Peds PrepU

Ch.11

Caring for Children in Diverse Settings

when should nb metabolic screenings occur

when child is over 48 h

Denver articulation screening

2.5-7 age groups those who test below-- retake in 2 weeks, referred for complete language testing if abnormal

cogenital hearing loss

60-80 dB delayed growth and development impaired verbal communication risk for injury

Classic temperament theory

9 parameters of temperament - activity level - rhythmicity - approach and withdrawal - adaptability - threshold of responsiveness - intensity of the reaction - quality of mood - distractibility - attention span - persistency easy difficult slow to warm up

vaccines for school aged pt

Tdap HPV- human papillomavirus MCV- meningococcal

The nurse is talking with an adopted child and the family. Which statement represents "positive" adoption language?

The birth mother was how old when your child was born? birth mother= proper term vs. natural or real mother

screening for autism

18-24 m

conductive hearing loss

effects middle ear structures fail to carry sounds waves to the inner ear fluid fills ear-- tympanic membrane is unable to move properly most often causes by serious otitis media premature infants hearing aids, cochlear implants

Hyperopia

farsightedness

children with out health problems should be seen by physician:

first week of life 1 m 2 m 4 m 6 m 9 m 12 m 15 m 18 m 24 m 30 m -- yearly until age 21

Place in proper order the vision screening procedures used by the nurse to assess children from neonate to school age.

fixate on an object at 10-12 inches follow object to midline follow object past midline respond to E chart use snellen test for visual acuity

DTaP

given in series of five injections 2m 4m 6m 15-18 m 4-6 y TdaP booster (every 11-12 years)

myelomeningocele and Spina Bifida related surgeries

avoid latex

Esotropia

cross-eyed-- form of strabismus

Record about a vaccine

Lot number and expiration date of vaccine Site and route of vaccine administration Manufacturer of vaccine

Ch.2

Factors Influencing Child Health

Infants born to mothers who are HbsAg-positive need to receive the hepatitis B immunoglobulin (HBIg) within how many hours?

HBIg needs to be given within 12 hours. series of 3 injections

The nurse is working with the parents of a school-age child who has juvenile arthritis. What is the most beneficial method for helping this child assess chronic but intermittent pain?

Have child keep a diary of when pain occurs.

Ch.9

Health Supervision

Sedation and children

conscious sedation- depressed consciousness-- not all reflexes are lost (IV) pain free and sedated usually for a procedure general anesthesia- client loses all reflexes

Ch.1

Introduction to child Health and Pediatric Nursing

The nurse is performing a vision screening for a 2-month-old. Which technique should the nurse use?

Move a card with a black-and-white checkerboard pattern in a 180-degree arc past the infant.

Ch.28

Nursing Care of the Child With an Alteration in Behavior, Cognition, or Development

Ch.16

Nursing Care of the Child With an Alteration in Intracranial Regulation/Neurologic Disorder

Ch.14

Pain Management in Children

muscular dystrophy abnormal lab values

creatine kinase byproduct of muscle wasting

stye

aka hordeolum localized infection of sebaceous gland of the eyelid follicle-- bacterial invasion

Meningocele

leakage from cystic area-- loss of CSF surgical intervention promptly needed shrill cry-- increased ICP position prone to protect the sac

The nurse is teaching parents of a 6-year-old child about otitis media (OM). What predisposes the child to OM infections?

bacteria entering through the Eustachian tube child's Eustachian tube is shorter, wider, and more horozontial

itching with cast

blowing cool air with a fan or a hair dryer may help relieve the feeling

strabismus intervention

botulinum injections

prehypertensive

bp greater than 120/80

femur fracture and fracture of long bones

breaks that happen between the rounded end and the central shaft of the bone can cause growth issues in the future breaks at the epiphyseal plate

Otitis media in infants is reduced by

breast feeding (infants should not be immunized before 2 months of age)

consent vs assent

children intact over the age of 7 should always be asked to give their assent

chalazion

chronic painless infection of the meibomian gland generally resolves on its own

Blepharitis

chronic scaling with discharge along the eyelid margin

Roles

clinical nurse specialist- masters degree: education, clinician, researcher clinical coordinator- BSN, leadership role case manager- integrating care to discharge ped NP- exams, diagnosis-- long term management

school aged children

concrete cognitive stage understand concepts of space, time, and dimension learn by seeing need hands on learning videos, books, diagrams, and illustrations

Osgood-Schlatter

disease that causes knee pain and painful swelling or prominence of anterior portion of tibial tubercle

retinopathy

overgrowth of retinal blood vessels

epiphysiolysis

pain with excess movement distal radius proximal humerus

strabismus

patch a child's eye

conjunctivitis

pink eye

infant mortality is most effected by

premature birth rates

When a child is hospitalized and must be away from the caregiver, the child goes through stages of response to the separation. The child who cries and refuses to let the nurse or anyone else provide comfort and is continually looking out the door to see if the caregiver is returning is in which stage of separation?

protest 1) protest 2) despair (withdraws and apathy) 3) detachment

rubella causes

sensorineural hearing loss

rickets

serum calcium and serum phosphate levels are low

Time-outs

should be 1 min per 1 year of age

What are some negative effects that chronic pain can have on the pediatric population

sleep disturbances, exhaustion, irritability, mood disturbances, and depression

The nurse is caring for a 2-year-old boy with cerebral palsy (CP). The medical record indicates "hypertonicity and permanent contractures affecting both extremities on one side." Based on these findings, the nurse identifies this type of CP as:

spastic spastic: permanent contractures on both extremities on one side, hypertonicity lower extremities athetoid: affects all four extremeties, sometimes face and neck mixed: spastic and athetoid mix ataxic: balance and depth perception

parens patriae

state has a right and duty to protect children

cataracts treatment

surgery

skeletal traction pin care

unhooking a weight while providing pin care

Gower's sign

weakness of proximal muscles those of lower limb uses hands to walk up their own body from a squatting position because of lack of thigh strength

syndactyly

webbing of fingers and toes

Ch.12

Caring for the Special Needs Child

eye injury after glass bottle shatters near his face

instill a few drops of a topical anesthetic into the affected eye acute pain after injury visualize surface: press firmly on lower lid until it turns out, grasp eyelashes and gently stretch upper eyelid downward cotton-tipped applicator: horizontally against center of applicator

cereal palsy

irreversible, non progressive disorder-- damage to developing brain during (prefix)-natal period many have normal intellegence appears at birth or during first 2 years of life

Amblyopia

lazy eye-- subnormal vision in one eye central vision fails to develop because the eye and brain are not working together child appears to be resting one eye and using the other for vision treatable before age 6

spicia cast

leaves the leg in a frog-like position usually bag placed between the legs to help support the cast covers whole leg while leaving feet open children with orthopedic disorders

infants with visual impairments

may not "fix and follow" do not make eye contact are unaffected by bright light do not imitate facial expressions

dimpling and hair growth (lumbosacral area)

may signal Spina Bifida occult (usually benign) MRI= diagnostic tool

otitis externa interventions

mixture of 1/2 rubbing alcohol and 1/2 vinegar to help with inflammation hair dryer on a cool setting

somatic pain

muscles or blood vessels

Myopia

near-sightedness light entering the eye focuses in front of the retina

Meperidine

not recommended for kids toxicity to CNS

nociceptive pain- cancerous tumor in bladder that has metastasized

noxious stimuli- damages tissue sharp burning dull aching cramping deep aching sharp stabbing

A child awaiting a blood draw procedure states, "I am so nervous and really do not want to have this done." Which response by the nurse is best?

"Imagine that you are swimming in a cool, shady pool where nothing can harm you."

The child with a surgically repaired myelomeningocele has a neurogenic bladder. How will the nurse best explain this problem to the parents?

"Old urine remains in the bladder because of poor emptying or overfilling, putting your child at risk for urinary tract infection."

Parents have a 3-year-old boy with a difficult temperament. Which guidance will be mosthelpful for the nurse to provide?

"Provide a place for him to roughhouse." control temperament don't offer activities counter to it

What would the nurse respond when the parent asks the nurse why the nurse is using pictures with high contrast patterns to assess their 4-month-old's vision?

"The child's eyes are more attune to high contrast patterns than to specific colors."

Ch.22

Alteration in Mobility/Neuromuscular or Musculoskeletal Disorder

Curious parents ask what type of immunity is provided to their child through immunization with various vaccines. What will be the nurse's answer?

Artificially acquired active immunity

The nurse is preparing a nursing care plan for a 2-year-old child with hearing impairment. Which intervention will be part of the plan?

Assess the child's ability to covey information unable to learn necessary information for communication if can't hear for first 36 months

Ch.8

Atramatic Care of Children and Families

After teaching a group of students about medications commonly used for neuromuscular disorders, the nursing instructor determines that the teaching was successful when the students identify which agent as a centrally acting skeletal muscle relaxant?

Baclofen skeletal muscle relaxant Tx for spasms and spasms assoc with motor neuron lesions

In understanding the development of the musculoskeletal system, the nurse recognizes that what is implanted in a gel-like substance during fetal life?

Cartilage

A 6-month-old girl is significantly underweight. Which assessment finding points to an inorganic cause of failure to thrive?

Child avoids eye contact Watching the interaction between mother and child to see if the child maintains eye contact may indicate that the child is being neglected, which is an inorganic cause for failure to thrive. Refusing the nipple is a sign of organic cause for failure to thrive. Prematurity is a risk factor for failure to thrive. Checking the health history may disclose other organic causes for failure to thrive.

A single, 18-year-old woman in her second trimester presents at the clinic with vaginal bleeding. She confides to the nurse in confidence that she has been using cocaine to "calm her nerves" and hopes it didn't harm her baby. What would be the nurse's best response to this situation?

Consult with the health care facility's institutional ethics committee for an appropriate response.

The nurse is performing a vision screening for 6-year-old child. Which screening chart is bestfor the nurse use to determine the child's ability to discriminate color?

Ishihara (numbers) CVTME- color discrimination in preschoolers

idiopathic scoliosis

S-shaped curvature of the spine

Ch.17

Sensory Perception/ Disorder of the Eyes or Ears

A 7-year-old child tells the school nurse that he and his parents sleep in their car every night. What action should the nurse take?

Speak with the child's parents to offer to contact community agencies for support.

The community health nurse is looking at measurements to capture information about general health status for a group of inner city children using recommendations of Healthy People 2020. Which factors are appropriate? Select all that apply.

number of days missed from school related to illness how the individual child considers his health history of chronic disease limitation of activity

younger than 7= DTaP

older than 7= TdaP

Byrant traction

on back with hips off the bed

Apgar test nb

The newborn with an Apgar score of 4 or less at 1 minute or of 6 or less at 5 minutes is at high risk for a hearing deficit. Careful, continuing follow-up is important.

The nurse is caring for a 3-year-old boy with a fracture of the humerus. His chart indicates "fracture is partially through the physis extending into the metaphysis." The nurse identifies this as which Salter-Harris classification?

Type II type I- through physis, widening type II- partially through physics extending to metaphysis type IV- through metaphysis, physics, and epiphysis Type V- crushing injury to physis

Diazepam

or valium used with traction (casting) antianxiety pill ALSO has effects of skeletal muscle relaxation

The client is a 1-year-old girl from a low-income family presenting with a vitamin D deficiency and anemia. What assistance program would you recommend to the child's young mother?

WIC

government programs

WIC: nutritional food to low income women and children CHIP: health insurance to newborns and their families who do not otherwise qualify for health insurance, medicaid, or are uninsured ECI: children with disabilities or developmental delays

SMA Type 1

Werdnig-Hoffman disease most severe autosomal recessive affects ability of spinal nerves to communicate with muscle-- leading to atrophy instruct parents on performing technique of chest percussion early childhood death from resp complications

atropine

atropine causes pupil dilation and further narrows the exit of fluid

hearing screening neonate

auditory brain stem response test ABR and EOAE evoked otoacoustic emissions test are indicated for newborns rinne and weber- 6 years of age tympanometry= 7+ m

Coloboma

hole in a structure of the eye (iris, retina, choroid, optic nerve)

simple contusion of the eye

ice 20 minutes as often as possible during the first 24 h bruising-- may take 3 weeks to resolve sclera hemorrhage-- no treatment, resolves in weeks simple contusion= no antibiotic ointment, corneal abrasion= antibiotic ointment

prior to discharge from NICU

infant will be tested for O2 desat in the car seat

photophobia occurs with

infantile glaucoma typically will keep their eyes closed affected eye may appear enlarge increased tearing

tubes

inserted into a section of the eardrum where hearing is not affected stay in place 6-12 m and come out by themselves pressure equalizing tubes via a myringotomy

fracture assessment

inspection, observation, palpation