Real Pedi #1

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Author:
Thenordski
ID:
196353
Filename:
Real Pedi #1
Updated:
2013-01-29 17:51:08
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Nursing Pediatrics
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Pedi test #1
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  1. Seperation Anxiety
    • - 3 stages
    • - child will revert to protest stage when parents visit
    • - prolonged detachment phase can dmg parent-child bonding
  2. 3 Stages of Seperation Anxiety
    • -Protest (cry for parents, cry until exhaustion)
    • -Despair (depression, withdrawn)
    • -Detachment (deny need for parents, uninterested in visits)
  3. Infant Hospital Prep
    • - involve parents
    • - use familiar objects
    • - use distraction/soothing methods
  4. Toddler Hospital Prep
    • - involve parents
    • - simple explainations
    • - allow choices
    • - 1 direction at a time
    • - give permission to express saddness
  5. School Age Hospital Prep
    • - Same as infant & toddler
    • - let child examine equip
    • - encourage to verbilize fear
    • - offer small reward (sticker)
  6. Teenager Hospital Prep
    • - allow privacy
    • - involve in tx
    • - explain tx and equipment
    • -suggest coping mech.
  7. Ear Drop Admin
    • - keep in supine position with unaffected ear down
    • - Children under 3 = pull pinnea down and back
    • - Children over 3 = pull pinnea up and back
  8. Application of oint/cream
    • - After bath (when skin is clean & dry)
    • - Skin area is larger and skin is thinner with kids (faster absorption(
  9. Admin of oral meds
    • - Do not mix with favorite drink/food
    • - Do not call it "candy"
    • - offer rewards or fluids after
  10. Acne
    - inflam of sebaceous glands/hair follicles
  11. Comedo
    • - plug of bacteria, sebum, keratin
    • - open comedo = black head
    • - closed comedo = white head
  12. Sebum
    - fatty substance that is secreted when seb. glands enlarge due to increase in hormones
  13. Acne Rx/Tx
    • - antibiotics (tetracycline, erythromyacin, doxycycline)
    • - topical (retin-A, benzoyl peroxide)
    • - Accutane
    • - balanced diet, skin cleasing
  14. 4 Types of Burns
    - Thermal, radiation, chemical, electrical
  15. Steps in burn emergency care
    • 1) stop burning process
    • 2) evaluate injury
    • 3) cover burn
    • 4) transport to hospital
  16. Nursing considerations with burns
    • - skin is thinner and larger surface area
    • - immature immune sys = shock/heart failure
    • - increase basal metabolic rate = more calories needed to heal
    • - skins is more elastic = scars easily
  17. When is burn pt hypovolemic?
    • - first 24 hours
    • - nurse care = fluids to replace lost fluid and maintain blood pressure
  18. When is burn pt hypervolemic?
    • - 2-3 days after initial burn
    • - First sign of fluid overload = increase urine output
  19. What worsens acne?
    - steroids and seizure medications
  20. Is aspirin and tylenol okay to take with acne?
    yupyup
  21. Burn tx
    • - moisturizers (Nivea, coco butter)
    • - anti-histamines (helps with itch)
    • - bicarb of soda baths (soothing)
    • - sunblock (prevents hyperpigmentation)
    • - no ointments with lanolin
  22. Burn rx
    • - silver sulfa (no stinging)
    • - metenide ace (painful, care for met. acidosis)
    • - silver nit (needs to be kept wet, stains)
    • - bacitracin (painless)
  23. 1st s/sx of sepsis (burn)
    • - disorientation
    • - fever
    • - diminished BS
  24. Intertrigo
    - rash under skin folds
  25. Scabies
    • - parasitic infection caused by itch mite
    • - burough in webs of fingers/toes
    • - cause intense itching at night (possible lesions)
  26. Nursing care for scabies
    • - Elimite (used in kids older than 2 months)
    • - Mites die in 2-3 days
    • - all ppl in contact need tx
  27. Lice (pediculosis)
    • - spreads via person to person
    • - causes intense itching and excoriation
    • - lay eggs in hair (hatch in 3-4 days)
    • - lice required to bite
  28. 3 types of pediculosis
    • - pubis (pubic lice)
    • - corporis (body lice)
    • - captis (head lice)
  29. Nurse care for Lice
    • - Nix shampoo (can re-tx in 7-10 days)
    • - vasoline in eye lashes/brow
    • - Hair combed with 1:1 water vineger solution
    • - any person in contact needs tx
  30. Frostbite
    • - freezing of a body part
    • - torso warmed first for survival
    • - skin will appear pale, hard, without sensation
    • - Skin dmg will be similiar to burns
  31. Sign that sensation has returned (Frostbite)
    • - skin has deep purple flush
    • - extremely painful
  32. Tx for frost bite
    • - dry clothing, warm blankets, sleeping bags
    • - warm, moist O2
    • - Whirlpool soaks for ulcers and blisters
    • - Warming baths (100-108F)
    • - VS & pain mgt crucial
  33. Chillblain
    cold injury with erythema & formation of vesicles/ulcerative lesions due to vasoconstriction
  34. Strawberry Nevus
    • - common hematoma (not apparent til after few weeks)
    • - harmless, does not require tx (fade)
    • - lesions are bright red and gradually blanch
  35. Port Wine Stain
    • - present at birth; darken as child ages
    • - appears flat and demercated
    • - caused by dilated dermal capillaries
  36. Cradle Cap
    • - inflam of skin that involves sebaceous glands
    • - itchless, appears as ezcema
    • - seen in newborns, infants, and puberty
  37. Characteristics of Cradle cap
    • - thick, yellow, oily, adherent, crustlike scales on scalp and forehead
    • - skin under scales will appear red
  38. Tx for Cradle cap
    • - Dandruff shampoo on teens ONLY
    • - mineral/baby oil will soften scales
    • - soft brush used to remove
  39. Injection sites
    • IM Infant - vastis lateralis
    • IM child - ventrogluteal (walking age)
    • IM adol - Deltoid
  40. Common skin lesions
    - macules, papules, vesicles, pustules, crust, ecchymosis, wheal
  41. Macules
    • - flat, circular
    • - freckle
  42. Papule
    • - raised, circular
    • - pimple
  43. Vesicle
    • - raised, fluid filled
    • - cold sore, chicken pox
  44. Pustule
    • - raised, puss filled
    • - acne, impetigo
  45. Crust
    scab
  46. Wheal
    • - raised, red, irregular
    • - bug bite, allergic reaction
  47. Ecchymosis
    bruise
  48. Eczema
    • - atopic dermititis
    • - inflam of genetically hypersensitive skin
    • - thought to be caused by allergies/stress
    • - worse in winter; remissive
    • - rarely seen in breastfed infants, most common in first 2 years
  49. Nursing care for eczema
    • - tx done at home rather hospital (easily inf.)
    • - goal is to prevent inf, reduce inflam, relieve itch, and hydrate the skin
    • - oils applied to skin after bathing (moisture gets sealed rather than excluded)
  50. Tx for eczema
    • - emollient bath (oatmeal, baking soda + corn starch)
    • - hair washed with soap sub. (dove, neutr.)
    • - elbow restraints, oil+gloves
    • - cottom fabric
    • - nails kept short
  51. Rx fo eczema
    • - corticosteroids
    • - antibiotics
    • - Aquaphor
    • - Alpha ker theraputic bath oil
  52. Incubation period
    Time between invasion of pathogen and onset of symptoms
  53. Prodromal period
    • - initial stage of disease
    • - time between onset of symptoms and appearance of fever/rash
  54. 2 Types of Isolation precautions
    • - Standard
    • - Transmission based (airborne, contact, droplet)
  55. Airborne precautions
    • - used for airborne transmission (TB)
    • - negative air pressure room, N95 mask
  56. Contact precautions
    • - skin to skin transmission
    • - gloves and gown
  57. Droplet precautions
    • - Flu
    • - mask, gown, gloves within a 3 foot radius
  58. Wilm's Tumor (nephroblastoma)
    • - kidney tumor
    • - no s/s during early stages of growth
    • - seldomly affects both kidneys
    • - IV pyelogram will reveal normal tissue left and tumor growth
    • - discovered by MD or parent
  59. Tx for nephroblastoma
    • - avoid unnecessary handling of abd
    • - combo of surg/chemo/radiation
    • - avoid contact sports postop
  60. UTI
    • - most common in girls
    • - repeated inf = sexual abuse
    • - s/s based on age (usually fever, chills, vomiting)
  61. Testing for UTI
    • - do not collect urine from diaper
    • - midstream sample for children potty trained
  62. Tx for infant UTI
    • - infant <1 yo is hospitalized
    • - low-dose antimicrobial rx
  63. Nephrotic Syndrome (nephrosis)
    • - most common in boys 2-7 yo
    • - presence of protein in urine, hypoalbuminemia, edema
    • - idiopathic
  64. S/Sx of Nephrosis
    • - characterized by slow progessive edema (around eyes and ankles)
    • - weight gain and abd distention
    • - normal b/p
    • - child will be pale and irritable
  65. Tx for nephrosis
    • - steroid therapy
    • - aimed to reduce edema, prevent inf, reduce protein loss, and prevent rx toxicity
    • - monitor I & O's and VS
    • - pt turned frequently to avoid resp inf
    • - NO vaccinations
  66. Glomerulonephritis
    • - allergic reaction to strep.
    • - affects both kidneys
    • - usually affects boys 3-7 yo
  67. S/sx of glomerulonephritis
    • - hyperkalemia
    • - decreased output
    • - periorbital edema
  68. Tx for glomerulonephritis
    • - Limit activity and stress
    • - urine cultures
    • - K, Na, and H20 restrictions
    • - children with HTN monitored for ICP
  69. Hypospadias
    • - congenital defect
    • - urinary meatus not at tip
    • - chardee
    • - surgery before 18 months
    • - NO circumcision
  70. Chardee
    downward curvature
  71. Nephrostomy
    • - Tube passes through flank and into pelvis of kidney
    • - collects urine via ostomy
    • - bypasses urter, bladder, urethra
  72. Care for dying child
    - encourage parents to use honesty
  73. Hemopytsis
    Blood tinged sputem

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