Peds test # 1

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sam10h
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Peds test # 1
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2012-03-17 22:11:12
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Peds test #1
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  1. solu-medrol
    asthmatic
  2. Type of fluid delivered by CVL
    glucose and electrolytes
  3. albumin,plasma,frozen plasma
    colloid
  4. fluid leaks into subQ tissue; site cool to touch, solution rate slows
    infiltration
  5. Erythema at site, pain, buring at site, warmth over site, slowed infusion rate
    phlebitis
  6. neonates core body temp
    97.7 to 99.7
  7. rectal temp in children
    98.6 to 99.5
  8. uses both parent ovservation and direct observation and has long been the standard for developmental screening. Covers children 2 weeks to 6 years of age
    Denver II test
  9. DDII is used to test ? in newborns

    Infants

    Children
    Newborns - neurological problem

    infants - to identify nature of possible problems for interventions

    children - to delineate acedemic and social problems in order to begin interventions
  10. Psychosocial; cognitive; psychosexual
    Erickson; piaget; freud
  11. basic trust vs. mistrust
    infancy
  12. autonomy vs shame
    1 - 3
  13. initiative vs guilt
    3 to 6
  14. industry vs inferiority
    6 to 12
  15. identity vs confusion
    12 - 19
  16. birth - 18 months
    oral stage
  17. 18 months to 3 to 4 years
    anal stage
  18. 3 to 7 years
    phallic
  19. 7 to puberty
    latent
  20. 32 to 60 weeks use ? for pain scale
    CRIES
  21. CRIES stands for:
    Crying, requiring oxygen, increased vital signs, expression, sleepless
  22. may increase risk of seizures; use for brief treatment; max usage 48 hours or 600 mg in 24 hours
    meperidine
  23. IM injection sites
    vstus lateralis; deltoid; dorsogluteal
  24. largest muscle in infants/small children; use 5/8 to 1 inch needle
    Vastus lateralis
  25. ___ mL in infant
    0.5
  26. ___ ml in toddler
    1
  27. __ ml in pre school
    2
  28. use 1/2 to 1 inch, 0.5 to 1 ml injection, more rapidly absorbed
    deltoid
  29. do not use in children under 5; 1/2 to 1 1/2 inch needle; 1.5 to 2 ml
    Dorsogluteal
  30. administered in a tubing port with the flow to the child blocked
    IV retrograde
  31. used to further dilute drug
    buretral
  32. volume greater than 1 mL give in a ___ syringe
    tuberculin
  33. 0.5 mL equals
    low dose syringe
  34. Give SQ and intradermal in what parts of the body?
    centered 3rd lateral aspect of upper arm; abdomen; center 3rd of anterior thigh
  35. physical & motor two month old developmental milestones
    closure of posterior fontanelle, doll's eye reflex, dance reflex, grasp reflex, grasp reflex, less head lag, when on stomach able to lift head almost 45 degrees, decreased flexion of extremities while on stomach
  36. sensory/cognitive markers of two month old
    head turns from side to side with sound stimulation at the level of the ear, beginning to visually fix on close objects, crying becomes differentiated, coos, vocal response to familiar voices, smiles
  37. physical/motor skills of 4 month old
    weight gain about 20 grams per day, demonstrate fading of infant reflexes, almost no head lag, able to sit straight up if propped, raise head 90 degrees, able to roll from back to one side, tryies to reach objects with hand, plays with rattle, able to grasp rattle, able to place objects in mouth
  38. have well-established close vision, beginning eye-hand coordination, able to make consonant sounds N, K, P, G, B, able to laugh out loud, anticipates feeding, begins to show memory, demands attention by focusing
    sensory/cognitive skills of 4 month old
  39. should have doubled birth weight, able to lift chest/head while on stomach, able to sit in a high chair with straight back, teething, drooling, able to bear almost all weight when standing, rolls from back onto abdomen, able to hold own bottle, able to pick up a dropped bottle
    Physical/motor of 6 month old
  40. Vision between 20/60 and 20/40; can locate sounds not made directly in ear, prefers more complex sound stimulation, starts to imitate sounds, sounds resemble one-syllable words, enjoys hearing own voice, begins to fear strangers, recognizes parents, begins to imitate actions, able to recognize the need to pick up an object
    Sensory/cognitive markers of 6 month old
  41. triple birth weight; grow to a heaight of 50% over birth length; head circumference that equal that of chest; have 6 to 8 teeth; nearly closed anterior fontanel no longer have a Babinski reflex; walks independently or with support of hand; sits down without help; tries to build a tower out of 2 blocks; turns through pages of a book by flipping it many times
    physical/motor of 12 month old
  42. follows fast moving object; has control over response to sounds; comprehends several words; can say mamma, papa; comprehends simple commands; tries to imitate animal sounds; associates names with objects; searches for objects; searches for objects that are hidden; may develop attachment to a toy or object; experiences separation anxiety; may make brief exploratory journeys away from parents
    12 month old/sensory
  43. the infant is in what Erikson stage?
    trust vs. mistrust
  44. effects of prolong separation in a 0-12 month old
    unable to form trusting intimate relationships, languate impairment, deficiency in abstract personality, possible delayed physical growth, possible increased susceptibility to diseases
  45. Signs of reactive attachment disorder
    not cuddly with parents, poor eye contact, poor impulse control, destructive to self & others
  46. how much feeding should an infant get per day
    wt x 2.5 oz
  47. sleep pattern for newborns
    approx. 16-17 hours/day, sleeps through the night at about 3 months
  48. sleep pattern for 3/4 months
    nocturnal sleep, 9-11 hours, naps 3-4 hours
  49. 6-12 months sleep pattern
    nocturnal sleep, 11 hours, naps 3 hours
  50. The main purpose of limit-setting during infancy is in ___
    injury prevention
  51. Discipline for infant
    use negative voice, stern eye to eye contact, time out (late infancy)
  52. signs of teething
    drooling, increased finger sucking, biting on hard objects, irritability, difficulty sleeping, mild temp elevation, ear rubiing, decreased appetite for solid foods
  53. inborn error of metabolism; involves complete absence or severely reduced presence of lactase
    Congenital lactase deficiency
  54. most common type; decrease in intestinal lactase; common in asians, southern europeans, arabs, israelis, african americans
    primary lactase deficiency
  55. caused secondary to damage of the intestinal lumen which destroys lactase
    secondary lactase deficiency
  56. symptoms of lactose intolerance
    abdominal pain, bloating, flatulence, diarrhea, onset 30 minutes to several hours after consumption of lactose
  57. therapy for colic
    sedatives, simethicone, investiage cow's milk allergy
  58. results from a physical cause
    organic failure to thrive
  59. unexplained by organic/enviornmental causes
    idiopathic failure to thrive
  60. chronic, recurrent, inflammatory reaction of the skin
    seborrheic dermatits
  61. called eczema, pruritic, usually associated with allergy
    acute dermatitis
  62. therapeutic management of eczema
    hydrate the skin, relieve pruritus, reduce inflammation, prevent/control secondary infection
  63. closed anterior fontanel; growing at slower rate, has less of an appetite; control sphincter muscles; runs with lack of coordination, falls frequently; jumps in place; able to get onto chairs; walks up stairs; can build tower of 3-4 blocks; imitates scribbling; turn pages of book 2 or 3 at a time
    physical/motor skill markers of 18 month old
  64. can say 10 or more words; identifies parts of body; understands and is able to point to and identify common objects; imitates; feeds self; able to take off some clothing; begins to feel a sense of ownership and says "my"
    sensory/cognitive markers of 18 month old
  65. gains about 5 lbs; 3 inches; has improved balance/vision; may have daytime control over bowel/bladder functions; can briefly balance on one foot; may walk upstairs; can construct a block tower of more than 9 cubes; can easily place small objects in small openings
    physical/motor skills for 3 years old
  66. has a vocab of hundreds of words; composes sentences of 3 to 4 words; nearly all of speech should be understandable; frequently asks questions; can dress self; has longer attention span; feeds self without difficulty; acts out soical encounters through play activities; has some decrease in separation anxiety for short periods of time
    sensory/cognitive skills for 3 year old
  67. what Erikson stage is a 3 year old in?
    autonomy vs. shame & doubt
  68. normal sleep of a 3 year old
    total sleep time averages 12 hours a day with nap
  69. a condition characterized by an increase in the degree and extent of the enamel's porosity
    flourosis
  70. term and preterm infants with mothers are HBV surface antigen positivve or unknown; within 12 hours of birth
    Hepatits B virus
  71. recommended after 2 years of age in 11 states; 2 doses given six months apart
    Hepatitis A
  72. Commonly administered with tetanus/pertussis vaccines; may be given in combo with H influenza type B vaccine; 5 part series with boosters needed every 10 hours
    Diphtheria
  73. used for routine primary immunization; provided antitoxin levels for 10 years or more
    tetanus
  74. recommended for all children 6 weeks through 6 years who have no neurologic contraindications
    pertussis
  75. inactivated polio virus is recommended for the 4 dose series
    Polio
  76. given routinely at 12-15 months; second immunization recommended at 4-6 years or 11-12 years
    measles
  77. recommended at 12-15 months; usually given in combo with measles and rubella vaccines
    mumps
  78. recommended at 12-15 monts of age; all females should be immunized at child bearing age; not given to women; child can receive vaccine if mother is pregnant
    rubella
  79. provides protection against serious infections caused by Hib, like pneumonia, epiglottitis, bacterial meningitis, sepsis; given at 2, 4, and after 12 months
    haemophilus influenzae type B
  80. recommended at 12-18 months; can be given from 19 months to 13 years
    varicella
  81. recommended for all children at 2, 4, and 6 months of age; final dose at 12-15 months of age
    pneumonococcal
  82. recommended annually in children greater than 6 months
    influenza
  83. 3 to 5 years of age is the ___ period
    preschool
  84. at 3 years old, some gross motor development includes:
    more skilled at running, early throwing/kicing; able to catch a bounced ball; able to pedal tricycle; able to steer around 4; about to hop on 1 foot, able to balance on 1 foot for up to 5 seconds; able to perform heel to toe walk
  85. fine motor skills starting at 3:
    use of scisssors; self dressing; ability to put on clothes properly; manage spoon/foot neatly; spreading with a knife about 5
  86. age 15 months; early spontaneous scribblings
    placement stage
  87. copies circles; X's
    shape stage
  88. simple forms are drawn together
    design stage
  89. 2 or more figures are combined
    combine stage
  90. 3 or more figures are combined
    aggregate stage
  91. ages 4-5; recognizable objects
    pictorial stage
  92. DASE (3 to 5 year old)
    denver articulation screening examination
  93. common cause of speech problems
    hearing loss; developmental delays; autism; lack of verbal stimulaion
  94. sleep for 3-5 year olds
    12 hours per night
  95. eruption of primary teeth is complete in ___
    preschoolers
  96. in car, birth to 1 year old/20 pounds
    rear facing car seat
  97. 20 - 40 poungs in car
    forward facing car seat
  98. 40-80 pounds (8 year old) in car
    booster seat
  99. Medication therapy for erythema
    Antipyretics, analgesics, anti-inflammatory drugs
  100. nursing considerations for rubeola
    isolate until 5th day of rash; bed rest; antipyretics; dim lights; cool mist vaporizer
  101. school age is generally defined as:
    6 to 12 years
  102. shedding of first deciduous teeth and ends at puberty
    school age
  103. biologic development in school age children:
    height increases by 2 inchers per year; weight increases by 2 to 3 kg per year; fairly smooth/strong motor skills, but vary widely; fine motor skills also vary
  104. defined as 2 years preceding puberty; about 9 to 12
    prepubescence
  105. greatest vulnerability for dental caries
    ages 4-8, 12-18
  106. repeated voluntary/involuntary passage of feces of normal consistency into places not appropriate
    encopresis
  107. no glandular tissue; areola follows skin contours of chest
    tanner I
  108. breast bud forms; areola widens; small area of surrounding glandular tissue
    Tanner II
  109. breast begins to become elevated
    Tannyer III
  110. increased breast size/elevation; areola/papilla form a seondary mound
    Tanner IV
  111. breast reaches adult size
    tanner V
  112. testicular volume less than 1.5
    tanner 1
  113. testicular volume between 1.6 and 6; skin on scrotum thins, reddens, enlarges
    tanner II
  114. testicular volume between 12/20; scrotum enlarges
    tanner III
  115. testicular volume between 12/20; s
    tanner IV
  116. testicular volume greater than 20 ml
    tanner V
  117. small amount of long, downy hair with slight pigmentatin at base of the penis/scrotum or labia majora
    tanner II
  118. hair becomes coares/curly; begins to extend laterally
    tanner III
  119. adult like hair
    tanner IV
  120. hair extends to medial surface of thighs
    tanner 5
  121. the chest circumference is usually _ to _ cm smaller than head circumferences in infants
    2 to 3
  122. RR varies between __ and ___ in infants
    40-60
  123. a sequence of relatively vigorous respiratory efforts followed by apnea of as long as 10 to 15 seconds (common in infants)
    periodic breathing
  124. chest wall collapses as the abdomen distends on inspiration, particularly during sleep (common in infants)
    paradoxic breathing
  125. high pitched, piercing sound most often heard after inspiration; result of an obstruction high in respiratory tree
    stridor
  126. when infants tries to expel trapped air of fetal lung fluid while trying to retain air and increase o2 levels
    respiratory grunting
  127. incomplete expansion of the lung a birth or the collapse of the lung at any age
    atelectasis
  128. inflammation of large airways
    bronchitis
  129. inflammatory response of the bronchioles and alveoli to an infective agent
    pneumonia
  130. viral infection of the lung; normal an upper respiratory infection
    influenza
  131. great difficulty breathing in preterm infant
    respiratory distress syndrome
  132. result of an imperfectly structured diaphragm
    Diaphragmatic hernia
  133. autosomal recessive disorder of exocrine glands involving lungs, pancreas, and sweat glands
    cystic fibrosis
  134. acute, life threatening infection involving epiglottis/surrounding tissues
    epiglottis
  135. syndrome that generally results from infection with a variety of viral agents; barking, brassy cough; neeeds IV fluids and high calories
    croup
  136. bronchiolar inflammation leading to hyperinflation of the lungs occuring most often in infants younger than 6 months
    bronchiolitis
  137. lungs begin to form ___
    about 4 weeks of gestation
  138. symptoms of diaphragmatic hernia
    bowel sounds heard in chest; respiratory distress; flat/scaphoid abdomen; PMI shifted to right
  139. croup syndrome infects the:
    epiglottis; larynx
  140. toddler and preschool ages are at a hight risk for:
    viral infections
  141. "common cold"
    nasopharyngitis
  142. therapeutic management for common cold
    oral penicillin, IM penicillin G, oral erythromycin
  143. nursing considerations for tonsilitis
    liquid to soft diet; cool mist vaporizer; warm saline gargle; acetaminophen or ibuprofen
  144. position on __ or ___ after tonsillectomy
    side, abdomen
  145. sore throat; fatigue; lack of energy; lymphadenopathy; macular rash; needs a heterophil test, monospot, bed rest, oral penicillin
    infectious mononucleosis
  146. pharmacologic management for otitis media
    oral amoxocillin; bactrim; septra; pediazole; IM ceftriaxone
  147. "Swimmer's ear"
    otitis externa
  148. triad of symptoms - spontaneous cough, drooling, agitation; sore throat, pain, retractions, mild hypoxia, inspiratory stridor
    acute epiglottitis
  149. most common of croup syndromes; inspiratory stridor, barking cough, can progress to respiratory acidosis
    acute larngotracheobronchitis (LTB)
  150. therapeutic management of LTB
    airway management, maintain hydration, high humidity with cool mist, epinephrine, steroids
  151. spasmodic cough, occurs chiefly at night, children ages 1 to 3
    acute spasmodic laryngitis
  152. infection of mucosa of upper trachea; needs antipyretics, antibiotics, humidified oxygen
    bacterial tracheitis
  153. dry, hacking, non-productive cough for 2-3 days progreessing to a productive cough
    bronchitis
  154. RSV stands for
    respiratory syncytial virus
  155. symptoms of bronchiolitis/RSV
    rinorrhea, fever, poor fever, possible otits media
  156. low respiratory symptom of RSV/bronchiolitis include
    wheezing, retractions, dyspnea, tachypnea, diminished breath sounds
  157. high humidity, IV fluids, nasal suctioning, pulse ox, ribavirin, respiratory isolation
    therapeutic management for RSV/bronchiolitis
  158. nursing considerations for RSV/bronchiolitis
    isolation, nursing assignments, parent education
  159. clinical manifestation of pneumonia:
    headdache, nausea, vomiting, diarrhea, abdominal pain, chest pain, Poor feeding, abrupt temp changes with seizures, air hunger/circumoral cyanosis
  160. oral amoxicillin (if less than 5), eryhtromycin, clindamycin, chloramphencial, cephalsporins
    treatments for pneumonia
  161. some nursing considerations for pneuomia:
    oxygen therapy, good resp. assessment, isolation, IV fluids, mist tent, postural drainage, hospitalize infants, home care for older child, decrease anxiety, cluster care to allow rest, comfort
  162. clincial manifestations for viral pneumonia:
    fever, cough, unproductive cough to small whitish sputum, rhonchi, nasal flaring, dullness on percussion, retractions
  163. treatment for pneuomia
    oxygen, fluids, CPT/postural drainage
  164. only safe balloons for kids are:
    mylar balloons
  165. avoid these aspiration risks:
    oily nose drops, solvents, talcum powder
  166. manifestations of aspiration pneumonia:
    restlessness, confusion, drowsiness, coma, immediate pulmonary symptoms
  167. nursing considerations for aspiration pneumonia
    position infant on right side after feedings, avoid oil based nose drops/vitamins; do not use talcum powder; set up for removal by endoscopy
  168. increased production of mucus, rhinorrhea, nasal obstruction, sneezing, nasal pruritus, snoring, frequent URI, dark circles under eyes
    allergic rhinitis
  169. diagnosis/treatment of allergic rhinits
    immunotherapy, antihistamins, nasal sprays
  170. Step I in asthma
    mild, intermittent asthma
  171. Step II
    mild persistent asthma
  172. Step III
    moderate, persistent asthma
  173. step IV
    severe, persistent asthma
  174. corticosteroids, cromolyn sodium, nedrocomil, long actings B agonists, aminophylline, theophylline, theodur, singulair
    long term control meds for asthma
  175. short acting beta agonists (albuterol, metaproternol, terbutaline), anticholinergics (atropine), systemic corticosteroids
    quick relief medications for asthma
  176. respiratory distress continues despite vigorous therapeutic measures
    status asthmaticus
  177. emergency treatment for status asthmaticus
    epinephrine 0.01 mL/kg subQ (max dose is 0.3 mL)
  178. endocrine gland dysfunction that produces multisystem involvement
    cystic fibrosis
  179. impaired digestion/absorption of fat
    steatorrhea
  180. impaired digestions/absorption of protein
    azotorrhea
  181. clinical manifestations of tuberculosis
    fever, malaise, anorexia, weight loss, cough, aching pain, tightness in chest
  182. isoniazid X 9 months; rifampin X 6 months

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