OB/PEDS Test 3

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ssoucie
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246569
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OB/PEDS Test 3
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2013-11-13 22:02:12
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OB PEDS Test
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OB/PEDS Test 3
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  1. Where should you not administer any injections in, for infants and young children?
    Gluteus Maximus
  2. This is the IM site for infants (age birth-36 month)?
    Vastus Lateralis
  3. This site is a muscle located in the anterolateral aspect of middle or upper thigh?
    vastus lateralis
  4. What age group are IM injections, in the vastus lateralis done in?
    • Infants
    • age birth- 36 month
  5. Where is the preferred IM site for older toddlers, children, & adults?
    Deltoid Muscle
  6. IM injections in the deltoid process are preferred in what age group?
    older toddlers, children, & adults
  7. Where is the SubQ injection site for infants?
    fatty area of the anterolateral thigh
  8. Where is the preferred SubQ injection site for older toddlers, children, & adults?
    fat part of outer aspect of upper arm
  9. What do you do when doing a SubQ injection, to prevent from injecting into the muscle?
    pinch up SQ tissue
  10. multiple injections given in the same extremity, should be separated as far apart as possible, preferably at least ____-___?
    • 1" - 1.5" apart
    • minimum of 1"
  11. The vastus lateralis is the preferred site for IM injections until the deltoid muscle has developed adequate mass, at approximately what age does this happen?
    36 months
  12. Antibodies from mom pass to baby, and provide limited protection, it decreases over several months after birth?
    Passive Immunity
  13. A childe develops their own antibodies through exposure to natural diseases & immunizations
    Active Immunity
  14. What is the most common transmission of disease in children?
    Fecal & respiratory route
  15. How do immunizations work?
    immunization introduces an antigen, the antigen triggers an immune response, then child produces antibodies against particular disease
  16. This dose is 1:1000
    epinepherine
  17. how much epinephrine is safe to give?
    0.01 ml/kg per dose; up to 0.5ml IM
  18. how often can Epinephrine be administered?
    can be repeated q 10-20min up to 3 doses
  19. This should be done in children at the time of vaccine, with a history of seizures?
    Give acetaminophen at time of vaccine, and q 4hrs for 24 hrs
  20. When is a tetanus booster recommended?
    after 5-10 years for contaminated wound or burn
  21. Prior to the polio vaccine, allergies to ____, ____, & ____ should be asked about?
    Neomycin, Streptomycin, Polymycin B
  22. When giving the polio vaccine, you know the fluid should be what color?
    Clear & Colorless
  23. All doses of the polio vaccine must be given ______ apart?
    4 weeks
  24. Prior to MMR vaccine, you need to know child allergies to ____ & ____
    neomycin & gelatin
  25. After MMR vaccine, the child should be observed with _____ ____ for _____ minutes
    • Egg Allergy
    • 90 minutes
  26. College students need to have a 2nd dose of this?
    MMR
  27. Pregnancy should be avoided for _____ months after MMR vaccine is given?
    3 months
  28. If mother test positive for this, then the baby needs to get first dose of this, and when do they need it?
    Hep B, within 12hours of birth
  29. The dose series of Hep B is how many?
    And if getting the series when can they, and when should they not get it?
    • -Series of 3
    • - Can get series any age
    • - Should not have last dose before 6 months of age
  30. Incomplete immunization series puts infants at risk for _____?
    Infection
  31. What is medical name for chicken pox?
    Varicella
  32. What is mode of transmission for varicella?
    Airborne/ Contact
  33. What is period of communicability for varicella?
    5 days before the onset of the rash till ALL lesions have crusted over
  34. onset with fever, malaise, and headache, before eruption of skin rash begins as macule on erythematous base & progresses to a papule, then to a clear fluid filled vesicle, describe what disease?
    • Varicella
    • (Chicken Pox)
  35. What is this?
    typically thick, bluish white to grayish black patch covering the tonsils?
    Diptheria
  36. What is transmission of Diptheria?
    Contact or Droplet
  37. What is period of communicability of Diptheria?
    usually 2-4 wks or until 4 days after antibiotics are started
  38. Endotoxins causing myocarditis & peripheral neuropathy, are complications of _____?
    Diptheria
  39. What medicine should be given for Diptheria?
    Antibiotics & Antitoxins
  40. What is mode of transmission for Fifth Disease?
    Droplet
  41. When is the period of communicability highest for fifth disease?
    Before the onset of the disease
  42. This disease manifestations are described as fiery red rash on cheeks?
    5th disease
  43. This rash usually occurs with fiery red rash on cheeks, will develop onto trunk, & extremities, but WILL NOT be on palm & Soles?
    5th disease
  44. The agent of _____ is Morbillivirus?
    Measles (Rubeola)
  45. What is mode of transmission for Measles?
    Airborne, Droplet, Contact
  46. Manifestations of _____ are typically, fever, conjunctivitis, cough, anorexia, Koplik spots on buccal mucosa, maculopapular rash on face, trunk, & limbs that do NOT blanch?
    Measles
  47. Measles have _____ Spots?
    Koplik
  48. What are the Mumps?
    Parotitis
  49. Mode of transmission for Mumps is?
    Droplet
  50. Typical manifestations for _____ are fever, headaches, earache, parotid gland swelling?
    Mumps
  51. Parotid Glad Swelling is a typical manifestation of this?
    Mumps
  52. Orchitis & Deafness are typical complications of this?
    Mumps
  53. What is pertussis?
    Whooping Cough
  54. Mode of transmission for Pertussis?
    Droplet
  55. The smaller the child, the greater risk for respiratory distress with this disease?
    Pertussis
  56. The manifestations of this are runny nose, fever, mild cough, that generally becomes worse at night?
    Pertussis
  57. What are the German Measles?
    Rubella
  58. What is Rubella also known as?
    German Measles
  59. What is mode of transmission for Rubella?
    Droplet or Contact
  60. This is usually a mild disease, but a major risk factor fetus if mother is infected in 1st trimester?
    Rubella
  61. Mode of transmission for Strep Throat is?
    Droplet
  62. Beefy red pharynx with exudate & tender cervical nodes, are typical manifestations of ____?
    Strep throat
  63. Mode of transmission for Scarlet Fever is___?
    Droplet
  64. First 12-48 hrs, sandpaper rash appears, starting on neck & spreading to trunk & extremities, And classic strawberry tongue is seen on 4-5th day?
    Scarlet Fever
  65. After 3-4 days, the rash begins to fade & tips of toes & fingers begin to peel, then 4-5 days later, classic strawberry tongue appears?
    Scarlet Fever
  66. What are the diseases that are with streptococcus group A?
    Strep Throat, Scarlet Fever, Impetigo
  67. What is mode of transmission for Impetigo?
    Contact with skin lesions
  68. These lesions are honey colored crusted at te sire of open lesions?
    Impetigo
  69. What is the most common vectorborne illness in N. America?
    Lyme Disease
  70. A tick must feed for __ - __ hours to transmit lyme disease?
    24-36 hrs
  71. what should high fever associated with common diseases be treated with?
    non-aspirin antipyretics, unless otherwise directed
  72. what should be used to relief itching associated with common diseases?
    antihistamines & oatmeal baths
  73. Less than 37 completed weeks of pregnancy is considered?
    preterm
  74. What is considered preterm?
    Less than 37 completed weeks
  75. 37 - 41 completed weeks of pregnancy Is considered?
    Term
  76. Full term pregnancy is considered at?
    37-41 completed weeks
  77. greater than 42 weeks pregnancy is considered?
    Postterm
  78. Post-term pregnancy is considered?
    greater than 42 weeks.
  79. Late preterm infants are being seen born, why??
    Because of scheduled C-sections and Inductions
  80. How are infants classified as (SGA) small gestational age?
    below the 10th percentile for birth weight
  81. SGA infants are more commonly seen in what situation?
    mothers who smoke, or have high blood pressure
  82. What is Intrauterine Growth Restriction (IUGR)?
    Advanced gestation & limited fetal growth
  83. These infants are more difficult to arouse to a quiet alert state and can have difficulty feeding?
    Large for Gestational Age (LGA)
  84. these infants have a birth weight at or above 90th percentile?
    Large gestational age (LGA)
  85. What is the most common metabolic disorder in infants?
    Hypoglycemia
  86. When assessing / examining a baby or child, how should you assess?
    ex, head to toe, feet to head, complex to simple, non-invasive to more invasive??
    Non-invasive to more invasive
  87. 2 main risk factors for respiratory distress syndrome include?
    prematurity & surfactant deficiency disease
  88. respiratory distress is also known as _____ _____ ?
    Surfactant Deficiency
  89. What is surfactant deficiency?
    respiratory distress syndrome
  90. What is transient tachypnea of the newborn?
    Excess Fluid in the lungs
  91. What is excess fluid in the lungs of a newborn?
    transient tachypnea
  92. The transient tachypnea newborn, may not have trouble breathing right after birth, but may begin to have difficulties shortly after, then clears completely within ___-____ hrs?
    48-72 hrs
  93. What does the nurse do for the infant who is suspected of having meconium aspiration syndrome?
    suction from the airways of the infant before they draw their first breath
  94. two types of hyperbilirubinemia, what are they and when do they appear?
    • Physiologic = appears AFTER 1st 24 hrs
    • Pathologic = appears DURING 1st 24 hrs (WORSE)
  95. This type of hyperbilirubinemia occurs AFTER the 1st-24hours?
    Physiologic
  96. This type of hyperbilirubinemia occurs DURING the 1st-24 hours?
    Pathologic
  97. This type of hyperbilirubinemia is considered the worse type of the two?
    Pathologic
  98. This type of hyperbilirubinemia is associated with hemolytic disease, RH & ABO incompatibility?
    Pathologic
  99. ____ develop from the deposit of bilirubin in the skin?
    Jaundice
  100. What normally clears unconjugated (indirect) bilirubin in the utero?
    Placenta
  101. Where is bilirubin excreted?
    the stool
  102. To prevent metabolic complications of hyperbilirubinemia, initiate early, ______ _____. Also administer ______ to all unsensitized  mothers who are Rh negative after delivery of baby?
    • frequent feedings
    • RhoGAM
  103. _____ should be initiated in infants who develop hyperbilirubinemia?
    phototherapy
  104. Hypoglycemia can indicate _____ in infants?
    infection
  105. This chronic lung disease is usually caused by prematurity & they are on O2 for atleast 28 days, ______ _____ ventilation & O2 treatment, then infant can be gradually weaned.
    • Bronchopulmonary Dysplasia
    • Positive Pressure
  106. Birth of a child requiring NICU care elicits the _____ _____ in parents?
    grief response
  107. For supporting parents of newborn in NICU, the nurse should focus on the ____ of the infant.
    positives
  108. In infants, the anterior fontanel is palpable until about _____?
    18 months
  109. In infants, the posterior fontanel is palpable until about _____?
    2-3 months
  110. In Children, their cardiac output id dependent, not _____ _____?
    stroke volume
  111. In children their ____ ____ is dependent, not stroke volume?
    Cardiac Output
  112. Children are susceptible to trauma due to poor protection of _____ & _____?
    liver & spleen
  113. Kidneys don't concentrate urine effectively in children until approximately ____ months?
    12-18 months
  114. Children have a faster respiratory rate until approximately age ____?
    10
  115. The _____ is the primary breathing muscle in children?
    diaphram
  116. True / False
    Adults bones are more soft and easily bent or fractured than children?
    False - children's are more soft, easily bent until puberty
  117. Children's muscles are approximately ____% of their weight?
    Adults muscles are approximately ____ % of their weight?
    • 25% - child
    • 40% - adults
  118. When building rapport/ trust with children, _____ should be used cautiously in teens?
    humor
  119. newborns & infants< 6 months old, how should they be assessed?
    least invasive first to more invasive procedures last.
  120. A head to toe sequence assessment starts at this age?
    school age
  121. When assessing the ear, the auditory canal should be ____?
    pink
  122. When assessing the ear, the tympanic membrane should be _____ & _____?
    pearly grey & translucent
  123. When assessing the heart, and auscultating cardiac sounds, the ____ is normal in children?
    S3
  124. When assessing the abdomen, what is the order of assessment?
    inspect, auscultate, percuss, palpate
  125. What is the DDST? and what is it used for?
    Denver Developmental Screening Test= used to screen development, not intelligence.
  126. Eriksons - Trust VS. Mistrust - is what age?
    Infants - Birth to 1yr
  127. Eriksons - Autonomy VS. Shame & Doubt - is what age?
    Toddlers - 1-3 yrs
  128. Eriksons - Initiative VS. Guilt - is what age?
    Pre-school - 3-6 yrs
  129. Eriksons - Industry VS. Inferiority- is what age?
    School age - 6-12 yrs
  130. Eriksons- Identity VS. Role Confusion - is what age?
    Adolescents - 12-18 yrs
  131. Normal stressors for ____ include...
    * Separation anxiety
    * Stranger anxiety
    * Painful, invasive procedures
    * Immobilization
    * Sleep deprivation, sensory overload
    Infants
  132. Therapeutic play for infants include??
    Mobiles, mirrors, music, cuddle r rock infant, lullabies, talking to infant
  133. Normal stressors for ____ include..
    * Separation Anxiety
    * Loss of Self Control
    * Immobilization
    * Painful, Invasive procedures
    * Bodily injury, mutilation
    * Fear of dark
    Toddlers
  134. When doing a procedure on a toddler, where should procedure take place?
    In treatment room if possible
  135. Therapeutic play for toddlers?
    • peek-a-boo
    • familiar blanket, stuffed animal
    • stories read to them
    • dolls
    • building blocks
    • puzzles
  136. Normal stressors for ___ include....
    * Separation anxiety, fear of abandonment
    * Loss of self control, bodily function
    * Bodily injury, mutilation
    * Painful, invasive procedure
    * Fear of dark & monsters
    Preschool
  137. When performing procedure on preschooler, where should it take place?
    treatment room if possible
  138. Therapeutic play for preschoolers?
    playing with safe hospital equipment, crayons/book, puppets, magnet board, play dough
  139. Normal stressors for _____ include...
    * loss of control
    * loss of privacy & control over bodily functions
    * bodily injury
    * separation from family & friends
    * painful, invasive procedures
    * fear of death
    school age
  140. Normal stressors for ____ include....
    * Loss of control
    * Fear of altered body image, disfigurement, 
    * Fear of disability
    * Fear of Death
    * Separation from peers
    * Loss of privacy & identity
    Adolescents
  141. What pain assessment scales are self reporting?
    Faces & Oucher
  142. What pain scales are used in non-verbal children?
    NIPS & FLACC
  143. What are the 5 rights of medcations?
    • Right - Patient
    • Right - Drug
    • Right - Dose
    • Right - Route
    • Right - Time
  144. What is it when an infant has been on supplemental oxygen for at least 28 days after birth?
    bronchopulmonary dysplasia
  145. What does treatment of bronchopulmonary dysplasia, ventilation require?
    positive pressure
  146. If diagnosed with bronchopulmonary dysplasia, what can it lead to?
    atelectasis & hyperexpansion
  147. When does respiratory distress occur?
    immediately after birth
  148. What is excess fluid in the lungs of a newborn?
    Transient Tachypnea
  149. This type of newborn, may have more difficulty feeding & are more difficult to arouse to a quiet alert state
    Large for Gestational Age
  150. What is a well known condition that is associated with excessive fetal growth?
    Gestational Diabetes
  151. Birth trauma, resulting in shoulder dystocia is a common complication of?
    • LGA
    • Large gestational age
  152. An APGAR score of <7 is ?
    Bad
  153. An APGAR score of >7 is?
    Good
  154. What is a normal lab result of bilirubin at birth in the infant?
    <3mmg
  155. After an infants delivery, their ____ must start to conjugate bilirubin?
    liver
  156. In phototherapy, due to hyperbilirubinemia, what does the stool look like?
    bright green
  157. In neonatal sepsis, what is the most common sign?
    poor feeding
  158. In children under ____, they have a short, narrow trachea?
    under 5
  159. If a child is distressed, their ____ is not effectively expired?
    C02
  160. Does dehydration hit children or adults sooner?
    Children
  161. When doing a physical assessment on a child, what are the growth measurements recorded on plot growth chart?
    Length, Height, Weight, Head Circumference.
  162. The DDST test, screens children up to age 6, in 4 categories, what are they?
    • Personal-Social
    • Fine Motor-Adaptive
    • Language
    • Gross Motor
  163. The DDTS screens children, up to what age?
    6
  164. What is nitric oxide used for?
    used for meconium aspiration syndrome
  165. What is surfactant used for?
    replacement therapy for RDS & meconium aspiration syndrome. it improves oxygenation & decreases the incidence of air leaks. It decreases the need for ventilator support
  166. what is lidocaine used for?
    local anesthesia for painful procedures

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