ATI Pediatric Study Guide for Quiz #2

• Expected S/S of Lead poisoning Anorexia (lack of appetite) • What to do if child presents with foul, ribbon like stool (Hirschsprung's Disease)? Prepare the parents and child for surgery A temporary ostomy will be done • S/S of Intussusception Blood and mucus for stool "currant jelly stool" • S/S of Hernia Strangulation Child may vomit and have severe abdominal pain • Home care of Hepatitis No high fat diet • What position to place a child with cleft lip/palate? Side lying on the unaffected side Use elbow restraints • S/S of Esophageal Atresia Unexplainable cyanosis Chocking with feedings • S/S of Pyloric Stenosis Projectile vomiting followed by hunger Take them to the doctor • Celiac Disease diet Rice is ok to eat Can't eat Barley Rye Wheat Oats • Nursing Interventions for patient about to have an Appendectomy Start IV fluids NPO Start IV antibiotics Prepare Pre-op medications • Nursing Interventions for patient after having an Appendectomy Things that need immediate attention • Refusing to ambulate • IV site pain • Post-op pain • Important to know about Epispadias and Hypospadias Lab results will always have bacteria After surgery to repair Hypospadias • Avoid baths until shunt is removed • Nephrotic Syndrome (Nephrosis) Periorbital edema (cardinal sign) Generalized edema Pallor Anorexia Proteinuria Fever Cough • Adverse Effect of Sulfamethoxazole-Trimethoprim (Bactrim) Photosensitivity • Asthma medication Beclomethasone • WOF Oral candidiasis (thrush) associated with metered-dose inhaled (mdi) corticosteroids Albuterol • Open airways • Decreased coughing • Prevent wheezing Montelukast • Chew tablet at evening • Common cause of Toxic Shock Syndrome High absorbency tampons • Patient teaching for SIDS Place baby on back to sleep (supine) Should not sleep with parents for ease of breast-feeding • Orchiopexy Procedure to correct Cryptorchidism (testes fail to descend) After this procedure don't let child decide when to return to play activity • Hemolytic Uremic Syndrome Child has been anuretic (unable to pee) and getting peritoneal dialysis • Nurse is to restrict fluids for the dialysis patient • Glomerulonephritis An allergic reaction to group A Strep • Child had strep 2 weeks before being diagnosed S/S • Mild to High urinary specific gravity • Normal (1.000 to 1.030) • Serum creatinine 1.3 mg • Normal (0.3-1.0 mg) Diet • Low sodium • Fluid restricted • If child with strabismus (cross-eyed) tilts head to the side, what might they need? Corrective lenses • Tuberculosis Take INR for the full 9 months • Cystic fibrosis Testing • Sweat chloride test Treatment • Pancreatic lipase capsule • Taken with meals and snacks Diet • High fat and high sodium • Loaded baked potatoes 🤤 Teaching • Wash hands before eating • Respiratory Syncytial Virus (RSV) Contact and droplet precaution In private room • Epiglottitis Air Obstruction due to swelling of epiglottis • Thrust chin forward and open mouth Apply O2 via mouth mask (humidified) • Croup Don’t give cough syrup if coughing develops During acute spasmodic episode keep children indoors during cool humid night air Diminished breath sounds • Seizures Side lying position Nursing Intervention • Time the episode • Move furniture away • Loosen tight clothing • Stay with child Obtain history of contributing factors that trigger a seizures before they occur • Reyes syndromes S/S • Persistent, profuse vomiting Instructions • Avoid salicylate (aspirin) for viral disease • No meds containing salicylic • Hydrocephalus Palpate infants anterior fontanelle if level of consciousness is diminished • Meningococcal meningitis Isolation precautions for at least 24 hours after first antibiotic treatment • Otitis media (ear infection) Possible cause • Smoking in the house Smoke is a common allergen to infants Myringotomy • Inserting tympanostomy tubes If small amount of reddish drainage found • Document findings • Bacterial conjunctivitis Teaching for mom • Wash hands frequently • Give eye drops • Don’t share washcloths or towels • Laryngotracheobronchitis Nurse can detect airway obstruction if heart rate is increased • Pneumonia Position child upright for maximum lung expansion • Gastroenteritis Nurse to check if child is voiding • Observe for dehydration • Gastroesophageal (Gastric) Reflux Vomiting Weight loss Wheezing/Apnea • Poison upright after feeding • Wilms Tumor Abdominal Mass • Avoid pressing Most common, malignant, renal and intra-abdominal tumor • Spinal Bifida Dimple in sacral area Child is to sleep prone Child on latex precautions so they don't get a latex allergy • Smoke Inhalation Can lead to atelectasis (collapsed lung) Acute respiratory disease syndrome (ARDS) Can cause carbon monoxide poisoning Inhibits surfactant secretion • Carbon Monoxide Poisoning Not to breathe in so mom should not determine odor Causes headache Don't use pulse oximeter on child Things to do • ABG test • Oxygen administration • Monitor I & O's • What to expect with a head Injury? Gross incoordination while walking (ataxia) • Home oxygen therapy and oximeter Probe can be applied to toe or finger Not accurate with excessive movements Notify MD if reading is consistently 100% Do not need to rotate oximeter every 24 hours • Risk factor for Respiratory Distress with Respiratory Acidosis Small for gestational age • Spinal Cord stuff that I could find Meningitis • Inflammation of the meninges, which are the connective tissues that cover the brain and spinal cord. Meningitis is caused by bacteria, a virus, or fungus in the cerebrospinal fluid. Myelomeningocele • Protrusion of a sac-like cyst that contains meninges, spinal fluid, and a portion of the spinal cord and nerves. Drowning Injuries • Spinal cord injury is an expected finding in drowning injury Encephalomyelitis • Inflammation of the brain and spinal cord, typically due to acute viral infection • Hearing Impaired Child Speak slowly while facing the child • Post tonsillectomy with frequent swallowing Needs immediate attention due to bleeding Sit child up so they don't aspirate on blood • Brain Tumor Safety issues Initiate seizure precautions • Exstrophy of the Bladder Extrusion of urinary bladder outside the body due to lower part of abdomen wall and bladder wall missing • Vomiting Place patient in side-lying position • If a patient has been having diarrhea for 3 days Rehydrate Assess fluid balance Give Pedialyte • To assist in hydration Give Pedialyte • For a lactose intolerant patient Give calcium supplement • All about Dehydration Moderate stage • Increased respiratory rate Indication of dehydration • Serum Potassium 2.5 mg/dL (<--- too low) Don't take temperature rectally • Ingestion of salicylate Give activated charcoal Gastric lavage • Ingestion of vitamin/iron tablets or liquid furniture polish Contact poison control • If child is suspected to have worms (Vermiculates, Enterobiasis) Scotch tape test • Sign of UTI Frequent voiding • Enuresis (Bedwetting) Emotional problems/issues • Photophobia Avoid using the T.V. • Hydrocele Explain to parent that it is usually self-correcting within a year • Myelomeningocele (Spina Bifida) Moist dressing applied to site • Post-op Tonsillectomy Cold Popsicle • Bacterial meningitis Administer Antibiotic • What is the brand name of Human Papillomavirus (HPV) Vaccine? Gardasil • Pertussis (Whooping Cough) Droplet precaution • Appendix ruptured Surgical emergency when child says • "My belly doesn’t hurt anymore" Leads to Peritonitis • Pain scale for children Faces FLACC • Sign of aids in 2 year old Candidiasis • Stages of development by Erik Erikson School-age child is at the Industry vs. inferiority stage WOF a child with asthma will be a distractor (it's a physical disorder) tsk tsk • Ventricular Peritoneal Shunt Position on non-operative site Priority intervention if child exhibits • Lethargy • Increased intracranial pressure • Decreased LOC • S/S of GERD Gastroesophageal (Gastric) Reflux Vomiting Weight loss Wheezing/Apnea • Poison upright after feeding • Adolescents with blunt trauma to abdomen with B/P of 92/50 Internal hemorrhage • Expected finding in Acute Appendicitis Increase in WBC (leukocytosis) • Child with Gastroenteritis What activity to give them • Drawing • Painting • Immunization for a 5 year old Varicella (Chicken pox vaccine) • Child with Acute Nephritic Syndrome are prone to infection Sign of acute respiratory infection • Fever/cough Report to MD • Yellow nasal drainage • Serum protein 3.0 g/dL • If child falls, some indications of intercranial pressure are Bulging fontanelle Irritability or fussiness • Contraindication for live influenza vaccine Allergic to eggs