Pediatric Nursing

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Author:
dimacuha
ID:
181921
Filename:
Pediatric Nursing
Updated:
2012-11-13 19:09:58
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NCLEX PN PEDIATRIC PATHOS
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Pediatric Nursing (PATHOS) #1
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  1. PERTUSSIS (whooping cough)
    Bacterial Infection
    -Key Facts
    -Top 3 Signs
    • KEY FACTS ABOUT PERTUSSIS:
    • Highly contagious
    • Infects respiratory tract
    • Caused by Bordetella pertussis (most common), B. parapertussis, or B. bronchiseptica
    • Transmitted by direct inhalation or through contact with articles contaminated by respiratory secretions, such as linen
    • TOP 3 SIGNS OF PERTUSSIS
    • 1. Spasmodic, recurrent coughing with tenacious mucus; cough ends in a loud inspiration whoop
    • 2. Epistaxis during paroxysmal coughing
    • 3. Exhaustion and cyanosis after coughing spell
  2. DIPHTHERIA
    Bacterial Infection
    -Key Facts
    -Top 3 Signs
    • KEY FACTS ABOUT DIPTHERIA:
    • Highly contagious
    • Toxin-mediated
    • Caused by Corynebacterium Diphtheriae
    • Usually infects respiratory tract
    • Rare
    • TOP 3 SIGNS OF DIPHTHERIA
    • 1. Thick, pathchy, grayish green membrane over pharynx, larynx, tonsils, soft palate, and nose
    • 2. Sore throat, rasping cough, hoarseness
    • 3. Airway obstruction
  3. TETANUS (lockjaw)
    Bacterial Infection
    -Key Facts
    -Top 3 Signs
    • KEY FACTS ABOUT TETANUS:
    • Acute exotoxin-mediated infection
    • Usually systemic
    • Caused by Clostridium tetani
    • Transmitted through puncture wounds, burns, or open wounds contaminated by soil, dust, or animal excreta that contains C. tetani
    • TOP 3 SIGNS OF TETANUS:
    • 1. Rigid neck and facial muscles
    • 2. Spasm and increased muscle tone near the wound
    • 3. Profuse sweating and low grade fever
  4. HAEMOPHILUS INFLUENZAE TYPE B (HIB) INFECTION
    Bacterial Infection
    -Key Facts
    • KEY FACTS ABOUT H.INFLUENZAE TYPE B INFECTION
    • Transmitted by direct contact with secretions or airborne droplets
    • Signs and symptoms depend on presenting infections but may include generalized malaise and high fever
  5. DOWN SYNDROME
    Altered Neurosensory Function
    -Key Facts
    -Key Signs
    -Prenatal diagnosis using amniocentesis
    -Conditions coexisting with Down syndrome
    -Key Nursing Interventions
    • KEY FACTS ABOUT DOWN SYNDROME:
    • Congenital Condition
    • Characterized by mental retardation and multiple associated defects
    • Caused by genetic nondisjunciton resulting in three chromosomes on the 21st pair or translocaiton of chromosomes 21
    • Commonly associated with congenital heart defects and other abnormalities
    • KEY SIGNS OF DOWN SYNDROME:
    • Brushfield's spots
    • Flat, Broad forehead
    • Flat nose
    • Hypotonia
    • Mild to Moderate retardation
    • Protruding tongue
    • Short stature with prudgy hands
    • Simian crease
    • Small head with slow brain growth
    • Upward slanting eyes
    • Genital and perineal abnormalities
    • PRENATAL DIAGNOSIS OF DOWN SYNDROM USING AMNIOCENTESIS
    • Recommended for women older than age 34, regardless of a negative family history
    • Recommended for a women of any age if she or the father carries a translocated chromosome
    • CONDITIONS COEXSISTING WITH DOWN SYNDROME:
    • Congenital heart problems
    • Vision defects
    • Hypothryroidism
    • Skeletal, immunologic, metabolic, biochemical, and oncologic problem
    • KEY NURSING INTERVENTION FOR DOWN SYNDROME:
    • Provide activities and toys appropirate for the child
    • Set realistic, reachable goals
    • Provide stimulation and communicate at a level appropirate to the child's mental age
    • Mainstream daily routines to promote normalcy
    • Encourage parents to care for, bond with, and hold their child.
  6. HEAD INJURY
    -Causes
    -Types
    -Complications
    -Top 3 Assessment findings
    -Medications
    -Key Nursing Interventions
    • CAUSES OF HEAD INJURY:
    • Motor vehicle-related accidents
    • Child abuse
    • Vigorous shaking
    • Bicycle accident
    • Sports accidents
    • Falls
    • TYPES OF HEAD INJURIES:
    • Scalp laceration
    • Epidural, intracranial hemorrhage
    • Subdural hemorrhage
    • Concussion
    • Contusion
    • Skull Fracture

    DIDN'T FINISH CARD!!!
  7. HYDROCEPHALUS
    -Key Facts
    -Causes
    -Key Signs
    -Causes of communicating hydrocephalus
    -Complications
    -Diagnostic Test
    -Types of Shunt
    -Caring for a Shunt
    • KEY FACTS ABOUT HYDROCEPHALUS:
    • Excess CSF in ventricles and subarachnoid spaces
    • Can be noncommunicating (CSF flow is blocked) or communicating (CSF absorbs abnormally)
    • CAUSES OF NONCOMMUNICATING HYDROCEPHALUS:
    • Congenital anomalies
    • Infection-syphilis, granulomatous disease, meningitis
    • Tumor
    • Cerebral aneurysm
    • Blood clot after intracranial hemorrhage
    • KEY SIGNS OF HYDROCEPHALUS:
    • Increased head circumference
    • Full, tense, bulging fontanels
    • Widening suture lines
    • Distended scalp veins
    • Irritability or lethargy
    • Decreased attention span
    • High-pitched cry
    • Sunset sign
    • Inability to support the head
    • "Cracked pot" sound
    • Vomiting not related to food intake
    • CAUSES OF COMMUNICATING HYDROCEPHALUS:
    • Surgery to repair a myelomeningocele
    • Adhesions between meninges at the base of the brain or meningeal hemorrhage
    • Rarely, a tumor in the choroid plexus that causes an overproduction of CSF
    • COMPLICATIONS OF HYDROCEPHALUS:
    • Physical injury
    • Delayed growth and development
    • Decreased intracranial adaptive capacity
    • DIAGNOSTIC TEST FOR HYDROCEPHALUS:
    • Angiography
    • CT scan
    • MRI
    • Skull transilluminaiton
    • Skull X-rays
    • TYPES OF SHUNTS:
    • Ventriculoperitoneal-allows CSF to drain form the lateral ventricle to the peritoneal cavity
    • Ventriculoatrial - drains fluid from the lateral ventricle into the right atrium of the heart and ultimately directs fluid into the venous circulation
    • CARING FOR A SHUNT:
    • Having the child lay flat to avoid rapid decompression
    • Observe for shunt blockage and signs of increased ICP
    • Observe for signs of infection
    • If the shunt's caudal end is externalized, keep the CSF drainage bag at ear level to prevent ICP changes
  8. AMBLYOPIA (lazy eye)
    -Key Facts
    -Assessment findings
    -Key Nursing Interventions
    • KEY FACTS ABOUT AMBLYOPIA:
    • Also called lazy eye
    • Can lead to diplopia and vision loss
    • Caused by strabismus, un equal refractive errors, cataracts, and corneal opacities
    • ASSESSMENT FINDINGS IN AMBLYOPIA:
    • Decreased visual acuity in the affected eye despite optical corection
    • Possible central vision loss in supressed eye
    • KEY NURSING INTERVETIONS FOR AMBLYOPIA:
    • Provide the child with safe environment
    • Review the components of a safe environment with the child and his family
    • Place important objects of the side where the child has the better vision.
    • Promote independence in ADL's and self-care
    • Teach the child to utilize assistive devices, as necessary
  9. CONJUNCTIVITIS (pink eye)
    -Types
    -Signs
    -Managing
    • TYPES OF CONJUNCTIVITIS:
    • Infectious (bacterial or viral)
    • Allergic
    • Irritant
    • Chemical
    • SIGNS OF CONJUNCTIVITIS:
    • Bacterial:
    • purulent drainage
    • crushed drainange over eyelid
    • inflamed conjunctiva
    • edamatous eyelid
    • generally a bilateral infection
    • Viral:
    • occurrence with upper respiratory infection
    • watery or serous drainage
    • inflamed conjunctiva
    • edamatous eyelid
    • Allergic:
    • Itching
    • Watery or thick discharge
    • Inflamed conjunctiva
    • Edamatous eyelid
    • Irritant:
    • tearing
    • pain
    • inflamed conjunctiva
    • generally a unilateral reaction
    • Chemical:
    • tearing
    • possibly severe eye irritation and pain
    • redness and swelling
    • MANAGING CONJUNCTIVITIS:
    • Topical antibaterials (bacteria and viral conjunctivitis)
    • Antihistamines (allergic conjunctivitis)
    • Removal of foreign body
  10. INCREASED INTRACRANIAL PRESSURE
    -Causes
    -How the Brain Compensates
    -Complications
    -Top 3 Signs in Infants
    -Top 3 Signs in Children
    -Managing
    -How to Minimize
    • CAUSES OF INCREASED ICP:
    • Tumors or space-occupying lesions
    • Accumulation of fluid within the ventricular system
    • Bleeding or hemorrhage
    • Edematous brain tissue
    • Trauma
    • HOW THE BRAIN COMPENSATES FOR INCREASED ICP:
    • Limits blood flow to the head
    • Displaces CSF into the spinal cord
    • Increased CSF absroption or decreased CSF production
    • COMPLICATIONS OF INCREASED ICP:
    • Brain death
    • Cardiac arrest
    • Respiratory insufficiency or arrest
    • TOP 3 SIGNS OF INCREASED ICP INFANTS:
    • 1. Bulging fontanels without normal pulsations
    • 2. Shrieking, high-pitched cry
    • 3. Increased head circumference
    • TOP 3 SIGNS OF INCREASED ICP IN CHILDREN:
    • 1. Vomiting
    • 2. Headache
    • 3. Seizures
    • MANAGING INCREASED ICP:
    • Subdural tap
    • Ventricular tap
    • Hyperventilation via mechanical ventilation
    • Medications, including antibiotics, corticosteroids, osmotic diuretics, barbiturates, and anticonvulsants
    • HOW TO MINIMIZE ICP:
    • Maintain the head of the bed at 15-30 degrees
    • Position the child with his head midline to promote drainage of the venous system and to avoid pressure on the jugular veins
    • Avoid performing Valsalva's maneuever and prevent painful stimuli.
    • Provide a quiet enviroment
    • Manage pain
  11. MENINGITIS
    • KEY FACTS ABOUT MENINGITIS:
    • Involves inflammation of the meninges and spina cord
    • Sudden onset
    • Causes serious¬†illness within 24 hours
    • Prognosi i good and complications are rare if recognizd early
    • KEY FACTS ABOUT ASEPTIC MENINGITIS:
    • Caused by viral infection
    • Characterized by headace, fever, vomiting, and mingeal symptoms
    • Cultures are negative for bacteria
    • Treatment includes bed est, maintenance or fluid and electrolyte balance, analgesics, and exercise
    • 10% to 15% of bacterial meningitis cas are fatal
    • Common in infants and toddlers
    • May result in respiratory compromise, respirtory arrest, physical injuy, or deth

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