Pediatric Exam #13 (Chp. 41-42) Integumentary, Communicable Disease, and Cognitive/Mental Health Disorder

Withdrawal symptoms

(physical and psychological symptoms that occur when the drug is no longer being used

Why do pre-adolescent abuse anabolic steroids?

-Adolescent athletes take anabolic steroids to build up muscle mass in the belief that the drug will increase their athletic ability. -Other adolescents may take them to build muscles and to achieve a "manly" appearance that they believe will make them more attractive.

Describe autism and its clinical manifestations.

-Impaired verbal and nonverbal communication -Repetitive behaviors -Self-injurious behaviors possible -Disrupted routine may cause distress -Slow to develop speech, echolalia -Atypical sensory perception, overresponsive, underresponsive -Sleeping problems -May be cognitively impaired or demonstrate unusual abilities

Identify the characteristics of a child with ADHD.

-Impulsiveness -Easy distractibility -Excessive fidgeting or squirming -Difficulty sitting still -Difficulty playing quietly -Problems following through on instructions, despite being able to understand them -Inattentiveness when being spoken to

What are the contributing factors and treatments for candidiasis?

-Nystatin is medication for candidiasis

State how to provide comfort for the infant with infantile eczema and what teaching would be necessary for the family

-Oral antihistamines -topical corticosteroid ointments -Wet soaks or colloidal baths (lukewarm water no soap) -Lubrication is essential to retain moisture and prevent -Inhalant and contact allergens should be avoided -Window drapes and rugs should be removed or made of washable fabric that can be frequently laundered.

List the warning signs for suicide in children.

-Previous suicide attempt -Thoughts of wishing to kill self -Plans for self-destructive acts -Feeling "down in the dumps" -Withdrawal from social activities -Loss of pleasure in daily activities -Change in activity—increase or decrease

State the different diseases ticks can carry

-Rocky Mountain spotted fever -Lyme disease

Describe scabies, what it looks like, how it is transmitted, and treated

-Skin infestation by scabies mite Sarcoptes scabiei -Burrows between fingers and toes and in warm folds of body -Transmission close personal skin-to-skin contact **Clinical manifestations: burrows visible as dark lines; mite appears as black dot; severe itching, scratching can result in secondary infection -Treatment: permethrin cream, follow directions, repeat in 1 to 2 weeks

What are the special considerations for treatments in the first 24 hours in regards to airway and fluids?

-The adequacy of the airway must be determined in case an endotracheal tube needs to be inserted or (rarely) a tracheostomy performed. -The primary concern is to replace body fluids that have been lost or immobilized at the burn areas.

second degree burn

-The epidermis & underlying dermis are injured and devitalized or destroyed -Regeneration of the skin occurs from the remaining viable epithelial cells in the dermis -red and very painful blisters and weeping -blisters vary in color, from a patchy white to red color.

What are the recommended treatments for acne vulgaris, and special considerations regarding acne medications.

-Topical medication in variety of forms -Antibiotic therapy for inflammatory acne -Isotretinoin for severe inflammatory acne, warn about side effects; pregnancy category X drug *Acknowledge and accept adolescent's perception and feelings *Be supportive and understanding

first degree burn

-epidermis is injured, but there is no destruction of tissue or nerve endings -Thus, there is erythema, edema, and pain but prompt regeneration

third degree burn

-epidermis, dermis, and nerve endings are all destroyed and the injury can go into the subcutaneous tissue -Pain is minimal -skin varies from a waxy white to a gray to a black charred color -no longer any barrier to infection or any remaining viable epithelial cells

Describe the signs and symptoms of candidiasis

-mouth has white coating that looks like milk curds

Describe the clinical manifestations of skin allergies and the treatments

-rash appears in the area of the exposure to the skin -often bright red and swollen with blisterlike vesicles (vesicles may weep or rupture and form a crust) -intense itching *Topical corticosteroids *Antihistamine drugs (topical or systemic) *Cool wet dressings are soothing, reduce redness, and also help relieve itching.

List the signs and symptoms of anorexia nervosa, and why contract agreements are recommended for these patients?

-skeletonlike appearance -appear sexually immature -dry skin/ brittle nails,lanugo -amenorrhea -constipation -intolerance to cold, bradycardia, arrhythmias, low blood pressure, and anemia -Malnutrition, dehydration, and electrolyte imbalances These agreements, which are usually part of a behavioral modification plan, specify the child's and the staff's responsibilities for the diet, activity expectations for the child, and other aspects of the child's behavior. The contract may also spell out specific privileges that can be gained by meeting the contract goals. This places the child in greater control of the outcome.

Describe the treatment of impetigo and the precautions the nurse and caregivers must follow.

-topical antibiotic therapy (mupirocin) -Oral antibiotics (7- to 10-day course) -Daily washing of the crusts helps speed the healing process -follow contact (skin and wound) transmission precautions, including wearing a cover gown and gloves.

Kahoots

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PowerPoint questions

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The dermatologist treating a 16-year-old girl with a history of severe acne has ordered a pregnancy test so she can be started on a course of isotretinoin. The teen's caregiver has said that her daughter is a virgin and she refuses to allow her to have the required pregnancy testing. What would be the best action for the nurse to take?

Acknowledge the caregiver's discomfort about the pregnancy testing but encourage her to allow her daughter to have the testing so that she can use the medication.

Compare the difference between active and passive immunity

Active immunity: stimulates development of antibodies to destroy infective agent without causing disease; occurs when vaccine is given Passive immunity: antibodies obtained from an immune person, given to someone exposed to disease to prevent them from getting disease

Adolescent athletes often take which of the following because they believe it will increase their athletic abilities

Anabolic steroids

Which action by the nurse should be the most appropriate action for the nurse to do FIRST for a burn?

Apply cold compress to the area

Discuss infantile eczema and include signs and symptoms

Atopic dermatitis (eczema) is considered, at least in part, an allergic reaction to an irritant. -usually starts on the cheeks and spreads to the surfaces of the arms and legs -severely dry skin, intense itching -initial reddening quickly followed by papule and vesicle formation

Describe the priority nursing intervention for nonorganic failure to thrive

Avoid judgmental, stereotyped feelings when dealing with the family caregivers of such a child.

The LVN recognizes in working with children that a child who has polyphagia will likely exhibit which of the following?

Compulsive overeating

The nurse is caring for a child with an eating disorder. Which is the priority treatment for the disorder?

Correct fluid and electrolyte imbalances

Which disorder is a concern in adulthood as well as in childhood for a person who is overweight/obese during childhood

Diabetes Melkite's

Explain enuresis and encopresis.

Enuresis: continued incontinence of urine beyond the age when control of urination is commonly acquired Encopresis: chronic involuntary fecal soiling beyond the age when control is expected (about 3 years of age)

What is the cause of mononucleosis?

Epstein-Barr virus (EBV)

List the treatments for gonorrhea and chlamydia, including the treatment of a pregnant female

Gonorrhea- ceftriaxone, azithromycin, and doxycycline to prevent an accompanying chlamydial infection Chlamydia- Doxycycline or azithromycin In the pregnant adolescent, erythromycin or amoxicillin can be used to avoid the teratogenic effects of these drugs.

The nurse is collecting data on a 4-month-old child brought to the clinic by the caregiver. The nurse observes the child's mouth and notes a white coating that looks like milk curds. Which if the following would be most important for the nurse to ask the caregiver?

Has your child been treated for any type of infection lately?

10 year old has pattern of school success, she doesn't want to go to school abdominal pain before and she's fine on the weekends what would you ask her

Have you explored with this child if something is causing her to be afraid to go to school?

What is the major complication that can occur in the first 48 hours of a major burn? Describe the signs and symptoms of that complication.

Hypovolemic shock is the major manifestation in the first 48 hours in massive burns. -Edema becomes noticeable -low blood pressure -rapid pulse -pallor -considerable apprehension

What is impetigo caused by

In newborn: S. aureus in older child: group A beta-hemolytic streptococci

Candice age 16 overdue for checkup, she has been lethargic angry and sad now she has her drivers license she is happy the seemingly well being and drastic change in bahavior should be further investigated

Is planning to commit suicide

Which intervention is to best assure an uncomplicated recovery for a teen with mono?

Precautions to avoid a secondary infection

What is school phobia? Describe the priority nursing intervention for this child?

School-phobic children may have a separation anxiety because of a strong attachment to one parent, usually the mother, and they fear separation from that family caregiver, perhaps because of anxiety about losing them while away from home or at school. -reduce the anxiety and help the child find a sense of security

Describe echolalia in the autistic child.

Slow to develop speech

What is impetigo?

Superficial bacterial skin infection

Child's third time she has been treated for PID, which action by the nurse would be the most appropriate

Take the child to a private room and interview sexual history and partners

The nurse admits a child who has sustained a severe burn. The child's immunizations are up to date. Which immunization would the child most likely be given at this time?

Tetanus toxoid vaccine

Explain how to remove a tick found on the human body

The caregiver should use tweezers to carefully remove the tick without crushing it

The caregiver of a 4-year- old girl who lives in a heavily wooded area calls the clinic nurse to report that the child has a swollen tick on her arm. What would be the best action for the caregiver to follow in removing the tick?

The caregiver should use tweezers to carefully remove the tick without crushing it

The nurse is collecting data on an 18-month-old child with a dignossis of autism spectrum disorder (ASD). What clinical manifestation would likely have been noted in the child with this diagnosis?

The child does not make eye contact

Which statement made the the instructor is the most accurate regarding the integumentary system?

The largest organ of the body help regulate body temperature

The nurse is caring for an infant who has impetigo and is hospitalized. Which nursing intervention is the highest priority for the child?

The nurse follows contact precautions.

What body system should be monitored closely because of the decreased blood volume with a major burn? How would you know if it is functioning adequately?

Urinary output -An output of 1 to 2 mL/kg/hr for children weighing 30 kg (66 lb) or less OR 30 to 50 mL/hr for those weighing more than 30 kg, is desirable. -indwelling catheter facilitates the accurate measurement of urine and specific gravity After the first hour, the volume of urine should be relatively constant.

The nurse is working with a children diagnosed with autism, what is an example of echolalia

When she watches TV and hears a commercial she repeats one word from the commercial but doesn't seem to understand what she is saying

Dependence

a compulsive need to use a substance for its satisfying or pleasurable effects

polyphagia

compulsive overeating

Obesity

excessive accumulation of fat that increases body weight by 20% or more over ideal weight

Describe acne vulgaris including signs and symptoms

may only be a mild case of oily skin and a few blackheads or it may be a severe type with ropelike cystic lesions that leave deep scars, both physical and emotional. -comedones (blackheads and whiteheads), -papules and pustules on the face, the back, and to some extent the chest

Substance abuse

misuse of an addictive substance that changes the user's mental state

What treatment goal has the highest priority for this child with AIDS?

preventing spread of infection

What is the highest priority for the child with AIDS?

risk of infection for the child and the risk of transmitting the virus to others

Contact agreements are often recommended for clients with eating disorders. In forming a contract with a hospitalized adolescent diagnosed with anorexia nervosa, the nurse should make a point to:

stress to the client that she is in control of the outcome of her care

Tolerance

the ability of body tissues to endure and adapt to continued or increased use of a substance

Describe the signs and symptoms of infectious mononucleosis, and the treatment for the disease

variety of symptoms, mild to severe; -fever -sore throat with enlarged tonsils -thick, white membrane covering tonsils; -palatine petechiae; swollen lymph nodes; enlargement of spleen; extreme fatigue, lack of energy; headache, abdominal pain, epistaxis