Exam 3 Review

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Exam 3 Review
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2015-02-19 00:51:29
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  1. What is Chronic Sorrow
    Many parents of children with chronic illness experience chronic sorrow (feeling of sorrow and loss that recur in waves over time).
  2. T or F: Young children do not know that there is something wrong when they have a terminal
    illness.
    • False:
    • Children, even a young age are perceptive.

    • Even if they are not told outright that they are dying, they realize
    • that something is seriously wrong and that it involves them. 

    • Often helping parents understand that honesty and shared decision making between then and their child are important to the child’s
    • and family’s emotional health encourages parents to allow discussion of dying
    • with their child.
  3. What is the primary nursing goal R/T separation anxiety?
    - Preventing or minimizing separation

    - A primary nursing goal is to prevent separation, particularly in children younger than 5 years of age.

    - Many hospitals have developed a system of family-centered care.

    - This philosophy of care recognizes the integral role of the family in a child’s life and acknowledges the family as an essential part of the child’s care and illness experience.

    - The family is considered to be partners in the care of the child.

    - Encourage parents to do rooming in

    - Family-centered care also supports the family by establishing priorities based on the needs and values of the family unit.
  4. What are the complications of scarlet fever?
    • Peritonsillar and retropharyngeal abscess
    • Otitis media
    • Acute glomerulonephritis
    • Acute rheumatic fever
    • Polyarthritis
    • Toxic shock syndrome
    • Osteomyelitis
  5. What is a good sport for child with asthma?
    Swimming is well tolerated by children with Exercise Induced Bronchospasm (EIB) because they are breathing air fully saturated with moisture and because of the type of breathing required in swimming
  6. What is the diet for child with cystic fibrosis?
    • Well-balanced
    • High-protein,
    • High-caloric diet
  7. Clinical manifestations of Hirschsprung Disease
    • NB: Failure to pass meconium, refusal to feed, Bilious vomiting, abdominal distention
    • Infancy: Growth failure, constipation, abdominal distention, diarrhea and vomiting, explosive watery diarrhea, fever, appears significantly ill
    • Childhood: constipation, ribbon-like, foul-smelling stools, abdominal distention, visible peristalsis, easily palpable fecal mass
  8. What is the nursing interventions for Esophageal Atresia (EA) and Tracheosophageal Fistula (TEF)?
    • NPO
    • IV fluids are initiated
    • Positioned prone or semi-upright to facilitate drainage of secretions and decrease the likelihood of aspiration
    • oral pharynx should be kept clear of secretion by oral suctioning
  9. What are the three C's of Tracheoesophageal Fistula (TEF)?
    • Coughing
    • Choking
    • Cyanosis
  10. What are the clinical manifestations of Hypertrophic Pyloric Stenosis?
    • Projectile Vomiting
    • infant hungry
    • weight loss
    • signs of dehydration
    • distended upper abdomen
    • easily palpable olive-shaped tumor in the epigastrium (tight of umbilicus)
    • Visible peristatlic waves (move left to right)
  11. What are clinical manifestations of celiac disease?
    • diarrhea
    • abdominmal distention
    • failure to thrive, or wt loss

    • Celiac Disease:
    • Gluten intolerance = no wheat, barley, rye, oat grains
  12. Emergency poison Tx?
    • (preventing absorption):
    • place child in side lying, sitting or kneeling position with head below chest
    • administer activated charcoal, administer drug antidote, perform gastric levage
  13. acute signs of lead poisoning?
    nausea, vomiting, constipation, anorexia and abdominal pain

    • Universal screening should be done at 1-2yrs
    • Any child who btwn 3-6 should be tested if not previously

    Chelation is term used for removing lead from circulating blood
  14. What are the signs and symptoms of systemic venous congestion?
    • Weight gain
    • hepatomegaly
    • peripheral edema, especially periorbital
    • acites
    • neck vein distention (children)
  15. what are the signs and symptoms of pulmonary congestion?
    • tachypnea
    • dyspnea
    • retractions (infants)
    • flaring nares
    • exercise intolerance
    • orthopnea
    • cough
    • hoarseness
    • cyanosis
    • wheezing
    • grunting
  16. List 4 characteristic findings of extracardiac emboli formation in Infective Endocarditis
    • splinter hemorrhages (thin black lines) under the nails
    • Osler nodes (red painful intradermal nodes found on padds of philanges)
    • Janeway lesions (painless hemorrhagic areas on palms and soles)
    • Petachiae on oral mucous membranes
  17. Hypovolemic Shock
    • Characteristics:
    • reduction in size of vascular comartment
    • falling BP
    • poor cap filling
    • low CVP
    • Most Frequent causes:
    • blood loss
    • plasma loss
    • extracellular fluid loss
  18. Distributive shock
    • Characteristics:
    • reduction in peripheral vascular resistance
    • profound inadequacies in tissue perfusion
    • increased venous capacity andpooling
    • acute reduction in return blood flow to the heart
    • diminished cardiac output
    • Most Frequent causes:
    • anaphylaxis (anaphylactic shock)
    • sepsis
    • loss of neuronal control (neurogenic shock)
    • myocardial depression and peripheral dilation
  19. Clinical manifestations of shock
    • apprehensiveness
    • irritability
    • unexplained tachycardia
    • thirst
    • pallor
    • diminished urinary output
    • reduced perfusion of extremities
    • confusion and somnolence
    • tachypnea
    • oliguria
    • cool pale extremities
    • decreased skin turgor
    • poor capillary filling
  20. emergency tx for shock
    • ventilation: Establish airway, administer oxygen - usually 100% by mask
    • Fluid administration: restore fluid volume as ordered
    • cardiovascular support: administer vasopressors (epinephrine)
    • general support: keep child flat with legs raised above level of heart, keep child warm and calm
  21. What are Signs and Symptoms of early septic shock?
    • chills
    • fever
    • vasodilation: with increased cardiac output that results in warm, flushed skin
  22. what is allogeneic Hematopoietic Stem Cell Transplantation (HSCT)?
    Allogeneic HST involves matching a histocompatible donor with the recipient
  23. What is the first line of therapy for nephrosis?
    corticosteroids
  24. What is the treatment for scorpion stings?
    • delay absorption of venom by keeping child quiet
    • place involved area in dependent position
    • administer antivenin
    • relieve pain
    • admit to pediatric intensive care unit for surveillance
  25. Emergency treatment for minor burns
    • stop the burning process
    • apply cool water to the burn or hold the burned area under cool running water
    • do not use ice
    • do not disturb any blister that form unless the injury is from a chemical substance
    • do not apply anything to the wound
    • cover with a clean cloth if risk of for damage or contamination
    • remove burned clothing and jewelry
  26. Fun Fact
    during therapeutic communication the nurse responds to the feeling level of the clients communication
  27. Fun Fact
    to build successful therapeutic relationships with families, it is necessary for nurses to recognize parents' expertise with regard to their child's conditions and needs
  28. fun fact
    nurses working with children, who have chronic and complex conditions, should not focus on the child's chronological age or diagnosis
  29. Fun Fact
    children with complex chronic conditions may be at increased risk for behavior or emotional problems
  30. Fun Fact
    All children with any type of chronic condition that may affect medical care should wear some type of identification such as a Medic Alert Bracelet
  31. Fun Fact
    in a shared decision making model, the health care professionals provide honest, clear information regarding diagnosis, prognosis, treatment options ad risk benefit assessment
  32. fun fact
    children with chronic and complex conditions and their families face numerous challenges in achieving normalization
  33. fun fact
    a major goal in working with the family of a child with chronic or complex illness is to support the family's coping and promote their optimal functioning throughout the child's life
  34. Fun Fact
    the extensive stresses in the family can leave fathers feeling depressed, weak, guilty, powerless, isolated, embarrassed and angry
  35. fun fact
    Responsibility for caregiving, differential treatment by parents, and limitations in family resources and recreational time are often the experiences of siblings of ill or disabled children
  36. Fun Fact
    Frequently the guilt stems from a false assumption that the child's condition is a result of a personal failure or wrongdoing such as not doing something correctly during pregnancy or birth
  37. Fun Fact
    Well adapted children gradually learn to accept their physical limitations and find achievement in a variety of compensatory motor and intellectual pursuits
  38. Fun Fact
    Children nearing puberty also need to understand the maturation process and how their chronic illness may alter this event
  39. Fun Fact
    The nurse should not rely solely on the parental reports when assessing the child's feelings about having a chronic condition
  40. Fun Fact
    Nurses help parents understand the disadvantages of not telling children (eg, deprives them of the opportunity to discuss their feelings openly and ask questions, incurs the risk of their learning the truth from outside a sometimes less tactful sources, may lessen children's trust and confidence in their parents after they learn the truth) (terminally ill children know when they are seriously ill)
  41. Fun Fact
    To support the family's coping methods, parents can be encouraged to discuss their feelings toward the child, the impact of this event on their marriage, and associated stresses such as financial burdens
  42. Fun Fact
    The nurse observes the child responses to the disorder, ability to function, and adaptive behaviors within the environment and with significant others, explores the child's own understanding of his or her illness or condition and provides support while the child learns to cope with his or her feelings
  43. Fun Fact
    Siblings may also experience embarrassment associated with having a brother or sister with a chronic or complex condition

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