Pediatrics

3 phase management of dehydration

Initial - Bolus isotonic solution to quickly expand ECF 2nd - Replace deficits 3rd - Oral rehydration / feeding / Pedialyte

What should be the initial bolus of crystalloid fluid replacement for a pediatric patient in shock? A. 20 ml/kg B. 10 ml/kg C. 30 ml/kg D. 15 ml/kg

A. Fluid volume replacement must be calculated to the child's weight to avoid over-hydration. Initial fluid bolus is administered at 20 ml/kg, followed by another 20 ml/kg bolus if there is no improvement in fluid status.

Maintenance Fluid Requirement Calculation

100 mL/kg for first 10 kg 50 mL/kg for second 10 kg 20 mL/kg for remainder of wt. in kg Divide total amount by 24 hours = mL/hr

Piaget - Formal Operational

11 to adulthood Abstract thought and problem-solving

Piaget - Preoperational

2 - 7 years old Egocentric - Everyone see's the world at the child does Believe in magical powers/ animism

Piaget - Concrete Operational

7 - 11 years old Reasoning becomes more logical but remains at concrete level Principle of conservation is learned

Cystic Fibrosis

A genetic disorder of the exocrine glands that's present at birth. Affects both the respiratory and digestive systems. Fluids become thick and sticky blocking ducts, tubes, and passageways. No cure

Centration

A preoperational thought pattern involving the inability to take into account more than one factor at a time.

RSV

A virus that causes infection on the lungs and respiratory tract Can obstruct the airway and cause impaired gas exchange Serious in young babies

Kim is using bronchodilators for asthma. The side effects of these drugs that you need to monitor this patient for include: A. tachycardia, nausea, vomiting, heart palpitations, inability to sleep, restlessness, and seizures. B. tachycardia, headache, dyspnea, temp . 101 F, and wheezing. C. blurred vision, tachycardia, hypertension, headache, insomnia, and oliguria. D. restlessness, insomnia, blurred vision, hypertension, chest pain, and muscle weakness.

A.

While examining a 2-year-old child, the nurse in charge sees that the anterior fontanel is open. The nurse should: A. Notify the doctor B. Look for other signs of abuse C. Recognize this as a normal finding D. Ask about a family history of Tay-Sachs disease

A. Because the anterior fontanel normally closes between ages 12 and 18 months, the nurse should notify the doctor promptly of this finding. An open fontanel does not indicate abuse and is not associated with Tay-Sachs disease

Hirschsprung's Disease

Absence of gaglion cells in distal portion of the bowel AKA megacolon - a partial or complete obstruction that is a result of part of the colon being obstructed and stopping proper motility. The affected portion of the bowel narrows, becomes dilated, and fills with feces and gas.

S/S of Hirschsprung's Disease

Absence of meconium in newborn Abdominal distention Severe constipation in older children Poor weight gain/feeding intolerance

Sudden infant death syndrome (SIDS) is one of the most common causes of death in infants. At what age is the diagnosis of SIDS most likely? A. At 1 to 2 years of age B. At I week to 1 year of age, peaking at 2 to 4 months C. At 6 months to 1 year of age, peaking at 10 months D. At 6 to 8 weeks of age

B.

When developing a plan care for a hospitalized child, nurse Mica knows that children in which age group are most likely to view illness as a punishment for misdeeds? A. Infancy B. Preschool age C. School age D. Adolescence

B.

When developing a plan of care for a male adolescent, the nurse considers the child's psychosocial needs. During adolescence, psychosocial development focuses on: A. Becoming industrious B. Establishing an identity C. Achieving intimacy D. Developing initiative

B. According to Erikson, the primary psychosocial task during adolescence is to establish a personal identity. The adolescent attempts to establish a group identity by seeking acceptance and approval from peers, and strives to attain a personal identity by becoming more independent from the family

Piaget - Sensorimotor

Birth to 2 years A child learns to manipulate their environment in order to meet physical need

A child is diagnosed with Wilms' tumor. During assessment, the nurse in charge expects to detect: A. Gross hematuria B. Dysuria C. Nausea and vomiting D. An abdominal mass

D. The most common sign of Wilms' tumor is a painless, palpable abdominal mass, sometimes accompanied by an increase in abdominal girth.

Non-organic failure to thrive

Decrease growth due to lack of love and stimulation

Infancy birth weight

Doubles in 6 months Triples in a year

CF lung symptoms

Frequent respiratory infections Barrel-shaped chest Enlarged right ventricle Chronic cough - wheezing - dyspnea Bronchiole obstruction

Interventions for RSV

High humidity 02 Increase fluid intake Rest Bronchodilators / Corticosteroids Diuretics

Shaken baby syndrome

Occurs in infants under 18 months of age Retinal hemorrhage Subdural or subarachnoid hematoma Breathing difficulties, seizures, dilated pupils, lethargy, unconsciousness

FLACC pain scale

Pain scale for non-verbal patients unable to communicate

Three categories of neglect

Physical Educational Psychological

Three categories of sexual abuse

Physical - Fondling and intercourse Non-physical - Indecent exposure, internet porn Violent - Rape and other sexually violent behaviors

Conservation

Piaget's term for the awareness that physical quantities remain constant in spite of changes in their shape or appearance

A 6-month-old female presents with rhinorrhea, cough, poor feeding, lethargy, and fever. She is diagnosed with bronchiolitis. Which of the following is most likely causing her condition?

RSV

CF complications

Rectal prolapse in infants Liver cirrhosis Frequent pneumonia Osteoporosis Cor Pulmonale - enlargement of the right side of the heart due to disease of the lungs or pulmonary blood vessels

Diagnostic tests for cystic fibrosis

Sweat tests Chest X-Ray Pulmonary function test