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BABY REFLEX 3 mo holds head erect when sitting on exam table, turns head to locate sound, smiles when

n sees mother 5 mo double wgt 6 mo tries to grasp things out of reach 9 mo play peek-a-boo, say mama/dada 8 mo- sit upright unsupported 12 mo 3 to 5 words in addition to mama/dada 18-20 thumb sucking, normal behavior head size 32-36 cm chest 32 cm Babinski disappear after 1 Extrusion d after mo DRUGS Lidocaine- PVCs occurring 6-10/min, may result in Vtach Verapamil (Calan) antihypertensive, CCB Isoproterenol (Isuprel) antidysrhythmic, heart block, ventricular dysrhythmias Atropine antiryhthmic, tx bradycardia Procainamide HCL (pronestyl) treat PVCs/atrial tach, AR: severe hypotension Carafate take with lanoxin after breakfast. gemfibrozil ranitidine(Zantac) take at hours of sleep Biperiden (Akineton) tx for extrapyramidal effects, antiparkinsonian agent Glipizide tx type 2 dm Compazine antipsychotic, antianxiety Thorazine antipsychotics, antiemetics. SE: difficulty urinating (anticholinergic rxn) Bromocriptine (Parlodel) tx antiparkinson, antidm, dopamine antagonist. take meds w meals Indomethacin (indocine) antirheumatics, nsaid, take w food Cimetidine h2 antagonist. May cause d, take w meals and before bed, acne rash. Risperidone (Risperdal) wgt gain, avoid xtreme temp, portect sun exposure, change position slowly Amphotericin B INH AR: peripheral neuropathy Cholestyramine (questran) Reglan- tx nausea, x use for duodenal ulcer Tagamet give w meals Amphogel give 1h at least after meal Gentamycin AR:ototoxicity Cytoxan cause alopecia in 4-5 wks Lithim AR: tremors, muscular weakness, ataxia, dv, drowsiness Sulindac (clinoril) nsaid. call doc if ecchymosis occurs Glucosteroids hypok and hyperna Do not use ace with Lasix Benzotropines antipark

Take ldopa with low protein diet to gi upset Phenergan/promethazine antiemetic Do not take ssri (Celexa/citalopram) with Tylenol cause serotonin syndrome Lasix and Indocin - ototoxic Fosamax tx osteoporosis, wear sunscreen, cause photosensitivity Questran/cholestyramine bile acid sequestrant; se: constipation, tx chol PEDS School age explain =draw what will happen, read a book Preschool explain in simple terms, demonstrate with dolls Phototherapy 72 hrs old baby with bilirubin 15mg/dl OB Placenta previa painless bleeding Rh negative woman + Rh positive man = Rh incompatibility Terbutaline (Brethine) Butorphanol tartrate (Stadol) opiod analgesic; decrease respirations, check vitals 2- 5 lb (2.5kg) first tri; 0.66 1.1 lb (0.5 kg) wkly 2-3 tri transition phase dilated 9 cm, having contractions every 3cm for 50 sec; do not give analgesic 12 wks pregnancy can hear hrtbeat probable sign of preg positive pee test, +hegars sign preseumtive sign of preg quickening positive sign of preg hear hrtbeat fundus 10-12 wks slightly symphysis pubis 16 wks halfway btwn symphysis pubis and umbilicus 20-22 at level of umbilicus 28 wks 3 fingers umbilicus 36 wks - ensiform cartilage MEDSURGE Prevent dumping syndrome: lay down 30 min after meals, drink fluids between meals, and reduce carbs Hyponatremia headache, apprehension, lethargy, twitching, convulsions, diarrhea, fingerprinting of skin. Hemolytic reaction *priority nv, low back pain, hematuria, tx stop blood, get urine specimen, maintain blood volume and renal perfusion. Febrile reaction fever, chills, nausea, headach. Tx stop blood give aspirin Strabismus double vision, visual axes not parallel Standard precautions CMV (wear eye protection if splashes) Cystic fibrosis inherited through autosomal recessive trait Hep B additional vaccine given at 1 and 6 mo.

Cushings priority prevent fluid overload due to na and h2o retention Diet should be low carb/sodium , protein Swan Ganz catheter indirectly measures pressure in the ventricles Paracentesis- void before procedure Bronchoscopy monitor for tachypnea after CVP 3-12 cm water pressure normal range Contact rsv, s.aureus, Droplet rubella (german measles), meningitis Addisons hyperkalemia Enema administer 12-18 inches high Charcoal give w/in 2 hrs Ammonia 15-45 mcg/dl Complete hrt block do not use lidocaine/cardiac depressants, use atropine, temp pacemaker, isoproterenol (isuprel) Cholecystitis symptoms: belching, nausea, ruq pain, jaundice is complication + Trosseus sign muscle spasm when taking bp, indicates tetany, low calcium + chvostek - facial twitching when stroked, indicates low calcium complication of impetigo periorbital edema (poststrep glomerulonephritis neuroleptic malignant syndrome high temp, rigidity, oculogyric crisis, sev htn. Hold thorazine, call doctor. Tx parlodel, Dantrium pvd x elevate legs, x apply heat ptt 20-25 or 32-39 sec. therapeutic range 1.5-2x N do not take metformin pior to renal tomography risk for lactic acidosis lumbar laminectomy must stay supine/flat assessment inspect, palpate/percuss, listen pinpoint eyes heroin od lyme disease sx: rash, intermittent fever, headache, fatigue, muscle pain, stiff neck amputation do not elevate limb after 24 hrs. suction should be set at 80-120 mmHg for trach rotavirus put client close to nurse station with private room renal patients more susceptible to CNS side effects medication (ex. Tagamet)

get urine sample for hemolytic reaction (ss: nv, lbp, hypotn, pulse, urine, hematuria remove gloves, eyewear, gown, mask

basic care comfort 6-12% mobility assessment, joint movements, activity + exercise, avoiding injury, assisting patient for mobility, adl terminology for assessment of posture erect complications: lumbar lordosis concavity in lumbar region kyposhis convexity in thoracic region scoliosis lateral curvature of vertebral column