The abnormal "sucking in" of the space between the ribs or under the sternum:
(?) trachea rises during inspirations and lowers during expirations
__________ is an obstructive respiratory process characterized by periods of exacerbation and remission.
What is the most common chronic illness in childhood?
Asthma is caused by a:
hypersensitivity immune response
Asthma usually manifests by age ___.
Commonly affects which gender?
Asthma flare-ups are usually associated with:
Ways to allergy proof the house:
avoid odors and sprays
have air ducts cleaned annually
wash bed linens every 7-10 days in hot water
keep child indoors while lawn is being mowed
wet-mop bare floors weekly
use washable window shades
avoid using cellar/basement as a play area
irritants (tobacco/wood smoke, odors, sprays)
strong emotions: (fear, anger, laughing, crying)
foods: (nuts, milk, dairy)
conditions: (GERD, tracheoesophageal fistula)
Ways to prevent URI (infection control):
avoid smoke and Lysol sprays
in the hospital: contact precautions and limited contact with others; do not share meds from others
The most common, serious, chronic, life-threatening, genetic disorder of US Caucasian children:
common systems affected:
common systems affected: respiratory & GI
airway clearance: mucus clearance device (flutter device) & somersaults/headstands therapeutic for resp system; teach infection prevention/home care such as chest PT, breathing exercises
For a patient with cystic fibrosis, you should direct tx towards organs involved including:
freq resp assessment
isolation if infection
antibiotics after C&S, CPT, & postural drainage
resp tx's (aerosols, Pulmozyme)
humidified O2 via croupette or mask
pancreatic enzymes w/ meals/snacks
high cal/high protein diet
electrolyte levels (Na & Cl)
provide salt w/ meals prn
PO & IV fluids
tx constipation/fecal impaction prn
An inflammatory viral infection of the bronchioles commonly caused by RSV:
characterized by: mucosal edema, increased mucus secretion, bronchiolar obstruction, and over distention of the alveoli
s/s: begins as URI, then apnea, fever, shallow resp, cough, tachypnea, dyspnea, tachycardia, irritability, fatigue, feeding difficulty
dx: nasal wash/swab, for RSV (specimen on ice & immediately transported to lab), testing for serum RSV antibodies, CXR, WBC, pulse ox
RSV tx is used for:
antiviral med used for severely ill infants or infants who have heart/lung problems that place them at high risk for serious complications
admin. by fine-droplet aerosol mist while infant is in mist tent; leaves white mist in tent
if infant is on vent, must monitor vent tubes (may be warped by ribavirin)
teratogenic effects reported
can cause preccipitation on surface of plastics
caregivers w/ contacts may develop conjunctivitis
turn off neb to allow mist to settle before opening tent
__________ causes a sudden, unexpected death of an apparently healthy infant.
Infants at higher risk:
Most infants affected have been sleeping __________.
male, Native American/African Americans, low birth weight, lower SES, mother is less than 20, mother smoked during pregnancy, passive smoke exposure, multiple births, infants not firstborn, sibling of SIDS victims
CPR for infant:
CAB- circulation, airway, breathing; 30:2
2 rescuers- 15:2
What is the priority for a pt with croup?
What should you have close by?
airway management (ABCs)
What could a parent do at home to help manage the symptoms of croup?run hot water in bathroom w/ door closed to create steam; let child inhale moist air for 2 mincool mist humidifier at bedsideno improvement? take to ER
run hot water in bathroom w/ door closed to create steam; let child inhale moist air for 2 min
cool mist humidifier at bedside
no improvement? take to ER
__________ is an obstructive airway infection caused by swelling of the tissue above the vocal chords characterized by rapidly occurring inflammation of the epiglottis.
It is a life-threatening __________!
Often caused by:
It is not common, but when it does occur, it most frequently affects children ages __________ and occurs any season.
When does this usually happen? (?)
Hib & PCV (vaccinations decrease incidence)
Passive smoke effects:
↓ birth weight/growth rate
↑ risk of SIDS
↑ # of resp/ear infections
↑ stillbirths/premature births
↑ asthma s/s & attacks
precursor to chronic lung disease
A colorless, odorless, tasteless gas that causes injury and death by interfering with cellular respiration:
How does carbon monoxide poisoning occur?
interferes w/ cellular resp
enters bloodstream & combines w/ hemoglobin which causes tissue hypoxia.
What is responsible for over 1/2 of all fatal poisonings in the US?
What are sources of CO?
poorly ventilated vehicles
gas lamps, stoves, grills
The failure of eyes to direct gaze at the same object simultaneously can be defined as:
Strabismus is caused by an imbalance of __________.
A pt with strabismus may appear to be __________.
Inward deviation (toward the other eye) is:
Outward deviation (turns away from the other eye)
__________ is a common cause of the "lazy eye"
If a pt has strabismus, what could you do to try to help the affected eye to improve through use?
cover unaffected eye with patch
Strabismus may require __________ before the child starts school.
Early tx of strabismus is necessary to prevent:
amblyopia and blindness
What is the newer tx for strabismus?
inject botulinum toxin in small doses to weaken rectus muscle to align
__________ impairment is mistakenly labeled as inattentive/ less intelligent.
Hearing assessment starts at __________ by assessing the __________ reflex.
startle (Moro) reflex
Hearing loss that involves mechanical interference with transmission of sound (e.g. ear wax, otosclerosis, infection); most common
Hearing loss that involves inner ear problems like damage to the organ of Corti, optic nerve, or brain:
How to communicate with a pt with hearing loss:
approach with smile
face child while speaking; stand close
keep hands away from face
speak toward unaffected ear
speak clearly without over-enunciating
Inflammation and infection in the middle ear:
What are some s/s of otitis media?
severe pain in ear/earache
pulling/tugging at ear or rolling head side to side
interference in hearing
high fever (febrile seizures)
Spontaneous __________ of the eardrum may cause a decrease in s/s of otitis media and drainage from the ear.
__________ is the microscopic incision to relieve pressure from fluid buildup in the middle ear. (incision heals better than tear)
Complications of strep throat:
T&A Post-op management:
observe for hemorrhage
keep throat moist
liquid diet (no red dye)
rinse mouth after milk products
no citrus fruits, carbonated beverages, hot fluids, rough foods, sour liquids
avoid gargling, coughing, clearing throat, sneezing, blowing nose, and overexertion
may give gum but no Aspergum
Over-use/long term use of nasal decongestants can lead to __________ congestion.
Diaper rash prevention:
frequent diaper changes
keep skin clean and dry
use mild soap when cleansing/rinse well
disposable diapers are best
avoid fastening diaper too tightly
rinse all baby clothes/cloth diapers throughly to decrease irritants
What is the priority in the rehab phase of a burn?
prevent scars/contractures, PT/OT/rehab, functional and cosmetic reconstruction, psychosocial counseling
3rd and 4th degree burns need __________ to heal.
The Parkland formula for fluid resuscitation:
4 mLXwt in kgX% of body burned
monitor sun/UVR exposure
high SPF lotion
avoid sun between 10a-4p
Warning: Administer O2 with caution to children because high concentrations may lead to:
carbon dioxide narcosis & retinopathy
A 1 year old has about ___ teeth.
__ above and __ below.
You can use the -6 rule up to __ months of age.
The Academy of Pediatrics Dentistry recommends that the 1st visit occur by the age of __, but most children begin seeing a dentist between 2 and 3 years. Healthier baby teeth=healthier permanent teeth.
__________ is a normal response to a new baby in the house.
Examples of behavioral patters that may happen when a new sibling arrives:
biting or pinching
Car seats: infants to 1 year & 22 lbs seats should be:
facing backwards and in the middle back seat
Car seats: 22 lbs & up should be in a
forward car seat
Car seats: the youngest child should be in the __________.
The posterior (triangle) fontanel should be closed at __ months.
The anterior (diamond) fontanel should be closed around __ to __ months.
What are some common allergens in children?
citrus fruits (strawberries, oranges, tomatoes)
Based on a 1,200 cal diet:
Grains: 4 oz
Fruits: 1 cup
Dairy: 2 cups
Protein: 3 oz
Piagets theory: __________ stage.
egocentrism, concrete thinkers, magical thinking
Freud's theory: __________ stage.
Erikson's theory: __________ stage.
autonomy vs shame and doubt stage
Kohlberg's theory: __________ stage.
egocentric point of view, tests boundaries, don't know the difference between right and wrong
Toilet training begins at about __ to __ months.
voluntary control of anal and urethral sphincters beginning at about 18-24 months
bladder control and myelin sheath not fully developed until about 1 1/2 -2 years of age
must be willing to sit on the potty for several minutes at a time
use a potty chair or standard size toilet with a stool for toddler to put feet on to feel secure
5-10 min practice sessions
bowel training usually easier
praise for going and trying
do not punish for accidents
frequent reminders and trips to the bathroom
more consistency the easeir routine will be and the toddler will adapt
What is the age range of a toddler?
2 years of age:
A toddler gains about __ to __ lbs a year.
A toddler's birth weight is quadrupled by __ years of age.
Separation anxiety and stranger anxiety is at its peak in __________