ATi peds Flashcards


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1

When does the posterior fontanel close?

between 6 and 8 weeks of age

2

When does the anterior fontanel close?

between 12 and 18 months of age

3

what kind of test should you use to test the visual acuity of children who are unable to read letters and numbers?

tumbling E, HOTV

4

how should older children be tested for visual acuity?

Snellen chart or symbol chart

5

The Ishihara color test or the Hardy-Rand-Rittler color test are used to assess ____________ _________

color vision

6

peripheral vision is evaluated by having the client fixate on an object and say when it is moved out of range.

50, 70, 60, 90

7

amount of teeth that infants should have by one year of age: ______ to ______

______ deciduous teeth

________ permanent teeth

6 to 8, 20, 32

8

unilateral or bilateral breast enlargement that occurs for males during puberty

gynecomastia

9

rooting and sucking reflex should be seen from birth to _____ months

4

10

palmar grasp should be seen from birth to ______ months

3

11

plantar grasp, or when the infant's toes curl downward after the sole of their foot is touched, is seen from birth to ______ months

8

12

the moro reflex (startle) is seen from birth to ______ months. a typical reaction is when the infant's arms and legs symmetrically extend and then abduct while her fingers spread to form a C shape.

4

13

elicited by turning an infant's head to one side. The infant extends the arm and leg on that side and flexes the arm and leg on the opposite side.

Seen from birth to 3 to 4 months.

tonic neck reflex (or fencer position)

14

elicited by stroking the outer edge of the sole of an infant's foot up toward the toes. The infant's toes fan upward and out.

This is seen from birth to one year.

babinski reflex

15

Stepping is elicited by holding an infant upright with his feet touching a flat surface. The infant will then make stepping movements. This lasts from birth to _______________.

4 weeks

16

able to stand with slight swaying while eyes are closed, tests cerebellar function

Romberg test

17

infants gain approximately 150 to 210 g (about 5 to 7 oz) per week the first 6 months of life. Birth weight is at least doubled by the age of ____ months, and tripled by the age of ____ months.

6, 12

18

the circumference of infants' heads increases approximately 1.5 cm ( ____" ) per month for the first 6 months of life, and then approx. 0.5 cm ( ______" ) between 6 and 12 months of age.

0.6, 0.2

19

should only be used in infants over the age of 6 months

ibuprofen

20

demonstrates head lag and has a grasp reflex

1 month

21

lifts head off mattress when prone, holds hands in an open position

2 months

22

raises head and shoulders off mattress when prone, only a slight head lag.

No longer has a grasp reflex. Keeps hands loosely open.

3 months

23

rolls from back to side, places objects in mouth

4 months

24

rolls from front to back, uses palmar grasp dominantly

5 months

25

rolls from back to front, holds bottle

6 months

26

bears full weight on feet, moves objects from hand to hand

7 months

27

sits unsupported, begins using pincer grasp

8 months

28

pulls to a standing position, creeps on hands and knees instead of crawling. Has a crude pincer grasp.

9 months

29

changes from prone to a sitting position. Grasps rattle by its handle.

10 months

30

walks while holding on to something. Places objects into a container, has a neat pincer grasp.

11 months

31

sits down from a standing position without assistance. Tries to build a two-block tower without success.

12 months

32

supplements recommended for infants who are being exclusively breastfed after the age of four months.

iron

33

infants and toddlers remain in a rear-facing car seat until the age of ___ years or the height recommended by the manufacturer.

2

34

crib slats should be no further apart than 6 cm. Crib mobiles or crib gyms should be removed by __ to __ months of age.

4-5

35

preschoolers (3-6 years) should gain about 2 to 3 kg ( ____ to ____ lb) per year and grow about 6.5 to 9 cm ( 2.6 to 3.5 in) per year

4.4 to 6.6 lb

36

by age ____, a preschooler can ride a tricycle, jump off bottom step, and stand on one foot for a few seconds

3

37

by age ____, a preschooler can skip and hop on one foot. He should also throw the ball overhead.

4

38

by age ____, a preschooler can jump rope, walk backward with heel to toe, as well as throw and catch a ball with ease.

5

39

need 13 to 19 g/day of protein in addition to adequate calcium, iron, folate, and vitamins A and C

preschoolers

40

on average, preschoolers need about ____ Hours of sleep per day. Some may still require a daytime nap.

12

41

it is recommended that children use an approved car restraint system until they achieve a height of 145 cm (or ___ feet ____ " )

4 feet, 9 inches

42

school-age children (6 to 12 years) will gain about 2 to 3 kg ( ___ to ___ lb) per year and grow about 5 cm ( ___ inches) per year

4.4 to 6.6, 2

43

for piaget's "Concrete operations" stage, school-age children master the concept of conservation. Conversation of _______ is understood first, followed by _______, and then _______.

mass, weight, volume

44

at 12 years, _____ hours of sleep is needed each night. Resistance to bedtime is sometimes experienced around the age of 8 and 9 years, and again around the age of 11 years, but is typically resolved by the age of 12 years.

9

45

for this age group, children should be taught fire safety and potential burn hazards as well as safety precautions to take while cooking.

school-age children (6 to 12 years)

46

Girls stop growing at about __________ to _____________ years after the onset of menarche. They grow 5 to 20 cm (2 to 8 in.) and gain 7 to 25 kg (15.5 to 55 lb).

2 to 2.5

47

Boys stop growing at around 18 to 20 years of age. They grow 10 to 30 cm (____ to ____" ) and gain 7 to 30 kg (15.5 to 66 lb)

4 to 12 "

48

sexual maturation IN ORDER for girls

breast development, pubic hair growth (some girls experience hair growth before breast development), axillary hair growth, and menstruation

girls

49

sexual maturation IN ORDER for males

.

testicular enlargement, pubic hair growth, facial hair growth, and vocal changes

testicular enlargement, pubic hair growth, facial hair growth, and vocal changes

50

for adolescents, during times of rapid growth, additional ___________, ________, and ____________ are needed

calcium, iron, zinc

51

for this age group, inadequate intake of folic acid, vitamin B6, vitamin A, iron, calcium, and zinc is common

adolescents (12 to 20 years)

52

when administering meds via a _____________ tube, one must: confirm placement. use liquid formulation

-Do not add medication to the formula bag

-flush with water to clear tubing of residual medication

Feeding

53

for this treatment, use a mask for younger children and allow parents to hold during the treatment.

aerosol medication

54

administer on the inside surface of the forearm

use a TB syringe with a 26- to 30-gauge needle with an intradermal bevel

insert needle at a 15 degree angle.

do not aspirate.

intradermal injection

55

inject volumes of less than 0.5 mL

use a 1 mL syringe with a 26- to 30- gauge needle.

insert at a 90 degree angle. Use a 45 degree angle for children who are thin.

subcutaneous injection

56

use a 22- to 25-gauge, 1/2 - 1-inch needle.

vastus lateralis is the recommended site in infants and small children.

-position the child supine, side lying, or sitting.

-inject up to 0.5 mL for infants.

-inject up to 2 mL for children.

intramuscular

57

for this intramuscular injection, inject up to 1 mL.

deltoid

58

use a 24- to 20- gauge catheter

use for continuous and intermittent IV medication administration.

a child who requires short term IV therapy may complete it at home with the assistance of a home health nurse

peripheral venous access (IV)

59

a ___________ __________ central venous access device would be a nontunneled catheter or peripherally inserted central catheter (PICC)

short term

60

a ___________ __________ central venous access device would be a tunneled catheter or implanted infusion port

long term

61

self-report is used for children older than ___ years of age. Include the parent or caregiver in rating the infant or child's pain regardless.

4

62

used to help rate pain for ages 2 months to 7 years

FLACC (Faces, Legs, Activity, Cry, Consolability)

63

acceptable for mild to moderate pain

Tylenol (acetaminophen) and NSAIDs

64

acceptable for moderate to severe pain. Medications include morphine sulfate, oxycodone (OxyContin), and fentanyl (Duragestic). Combining a nonopioid and an opioid medication treats pain peripherally and centrally...this offers greater analgesia with less adverse effects (respiratory depression, constipation, nausea).

opioids

65

children playing independently but among other children, which is characteristic of toddlers

parallel

66

children playing together without organization, which is characteristic of preschoolers

associative

67

organized playing in groups, which is characteristic of school-age children

cooperative play

68

to decrease cerebral swelling, administer as prescribed.

mannitol (Osmitrol)

69

improves synthesis of blood clotting factors in the liver. Subcutaneous is preferred route.

vitamin K

70

variety of seizure episodes, symmetric or asymmetric involvement, brief contractions of muscle or groups of muscle. No postictal state. May or may not lose consciousness.

myoclonic seizure

71

muscle tone is lost for a few seconds. A period of confusion follows. Loss of muscle tone frequently results in falling.

atonic or akinetic seizure

72

eyes and head turn away from the side of focus, with or without loss of consciousness

aversive

73

tonic-clonic movements involving the face and most common during sleep

rolandic seizure

74

prolonged seizure activity that lasts longer than 30 minutes or continuous seizure activity in which the client does not enter a postictal phase. This acute condition requires immediate treatment to prevent loss of brain function, which may become permanent.

status epilepticus

75

demonstrates the arms, wrists, and fingers flexed and bent inward onto the chest and the legs extended and abducted. Late sign of coma.

decorticate (dysfunction of the cerebral cortex)

76

demonstrates a backward arching of the head and arms with legs rigidly extended and toes facing downward. Late sign of coma.

decerebrate (dysfunction of the midbrain)

77

myopia, or nearsightedness, is corrected with ______________ lenses.

biconcave

78

hyperopia, or farsightedness, is corrected with ______________ lenses.

convex

79

stabismus is treated with ______________ therapy, or the stronger eye is patched.

occlusion

80

What is the average temperature of a child that is 3-6months old?

99.5F

81

What is the average temperature of a child who is 1 year old?

99.9F

82

What is the average temperature of a child who is 5 years old?

98..6F

83

What is the average temperature of a child who is 7 years old?

98.2F

84

What is the average temperature of a child who is 9-11 years old?

98.1

85

What is the average temperature of a 13 year old?

97.9F

86

What is the average pulse rate in a newborn?

80-180

87

What is the average pulse rate in a 1 week - 3 month old?

80-220

88

What is the average pulse rate in a 3 month - 2 year old?

70-150

89

What is average pulse rate in a 2 - 10 year old?

60-110

90

What is the average pulse rate for a child who is 10 years and older?

50-90

91

What is the average amount of respirations of a newborn - 1 year old?

30-35

92

What is the average amount of respirations in a 1 and 2 year old?

25-30

93

What is average amount of respirations in a 2 to 6 year old?

21-25

94

What is the average amount of respirations in a 12 year old and older?

16-19

95

What would be the ranges for a child blood pressure who is a year old?

83-114

38-67

96

What would be the ranges of a child blood pressure who was 3 years old?

86-117

47-76

97

What would the ranges of child blood pressure who was 6 years old?

91-125
53-84

98

WHat would the ranges of child blood pressure be who was 10 years old?

98-129
59-88

99

What would the ranges of child blood pressure be for a 16 year old?

108-138
64-93

100

What test do you use to test visual acuity?

E or HOTV

101

What should the alignment of the ears be?

the top of the auricles should meet an imaginary line horizontal line that extend from the outer canthus of the eye

102

What testicle hangs lower?

left

103

Object permanence begins around what age?

9 months

104

How many words are said by a 1 year old?

3-5

105

According to Erikson a child from birth-1 year old should be in what stage?

Trust vs. mistrust

106

What does separation anxiety begin?

4-8months

107

What immunization should children get at birth?

Hep B

108

What immunizations should chidren get at 2 months?

Diphtheria

DTaP

Rotavirus

Inactivated Poliovirus (PV)

Haemophilus influenza type B (Hib)

pneumococcal vaccine (PCV)

hep B

109

immunizations at 4 months?

DTap

Retovirus

Inactivated poliovirus

Hib- Haemophilus type b

PCV

110

immunizatins at 6 months?

DTaP

IPV (6-18months)

PCV

Hep B (6 to 12 months)

Retavirus

Hib

111

Seasonal influenza

immunizations 6-12months

112

What vitamin is recommended to be started within the first few days of life?

Vitamin D

113

If a mother breastfeeds what is recommended for infants over 4 months?

Iron

114

After 6months of age how much fruit juice can the child have?

4-6oz

115

What are the indicators that the child is ready for normal food?

voluntary control of head and trunk

interest in solid foods

and disappearance of the extrusion reflex

116

At what age are fruits and vegetables introduced to the child

6-8months

117

When should table food be introduced to the child?

9months

118

At what age does the infant sleep through the night and takes one to two naps during the day?

12months

119

What is a reason that nurse should delay administering DTaP?

Ear infection

--decreases child's chances to develop a good immunity

120

between the ages of 1-3 the child grows ____ per year

7.5cm

3in

121

By age___, a child can walk with out help, creep up stairs, uses a cup wall and can build a tower of two blocks

15months

122

By age ___, a child can assume standing position, throws a ball overhand, manages a spoon without rotation, turns pages ina book, two or three at a time?

18months

123

by age __, a child can walk up and down the stairs by placing both feet on each step and builds a tower with 6 or 7 blocks?

2 years

124

By age __, a child can jump in place with both feet, stands on one foot momentarily, draws circles, has good finger-hand coordination

2.5 years

125

At what age is the preoperational age?

19-24months

126

How many words does a child know by 2 years old?

300 words

127

At the age 1-3 what stage of Erikson are they in?

Autonomy vs shame and doubt

128

At the age of 4-7 what stage of Piaget is a child in

Intuitive stage

-magical thinking

-Animism

-Centration

129

How many words should a 5 year old know?

2,100 words

sentences of 4-5 words

130

What stage of Erikson is a 4-7 year old?

Initiative vs guilt

131

What age do children begin to compare themselves to their peers?

5 years old

132

Immunizations for a 4-6 year old

IPV

DTaP

DTaP

133

immunizations of a 3 to 6 year old?

nfluenza flu vaccine-- 2 doses given at least 4 weeks apart are recommended for children through 8 years of age who are getting flu vaccine for the first time

134

How many G of protein does a preschooler need?

13-19g

135

On average, how many hours of sleep should a preschooler get?

12 hours and may even require a day time nap

136

At what stage of Piaget is a 6 to 12 year old?

Concrete

137

At was stage of Erikson is a 6-12 year old?

Industry bs inferiority

138

If not given between the age 4 and 5, a child at the age of 6 should get what immunizations

MMR

IPV

DTaP

Influenza

139

Immunizations for a 11 and 12 year old

Tdap

human papillomavirus- HPV2 or HPV4-in three doses for females

Meningococcal MCV4

140

what are health screening that should be done between the ages 6-12

scoliosis

141

How many hours of sleep is reccommeded for a 12 year old

9 hours

142

What final percent of height is achieved during puberty?

20-25%

143

What stage is a adolescent in of Piaget?

formal operations

144

What stage is a adolescent in on Erikson?

Identity vs role confusion

145

Immunzations of a adolescent (16-20)

Flu vaccine

Meningococcal MCV4 booster if first dose was between 13-15

146

What are health screenings needed for an adolescent?

scoliosis

147

what is patent ductus arteriosus PDA

the pulmonary artery and the aorta fails to close and results in increased pulmonary blood flow

148

what is pulmonary stenosis

narrowing of the pulmonary valve

could be asymptomatic or cyanosis and can lead to heart failure

149

What is aortic stenosis

faint pulses

hypotension

murmor

150

What is Coarctation of the aorta

elevated blood pressure in the arms
cool skin of lower extremities
heart failure

151

What is Transposition of the great arteries

murmor
severe to less cyanosis depending
heart failure

152

what is tricupsid atresia

a complete closure of the tricupsid that results in mixed blood flow

153

what is tetralogy of fallot have four defects that result in mixed blood flow

Pulmonary stenosis
ventricular septal defect
overriding aorta
right ventricular hypertrophy

154

what is Truncus arteriosus

failure of septum formation, resulting in a single vessel that comes off of the ventricles

155

What is hypoplastic left heart syndrome

left side of the heart is underdeveloped. An ASD or patent foramen ovale allows for oxygenation of the blood

mild cyanosis, HF, lethargic, cold hands and feet

156

What are some symptoms of impaired myocardial function

sweating, tachycardia, fatigue, cool extremitites with weak pulses, hypotension, gallop rhythm, cardiomegaly

157

what are some symptoms of pulmonary congestion

tachypnea, dyspnea, retractions, nasal flaring, grunting, wheezing, cyanosis, cough orthopnea

158

What is systemic venous congestion

hepatomegaly peripheral edema, ascites, neck vein distention, periorbital edema, weight gain

159

what is manifestations of hypoxemia

cyanosis, poor weight gain, tachypnea, dyspnea, clubbing, polychythemia

160

if a pulse for an infant is what that means who cannot give digoxin

90

161

if a pulse for a child is what that means you cannot give digoxin

70

162

what is a level that you should monitor if your patient is taken and ACE (pril)

potassium levels

163

what is hypoxemia

hypercynotic spell

164

what is rheumatic feverr

reaction of group A hemolytic infection to the throat`2-6 weeks following an untreated or partially treated strep

165

What are some symptoms of rhematic fevert

achycardia, cardiomegaly, prolonged PR interval, new or changed mutor, pericardial friction rub

166

What does the rash look like for rheumatic fever?

pink, nonpruritic macular rash on the trunk and inner surfaces of extremities that appears and disappears rapidly, indicating erythema marginatum

167

what are some lab tests for rheumatic fever

throat culture of GABHS

serum antistreptolysin-O titer- elevated or rising titer most reliable diagnostic test

C-reactive protein CRP- elevated in response to an inflammatory reaction

Erythrocyte sedimentation rate- elevated in response to an inflammatory reaction

168

what is the Diagnostic procedures rheumatic fever

ECG reveal the presence of conduction disturbances and to evaluate the function of the heart and the valves

169

For rheumatic fever what is the Jones Criteria

the presence of 2 mahor criteria or the presence of one major and two minor criteria

170

for rheumatic fever what is the major criteria for the Jones Criteria

Subcutaneous nodules

Carditis

Polyarthritis

Rash

Chorea

171

for rheumatic fever what is the minor criteria for the jones criteria

fever

arthralgia

172

What is hyperlipidema

is excess lipids (fat) in circulating blood

173

What are the risk factors for hyperlipidema

Genetic

obesity

lack of exercise

history of health conditions: diabetes, kidney disease, hypothyriodism

meds: birth control, diuretics, beta blockers

174

What are the lab tests for hyperlipidema

lipid profile-fasting for 12hr prior to test fasting blood glucose

175

what are some things a nurse should monitor for hyperlipidema

febrile illness 3 weeks prior to screening instruct about diet to lower cholesterol--low fat, whole grains, fruits and veggies encourage use of olive oil and canola oil

176

What medicine do you use for hyperlipidema?

Cholestyramine (Colestipol) use in children 8 years and older who have a LDL of 190 or higher or 160 or higher for pt who have risk factors

177

How much water should be used with powered meds?

4-6 oz

178

What are some complications of hyperlipidema

atherosclerosis

coronary heart disease

179

Waht is Kawaski disease

acute systemic vasculitis

known etilogy

180

Waht are the symptoms of kawasaki disease

Fever greater than 102

Irritabiability

Bright red, chapped lips

strawberry tongue with white coating or red bumps on the posterior aspect

nonblistering rash

enlarged lymph nodes

6-8 weeks to resolution

181

What are the labs you look at for with Kawaski disease

CBC, CRP, ESR, serum albumin

182

What medicines do you take for Kawaski disease

Gamma globulin (IVGG)

high dosage: 2g/kg over 10 to 12 hr

aspirin-80-100mg/kg/day divided every 6 hours

irritability can last 2 months

avoid immunizations for 11 months

183

What are the main complications of Kawaski disease

coronary artery dilation or aneurysm

184

if you have epistaxis how long should you apply pressure to the nose

sit and have the head tilted slightly forward and hold pressure to the lower are of the nose for about 10 min apply ice

185

Iron deficiency 12-36 months are at risk due to consuming what

diet high in cows milk without adequate intake of foods high in iron

186

iron deficiency for adolescents are at risk due to what

poor diets, menses, obesity, and rapid growth rates

187

What are the hgb and hct ranges for a 2 month old

9.0-14.0

28-42%

188

what are the hgb and hct ranges for 6-12year old

11.5

33-45%

189

What are the hgb and hct ranges for 12-18year old

male-13.0-16.0
37-49%
female-12.0-16.0
36-46%

190

What does reticulocyte count mean

can be decreased
indicates bone marrow production of RBCs

191

Why would you limit milk intake of a toddler to 32oz per day

Anemic

192

When a person drinks milk how are you supposed to give them iron pills1

1 hour before or 2 hours after

193

severe anemia can lead to what

Heart failer

194

autosomal recessive genetic disorder

Sickle cell anemia

195

What is a vaso-occlusive crisis for sickle cell anemia

severe pain

lasts 4 to 6 days

visual disturbances, hematuria,

chronic: systolic murmor, kidney failure, systolic murmor, seizures

196

What is sequestration crisis for sickle cell anemia?

excessive pooling of blood primarily in the spleen and sometimes in the liver

197

What is aplastic crisis for sickle cell anemia

Extreme anemia as a result of decreased RBC

198

What is hyperhemolytic crisis for sickle cell anemia

Incraesed rate of RBC leading to anemia, jaundice and or reticulocytosis

199

What are the lab tests for sickle cell anemia

CBC
Sickledex
hemoglobin electrophoresis-seperates to determine

200

What happens in a sickle cell crisis

Hgb drops
WBC is elevated
Bilirubin and reticulocyte levels are elevated
Peripheral blood smear reveals sickle cell

201

What are the diagnostic procedures for sickle cell anemia

Transcranial doppler test (TCD)
---can detect cardiovascular accident
----annually for ages 2 to 16 for pt who SCD

202

What is the nursing care for sickle cell anemia

rest and Oxygen
maintain fluid and electrolyte balance
pain management-mild analgesic, severe-opiods
blood samples
treat and prevent infection

203

What are some complications of Sickle cell anemia

CVA
Acute chest syndrome

204

What is hemophilia in general

difficulty controlling bleeding

205

What is hemophilia A

Classic hemophilia
Lack of factor VII
accounts for 80% of cases

206

What is hemophilia B

lack of IX

Christmas disease

207

What are subjective findings in hemophilia

excessive bleding, joint pain, impaired mobility, easy bruising

208

What are objective data findings in hemophilia

active bleeding
platelet and prothrombin time within expected range or prolonged
whole blood clot is in expected range or even prolonged

209

Nursing care for a patient who has hemophilia

avoid temp in rectum
apply pressure for 5 minutes after injections, venipuncture, or needle sticks.
monitor urine, stool and NG for blood
elevate and apply ice to effected joints

210

What are the medications you give for a person who has hemophilia

1-deamine-8-arginine (DDAVP) increase plasma factor VII only for hemophilia A

corticosteriods -hematuria, hemarthrosis, chronic synovitis

NSAIDS- for synovitis

211

How should you dress children who have hemophilia

in extra layers for more protection

212

What are some things a nurse should watch for if the patient has hemophilia

shock
uncontrolled bleeding
blood transfusions
intracranial bleeding
prophylaxis treatment
joint deformity

213

what age can the rotavirus effect people

all ages

214

incomplete fusion of the oral cavity during intrauterine life

cleft lip

215

incomplete fusion of the palatine plates during intrauterine life

cleft palate

216

when is the repair of cleft lip

done between 2-3months
infants should be at least 10 weeks old, weigh 10 lbs, have a hbg of 10g/dL

217

When is cleft palate repair typically done

6 to 12 months
majority require a second surgery

218

What do for successful feeding for isolated Cleft lip

encourage breast feeding
use a wide based nipple for bottle feeding
squeeze the infants cheeks together during the feeding to decrease the gap

219

what do you for successful feeding for cleft palate

position person upright wihile cradling the head during the feeding
use a speicalized bottle with a one way valve and a special cut nipple
syringe feeding

220

post op care of Cleft lip and cleft palate

no sucking
avoid hard toys
administer analgesics
position upright
watch for crusting
elbow restraints
saline to clean site
palates packing is typically removed in 2 to 3 days

221

what is something that patients who have left palate more susceptiable to

infection of the sinuses
ear infection

222

What is GER

it self limiting and usually resolves by 1 year of age gastric content backs up into the esophagus

223

how does GERD happen

tissue damage from GER

224

What are the risk factors of GER

prematurity, bronchopulmonary dysplasia, neurological impairments, asthma, cystic fibrosis, cerebral palsy, scoliosis

225

What are the risk factors of GERD

neurologic impairments, histal hernia, esophageal atresia, morbid obesity

226

What are some symptoms of GERD and GER infants

excessive spitting ro forceful vomit
excessive crying
blood in stool
arching of the back
failure to thrive
apnea
respiratory problems

227

What are osme symptoms of GERD and GER in children

heartburn, ab pain, difficulty swallowing, chronic cough, chest pain

228

What are the diagnostic tests for GER and GERD

upper GI test 24 hour intra esophageal pH study to measure the amount of gastric juices endoscopy with biopsy to detect esophagitis scintigraphy

229

Nursing interventions for GER

thicken the infants formula with 1 tsp to 1tsp rice cereal per 1 oz formula
avoid caffeine, citrus, spicy or fried food
assist with weight control
elevated 30 degrees for 1 hour post

230

Nursing interventions for GERD

initiate interventions for GER
administer proton pump such omeprazole (Prilosec) or an h2 receptor antagonists such as ranitidine (Zantac)

231

What are the therapeutic procedures for GER and GERD

aparoscopic surgical procedures to decrease reflux

232

What are the complications for GER and GERD

recurrent pneumonia, weight loss, and failure to thrive

233

what is hypertrophic pyloric stenosis

thickening of the pyloric sphincter which creates an obstruction
usually occurs the first 5 weeks of life

234

What are the risk factors for hypertrophic pyloric stenosis

Genes

235

What are the objective and subjective date for hypertrophic pyloric stenosis

vomit following a feeding
blood tinged vomit
constant hunger
olive shaped mass in the RUQ
skin dry or pale
failure to gain weight
decreased skin turgor
rapid pulse
sunken eyes

236

What are the lab tests for hypertrophic pyloric stenosis

electrolytes
ultrasound
sausage shaped mass

237

What are preoperative procedures for hypertrophic pyloric stenosis

IV fluids
NG tube
NPO
I and O
daily weights

238

What are the post operative procedures for hypertrophic pyloric stenosis

VS
antiemetic
IV Fluids
monitor daily weights
start clear 4 to 6 hr

239

what is hirschsprung disease

structural anomaly of the GI tract caused by lack of ganglionic cells sin segments of the colon = decreased motility and mechanical obstruction

240

What are the signs of hirschsprung disease newborn

failure to pass meconium within 24-48 hour after birth
vomit bile
refuse to eat
ab distention

241

what are the signs of hirschsprung disease of infant

failure to thrive
ab distention
vomit
constipation and diarrhea

242

What are the signs of hirschsprung disease of an older child

failure to thrive
ab distention
peristalsis
palpable fecal mass
constipation
foul smelling, ribbin like stool

243

What are the lab tests for hirschsprung disease diagnostic

electrolytes
CBC

rectal biopsy to show absence of ganglion cells

244

What type of diet do they have for the hirschsprung disease

high protein, high calorie, low fiber
Total parenteral feeding in most cases

245

preop for hirchsprung disease what should you monitor for?

entercolitis

246

how should you prepare the patient before surgery

perform bowel prep with saline enemas and oral antibiotics

247

What are some complications for hirschsprung disease

enterocolitis-inflammation of the bowel

measure ab girth
watch for sepsis, peritonitis, or shock from enterocolitis
administer antibiotics

248

What is intussusception

one part of the intestine telescopes into another part, results in lymphatic and venous obstruction that results in edema in the area

can progress into ischemia and increased mucous

typ between 3 months and 3 years

249

What are the risk factors for intussusception

cystic fibrosis

250

what are the subjective and objective data of intussusception

sudden ab pain
screaming when drawing knees to chest
ab mass
vomit
fever
dehydration

251

What are the diagnostic procedures for intussusception

ultrasound

252

what is the nursing care?

IV fluids and NG tube

253

what are the therapeutic measures?

air enema without contrast

254

What is appendicitis

inflammation of the appendix from obstruction of the luman

255

What are some objective and subjective collections of appendicitis

ab pain in RUQ
rigid ab
fever
diarrhea or constipation
tanchycardia
anorexia
possibe vomitWhat are some objective and

256

What are the lab tests for appendicitis
diagnostic tests

CBC
urinalysis

257

What should a person avoid with appendicitis

enemas or laxitives

258

What are the therapeutic procedures for appendicitis

laparoscopic surgery
-IV fluids and antibiotics

259

what are the preop procedures of appendicitis

electrolyte and fluid treatment
NG tube
IV antibiotivs

260

what is the complications of appendicitis

peritonitis
watch for fever, pain, rigid ab, tachycardia, pallor, chills

261

what is post op appendicitis

VS
IV fluids
NG tube suction

262

What is Meckels diveritculum

complication from failure of the omphalomesenteric duct to fuse during embryonic development

263

What are the signs and symptoms of Meckles divericulum

can asymptomatic
ab pain
bloody mucous stool

264

Meckles devericulum lab values
diagnositic

CBC
radionucleotide scan

265

what are the therapeutic measures for meckles diverticulum

surgical removal

266

What is pre op meckles diverticulum

monitor blood transfusion
provide oxygen
IV antibiotics
maintain bed rest
monitor blood in stools

267

What is post op meckles diverticulum

resp status
oxygen
analgesics for pain
check bowel sounds and function
maintain NPO
NG tube low continuous suction

268

What are the compications of meckles diverticulum

GI Hemorrhage and bowel obstruction

269

What is enuresis

must occure for at least twice a week for at least 3 months- inappropriate urination

270

how do you get enuresis

family history
disorders associated with bladder dysfunctiom
the male gender
emotional factor

271

What is the management of enuresis

empty bladder before bed
restrict fluids in the evening
avoid fruit drinks and soda
have child change bed linens immediately after
wake the child up at night to void

272

What medications would you take enuresis

oxybutynin (Ditropan)

273

what is urethritis

inflation of the urethra

274

what is pyelonephritis

inflammation of the upper urinary tract and the kidneys

275

What are signs that an infant has a urinary infection

poor feeding
increase in thirst
frequent urination
straining with urination
foul smelling
fever
diaper rash
dehydration
seizure
pallor

276

What are the signs that a uti happened in a child

poor appetite
vomit
slowth growth
increase of thirst
enuresis
swelling of the face
seizures
pallor
fatigue
blood urine
edema
hypertension
tetany

277

What urine culture for uti

urinalysis; weak acid or neutral alkaline
protein: positive
glucose: positive
ketones: positives
leukocytes: positive
nitrates: positive

278

what are the diagnostic procedures uti

percutaneous kidney tap
bladder wash outs
ultrasound
Voiding cystourethrogram
IV pylegram
Dimercaptosuccinic scan

279

what type of meds do you give for uti

penicillins, sulfonamides, cephalosporin, and nitrofurantoin

280

What is Chordee

ventral curvature of the penis

281

what is Bladder exstrophy

epispadias present
exposed bladder, urethra and ureteral orifices through the suprapubic area

282

What is hypospadias

meatus opening below the glans penis
meatus opening along the ventral surface of the penis, scrotum or perineum
possible chordee present

283

What is epispadias For a Male

widened pubic synthesis
broad spadelike penis
urethra on the dorsal surface of the penis

284

What is epispadias For a female

wide urethra
bifid clitoris
possible exstrophy

285

What is phismosisi

nability to retract foreskin

286

inability to retract foreskin of penis

phimosis

287

inability to retract foreskin of penis

cryptorchidism

288

enlarged scrotal sac possible pain

hydrocele

289

bulge above the testicle when bearing down mild to moderate pain

varicoele

290

enlargement of affected testicle sudden, severe onset of pain

testicular torsion

291

possible congenital adrenal hypoplasia
enlarged clitoral hood
enlarged clitoris
micropenis
bifid scrotum

Ambiguous genitalia

292

What is obstructive uropathy-

surgical procedure that divert the flow of urine to bypass the obstruction

293

Inguinal hernia symptoms

Painless swelling

294

surgical release of fibrous band

chordee

295

bladder exstrophy needs__________________

immediate surgery

296

Exposed bladder, urethra and urethral orifices through Supra public area

Bladder exatrophy

297

hypospadias/ epispadias surgery

the first year of life
male circumcision not performed

298

What is Epispadis male

Wide pubic symphysis
Broad spadelike penis
Urethra opened on dorsal surface of the penis
Possible exstrophy of the bladder

299

circumcision in severe cases

phimosis

300

circumcision in severe Inability to retract the forsake cases

cryptorchidism

301

Structural or functional obstruction in the urunary system

Obstructive uropathy

302

With obstructive uropathy if it is partial it can...

Go undetected

303

Protrusion of the abdominal organs through the inguinal canal into the scrotum

Inguinal hernia

304

Ventral curvature of the penis

Chordee

305

Eversion of the posterior bladder through the anterior bladder wall and Lower abdominal wall

Bladder exstrophy

306

Urethral opening located behind the glans of the oenis or on the central surface of the penile shaft

Hypospadis

307

Meatal opening located on the dorsal surface of the penis

Epispadis

308

Narrowing of the preputial opening of the foreskin

Phimosis

309

Undescended testes

Cryptochidism

310

Elongation, dilation, and twisting of the veins superior of the vesicle
Mild to moderate pain
Bulge above testicle

Variocele

311

Testicle hangs free from the vascular structure
Enlargement of testicle
Sudden to severe pain

Testicular torsion

312

Child become aware of and interesting in there gential area at what age ____years

3-6

313

Structural repair of genitalia is typically done at what age

6-15 months Or before 3 years old

314

Antibody antigen disease that occurs as a result of certain strains of the group a strept and is most common in children 2-7

A cute poststreptococcal glomerulonephritis

315

Inability to palpate testes within the scrotum

Cryptorchidism

316

Cloudy tea colored urine
Decreased output
Irritability
Ill appearance
Lethargy
Anorexia
Discomfort-headache, ab pain, dysuria
Periorbital edema
Facial edema in morning
Ab edema in evening
Mild to severe hypertension

Throats culture
Urinalysis-proteinuria
Renal-BUN and creatine
ASO titer- positive for the presence of strept antibodies
AHase and ADNase-B
Serum complement (C3)

Chest x ray

Acute poststreptococcal glomerulonephritis

317

Allow protein especially albumin to pass into urine resulting in decreased serum osmotic pressure
Typically between 2 and 7
Look for weight gain
Facial or eye edema
Edema in legs
Ascites
Decreased frothy edema

Nephrotic syndrome

318

Lab tests for nephrotic syndrome

Urinalysis
Proteinuria
Hyaline casts
RBCs
Oval fat bodies

Hypoalbuminemia
Hyperlipidema
Hemoconcentration
Hyponatremia
Glomerular filtration rate