirin is no longer recommended. Eye exams should be done regularly to prevent damage due to inflammations. What is a VP shunt? A ventriculoperitoneal (VP) shunt is placed to relieve pressure in the ventricles of the head. Primarily used in hydrocephaly. What is the field of gaze in a newborn and how important is this? If a newborn does not respond when you talk or stare back at you when you are ‘en face’ position then you may consider they have a hearing, sight, or autistic problem.  WithinD7 hoursDafter birth infants take a remarkable interest in their mothers' faces and have been shown to imitate facial expressions made by caregivers.  Between 6-10 weeks, baby begins to direct her eyes more intentionally by looking directly at her caregiver and holding the gaze with eyes widening.D   AtDaround 3 months, baby can follow the movements of her caregiver as she moves about at a distance.D ByD9-11 months, babies develop the ability to follow the actual eye gaze of the adult. It means that they already understand that the eyes are meant to look and see.D What is patent ductus arteriosus (PDA)? A PDA is a heart defect characterized by a machine-like murmur and treated by giving a course of indomethacin (Indocin) to see if it will close without surgery. If it does not close on its own within a few days, then surgery may be required to prevent lung problems. What are the signs and symptoms of congenital hip dysplasia? Asymmetrical gluteal folds. Often seen in breech babies. A hip ultrasound will be done as well as the Ortolani maneuver to check for a loose hip in the socket. Treated by using a Pavlik harness to abduct the hips, traction, or serial casting. What is a Wilms's tumor? Most common kidney tumor in children. Nephroblastoma that starts in the kidney. May feel a mass in the abdomen at which time you STOP palpating and notify the doctor. Place sign over bed to not manipulate abdomen or palpate. Why do sickle cell patients have enuresis? Because they are asked to over hydrate to prevent a crisis, they are unable to concentrate their urine well and it cannot be helped. Enuresis is a sign of sickle cell disease. What causes acute glomerulonephritis (AGN)? Post-streptococcal infection  Tea colored urine with hematuria, protein, and HPH with fluid retention.  Self-limiting What is acute myelocytic leukemia (AML) in children and what are the symptoms? This is a type of blood cancer where blasts cell do not become healthy white blood cells and stay in the bone marrow.  Anemia, frequent infections, bone and joint pain, bruising and bleeding with petechiae.  Peaks between age 2 to 5 years of age. What kind of diet is best for celiac disease? Gluten free items and ingredients. Read labels and look up these foods online to find out what you should be eating. What are the signs and symptoms of pyloric stenosis? Olive shaped mass in the upper stomach region and visible peristaltic waves. What may be a problem seen after surgery for Tetralogy of Fallot? What are the 4 defects associated with Tetralogy of Fallot? Post-op fatigue, causing poor appetite and respiratory distress. Watch for congestive heart failure.