PEDS RETAKE QUIZ 4

What do you want to feed Infants with GER?

Thickened formula w/ 1 tsp to 1 tbsp rice cereal per 1 oz formula

What is Pyloric stenosis and when does it occur?

Thickening of the pyloric sphincter, which creates an obstruction; occurs first few weeks of life

what meds can you take together in Acute Renal Failure

furosemide and mannitol to provoke a flow of urine in child who has oliguria and no lower tract obstruction

What is hypotonic dehydration and what is the lab result for it?

greater loss of electrolytes than water ; Low sodium

What is hypertonic dehydration and what is the lab result for it?

greater loss of water than electrolytes ; High sodium

stepping/dancing reflex

hold up w feet on flat surface baby makes stepping movements up to 4 weeks

when are MMR and V vaccines given

12-15 months, 4-6 years

at what age does child build a tower of two block

15 mo

rooting reflex

when baby cheek is stroked and baby turns head that way 3-6 mo

nursing actions when applying EMLA (lidocaine and prilocaine topical ointment)

-apply 60 min before injection. -place occlusive dressing over cream -before procedure remove dressing and clean skin -check for redness or blanched skin -demonstrate to child its not sensitive -instruct parents to apply med at home before procedure

nursing actions for CV d/o when taking Furosemide

-encourage to eat food high in K+ -monitor I&O & daily wt -monitor AE: hypoK+, n/v/dizziness

nursing actions for Renal d/o when taking Furosemide

-encourage to eat food high in K+ -monitor blood electrolyte levels (hypokalemia)

gentamicin nursing teaching

-finish all abx !

What is the MOA of digoxin? nursing action ?

-improves myocardial contractility - hold if infant or up to school age HR <90 -monitor therapeutic level -monitor for toxicity (bradyc, abd pain, vision changes)

how do you assess internal ear cannal

-infants and toddler - pull pinna down and back to see tympanic membrane -children over 3 pull pinna up and back -light reflex should be visible

What are s/sx of Gastroesophageal reflux (GER) in Children? 5

-noncardiac chest pain -abd pain -heartburn -difficulty swallowing -chronic cough (respiratory or GI)

what are 2 anti-epileptic meds and moa

-phenytoin -diazepam -v severe seizures

what are you going to see in a patient when taking too much calcium supplement

-renal stones -high calcium high HR -low calcium low HR

what is contraindicated when taking Mannitol for Reye syndrome

-salicylates (aspirin)

what is the correct alignment of the ears

-should align w top of the ears and horizontally from outer canthus of eye

describe fontanels

-should be flat -posterior closes at 8 weeks -anterior closes at 12 -18 mo

What s/sx of Hirschsprung's disease in Newborns? (4)

- Failure to pass meconium w/i 24-48 hrs after birth - Episodes of vomiting bile - Refusal to eat - Abd distention

What s/sx of Hirschsprung's disease in Infants? (4)

- Failure to thrive*(weight, height, color) - Constipation* - Vomiting* - Episodes of diarrhea, vomiting

What are three types of Dehydration?

- Isotonic - Hypotonic - Hypertonic

how do assess for dehydration in child

-skin turgor on the abd and thigh and forearm

How is Salmonella transmitted? (2)

-undercooked meats and poultry -person to person

What are some Interventions of Hirschsprung's disease?

- Stop vomiting *(priority) - Give IVF (Admin electrolytes/fluids) - Give TPN (Total Parenteral Nutrition)

What are some client teaching for Salmonella and state 4 things to avoid?

- Teach the client about the importance of hand washing after each bowel movement -

What are s/sx of Pyloric stenosis? 6

- Vomiting - nonbilious vomitus can be blood tinged - Constant hunger - Olive-shaped mass in the right upper quadrant of the abdomen -Failure to gain weight -Dehydration manifestations

What are s/sx of NEC? 8

- abd distention - gastric residuals - bloody stools - periods of apnea begin or worsen - hypotension - lethargy - poor feeding - decreased urinary output

what 2 d/o can Furosemide be used for and MOA?

-Cardiovascular d/o : moa : K wasting diuretic getting rid of fluid and sodium -Renal d/o : moa : rids of fluid from body

For a pt with Isotonic dehydration, how will you treat it? (3)

-D5W -LR -0.9% Normal Saline

What are s/sx of Gastroesophageal reflux (GER) in Infants? 5

-Forceful vomiting* -excessive crying* (vomit could go to lungs) -respiratory problems -Failure to thrive (FTT) -Apnea

For a pt with hypertonic dehydration, what urine gravity are they going to have? Color? (3)

-High -Dark -Little output

What kind of fluid will you give to a pt with hypotonic dehydration?

-Hyper >0.9

What s/sx of Hirschsprung's disease in a Child? (5)

- Abd distention - Visible peristalsis - Palpable fecal mass - Constipation - Foul-smelling, ribbonlike stool

What are 4 intervention for Salmonella and state process*?

- Assess/Monitor I&O - Avoid antibiotics - Avoid antimotility -Oral rehydration therapy* >Start replacement with an oral replacement solution (ORS) of 75 to 90 mEq of sodium/L at 40 to 50 mL/kg over 4 hrs >Repeat if needed >Maintenance therapy w/ ORS of 40-60 mEq of sodium/L and limit 150 mL/kg/day >Replace each diarrheal stool w/ 10 mL/kg of ORS for ongoing diarrhea.

What are 3 reasons to place an NG tube?

- Decompression - Lavage - Gavage

What is mild weight loss in Infants?

3%-5%

what med do you give for Status Epilepticus and moa

DIAZEPAM -muscle relaxant to v muscle spasms

What does it mean when you have aganglionic cells?

Causes a decrease in movement > causes obstruction > vomiting bile

If a newborn has NEC, are you going to feed this infant?

No; Give TPN or IV (to rest GI tract)

What is one intervention for Rotavirus and state process* (4)?

Oral rehydration therapy*: -Start replacement with an oral replacement solution (ORS) of 75 to 90 mEq of sodium/L at 40 to 50 mL/kg over 4 hrs -Repeat if needed -Maintenance therapy w/ ORS of 40-60 mEq of sodium/L and limit 150 mL/kg/day -Replace each diarrheal stool w/ 10 mL/kg of ORS for ongoing diarrhea.

What does the xray show for NEC?

Sausage looking intestines'

What is the antidote for warfarin?

Vitamin K (phytonadione)

If infant has NEC, what surgery may they need?

Temporary Colostomy

What is the antidote for heparin?

protamine sulfate IV

what do you monitor for when taking opioids analgesics?

respiratory depression.

moro reflex

startle reflex when hear loud noise or sudden movement and fingers form C shape (up to4 mo

plantar graps reflex

touch sole and toes curl downward (up to 8 mo

babinski reflex

upward stroke on foot and baby toes fan out up to 1 yr

what is the MOA when taking Mannitol for Reye syndrom and head injury

v cerebral swelling & ICP

at what age does baby hold bottle in fine motor skills

6 mo

at what age does baby roll from back to front in gross motor skills

6 mo

A nurse is reviewing the medical record of a 2-month-old infant who has rotavirus. The nurse notes a hemoglobin level of 12 g/dL and a hematocrit of 51%. Which of the following statements by the nurse indicates an understanding of the laboratory values? A."The infant might be dehydrated." B."The infant might be anemic." C."The infant might have received too much fluid." D."The infant might have leukemia."

A."The infant might be dehydrated." An increased hematocrit level indicates dehydration. Hematocrit levels rise when blood volume is decreased during dehydration.

what are teaching for injury prevention in child

ASPIRATION teaching: avoid small objects , loose buttons, and balloons BODILY HARM teaching : remove sharp objects, firearms kept locked away, BURNS teaching : pot handles should be turned toward back of stone and electrical outlets covered, wear sunscreen outside, water heaters less than 120F DROWNING teaching: dont leave unattended, toddlers closely monitored near pools FALLS teaching: crib mattresses lowest position w rails up, safety gates used across top and bottom of stairs

A nurse is caring for a toddler who has gastroenteritis caused by Salmonella. Which of the following is the priority action for the nurse? A.Weigh the child B.Initiate contact precautions C.Establish a skin care routine D.Obtain a recent food history

B.Initiate contact precautions Salmonella is a type of bacteria that is transmitted via contaminated feces, making contact precautions essential for preventing transmission. This client is at greatest risk for transmission of Salmonella to others; therefore, contact precautions are the nurse's priority.

If you place an NG tube in a baby with NEC, what is it for?

Decompression

What does necrotizing enterocolitis (NEC) interfere with?

Digestion; Ischemia results in death of mucosal celles leading to necrotic patches (interfering w/ digestion)

What is the antidote for digoxin?

DigiFag (digoxin immune fag)

where do u assess for heart rate in infant

apex

tonic neck reflex

arm/leg extension toward facing side up to 3-4 mo

What is Gastroesophageal reflux (GER)?

occurs when gastric contents reflux back up into the esophagus, making esophageal mucosa vulnerable to injury from gastric acid.

how do you monitor all medication therapeutic levels

peak and trough

If child has GI problem, +failure to thrive, +failure to eat, given TPN. Do they need surgery? What does it do? Is it permanent?

Yes; Surgical removal of the aganglionic (cells) section of the bowel; No > Temporary colostomy

at what age does baby move object from hand to hand in fine motor skills

7 mo

at what age does baby start to sit unsupported in gross motor skills

8 mo

at what age does baby use pincer grasp in fine motor skills

8 mo

what age do we use FACES pain scale

> 3 y

what age do we use numeric pain scale

> 5 y

What is severe weight loss in Infants?

>10%

What kind of fluid will you give to a pt with hypertonic dehydration?

-Hypo <0.9

What is necrotizing enterocolitis (NEC)?

-Inflammatory disease of the gastrointestinal mucosa caused by ischemia or hypoxia (no oxygen in area); colon

What are 10 s/sx of Salmonella?

-Mild to severe n/v -abd cramping -bloody diarrhea -fever -diarrhea (up to 2-3 weeks) -headaches -confusion -drowsiness -seizures -Can lead to meningitis or septicemia

If a child has hypertonic or hypotonic dehydration, what symptomology are you going to see?

-Neuro -Skin tinting

What are some client teaching for Rotavirus and state 4 things to avoid? (T=5)

-Parents should inform the child's school or day care of the infection/infestation. The child should stay home during the incubation period (48hrs) -Avoid fruit juices, carbonated sodas, gelatin, and chicken/beef broth (too much sodium/not enough carbs)

what are the 3 adverse effects when taking Chemo meds?

-alopecia -bone marrow depression and suppression -vomiting

nursing actions for iron supplement

-use ztrack method -use a straw w liquid med to prevent staining of teeth -take vitamin c to ^ absorption

at what age does child creep up stairs

15 mo

at what age does child build a tower of 3 or 4 block

18 mo

at what age does child manage a spoon w/o rotation

18 mo

at what age does child push and pull toys

18 mo

what age do we use FLACC pain scale

2 mo - 7 y

at what age does child build a tower of 6 or 7 block

2 y

at what age does child walk up and down stairs

2 y

at what age does child draw circle

2.5 y

at what age does child stand on one foot

2.5 y

when are DTAP vaccines given

2mo, 4mo, 6mo, 15-18mo, 4-6yrs

at what age does baby roll from back to side in gross motor skills

4 mo

at what age does baby roll from front to back in gross motor skills

5 mo

What is moderate weight loss in Infants?

6%-9%

What is Isotonic dehydration?

Equal amount of loss of water & electrolytes

nursing actions for too much calcium

FLUSHHH

Rotavirus is considered as a bacterial infection. TorF

False Its a viral infection

Salmonella is considered as a viral infection. TorF

False Its a bacterial infection

What are 6 s/sx of Rotavirus?

Fever Watery stools Diarrhea for 5-7 days Vomiting for 2 days Affects all aged children Most common cause for diarrhea for children <5yrs old

If child has GI problem, +failure to thrive, +failure to eat, given TPN. What is the priority for this patient, fluid or food?

Fluid d/t vasculature + circulation fluid

If child has GI problem, +failure to thrive, +failure to eat. What can be done for their nutrition?

Give TPN (Total Parenteral Nutrition)

What position should you have an Infant with GER that is vomiting ? 2

Sitting up & back straight (may sleep like this as well)

palmar grasp reflex

placing fingers and baby grasps on it ends at 4 mo