maternal child 4 note cards.txt

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dshamilton
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maternal child 4 note cards.txt
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2010-11-15 14:09:34
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maternal child unit
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Maternal child unit 4 notecards
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  1. What is the most important assessment of a patient with head injury?
    LOC
  2. What other body systems are affected by MD other than the muscles?
    Respiratory and Cardiac
  3. How do you maintain optimal functioning for a patient with MD?
    Range of Motion
  4. How do you detect a hearing problem in an infant over 6 months of age?
    They stop babbling, no verbal communication
  5. What is the optimal position to prevent aspiration in a patient with seizures?
    Sideline
  6. What characterizes a clonic seizure?
    Shaking of the entire body
  7. A patient has bacterial meningococcal, what are important actions of the nurse to prevent spreading the illness?
    Keep patient in isolation for 24-72 hours after starting antibiotic treatment.
  8. How do you position an infant for a lumbar puncture?
    Side line on edge of table curled up like a ball, be careful of airway and should put on a O2 monitor
  9. What is the main goal you want parents of a child with CP to have and why?
    PROM to conserve muscle tone
  10. How do you assess an infant for ICP?
    Measure head circumference daily and bulging fontanelle
  11. Problems adolescent will face that have seizures?
    Coping mechanisms tend to have body image issue, will not be able to drive, and may look for alternative coping strategies (alcohol/drugs)
  12. How is seizure disorders diagnosed?
    EEG
  13. What position do you place an infant with myelomenegecele In?
    Prone
  14. Signs and symptoms of meningitis besides nucheal rigidity?
    Fever, headache, irritability, vomiting, positive Kernigs sign
  15. What interventions are most important for a patient with a cast?
    Good skin care and orthoneuro checks
  16. How do you detect Scoliosis?
    Adam�s Test
  17. Which cast/harness is most effective for older kids with hip dysplasia?
    Spica cast
  18. What is a diagnostic assessment for cerebral palsy?
    Startle reflex after 6 months of age
  19. What is an important intervention for children with CP?
    Get in school early to help them learn to function individually
  20. What is the treatment for febrile seizures?
    Acetaminophen
  21. What isolation precautions do you use for a patient that has meningitis?
    Gloves, mask, gown
  22. What is amblyopia?
    Lazy eye
  23. What is the treatment for amblyopia?
    Patching the good eye for one hour each day
  24. How do you transfer a patient that has scoliosis?
    Log roll
  25. Is MD inherited or is it an acquired disease?
    Inherited
  26. Do we as nurses manipulate fractures?
    No
  27. What are some causes of hearing loss?
    Heredity, rubella, jaundice and LGA
  28. What are early signs of ICP in older children?
    Headache, vomiting, cognitive, personality and behavioral changes, diplopia, blurred vision, anorexia, nausea, weight loss and seizures
  29. What is diplopia?
    Double vision
  30. What are some late signs of ICP?
    Decreased LOC, decreased motor response to command (loss of B&B), abnormal sensation to painful stimuli, decreased pupil size and reactivity, decerebrate/decorticate posturing, abnormal breathing pattern due to pressure on brain stem.
  31. VS changes due to ICP?
    Increased temp and BP, decreased HR and RR
  32. What is a sign of a concussion?
    Early sign Projectile vomiting, late stage posturing
  33. If there is a change in VS with ICP this indicative that the ______ is involved.
    Hypothalamus
  34. ______ is very important intervention for patient with ICP.
    Reverse trendelenburg Positioning
  35. Intervention for ICP includes ___________ to help reduce cerebral edema.
    Corticosteroid such as dexamethasone (Decadron) and manitol
  36. Interventions for ICP include _____, given IV to remove fluid from interstitial tissue and reduce pressure.
    Manitol (osmotic diuretic)
  37. How does an osmotic diuretic help with ICP?
    Helps kidneys filter excess fluid
  38. What are some complications of increased ICP?
    Weight loss, hypotension, tachycardia, thirst, anxiety, increased urine output, diabetes insipidus
  39. Decerebrate and Decorticate posturing are signs of?
    Late signs of Increased ICP= brain stem involvement
  40. This type of posturing occurs when the midbrain is not functional; characterized by rigid extension and adduction of arms and pronation of wrists with the fingers flexed; legs extended and feet plantar flexed.
    Decerebrate
  41. This type of posturing occurs when the arms are adducted and flexed on the chest with the wrists flexed, hands fisted; lower extremities extended and internally rotated; feet plantar flexed; and denotes brainstem involvement
    Decorticate
  42. This type of posturing is seen with a major increase in ICP, a brainstem problem and/or brain damage. Seizures can also cause this temporary posturing.
    Opisthotonous
  43. An extreme hyperextension spasticity pattern where the patient assumes a total �bridging� or �arching� position. The individual may primarily bear weight on their heels and top or back of their head or posture with their heals contracting the buttocks and back of head resting on the spine. This is an extrapyramidal effect.
    Opisthotonous
  44. This is a problem with brain development and happens during fetal development.
    Neural tube defects
  45. Neural tube defects can be caused by.
    Tetratogen exposure and decreased folic acid
  46. Neural tube defects may be discovered by.
    A sonogram or mom�s alpha-feta-protein (AFP) test
  47. ______ is the absence of the cerebral hemispheres.
    Anencephaly
  48. ______ occurs when the upper end of the neural tube fails to close in early intrauterine life.
    Anencephaly
  49. _____ is revealed by an elevated level of AFP in the maternal serum or on amniocentesis and confirmed by a sonogram.
    Anencephaly
  50. With ______ the infant will have a brain stem, and the body continues to grow, the infant can live long enough to be born yet survival is not possible.
    Anencephaly
  51. ______ brain growth is so slow and disproportionate that it falls more than three standard deviations below normal on growth charts.
    microcephaly
  52. What are causes of Microcephaly?
    TORCH viruses and ETOH
  53. With children who have ______ the prognosis depends on the extent of restriction of brain growth and on the cause, they will usually have some type of MR.
    Microcephaly
  54. General term for all spinal disorders �divided spine�?
    Spina bifida
  55. _____ occurs when the posterior laminae of the vertebrae fails to fuse?
    Spina bifida occulta
  56. This type of spina bifida is so common that is may be missed?
    Spina bifida occulta
  57. _____ may be noticeable as a dimpling at the point of poor fusion, sacral spine.
    Spina bifida occulta
  58. _____ meninges covering the spinal cord herniated through unformed vertebrae.
    Meningocele
  59. With ____ there is still skin covering, but spinal cord protrudes through the vertebrae.
    Meningocele
  60. _____anomaly appears as a protruding mass, usually approximately the size of an orange, at the center of the back, looks like edema.
    Meningocele

    • What is the treatment for meningocele?
    • Surgery
  61. ______the spinal cord and the meninges protrude through the vertebrae?
    Myelomenegecele
  62. With _____ the spinal cord ends at the point, and motor and sensory function is absent beyond this point.
    Myelomenegecele
  63. with _______ there is no skin covering.
    Myelomenegecele
  64. What are some signs and symptoms of myelomenegecele?
    Urinary dribblers, flaccidity, lack of sensation of the lower extremities, club foot, and hydrocephalus due to trauma to the spinal cord
  65. With ______ encourage parents to touch their infants even though they are not able to hold them. Why can�t they hold their baby?
    Myelomenegecele, b/c of the open exposure and risk for infection
  66. What is a major symptom of myelomenegecele?
    Decreased response to painful stimuli in lower extremities
  67. What is a pre op intervention of an infant with myelomenegecele?
    Place infant in prone position with moist sterile saline gauze dressing over the site
  68. How do you assess for hydrocephalus?
    Measure head circumference daily and watch for bulging fontanel
  69. ______ is a group of nonprogressive disorders of upper motor neuron impairment that result in motor dysfunction. Affected children also may have speech, or ocular difficulties, seizures, cognitive challenges (MR) or hyperactivity.
    Cerebral palsy
  70. What causes CP?
    Lack of oxygen to the brain
  71. Causes of ______ are associated with low birth weight, premature birth, or birth injury.
    Cerebral palsy
  72. Severe jaundice can cause hypoxia therefore causing _______?
    Cerebral palsy
  73. What is a primary intervention in teaching parents about their children diagnosed with CP?
    The importance of passive and active muscle exercises to prevent contractures
  74. Children with ________ need periods of adequate rest.
    CP
  75. Is CP a (nonprogressive/progressive) disease?
    Nonprogressive
  76. What is amblyopia?
    Lazy eye
  77. _____ is curable if treated before age 6, and then changes decrease significantly?
    Amblyopia
  78. ____ can be treated if discovered before 6 years of age; early recognition is therefore important.
    Amblyopia
  79. _____ (cross-eyes) caused by unbalanced muscle control.
    Strabismus
  80. This eye infection is caused by bacteria, fungus or virus.
    Conjunctivitis

    • This eye infection is characterized by watery eyes and pustular drainage.
    • Conjunctivitis
  81. Interventions for conjunctivitis include.
    Good hand washing, wipe drainage from inner to outer canthus to avoid more contamination
  82. Conjunctivitis is highly contagious what type of precautions do you use?
    Contact
  83. What is Hyperopia?
    farsightedness
  84. What is myopia?
    An error in refraction in which light rays are focused in front of the retina, enabling the person to see distinctly for only a short distance
  85. What is astigmatism?
    A form of ametropia in which the refraction of a ray of light is spread over a diffuse area rather than sharply focused on the retina, due to differences in curvature
  86. What is Nystagmus?
    Involuntary back-and-forth or cyclical movements of the eyes
  87. What are greenstick fractures? Who do they commonly affect?
    Not broke all the way through, kids
  88. What causes spiral fractures?
    Abuse
  89. What is as comminuted fracture?
    A single bone broken in more than 1 place
  90. How is a comminuted fracture repaired?
    Open reduction
  91. What is the concern with comminuted fractures?
    High risk for infection
  92. What is a transverse fracture?
    A straight across break
  93. What is a compound fracture?
    A bone that is broken and penetrating through the skin
  94. What is the concern assoc. with a compound fracture?
    Infection
  95. What is a compression fracture?
    Fracture of the vertebra caused by pressure
  96. A compound fracture is also called a _____?
    Open fracture
  97. A fracture of a diseased or weakened bone produced by a force that would not have fractured a healthy bone?
    Pathological fracture
  98. Fracture without rupture of ligaments or skin, usually transverse?
    Simple fracture
  99. Is a surgical technique that is used to align and repair bone?
    Open reduction
  100. With this type of fracture repair rods or screws are used and is rarely used with children except in cases of scoliosis.
    Internal fixation

    • With this type of fracture repair no incision is made, bone manipulation is done through the skin.
    • Closed reduction
  101. With this type of fracture repair there is a high risk for infection?
    Open reduction
  102. What are ortho neuro checks? And how often are they done?
    Cast care including checking the skin color, temp, capillary refill, distal pulses usually every 2 hours
  103. What is an important intervention to teach parents of a child with a cast?
    Keep it clean and dry, cover for bathing
  104. What is the intervention to keep swelling down with a cast? What can swelling cause?
    Ice and swelling. Compartment syndrome
  105. ____ skin traction for treatment of hip synovitis or muscle spasms of the lower extremities or lower back.
    Bucks Traction
  106. This type of traction is applied with adhesive strips aligned with the long axis of the leg. Weights sufficient enough to produce the required extension are fastened to the inferior end of the strips by a rope that is run over a pulley to permit free motion.
    Bucks traction
  107. _____ is the use of opposing forces to straighten and reduce spinal curves that are severe when first diagnosed or that progress despite bracing.
    Halo Traction
  108. ____ traction is achieved using a ring of metal held in place with four stainless steel pins inserted into the skull bones.
    Halo traction
  109. What interventions are needed with Halo traction?
    Good skin care and good antibiotic are
  110. MD affects more ____ than ____.
    Boys than girls
  111. MD is a ____ disease?
    Progressive
  112. What is the Gower�s sign?
    The inability to rise from the floor except using the hands to �walk up� the body
  113. What is the Gower�s sign a diagnostic for?
    MD
  114. What is subluxation?
    Maintains contact with the acetabulum but no fully located in hip joint
  115. What is dislocated hip dysplasia?
    Its where there is no contact between the femoral head and acetabulum
  116. What is dysplasia?
    Acetabulum is shallow or sloped instead of cup shaped
  117. What is a positive Barlow�s sign indicative of?
    Dislocation
  118. What is a positive Ortolani�s test indicative of?
    Reduction
  119. What is a Galeazzi�s sign indicative of?
    Shortening of affected femur
  120. This type of brace for hip dysplasia is worn continually except for bathing.
    Pavlik Harness
  121. _____ occurs as a compensatory mechanism in children who have unequal leg lengths and sometimes in children with ocular refractive errors that cause them constantly to tilt their head sideways.
    Scoliosis
  122. Scoliosis is more common in _____ than _____.
    Girls than boys
  123. What is the name of the brace worn for scoliosis?
    Milwaukee brace
  124. How often is a Milwaukee brace worn and what is the problem with this?
    16-23 hours, compliance
  125. This brace is worn for scoliosis and extends over the spine and is worn 24 hours.
    Charleston Bending
  126. Spinal instrumentation means ____ are placed beside the spine
    Rods
  127. The edema that accompanies spinal instrumentation surgery can impair____.
    Circulation to the lower extremities
  128. ____ seizures are characterized by rigidity, extension of extremities, fixed jaw, respiratory cessation and dilated pupils.
    Tonic
  129. _____ seizures are characterized by rhythmic jerking of extremities, autonomic symptoms and possibly incontinence.
    Clonic
  130. Treatment of seizures includes what drugs?
    Depaken, Tegretol, Dilantin and Phenobarbital
  131. What diet changes might be prescribed for patients with seizures?
    Ketogenic diet
  132. What is a ketogenic diet?
    High in fat and low in protein and carbohydrate
  133. Can Phenobarbital be stopped abruptly?
    No
  134. What causes seizures?
    Cerebral edema, lack of oxygen
  135. What is a drop seizure, and what is its characteristic?
    Atonic, sudden loss of muscle tone followed by confusion
  136. Anything that causes pressure or swelling on the brain can cause______?
    Seizures
  137. _____ seizures consist of starring spells-last for a few seconds and can be accompanied by rhythmic blinking and twitching of the mouth or extremity.
    Absence
  138. What is the treatment for absence seizures?
    There is no first aid measure necessary
  139. Simple partial seizures may be characterized by?
    Focal motor components, aura before seizure, visual changes
  140. This type of seizure begins as simple and progresses to unconsciousness.
    Complex seizure
  141. This type of seizure is characterized by a sudden change in posture, such as an arm dropping, motor, sensory or behavioral changes.
    Complex seizures
  142. What is the treatment for complex seizures?
    Tegretol, Depaken, Dilantin and Phenobarbital
  143. ____ seizures are associated with high fever.
    Febrile
  144. Febrile seizures last for how long?
    15 to 20 seconds
  145. Once a child has a febrile they are more prone to having another? (True/False)
    True
  146. Children usually outgrow _____ seizures.
    febrile
  147. _____ is a seizure that last continuously for longer than 30 minutes.
    Status epilepticus
  148. What is the treatment for status epilepticus?
    IV Ativan or valium
  149. Status epileptus has a very poor prognosis why?
    Because of irreversible brain damage
  150. What causes status epileptus?
    Severe cerebral edema
  151. _____ seizures are characterized by rapid movements of the trunk or the infant suddenly slumps forward from a sitting position or falls from a standing position.
    Myoclonic (infantile)
  152. This type of seizure tends to burn itself out by 2 yrs.
    Myoclonic
  153. What is the treatment for myoclonic seizures?
    Parenteral adrenocorticotropic hormone (ACTH) and Vitamin B6, and Topamax

    • ____ sign is when the hips are abducted the hips with the hips and knees flexed, a palpable click is felt.
    • Ortolani�s sign
  154. ____ sign is when the hip dislocates under the examiners fingers while adducting then extending the legs.
    Barlow's sign

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