Pediatric Study Guide Quiz 2

9/5/2021 • Legg-Calvé-Perthes disease (LCPD) • Nursing care for buck extension • High-Fowlers just elevated • Traction places stress on the affected bone, joint, and muscle, so assessment for tightness, weakness, or contractures in uninvolved joints and muscles is performed. Adhesiv should only be removed when necessary. Active or passive ROM should be used on unaffected extremity only. Movement is expected with children. Each time a child moves, nurse should assess that proper alignment is maintained • A ventricular septal defect is associated with what? • Opening in the septum between the left and right ventricles • Sickle Cell Anemia - Discharge teaching and what to avoid? • Lots of hydration • Practice good hygiene • Avoid individuals who have colds/infections/viruses • Avoid Stress • Expected findings in Hip Dysplasia. Positive for what kind of test? • Expected Finding • Positive Barlow test (hip is dislocated by adduction) • Positive Ortolani test (hip put back in socket by abduction) • Positive Trendelenburg sign (hip points downward) • Manifestation coarctation of the aorta • A marked difference in the blood pressure and pulses of the upper and lower extremities (B/P in legs) • Open fracture • Risk for infection • Possibly affects bone growth • Iron deficiency anemia - How do you give liquid iron meds? • Combine with vitamin c • Use straw to prevent staining of teeth • Store in original container out of reach of children • How to prevent the child with Scabies and is scratching from touching the area? • Distract the child • Care of Frostbite • Sign and symptom in the hands • Early sign • Erythema • Late signs • Formation vesicles and ulcerative lesions • Extremities appear pale and hard without sensation • Position of legs with frostbite • Do not walk on frostbitten legs/feet/toes • Leukemia • Lab values • Platelets • Thrombocytopenia (low platelets) • Normal platelet count is 150,000 to 450,000 • RBC • Anemia (low Hgb and Hct) • WBC • Leukemic blasts (immature WBCs) • Neutropenia (low neutrophils) • S/S • Petechia/Bruising • Low-grade fever • Pallor • Bone and joint pain • Enlarged lymph nodes • Treatment for nausea • Avoid strong odors. Provide a pleasant atmosphere for meals • Provide small, frequent meals • Administer antiemetics, usually before meals • How to protect a child with Eczema from scratching? • File the nails • Elbow restraints • Topical steroids • Dietary care for wound healing? • Food high in protein • High Vitamin C • Nursing Teaching of Methotrexate • Take birth control to avoid birth defects 1/5 9/5/2021 • Avoid Alcohol • Immune suppression is a possible adverse effect • Cognitive development of pre-school child (3-6 years) • Child moves from egocentric thoughts at the beginning of this stage to social awareness and ability to consider viewpoints of others by the end of this stage • Animism: Assigning lifelike qualities to inanimate objects • Magical thinking • Impetigo S/S • Reddish macules become vesicular (Fluid inside) • Very contagious • Scoliosis definition • Deformity of the spine that also affects the ribs • S- curve in the back • S/S of Ductus Arteriosus ( ) • ontinuous (diastole and systole) “Machine-Like” murmur • ctivity intolerance: fatigues easily • ung issues due to pulmonary hypertension • oss of weight due to feeding issues (can’t suck very well if you can’t breathe properly) • S/S Kawasaki • Will need to know that peeling of the skin is a sign and to report swollen lymph to MD • onjunctivitis- without discharge • ash- but not vesicular / fluid-filled • denopathy > 1.5cm. (swollen lymph nodes) • trawberry tongue- Redness of oral mucosa or lips or dry peeling lips • and- Swelling or Erythema or hands feet (progresses to peeling but this is late) • ... 5 days of daily fevers • Hemophilia • Hemarthrosis • Bleeding into the joint spaces • What position for hemarthrosis in the knee? ( ) • est • ce the joint • ompression • levate affected limb • Idiopathic thrombocytopenic purpura • May have a recent history of rubella or other viral respiratory infection • Diagnosis confirmed by bone marrow aspiration • Osteomyelitis (infection of bones) • Elevated WBC and ESR • A bone scan may be more reliable • How to care for a child with diaper dermatitis • Keep the area dry and change frequently • How to prevent acne vulgaris flairs? • Routine skin cleansing • No greasy hair products • Excessive cleaning can irritate • Use topical benzoyl peroxide Retin-A • Acne Vulgaris exact cause? • Unknown • What are signs of herpes simplex type 1? • Tingling, itching or burning on lips • Vesicles and crusts form taking up to 10 days to heal • Recurrence of herpes zoster is triggered by what? • Stress • Immunocompromised • Pediculosis Capitis (head lice) • How to disinfect objects that cannot be put in the laundry? • Boil combs, brushed and hair accessories for 10 min. • Contain un-washable items in a tightly sealed bag for 14 days • What are manifestations of compartment syndrome • Pain that seems greater than the injury should warrant • Pain that is uncontrollable by any analgesics • Tetralogy of Fallot-Defect has a decreased pulmonary flow (SATA) • S/S • Feeding problems • Failure to thrive/Growth retardation • Frequent respiratory infections • Severe dyspnea during exertion • Polycythemia (increase of hemoglobin) develops to compensate for lack of oxygen • Treatment • Palliative procedure-Blalock-Taussig Shunt (temporary) • Complete surgical correction 2/5 9/5/2021 • Diabetes type 1 • WOF S/S of Hypoglycemia during the peak of NPH (aka Intermediate-acting) • Anxiety • Irritability • Headache • Tachycardia • Confusion • Dizziness • Blurry Vision • Diaphoresis • Tremors • How to prepare insulin Sick day management • Monitor glucose every 4 hours • Give insulin, even if child does not have appetite • Test urinary ketones with each voiding • Encourage liquids to aid in clearing ketones • How to treat low urine output • Vasopressin (anti-diuretic) by injection or nasal spray • Provide adequate fluids • • Congestive heart failure • Goals • Prevent infection • Reduce the work of the heart • Reduce the anxiety of the patient • Improve respiration • Maintain proper nutrition • Nursing Care • Organize care so that infant is not unnecessarily disturbed • Feed early if crying and late if asleep • Feedings are small and frequent • Oxygen is administered to relieve dyspnea • Medications are given as prescribed after dosages are checked for safety • Accurate recording of intake and output • Clinical Manifestations of Aortic Stenosis • A marked difference in blood pressure and pulses of upper and lower extremities • Breathlessness • Angina • Syncope • Fatigue • Possible heart murmur • How to detect sexual abuse? • Difficulty of walking • It is Mandatory to report if there's child abuse • Signs of Thalassemia • #1 Sign is Fever? • Fatigue • Weakness • Paleness • Slow growth • Signs of Hodgkin Disease ( ) • ainless swelling of lymph nodes in neck, armpits or groin • nexplained weight loss • atigue • ever • evere itching • Signs of Diabetes Insipidus • Polydipsia • Polyuria • Weak muscles • Weight loss 3/5 9/5/2021 • Clubfoot • deformity of the foot and ankle • Pavlik harness • Monitoring and care of skin and circulation • Assess neurovascularly (5Ps –pain, pallor, paresthesia, pulselessness, puffiness) • Check sensation on distal side of cast and capillary refill • How frequently will you monitor the skin and circulation? • I don’t know. Could be every 2 hours or once a shift. :O • Aplastic Anemia • Labs Values • Blood counts will be very low • Why are RBCs low? • Failure of cell-generating capacity of bone marrow • Tay-Sachs Disease • Primarily found in Ashkenazi Jewish Population • Infants are normal until about 6 months old then inability to sit up • Progress to blindness and mental retardation • No treatment • Signs of Hypothyroidism (SATA) • Infant is very sluggish and sleeps a lot • Tongue becomes enlarged, causing noisy respiration • Skin is dry, no perspiration • Hands and feet are cold • Infant feels floppy when handled • Chronic constipation • Hair eventually becomes dry and brittle • If left untreated, irreversible mental retardation and physical disabilities result • Sprain and Strains • Causative factor is twisting • Nystatin (powder) how to apply • Medication should remain in contact with fungal infection as long as possible • Apply after feeding • Common name of Tinea Pedis • Athletes foot • Most susceptible part of the body? • The knee • Know burns “Rule of Nines” • Burns: • Moderate • Partial-thickness burns involving 15% to 30% of body surface • Full-thickness burns involving less than 10% of body surface • Major • Partial thickness involving 30% or more of body surface • Full-thickness burns involving 10% or more of body surface • h 4/5 9/5/2021 5/5