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Throat culture group A strep, what antibiotic is used?
Oral Penicillin for 10 days, take complete course
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Intial intervention if child at home with laryngeal spasnm
take child to BR and turn on hot shower, humidity liquidifies secretions and decreases spams
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Post T&A if child is swallowing frequently what is wrong?
bleeding from surgical site
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Best choice for child for fluid replacement
- Popsicle
- no milk, tea, soda
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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
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What are classic s/sx of acute asthma attack and what position is helpful to child?
- expiratory wheeze
- orthopenic position
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Parent teaching of how to perform resp therapy
- give aersol followed by postural draingage before meals or 1 hr later
- it loosens secretions
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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
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How would you teach parent to clear infant's nostrils?
instill NS drops then removes nasal secretions with bulb syringe
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What are appropriate fluids to give asthmatic child to compensate for fluid lose through dyspnea?
- room temp water
- no cold beeverages
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Signs of theophylline toxicity
- stomach ache
- tachycardiac
- sweating profusely
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SIDS when lying infant in crib, which positions are most helpful?
back or sides to sleep
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Dry powder inhaler, why do you rinse mouth after use?
px candidiasis (thrush yeast infection)
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What sources are rich in iron?
- cream of wheat
- boiled eggs
- liver
- green, leafy vegs
- dried fruits
- beans
- nuts
- whole grain bread
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What liquid do you mix with ferrous sulfate drops?
OJ- has vit. C which aids in absorption of iron
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Factor IX deficiency- what condition does it cause?
Christmas disease- Hemophilia B
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How do you teach parents to stop bleeding at home if pt has Hemophilia A?
- pressure, ice, elevate, rest
- RICE
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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
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During blood transfusion, what do you closely assess for?
- fever
- chills
- headache
- itching
- back pain
- rash
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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
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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
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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
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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
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Complication of reapted blood transfusion for Thalassemia?
hemosiderosis- excessive iron deposits stored in tissue
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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
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During blood transfusion child c/0 back pain and itching, what do you do?
clamp off blood and keep line open with NS
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What equiment needs to be used for mouth care of child in chemo?
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How do you respond to a child questioning death or going to heaven?
who do you think will take care of you
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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
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Child has chemo has firm and distended abd, what is happening?
peripheal neuropathy signaled by severe constipation d/t decreased nerve sensation in bowels
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Adolescent states being scared, what is your response?
tell me what has you scared
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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
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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
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What is characteristic of newborn with ventricular septal defect?
a loud, harsh murmur with a systolic thrill
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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
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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
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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
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What FHR do you hold digoxin admin?
withhold dose if apical HR <100 bpm then tell MD
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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
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What would be a classic sign of congenital heart defect?
child fatigues during feeding or activity
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How does Kawasaki disease affect the childs heart and blood vessels?
inflammation weakens blood vessels = aneurysm
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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
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What does clubbing of fingers mean?
chronic hypoxia
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What are s/sx of dig toxicity?
- n/v
- anorexia
- irregular pulse and rhythm
- sudden pulse changes
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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
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What are involuntary, purposeless movements of limbs called?
Sydenham's chorea
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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
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What are characteristics of HDLs?
has lower cholesterol and triglycerides with an increased protein which are excreted by liver
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What are fats limited to in a heart healthy diet?
30%
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What is priority nursing diagnosis for child with chemo and neutropenia?
risk for infection
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What results when overproduction of immature WBCs occur?
increase susceptibility to infection
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What drug would you give before exercise with pt with exercise induced asthma?
inhaler before exercise to px attacks
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How would you explain why a child got CF?
both parents are carriers of the gene
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Child develops itching and apprehensive while getting blood transfusion, what do you do?
stop transfusion and run NSS and notify charge nurse
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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
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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
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What sports can an asthmatic child do?
- swimming
- gymnastics
- baseball
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What assessments would you make if child is experiencing paroxysmal hypercyanotic episode?
- spontaneous cyanosis
- resp distress
- weakness
- syncope
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What is the difference btwn SBP and DBP reading called?
pulse pressure
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How do you teach child pursed lip breathing?
inhale through nose then exhale through mouth with lips pursed like whistling
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