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When does the posterior fontanel close? When does a baby give its 1st social smile? When does a baby turn its head toward sounds? When does the Moro reflex disappear? When does a child achieve steady head control? When does a baby turn completely over? When does a baby transfer objects hand to hand? When does a baby play peek a boo for 1st time? When does stranger anxiety develop? When does a child sit unsupported? When does a child crawl? When does a child¶s fine pincer grasp appear? When does a child wave bye bye? When does a child walk with assistance? When does a child say a few words in addition to mama or dada? When does birth weight quadruple? When do you achieve 50% of adult height? What is the appearance of a toddler? What are the teeth of a toddler (1-3 year old) like? When does the anterior fontanel close? When does a child throw a ball overhand for 1st time? When can a child kick a ball? When does a child feed self with cup and spoon?
6 months 12 months By 8 weeks 2 months 3 months 4 months 4 months 5-6 months 7 months After 6 months 7-9 months 8 months 10 months 10-12 months 10 months 10-12 months 12 months 30 months 2 years Bowlegged and potbellied All 20 primary teeth are present 12-18 months 18 months 2 yrs 2 yrs
When can daytime toilet training begin? When can kids form 2-3 word sentences? When can kids form 3-4 word sentences?
2 yrs 2 yrs 3 yrs
When can child state full name?
When are temper tantrums common? What is Erickson¶s Theory of the toddler (1-3)?
Toddler (1-3) Developing a sense of autonomy
What type of toys should you give to babies under 1 year old? What happens to a baby under 1 whose parents are not able to stay with him? What is Erickson¶s Theory of infants under 1?
Mobiles, rattles, squeaking toys, picture books, balls, colored blocks, activity boxes May be inconsolable due to separation anxiety Developing a sense of trust Board and mallet, push/pull toys, toy phone, stuffed animals,
What are the toys appropriate for the toddler (1-3)?
storybooks with pictures, use of the hospital playroom bc of mobility (which is important to their development).
How much weight does a preschool child (3-5) gain each year/ inches grown each year? When do kids learn to run, skip, jump? How old are you when you start riding tricycle? At what age is standing erect began? When do you establish handedness? At what age do you use scissors? What age ties shoelaces? At what stage do you learn colors and shapes? What is the visual acuity of a preschooler? What is the thinking of a preschooler like? When does a child learn sexual identity/curiosity/masturbation? When are imaginary friends and fears common? Aggressiveness at ___years old is replaced by independence at ___years old. What should you make sure a preschooler knows about their illness? When is fear of mutilation from procedures common? How can you help restore body integrity?
5 lbs and 2-3 inches/year Preschool 3 years old Preschool Preschool 4 years old 5 years old Preschool 20/20 Egocentric and concrete Preschool Preschool 4, 5
They did not cause it, painful procedures are not punishment
Preschool, put on a Bandaid
What are appropriate toys for a preschooler? What is Erickson¶s Theory of Preschoolers?
Coloring books, puzzles, cutting/pasting, dolls, clay, toys that let you work out hospital experiences Developing a sense of initiative
School age (6-12 year olds) have what weight/height gain per year? What is Erickson¶s Theory of school-agers? When are primary teeth lost and permanent teeth established? At what age are you able to write script? Egocentric thinking in the school age child is replaced by _________. When are cause and effect relationships learned? When does socialization with peers become important? When do molars erupt? Whose growth spurt develops 1st? As early as what age? Adult-like thinking begins at what age? When does growth end? What is Erickson¶s theory for adolescents (12 to 19)? After 6 months what is the baby¶s concept of bodily injury? What is the toddler¶s concept of bodily injury? What is the preschooler¶s concept of bodily injury? What is the school age childs concept of bodily injury? What is the adolescent¶s concept of bodily injury? When can you start using the numeric pain scale? How can a non verbal child be assessed for pain? What are the best nondrug measures to reduce pain in infants? What are the best nondrug measures to reduce pain in toddlers and preschoolers? What are the best nondrug measures to reduce
4-6 lbs and 2 inches per year Developing a sense of industry school age 8 years Social awareness of others School age School age School age (6 year molars) Girls-10 years old. Boys at 14. 15 Girl-15, boys-17 Developing sense of identity
They can remember the pain Fear of intrusive procedures Fear of body mutilation
Fear of loss of control over their body
Change in body image
9 and up Using the FLACC pain assessment tool, that looks at the face, leg movement, activity, cry, and consolability Pacifiers, holding, rocking
Distraction Guided imagery
pain in school age and adolescents? At what age can you teach a child how to use PCA? 5 years old
When is MMR vaccine given? During a measles epidemic when can you give the MMR? What are contraindications for MMR? How do you administer the MMR vaccine? After the MMR vaccine what is a normal finding? When do you give the DTaP vaccine? How do you give DTaP vaccine? When do you have to stop giving DTaP vaccine? After the injection of DTaP what should the nurse tell the parents to do? When do you give the IPV vaccine? How do you administer IPV? What is the contraindication for IPV vaccine? How and when do you administer Hib vaccine? When and how do you administer the HepB vaccine? When and how do you give the varicella vaccine? What are normal side effects from DPT and IPV vaccinations? What can decrease soreness after thigh injections? How do you treat fever in a child with a communicable disease? What can you use for itching in
12-15 months and then 1 other time between 4 and 12 years old 6 months and then again at 15 months Allergy to neomycin or eggs SQ at 2 difft sites
Light rash 2 weeks later At 2 months, 4 months, and 6 months. THEN get boosters at 15-18 months and again at 4-6 years. IM apart from other vaccines At age 7, bc then you switch to Td vaccine
Give acetaminophen (Tylenol) At 2 months and 4 months, THEN boosters at 6-18months and again at 4-6 years old SQ or IM at separate site from other vaccines Allergy to neomycin or streptomycin
IM at 2, 4, and 6 months
IM at 0-2 months, 1-4 months, 6-18 months
12-18 months ±should be given with the MMR vaccine OR over 30 days apart
Irritability, fever under 102, redness and soreness at injection site for 2-3 days
Warm washcloth on injection sites, bicycling the legs with each diaper change
NON-ASPIRIN PRODUCT Diphenhydramine (benadryl)
communicable diseases? What is Rubeola (Measles)? How is it transmitted? When is it contagious? What are classic symptoms? When is chicken pox no longer contagious? What is German Measles? Highly contagious, viral disease that can cause neurologic problems or death, transmitted by droplets; contagious mainly during prodromal period when they have fever and upper respiratory symptoms; symptoms include photophobia, Koplik¶s spots in the mouth, rash starting on face and spreading downward. Once scabs have formed on all lesions A viral disease that can kill babies in 1st trimester; spread by droplets and contact, a red maculopapular rash spreads from face to rest of body and fades in 3 days Whooping cough; caused by bacteria prolonged coughing for 4-6 weeks; treated with erythromycin; complications are pneumonia, hemorrhage, and seizures Height and head circumference
What is pertussis? How do you measure past nutrition in a child? How do you measure current nutrition in a child?
Weight, skinfold thickness, arm circumference
How do you measure the body fat content of a child? What does vitamin B2 (riboflavin) deficiency look like?
Redness and itchiness of eyes, magenta tongue, delayed wound healing
How do you treat it? What does vitamin A deficiency (retinol) look like?
Give these kids green leafy veggies, liver, cow milk, cheddar cheese
Rough dry skin, cornea problems, retarded growth
How do you treat these kids? What are signs of dehydration in an infant/child? What are lab signs of metabolic acidosis (caused by dehydration)? When should you add potassium to IV fluids? What is the expected urine output for both infants and children per hour? How many children die from child abuse each year? How should burns in children be
Give them orange foods (sweet potatoes, peaches, apricots) Poor turgor, depressed fontanels, no tears, dry mucous membranes, weight loss, decreasued urine output pH under 7.3, low sodium and potassium, high Hct and BUN
ONLY when the child has adequeate urine output
3 to 5 thousand Using the Lund-Browder Chart, which takes into account the changing proportions fo the
assessed? How can the nurse BEST evaluate adequacy of fluid replacement in children? What interventions should be done FIRST when caring for a child who has ingested poison?
Monitor urine output
Assess repiratory, cardiac, and neuro status
Cardinal signs: restless, inc respirations, inc pulse, sweating What are the cardinal signs of respiratory distress in children, and other signs of resp. distress in kids? Other signs: flaring nostrils, retractions, grunting, bad breath sounds, accessory muscle use, head bobbing, low PO2, high PCO2, cyanosis, pallor Which usually occurs 1st: cardiac failure or respiratoy failure in children? What is epiglottitis caused by? HIB What is the classic position these kids are in? Upright sitting position with chin out and tongue protruding ("tripod position") Respiratory failure
What do you NEVER do in these patients? What causes bronchiolitis?
NEVER examine the throat of this child!!
What lung sounds do you hear?
Wheezing and rales
What are their respirations like? What is given to kids under 2 yrs old born either premature or with lung/heart disease to give passive immunity to RSV? What is a risk of untreated otitis media?
Respirations are shallow and fast
Conductive hearing loss
Pulling at ears, fever, pain, enlarged lymph nodes, discharge from ear IF drum is ruptured, What do you see on assessment? V/D
What can you do to ear for comfort?
Apply warm compress on ear
How can you reduce body temperature in children to avoid seizure risk? Tonsillitis can be either bacterial or viral. If related to strep why is treatment so important? Prior to tonsillectomy what lab values must be drawn? What are signs of postoperative tonsillectomy bleeding? Clearing throat, vomiting fresh blood, frequent swallowing PT and PTT, assess for history of bleeding of family hx of bleeding disorders bc the child can develop acute glomerulonephritis or rheumatic heart disease Tepid bath or Tylenol
when is highest risk for hemorrhage?
1st 24 hours and 5-10 days post surgery
These kids should NEVER be given what? What is the drug of choice for an acute asthma attack? What are the normal PO2 and PCO2 values for kids in an arterial blood gas draw? What nutritional support should be given to a child with CF? What type of genetic disease is CF?
Epinephrine bc it is a rapid acting bronchodilator
PO2: 83-100 PCO2: 35-45 pancreatic enzyme replacement, fat soluble vitamins, low carb, high protein, moderate fat diet autosomal recessive
How do you care for a child in a mist tent? An increased respiratory rate in kids puts them at risk for _____________.
Monitor temperature. Keep clothing dry. Keep tent edges tucked in, assess respiratory status. dehydration and acid/base imbalance Hole between the aorta and pulmonary artery, which normally closes within 72 hours
What is a patent ductus arteriosus?
postbirth. If it stays open blood from the aorta returns to the pulmonary artery, resulting in increased blood flow to the lungs and pulmonary hypertension. They can be 1 of three things:
Describe acyanotic defects.
1. L to R shunts 2. Increased pulmonary blood flow
3. Obstructive defects
VSD, ASD, PDA, AS, and coarctation of the aorta They can be either: 1. R to L shunts Describe cyanotic heart defects. 2. Decreased pulmonary blood flow 3. Mixed blood flow Examples The 3 T's: Tetralogy of Fallot, TA, TGV Acyanotic What is a ventricular septal defect? Blood from the L ventricle is shunted to the R ventricle through a hole and recirculated to the lungs, resulting in increased pulmonary blood flow What is an atrial septal defect? Oxygenated blood from the L atrium is shunted into the R atrium and lungs through a hole , resulting in increased pulmonary blood flow. It is a narrowing of the aorta which causes HTN in the upper extremities and decreased/absent pulses in the lower extremities. A narrowing at or around the aortic valve; Oxygenation to the systemic circulation is poor bc cardiac output is low. polycythemia When the pulmonary artery and aorta do not separate. The blood from the 2 ventricles mix and causes cyanosis Incompatible with life, a medical emergency where babies recieve prostaglandin E to keep ductus open. acyanotic
What is a coarctation of the aorta?
What is aortic stenosis? What is a common finding in children with cyanotic heart defects (3 T's)? What is truncus arteriosus?
What is transposition of the great vessels? Is CHF associated more with cyanotic or acyantoic defects? MANAGING DIGOXIN: 1. Before giving digoxin what must the nurse do?
1. Take child's apical pulse. If bradycardic do not administer.
2. 0.8-2.0ng/mL 2. What are therapeutic levels? 3. Throwing or spitting up What is an early sign of digoxin toxicity? 4. Hypokalemia What electrolyte imbalance increases digoxin toxicity?
Rheumatic fever is an _______disease. It is the most common cause of ________ in children. It is associated with an infection of ________. Rheumatic fever is a collagen disease that injures _________. What assessment findings are associated with rheumatic fever? Chest pain, SOB, tachycardia ALL the time, joint pain, chorea (involuntary movements), rash, subQ nodules over bony prominences, fever Inflammatory Acquired heart disease B-hemolytic strep bacteria Heart, blood vessels, joints, subQ tissue
Lab values? What medications are used to treat rheumatic fever? In ____________ (a type of congenital heart defect) the child often experiences "tet spells" (_________), which are relieved by which position? What is the nurse's goal in caring for kids with Down Syndrome? What is cerebral palsy?
Increased Erythrocyte sedimentation rate, increased ASO titer (anistreptolysin O). Penicillin, eryhtromycin, and aspirin Tetralogy of Fallot hypoxic episodes squatting or knee chest position help the child reach its OPTIMAL level of functioning An injury to the motor centers of the brain causes neuromuscular problems of spaasticity or dyskinesia (involuntary movements)
Its major risk factor?
Low birth weight Cerebral Palsy; it occurs when legs are extended and crossed over each other with feet plantar flexed.
What is "scissoring" a characteristic of? If a mother of a Cerebral Palsy child says she is having "difficulty with diapering," what is the mom describing? What should the nurse do while feeding a cerebral palsy child? What is the most common allergy of kids with spina bifida? What are 2 nursing priorities for the infant with myelomeningocele?
Prevent aspiiration by sitting the child upright and supporting the lower jaw
Latex 1. Prevent infection of the sac 2. Monitor for hydrocephalus (measure head circumference, assess fontanel, and neuro functioning).
What is hydrocephalus and assessment findings?
Accumulation of CSF within the brain and is often associated with spina bifida or meningitis
Symptoms: Increased ICP (low pulse, high BP), change in LOC, vomiting, seizures, bulging fontanels, widening suture lines, sunset eyes What is the surgery like for kids with hydrocephalus? Seizures are more common in what age group? A shunt is inserted into the brain ventricle and tubing is then tunneled through skin to the peritoneum where excess CSF is drained out Under 2 yrs old You get an aura. Then you lose consciousness and the body becomes stiff (tonic). Then Describe tonic clonic seizures (grand mal). you stop breathing and become cyonotic before you go into spasms (clonic) and relax. Pupils will be dilated and nonreactive to light, incontinent, and then you lay there sleepy and disoriented Usually occur between 4 anbd 12 years old. You lose consciousness for 5-10 seconds Describe absence seizures (petit mal). and appear to be daydreaming because posture is kept and you get minor face and hand movements. These kids may be doing poorly in school. What is the most common cause of increased seizure activity? What do you see in older children with bacterial meningitis (normally caused by HIB)? What do you see in infants with bacterial meningitis? With meningitis it is important to monitor hydration status and IV therapy. Why? What antibiotics are usually prescribed for bacterial meningitis? Medication noncompliance ICP, fever, chills, neck stiffness, opisthotonos, photophobia, positive Kernig's Sign (inable to extend leg when knee is bent toward chest), positive Brudzinski's sign (neck flexion causes flexion movements of lower extremities) BULGING FONTANELS, poor feeding, vomiting, irritable, seizures Bc with meningtitis there may be inappropriate secretions of ADH, causing fluid retention (cerebral edema) and dilutional hyponatremia Ampicillin, penicillin, chloramphenicol
How do kids usually get Reye's syndrome? What is the most common presenting symptom of brain tumors? How is a child usually positioned after brain tumor surgery? What is the mechanism for inheritance of Duchenne muscular dystrophy? What is "Gower's sign?" What is the first sign of renal failure? What are the symptoms of acute
ASA + chicken pox/influenza
Headache upon awakening
flat on his or her side
it is an x-linked recessive trait affecting mostly males An indicator of muscular dystrophy; difficulty moving to standing position-child has to walk up legs using hands to stand up. Decreased urine output blood in urine, recent strep infection, HTN, mild edema around eyes, positive ASO
Dietary interventions? what are the symptoms of nephrosis?
low sodium diet severa edema, massive proteinuria, frothy urine, anorexia, negative ASO titer
dietary interventions? Decribe safe monitoring of prednisone administration and withdrawal? How can you prevent Urinary Tract Infections in kids? what is the vesicoureteral reflex? What do you see in a kid with Wilms Tumor? What is THE MOST IMPORTANT thing for a nurse to do w/ a child who has Wilms Tumor? What is hypospadias?
high protein AND low salt Give prednisone every other day, signs of ededma/mood changes/GI distress should be reported; the drug should always be tapered. avoid bubble baths, pee a lot, drink lots of fluids (especially acidic ones), wipe from frant to back When urine backflows from the bladder up into the ureters. Recurrent UTIs are common. Mass at midline on abdomen, fever, pallor, lethargy, high BP (bc of excess renin secretion)
Prevent injury to the capsulated tumor by making sure noone palpates the abdomen.
When the urethra opens on the ventral side of the penis behind the glans
Why is surgical correction usually done before preschool? When is closure of cleft lip normally performed?
To schieve sexual identity, toilet training, and remove the fear of castration anxiety
When the baby weighs 10 pounds and has Hgb of 10g/dL.
After surgery how is child positioned?
on side or upright in car seat (NOT PRONE)
When is closure of cleft palate usually performed?
1 year of age to minimize speech impairment
After surgery how is the child positioned? How can you protect the surgical site on a child with cleft lip/palate? What is an esophageal atresia with tracheoesophageal fistula? In tracheoesophageal fistula what do you see on assessment?
on side or abdomen
Apply elbow restraints, minimize crying, maintain Logan Bow to lip if applied When the upper esophagus ends in a blind pouch with the lower esophagus connected to the trachea. It is a MEDICAL EMERGENCY!! The 3 c's (coughing, choking, cyanosis), exxcess salivation, resp. distress, aspiration pneumonia
What nursing actions are initiated for a child suspected of having esophageal atresia with tracheoesophageal fistula? What are the feeding techniques for a child with cleft lip/palate? What assessment findings do you see in kids with pyloric stenosis? What lab values are seen in kids with pyloric stenosis? What is postoperative nursing care for a child with pyloric stenosis? What assessment findings do you see in a child with intussusception (when 1 part of intestine telescopes into another part of intestine)? Why is a barium enema used to treat intussusception? Feed upright with lamb's nipple or prosthesis. Use frequent bubbling. Projectile vomiting, constant hunger, weight loss, dehydration, palpable olive shaped mass in RUQ, visible walves of peristalsis Low sodium, low potassium, metabolic alkalosis (low chloride, increased ph, increased CO2) IV hydration, small frequent feedings of oral glucose or electrolyte solutions, gradually increasing to full strength formula. Position ON RIGHT SIDE in semi fowlers after feedings Intermittent abdominal pain, screaming when legs are pulled toward abdomen, "currant jelly stools" (blood +mucus), sausage shaped mass in RUQ with empty RLQ (Dance sign) NPO immediately and suction secretions
It reduces intestinal telescoping via hydrostatic pressure instead of surgery
What is Hirschsprung's Disease? What do you see when assessing a Hirschsprung's Disease child?
Lack of persitalsis in area of colon where ganglion cells are missing. Fecal matter accumulates above this area. Failure to pass meconium in 1st 24 hours, distended abdomen, ribbon like stools
How do you take their temperature? What are signs of anorectal malformation? What are the Hgb norms for:
Take axillary temperature. Failure to pass meconium in 24 hours, meconium appearing from a fistula or in the urine, an unusual anal dimple
Newborn 14-24 1. Newborn 2. Infant 3. Child What are assessment findings in kids who have iron deficiency anemia? What is the genetic transmission pattern of hemophelia? What are assessment findings in a child Pale, fatigue, milk intake over 32oz/day, pica, low Hgb, Low serum iron values x-linked recessive transmitted by the mother and expressed by male offspring. These children are missing factors 8 or 9. Prolonged bleeding(after circumcision or in general); loss of motion in joints, prolonged Infant 10-15 Child 11-16
Never give these kids______.
Aspirin Both parent must be heterozygous carriers of the trait. Each child has a 1 in 4 chance of
Describe autosomal recessive transmission and give examples.
having the disease.
ex.) sickle cell, CF, PKU The trait is carried on the X chromosome, so it usually affects male offspring. With each pregnancy of a woman who is a carrier there is a 25% chance of having a child Describe X-linked recessive transmission. Give an example. with the disease. If male there is a 50% chance of getting disease. If female there is a 50% chance of being a carrier.
ex.) hemophelia What is the sequence of events in a vasooclusive crisis of sickle cell anemia? Why is hydration a priority in treating sickle cell disease? What should families and clients do to prevent sickle cell episodes? Do you give supplemental iron to kids with sickle cell anemia? Nursing interventions and medical treatment for a child with leukemia are based on which 3 physiological problems? Anemia (decreased RBCs), Infection (neutropenia), and bleeding thrombocytopenia (decreased platelets) RBCs clump together and block small blood vessels. Cells cannot get through the capillaries, causing pain and ischemia. Lowered O2 affects the HgbS and causes sickling. Hydration promotes hemodilution and circulation of RBCs through the blood vessels Keep hydrated, avoid high altitudes, avoid strenuous exercises, avoid unknown sources of infection No, bc it is not caused by iron deficiency. You DO give them folic acid, however, to stimulate RBC synthesis.
What should you have nearby when administering l-asparaginase to a leukemic patient? An infant with ________is often described as a "good, quiet baby" by the parents. What do you see in children with hypothyroidism? What are the outcomes of untreated congenital hypothyroidism? sleepy, poor feeders, flat expression, constipations, hypoactive Hypothyroidism Epinephrine and oxygen in case of anaphylaxis
Mental retardation, growth failure
What is phenylketonuria?
An autosomal recessive disorder where the body cannot metabolize the aa phenylalanine
What is the result of PKU? On assessment of a child with PKU what do you see? What are foods high in phenylalanine (which should be avoided if you have PKU)? What 2 formulas are prescribed for kids with PKU? What are the 3 classic signs of diabetes? Diabetes is diagnosed if the fasting blood sugar is greater than_____mg/dl. What do you do if a diabetic child is in ketoacidosis? What are the signs and symptoms of hypOglycemia? What are the signs and symptoms of hypERglycemia? What is the relationship between hypOglycemia and exercise? What is a complete fracture? What is an incomplete fracture? Wha is a comminuted fracture? What type of fractures have serious consequences in terms of growth of the affected limb? What re the 5 "P's" that may indicate ischemia in the fractured limb? What is a skin traction? What is Buck's Skin Traction? What is Dunlop Skin/Skeletal Traction? What is Russell Skin Traction?
The buildup of phe leads to CNS damage (mental retardation) and decreased melanin Newborn screening using Guthrie test is positive when serum phenylalanine is 4mg/dL or higher. Vomiting, failure to gain weight, hyperactive, musty urine odor high protein foods including meat, dairy, eggs, aspartame. This low protein diet should be done until brain growth is complete (6-8 years old).
Lofenelac and PKU-1
Polydipsia, polyuria (including bedwetting-"enuresis"), polyphagia
120+ Provide care for unconscious child, administer REGULAR insulin IV in Normal Saline, monitor blood gases, maintain strict I&O tremors, sweating, headache, hunger, nausea, lethargy, confusion, slurred speech, anxiety, tingling around mouth, nightmares polydipsia, polyuria, polyphagia, blurry vision, weight loss, weakness, syncope
During exercise insulin uptake is increased and the risk for hypOglycemia occurs. When bone fragments completely separate When bone fragments remain attached When bone fragments of the bone shaft break free and lie in surrounding tissue. Rare in children.
Fractures involving the epiphyseal (growth) plate
pain, pallor, pulselessness, paresthesia (pins and needles), paralysis Force is applied to the skin. This should NEVER be removed unless specifically prescribed by the MD For the lower extremities; keeps legs extended with no hip flexion. When there are 2 lines of pull on the arm 2 lines of pull on lower extremity (1 perpendicular, 1 longitudinal)
What is Bryant's Skin Traction? What is a skeletal Traction?
Both lower extremities are flexed 90 degrees at hips (rarely used bc extreme elevation of legs causes decreased peripheral circulation) When a pin or wire applies pull directly to the distal bone fragment
What is a 90 degree skeletal traction? What is a hip spica?
90 degree flexion of the hip and knee. The lower leg is in a boot cast. This can also be used on upper extremities.
A special type of cast used to immobilize the hip joints and/or the thigh
How do you help with toileting a child with a hip spica? What is compartment syndrome?
Use Bradford frame under the child. NEVER USE abduction bar to turn a child.
Damage to nerves and vasculature of an extremity due to compression. You see coldness, severe pain, inability to move extremity, poor capillary refill Assessment findings? What are the signs and symptoms of congenital hip dysplasia in infants? What are signs of hip dysplasia in older children? How does the nurse conduct scoliosis screening? Unequal skin fold of buttocks, positive Ortalani Sign (clicking with abduction), limited abduction of affected hip, unequal leg lengths Limp on affected side, positive Trendelenburg Sign (when standing on one leg the pelvis drops on the side opposite to the stance leg. ) Ask child to bend forward from hips with arms hanging free. Examine child for curvature of the spine, rib hump, and hip asymmetry Wear it 23 hours each day. Wear t-shirt under brace. Check skin for irritation. Perform What instructions should the child with scoliosis receive about the Milwaukee brace? A brace does not correct the curve of a child with scoliosis. It only stops or slows the progression. What is the potential outcome for untreated scoliosis? What is postoperative nursing care of a child with scoliosis? respiratory difficulty back and abdominal exercises. Modify clothing. Maintain normal activities as able.
Frequent neuro assessments, log roll for 5 days, keep npo, monitor NG tube/bowel sounds Used postoperatively for scoliosis patients.
Describe log rolling.
Requires 2+ people.
Client is moved on a draw sheet to the side of the bed away from which they are to be turned (rolled toward the L if they are to face the R).
Client is the turned in a simultaneous motion, maintaining the spine in a straight position. Pillows arranged for support and comfort What nursing care is indicated for a child with juvenile rheumatoid arthritis? Prescribed exercise to maintain mobility, splinting of affected joints, teach medication management and side effects
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