很重要SAUNDERS Pediatric - DISORDERS( 3 )

ventriculoperitoneal (VP) shunt revision 脑室与腹膜的分流术（Use for hydrocephalus）

Fever may be an indication of an infection of the shunt, which is the primary concern in the postoperative period(考）, related to a shunt insertion.

Digoxin administration in an infant.

If the heart rate is less than 100 beats per minute in an infant, the nurse should withhold the dose(考） and notify the registered nurse

greenstick fracture

One side of the bone being broken and the other side being bent

Permethrin （Nix）（"per咩 湿rain"）--antiparasite（Use： head lice and scabies.）

Permethrin 1% is an over-the-counter（记）, antilice product that kills lice and eggs with one application and that has residual activity for 10 days. The medication is applied to the hair after shampooing, left on for 5 to 10 minutes, and then rinsed out（考）.The hair should not be shampooed for 24 hours after treatment（记）.

Beta-thalassemia 地中海贫血

Beta-thalassemia is an autosomal（常染色体的） recessive（隐性的）disorder. This disorder is found primarily in individuals of Mediterranean [ˌmɛdətəˈreɪniən](地中海的）descent[dɪ'sent]血统（考）. The disease also has been reported in Asian and African populations.

Signs of increasing intracranial pressure.

- ALOC （altered level of consciousness ） - Vomiting - Unequal pupils - Hypertension & decreasing heart rate - Expanding pulse pressure - Seizure - Abnormal respiratory patterns - Posturing 1. Nausea is an early sign of increased ICP（考）. Late signs of increased ICP include a significant decrease in level of consciousness（是significant), Cushing's triad (increased systolic blood pressure and widened pulse pressure, bradycardia, and irregular respirations), and fixed and dilated pupils. Other late signs include decreased motor response to command, decreased sensory response to painful stimuli, posturing, Cheyne-Stokes respirations, and papilledema. 2. The nurse is monitoring an infant for signs of increased intracranial pressure (ICP) and notes that the anterior fontanel bulges when the infant is sleeping. Based on this finding, which is the priority nursing action? --ANS: Notify the registered nurse(考）. A larger-than-normal fontanel may be a sign of increased ICP within the skull. Although the anterior fontanel may bulge slightly when the infant cries, bulging at rest may indicate increased ICP. 注：Increasing oral fluids and placing the infant in the side-lying position are inaccurate interventions（记）. pt S/be put neutral midline position ,raise HOB 15-30 degrees.

Impetigo 脓疱症

1. Impetigo is most common during the hot and humid summer months. It begins in an area of broken skin, such as an insect bite（记）. It may be caused by Staphylococcus aureus, group A β-hemolytic streptococci, or a combination of these bacteria. It is extremely contagious(记）. Lesions are most often located around the mouth and nose（考）, but they may be present on the extremities The infection most often begins in minor cuts, insect bites, or a rash such as eczema — any place there is broken skin. But it can also occur on healthy skin. 2. The child should not attend school for 24 to 48 hours after the initiation of systemic antibiotics or for 48 hours（考） after the use of the antibiotic ointment.

seizure

1. Parent teaching regarding seizures： The nurse is assisting in collecting data on a child with seizures. The nurse is interviewing the child's parents to establish their adjustment to caring for their child with a chronic illness. Which statement by the parents indicates a need for further teaching？ --ANS: "Our child sleeps in our bedroom at night."(考） （Parents are especially concerned about seizures that might go undetected at night. The nurse should suggest a baby monitor. Reassurance by the nurse should ensure parental confidence and decrease parental overprotection. ） NOT： "Our child is involved in a swim program with neighbors and friends." "Our babysitter just completed first-aid and child resuscitation training." （demonstrate the parents' ability to choose respite care and activities appropriately. The parents need to be reminded that as the child grows, they cannot always observe their child, but their knowledge of seizure activity and care is appropriate to minimize complications.） 2. Which finding would indicate that a child had a tonic-clonic seizure during the night? --ANS: Blood on the pillow(考） The complications associated with seizures include airway compromise, extremity and teeth injuries, and tongue lacerations. Night seizures can cause the child to bite down on the tongue（考）. Seizures do not cause a high-pitched cry unless a tumor or intracranial pressure is the cause of the seizure diagnosis. Cyanosis can occur during the tonic-clonic part of the seizure activity, but blanching（toenails）does not occur. Migraine headaches are not common in children with seizures（记）.

Roseola (Exanthem Subitum)[ek'sænθəm] 玫瑰疹 [rə(ʊ)'ziːələ 肉 zioh啦

1. The communicable period is unknown. 2. Roseola infantum is a benign viral endemic illness of infants and young children caused by human herpes virus 6 (strain A or B) and possibly by herpes virus 7. Diagnosis is based on the high fever and the rash. The rash may last a few hours to 2 days. Acetaminophen is often used to try to control fever. Transmission may occur via nasal, buccal, or conjunctival mucosa fluids（考）. NOT: "The disease is transmitted through touching the skin, so the child should be isolated from the other children as much as possible."(Wrong）

nephrotic syndrome

1. The nurse is assisting in preparing a plan of care for a 4-year-old child hospitalized with nephrotic syndrome. Which intervention is most appropriate for this child? --ANS: Encourage the child to eat in the playroom（考）. (Mealtimes should center on pleasurable socialization. The child should be encouraged to eat meals with other children on the unit.) 注：nephrotic syndrome pt 不需要吃太多protein食品，A diet that is normal in protein with a sodium restriction is normally prescribed for a child with nephrotic syndrome. Parents or other family members should be encouraged to be present at mealtimes with a hospitalized child.

phantom limb pain

A 13-year-old child is diagnosed with osteogenic sarcoma of the femur. Following a course of chemotherapy, it is decided that leg amputation is necessary. Following the amputation, the child becomes very frightened because of aching and cramping felt in the missing limb. Which statement made by the nurse will best assist in alleviating the child's fear? --ans: "This aching and cramping is normal and temporary and will subside."(考） （This sensation of aching or cramping in the missing limb is most distressing to the child. The child needs to be reassured that the condition is normal and only temporary.）

Cerebral palsy(CP)

A loss or deficiency of motor control with involuntary spasms caused by permanent brain damage present at birth Which is the primary goal that should be included in the plan of care for a child who has cerebral palsy? --ans: Maximize the child's assets and minimize the limitations(考）.

care of the child with rubeola(measles)

A nursing consideration in rubeola is eye care. The child usually has photophobia, so the nurse should suggest Keep the child in a room with dim lights(考）.

Scabies 疥疮

Scabies usually appears as burrows or fine, grayish-red lines(考）. It is not caused by a fungal infection（记）, and it is treated with the application of a topical scabicide. It is transmitted by close personal contact with an infected person（考）, and it is endemic among schoolchildren and institutionalized populations（考）. Household members and contacts of the infected child need to be treated at the same time that the child is being treated（考）.

Rubeola (measles) 麻疹

The communicable period for rubeola ranges from 4 days before to 5 days after the rash appears（考）, mainly during the prodromal (catarrhal)[kə'tɑrəl （前驱期）stage. The small blue-white spots found in this communicable disease are called Koplik spots（记）. The rash usually begins centrally and spreads downward to the limbs（记）. Respiratory symptoms such as a very runny nose, cough, and fever occur before the development of a rash（记）.

Chickenpox (Varicella)

The communicable period is 1 to 2 days before the onset of the rash to 6 days after the onset and crusting of lesions（考）.

Rubella (German Measles)

The communicable period is 10 days before the onset of symptoms to 15 days after the rash appears（记）.

transverse fracture

The entire bone fractured straight across

Care of an infant with hemophilia.

The nurse is reinforcing home care instructions to the mother of an infant who has just been found to have hemophilia. The nurse should instruct the mother to do which? --ANS: Pad crib rails and table corners(考）. （注意是infant)

diphtheria 白喉

acute infection of the throat and upper respiratory tract caused by the diphtheria bacterium The communicable period ranges from 2 weeks or less up to several months.

compound (open) fracture

bone breaks through the skin. There is a greater risk of infection than a simple fracture(考）

simple (closed) fracture

bone is broken but there is no open wound in the skin

Tinea Capitis (Scalp Ringworm) 頭藓

fungal infection of the scalp Griseofulvin (Gris-PEG) --Antifungal It can treat fungal infections such as ringworm, "jock itch," and athlete's foot. Gris-PEG is given with or after meals（考） to avoid gastrointestinal (GI) irritation and to increase absorption. Oral suspensions should be shaken well. Parents are instructed to continue therapy as prescribed and not to miss a dose. Exposure to the sun is avoided during treatment.