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Throat culture group A strep, what antibiotic is used?
Oral Penicillin for 10 days, take complete course
Intial intervention if child at home with laryngeal spasnm
take child to BR and turn on hot shower, humidity liquidifies secretions and decreases spams
Post T&A if child is swallowing frequently what is wrong?
bleeding from surgical site
Best choice for child for fluid replacement
- no milk, tea, soda
What breath sounds do you report immediately if pt has resp synctial virus?
pt now has a quiet chest and previously had wheezing, could indicate air pathway obstruction and impending resp distress
What are classic s/sx of acute asthma attack and what position is helpful to child?
- expiratory wheeze
- orthopenic position
Parent teaching of how to perform resp therapy
- give aersol followed by postural draingage before meals or 1 hr later
- it loosens secretions
CF pt, to facilitate digestion and absorption of nutrients, what does child need to take?
- give pancreatic enzymes PO with each meal & snack
- it replaces enzymes body cant make
How would you teach parent to clear infant's nostrils?
instill NS drops then removes nasal secretions with bulb syringe
What are appropriate fluids to give asthmatic child to compensate for fluid lose through dyspnea?
- room temp water
- no cold beeverages
Signs of theophylline toxicity
- stomach ache
- sweating profusely
SIDS when lying infant in crib, which positions are most helpful?
back or sides to sleep
Dry powder inhaler, why do you rinse mouth after use?
px candidiasis (thrush yeast infection)
What sources are rich in iron?
- cream of wheat
- boiled eggs
- green, leafy vegs
- dried fruits
- whole grain bread
What liquid do you mix with ferrous sulfate drops?
OJ- has vit. C which aids in absorption of iron
Factor IX deficiency- what condition does it cause?
Christmas disease- Hemophilia B
How do you teach parents to stop bleeding at home if pt has Hemophilia A?
- pressure, ice, elevate, rest
What med do you teach parents to avoid for low plt count?
Aspirin, it interferes with plt fucntion and avoid to px risk of prolonged bleeding
During blood transfusion, what do you closely assess for?
- back pain
If child who has leukemia is symptomatic what would be your priorty intervention? Pt also has low plts
assess neuro status- low plts = risk of intracranial bleeding
Lymph node involvement of 3 major nodes would be what classsification for Hodgkin's disease?
stage 3 involves both nodes on both sides of diaphragm including cervical and inguinal nodes
Child is having sickle cell crisis with severe abd pain, what is happening?
vaso-occlusive crisis caused by onstruciton of blood flow by sickle celss, infraction, and vasospams
What is an important intervention to teach parents for sickle cell disease health maintenance?
drink plently of fluids to pxz dehydration which can trigger sickling process
Complication of reapted blood transfusion for Thalassemia?
hemosiderosis- excessive iron deposits stored in tissue
What is the child at risk for in acute lymphoblastic leukemia?
increased susceptibility to infection as a result of an over production of immature WBC in bone marrow
During blood transfusion child c/0 back pain and itching, what do you do?
clamp off blood and keep line open with NS
What equiment needs to be used for mouth care of child in chemo?
How do you respond to a child questioning death or going to heaven?
who do you think will take care of you
Pre-school aged child, what is their concept of death?
thinks death is reversible and only temporary and a person comes back alive soon after death
Child has chemo has firm and distended abd, what is happening?
peripheal neuropathy signaled by severe constipation d/t decreased nerve sensation in bowels
Adolescent states being scared, what is your response?
tell me what has you scared
What would be important focus of nursing care and last sense to leave in dying child?
- family should know hearing is last sense to leave
- should talk to child
What is ventricular septal defect?
blood is shifted/shunted L to R d/t an increase in L ventricle pressure causing a increase in pulmonary flow and no cyanosis
What is characteristic of newborn with ventricular septal defect?
a loud, harsh murmur with a systolic thrill
How would BP differ in all four extremties in coarctation of aorta?
- marked difference in BP and pulses btwn upper and lower extremities
- lower extremities have lower readings than arms d/t pressure increase proximal to defect and decrease distal to defect
How would you explain why infant likes to sit in squatting position in Tetralogy of Fallot?
child breathes easier d/t position increases return of venous blood back to heart
Why does dsypnea occur in Patient Ductus Arteriosus?
oxygenated blood recycles through lungs overburdens pulmonary circulation since blood circulates through ductus from pulmonary artery to aorta, bypassing L side of heart
What FHR do you hold digoxin admin?
withhold dose if apical HR <100 bpm then tell MD
What area of the heart would be affected by carditis from rheumatic fever?
affects tissues that cover the heart and valves which is the heart muscle and mitral valve
What would be a classic sign of congenital heart defect?
child fatigues during feeding or activity
How does Kawasaki disease affect the childs heart and blood vessels?
inflammation weakens blood vessels = aneurysm
What would you teach parents to do if infant had Tetralogy of Fallot and infant suddenly becomes cyanotic?
hold infants against shoulder with their knees bent up towards their chest
What does clubbing of fingers mean?
What are s/sx of dig toxicity?
- irregular pulse and rhythm
- sudden pulse changes
How does oxygenated blood flow in child with Hypoplastic left heart syndrome?
R side heart taking over pumping to both lungs and systemic circulation, PDA must be open to shunt blood from the lungs
What are involuntary, purposeless movements of limbs called?
What is time frame and frequency a child with Rheumatic fever get penicillin?
chemoprophylaxis protocol started with PCN G 200,000 units/dose monthly for 5 years
What are characteristics of HDLs?
has lower cholesterol and triglycerides with an increased protein which are excreted by liver
What are fats limited to in a heart healthy diet?
What is priority nursing diagnosis for child with chemo and neutropenia?
risk for infection
What results when overproduction of immature WBCs occur?
increase susceptibility to infection
What drug would you give before exercise with pt with exercise induced asthma?
inhaler before exercise to px attacks
How would you explain why a child got CF?
both parents are carriers of the gene
Child develops itching and apprehensive while getting blood transfusion, what do you do?
stop transfusion and run NSS and notify charge nurse
What would be focus of childs care if they are getting chemo?
- support group
- stimulate appetite
- keep hydrated
- no immunizations
- report exposure to infectious disease
How would you modify feeding for CHF infant?
- feed more frequently with small meals
- use soft nipple with big holes
- hold and cuddle
- increased calorie formula
What sports can an asthmatic child do?
What assessments would you make if child is experiencing paroxysmal hypercyanotic episode?
- spontaneous cyanosis
- resp distress
What is the difference btwn SBP and DBP reading called?
How do you teach child pursed lip breathing?
inhale through nose then exhale through mouth with lips pursed like whistling