4 months infant- just not right with their baby- inform dr-if - Poor head control and clenched

fists
 Failure to smile
 Extreme irritability

4 years death – temporary

5 years- anticipatory guidance- inform the parent to expect a more transquil period at this age

Acne- Clean the face gently with a mild soap once or twice each day.

acute adrenocortical insufficiency- monitor- observing for signs of hypokalemia

acquired immune deficiency syndrome (AIDS- prevention- Intravenous drug users should not share
needles

acute appendicitis- purpose of NT tube- prevent abdominal distention

Atopic dermatitis (eczema)- Associated with hereditary allergies

Autism is a complex developmental disorder-

Diagnosis criteria delay in social interaction, inability to maintain eye contact, language as used in social
communication.

Amputated – feeling pain in missing extremity- reassure the child that it is normal and is called phantom
limb sensation

Ambiguous genitalia- tests done - explain the disorder so parents can explain it to others.

Apnea of infancy- discharge plan- CPR teaching to parents

Asthma- pulmonary function tests- purpose of the peak expiratory flow rate (PEFR) is to: assess the
severity of asthma
 metered-dose inhaler to treat asthma- spacer

bacterial meningitis - keeping environmental stimuli at a minimum

barking cough at night- trying a cool-mist vaporizer at night and watching for signs of difficulty
breathing.

Group Abeta-hemolytic streptococci (GABHS) infection- Rx anitbiotics- to prevent - acute rheumatic

fever

brain tumour- post op- Close supervision is needed while the child is regaining consciousness.
 child is becoming irritable, and pupils are unequal and sluggish- inform dr
Burn- rehabilitative phase of care pressure applied- decrease the blood supply to the scar
 appears to accept pain with little or no response- request a psychological consultation
 25% burn enteral feeding ordered- enteral feedings may cause increased blood flow to the
intestinal tract

Blood transfusion- adverse reaction- stop transfusion and maintain a patent intravenous line with normal
saline and new tubing.

Biliary atresia- Liver transplantation may be needed eventually

Car accident-2-month-old infant- Moro, tonic neck, and withdrawal reflexes are present suggest-
neurological health

cardiac catheterization- nurse assess pulse distal to catheter insertion site is weak-- record the data on
the nurse’s notes

Cardiac defect before corrective surgery- desirability of promoting normalcy within the limits of the
child’s condition
Mixed cardiac defect- Transposition of the great arteries

Cardiac surgery next week -how to prepare child- children who are prepared experience less fear and
stress during hospitalization

Choke- Position the infant in a head-down, face-down position and administer back blows between the
shoulder blades

Chronic illness or complex condition effect of on child development vary at different ages- toddler-
hindered mobility.

Chemotherapeutic – Many chemotherapeutic agents are vesicants that can cause severe cellular damage
if the drug infiltrates

 Myelosuppression from leukemia or chemotherapeutic agent- using good hand hygiene

 Mucosal ulceration toddler- mouth wash with saline

Cellulitis- mgt - Oral or parenteral antibiotics

Cervical neck injury 12 hour ago- nsg -reactivity of pupils.

celiac disease- low gluten

cerebral palsy- goal- recognizing the disorder early and promoting optimal development
 most common cause- prenatal brain abnormalities
 after-school activities often provide children with CP opportunities for
socialization and recreation
 orthopedic surgery-difficulty swallowing- stabilize his jaw with one hand
(either from a front or side position) to facilitate swallowing.
 characterized by:Hypertonicity and poor control of posture, balance,
and coordinated motion.
  Any drug decrease spasticity- Implantation of a pump to deliver
medication into the intrathecal space to decrease spasticity has
recently become available.
 Spastic CP-cause- Sudden jerking movement caused by stimuli

cognitive impairment- subaverage intellectual functioning, deficits in adaptive skills, and onset at any
age.
 Primary goal- promote optimum development
 Guidance with discipline- Behaviour modification is an excellent form of discipline

Congenital limb deficiency- fit prosthetic device- When the infant begins sitting up and can maintain
balance

congenital hypothyroidism - early identification of the disorder

Congenital heart defects have traditionally been divided into a cyanotic or cyanotic defects- problematic
because children with acyanotic heart defects may develop cyanosis.

congenital heart defect is receiving palivizumab (Synagis)- prevent respiratory syncytial virus (RSV)
infection

Crohn’s disease- Coping with stress and adjusting to chronic illness

Croup- barking cough at night- trying a cool-mist vaporizer at night and watching for signs of difficulty
breathing.

Cushing syndrome- teaching patient- It is caused by excessive production of cortisol

Cyclosporine- teaching- Purpose of medication is to suppress rejection, Frequent hand hygiene

Cystic fibrosis- child has developed tachypnea, tachycardia, dyspnea, pallor, and cyanosis. –
pneumothorax
 c/m- mechanical obstruction caused by increased viscosity of mucous gland secretions
 vit- A, E , K

DDH developmental dysplasia of the hip-c/m- Asymmetrical thigh and gluteal folds
 Positive Ortolani and Barlow tests

 Shortening of limb on affected side

Denial- is a common reaction to the diagnosis of a complex condition or chronic illness- defense
mechanism-
is a necessary cushion to prevent disintegration
Dialysis peritoneal- adolescents can carry out procedures themselves
Diabetes mellitus type 1- child cannot avoid taking pills because - Your child’s pancreas doesn’t make
insulin and the oral hypoglycemics only add to an existing supply of insulin.”
exercise is not restricted unless indicated by other health conditions
 teaching point- Do not reuse needles, Insulin injections can be given by syringe or preloaded
insulin pen.
 Sign of hyperglycemia- nocturia, Blurred vision
 Physically active in summer- increase food intake

Diabetes insipidus- plan- encouraging the child to wear medical identification

Diabetes ketoacidosis- child develop - a life-threatening situation

Diarrhea with probable intussusception – adm of sir pressure to reduce intussusception, he pass brown
stool- inform DR
 ORS- continue breast feeding
 Symptoms for severe tachycardia, parched mucous membranes, sunken eyes and fontanel
 Child is vomiting after ORS- continuing to give the child ORS frequently in small amounts


Digoxin – 9 months infant- 4 ml- not give the dose; suspect dosage error.

Down syndrome caused by translocation- born to women younger than age 35 years
 2 week baby is like rag doll, he doesn’t cuddle me and lack of clinging or mouldingis-- the
result of the physical characteristics of Down syndrome
Duchenne) muscular dystrophy- Pseudohypertrophic- assessment finding Lordosis, Gowers sign,
Waddling gait

Dehydration- possible complication- Water intoxication

 Symptoms for severe tachycardia, parched mucous membranes, sunken eyes and fontanel
 Child is vomiting after ORS- continuing to give the child ORS frequently in small amounts

Dysrhythmia- electrocardiogram- count the apical rate for 1 full minute and compare it with the radial
rate

Eczema - Associated with hereditary allergies

Erythema infection- causative agent- human parvovirus B19.

Epiglottitis- abrupt onset of sore throat, pain with swallowing, fever, and sitting upright and forward nsg
interven- Vital signs
 Medical history
 Assessment of breath sounds
 Emergency airway equipment readily available
Epitaxis- Have the child sit up and lean forward.

electrocardiogram- Dysrhythmia- count the apical rate for 1 full minute and compare it with the radial
rate

Eye- reduced visual acuity in one eye despite appropriate optical correction- amblyopia

Eye patch removed after surgery- orient him to his immediate surroundings

failure-to-thrive-infant- Being persistent through 10 to 15 minutes of food refusal

febrile 40.5- apply a hypothermia blanket

Fractures- characteristics- Rapidity of healing is inversely related to the age of the child

Fragile X syndrome- another child will also have the same- explain that prenatal diagnosis of the
syndrome is now available

fluid retention best way - weigh the child daily

fluid imbalance- Immature kidney functioning

froglike” croaking sound on inspiration, is agitated, and is drooling. She insists on sitting upright- notify
the physician immediately and be prepared to assist with a tracheostomy or intubation.

Group Abeta-hemolytic streptococci (GABHS) infection- Rx anitbiotics- to prevent - acute rheumatic

fever

Goitre- nsg interven- have tracheostomy set at bedside

Guillain barre syndrome with infectious polyneuritis- muscle function will gradually return, and
recovery is possible in most children
 Nsg intervention- Assessing respiratory efforts

Glomerulonephritis – why BP is taken often- Acute hypertension, or high blood pressure, must be
anticipated and identified

head injuries- are infants particularly vulnerable to acceleration–deceleration- Musculoskeletal support

of head is insufficient

heart failure- receive Lasix- diuretics

 organizing activities to allow for uninterrupted sleep

 early sign- tachypnea

hearing loss – difficulty hearing faint or distant speech – slight hearing loss

hearing impairment is critical -effect on speech development

hemophilia- who fell on his arm -supportive measure-Elevate the area above the level of the heart

hepatitis A- Teach infection control measures to family members

 Preparation- initate immunization record
 Confirm hep -A status of the newborn mother
 Obtain a syringe 16 mm needle length
 Change the needle on syringe after drawing up the vaccine

Hip spica cast- nsg interven- check circulation.

high-frequency sound waves are translated into images by a transducer- echocardiography

Hirschsprung’s disease- The colon has an aganglionic segment

Hospitalization benefit- Increased learning of child growth and development.

 Social acceptance.
 Independence or self-reliance
 Child stress level associated with...- Lack of fit between parent and child
 Age
 Gender
 Young child discharge- instruct parent- Tendency to cling to parents
Demands for parents’ attention
New fears such as nightmares
 Health history- factor affect parent- Previous experience with illness or hospitalization
Available support systems
Medical procedures involved with treatment
Previous coping abilities
Cultural and religious beliefs

Hydrocephaly- post shunt revision- discharge-sign of malformation- Personality change
 Vomiting
 Fever

Hyperparathyroidism- cause- chronic renal disease.

Hypertension- primary therapy- treatment of the underlying cause.

 In infant- Irritability
Head rubbing
Waking up screaming in the night

hypothyroidism congenital- early identification of the disorder

hypospadias- promote development of normal body image.

Infant botulism- associated with honey

 Icu- Administer gentamicin sulfate (Garamycin) 10 mg per intravenous piggyback
every 12 hours.
 
Inflammatory bowel disease (IBD)- includes diet, vit supplements

infectious polyneuritis with Guillain barre syndrome - muscle function will gradually return, and
recovery is possible in most children

increased intracranial pressure (ICP)- assess irritability.

 Nsg intern to prevent- Avoiding activities that cause pain or crying


Immobilized- Change position frequently,

 take the child for a “walk” by wheelchair outside the room
 decrease muscle strength, tone and endurance from immobilization- Decreased exercise
tolerance


sudden infant death syndrome- risk - who sleep prone.

 who were premature.
 with prenatal drug exposure

Intussusception- with diarrhea – adm of sir pressure to reduce intussusception, he pass brown stool-
inform DR

Ischemia – 5 P -point of tenderness

 paresthesia
 petechiae
 paralysis

Iron preparation- green stool- normally expected change caused by the iron preparation

Jvnenile rheumatoid arthritis- therapeutic mgt- minimize physical deformity and preserve joint
function.

Kidney transplant- taking cyclosporine- teaching- Purpose of medication is to suppress rejection,

Frequent hand hygiene


Lab value- abnormal- PH-4

Present symptom- indicate nephrosis- Hypoalbuminemia

latex allergy- My child should not eat bananas or kiwis.

Laceration- contaminated with dirt and sand- wash with Normal saline
large abrasion -occlusive dressing- tegaderm applied to large abrasion- maintain a moist environment for
healing

leukemia-myelosuppression- using good hand hygiene

 Symptoms- petechiae, infection, fatigue

Lymphoma- receive radiation therapy- adverse effect of RX- fatigue

meningitis bacterial - keeping environmental stimuli at a minimum

 priority nsg care- administer antibiotic therapy as soon as it is ordered

Multiple injuries who is comatose- requires astute nursing assessment and management

Mucosal ulceration toddler- mouth wash with saline

Myelomeningocele- has neurogenic bladder disorder performed intermittent catherization- teach the child
to do self-catheterization
 Some degree of fecal continence can usually be achieved
 Most common problem- Neurogenic bladder.
 Most often associated with hydrocephalus
 Position and feed- prone, turn head to side, and nipple feed
 Cause- There may be no definitive cause identified.
 Sac- Covered with a sterile, moist, nonadherent dressing

 Newborn defect-Visible defect with an external saclike protrusion containing meninges,

spinal fluid, and nerves

 Early sign of infection- temperature instability (axillary), irritability, and lethargy

Myelosuppression from leukemia or chemotherapeutic agent- using good hand hygiene

Neural tube defects – prevented by daily folic acids -0.4 g OD

 not visible externally in the lumbosacral area would be called: spina bifida occulta

Nephrosis- lab value- hypoalbuminemia

Nephrotic syndrome- nsg interven- Adjusting activities to the child’s tolerance level
 best way to detect fluid retention- weigh the child daily

Nose bleeding- Epitaxis- Have the child sit up and lean forward.

NT tube- prevent abdominal distention

Osteogenesis imperfecta- It is an inherited disorder

Osteomyelitis- nsg interven- range of motion- move and turn the child carefully and gently to minimize
pain.

occlusive dressing- tegaderm applied to large abrasion- maintain a moist environment for healing
pain- Multiple injuries who is comatose- requires astute nursing assessment and management
 large dose of opioids are justifies when there are no other RX options

patent ductus arteriosus (PDA) to prevent:- increased pulmonary vascular congestion

pancreatic beta cells cause of – type 1 diabetes

palivizumab (Synagis)- prevent respiratory syncytial virus (RSV) infection

poison ivy- he touches leaf of- rinse his hands in cold, running water

peritoneal dialysis- adolescents can carry out procedures themselves

peptic ulcer- mgt- administering proton pump inhibitors

peak expiratory flow rate (PEFR) is to: assess the severity of asthma

Platelets- help your body stop bleeding by forming a clot (scab) over the hurt area.

proton pump inhibitor- Omeprazole (Prilosec)

 Pantoprazole (Protonix)

Preschool- large block, alphabet flash card, dolls, hand puppets.

 Stuttering when answering- complete child sentence
 Erickson- initiative
 Parents should determine exactly what the child wants to know before answering a question about
sex.
 body image has developed to include- fear of intrusive procedures
 effective communication- play

Pseudohypertrophic (Duchenne) muscular dystrophy- It is characterized by muscle weakness usually

beginning about 3 years old.
 Mgt plan- Recommending genetic counseling.


Psychosexual conflicts of preschool make extremely vulnerable- bodily injury and pain

Puberty- precocious- dress and activities should be appropriate to chronological age

Radiation therapy- adverse effect of RX- fatigue

Renal end stage disease – multiple stresses are placed on children with ESRD and their families because
the children’s lives are maintained by drugs and artificial means

Respiratory distress- have someone call for an ambulance/paramedic rescue squad.

Respiratory infection- goal- can trigger an episode or aggravate an asthmatic state
 Upper resp tract infection- suggest humified atmosphere- soothing inflamed mucous membrane

Retinoblastoma- c/m- White eye reflex

 Strabismus
 Red, painful eye, often with glaucoma
 Severe permanent visual impairment

Ringworm is spread by direct contact

Rheumatoid arthritis- therapeutic mgt- minimize physical deformity and preserve joint function.

Rheumatic fever- lab test- Antistreptolysin-O titer (ASO) titre

Rhabdomyosarcoma- The most common sites are the head and neck.

Rocky Mountain spotted fever – tick remove from scalp-c/m- fever.

 petechial rash.
 severe headache.

Scabies-instruction- be prepared for symptoms to last 2 to 3 weeks

Seizure disorder- long term care- Mortality is associated with seizure severity and frequency
 Seizure last 35 minutes- status epilepticus
 Nsg interven- avoiding suctioning the child during the seizure.
 describing and documenting the seizure activity observed

separation anxiety- the protest phase- cling to parents

shock- compensated – clinical sign- apprehension

sickle cell anemia- teach parents and child how to minimize crises
 severe chest pain, cough, dyspnea- first action- notify the practitioner because chest syndrome is
suspected


Skin- wet compresses or dressings to the skin- apply the desired solution on cotton gauze or soft cotton
cloths such as clean handkerchiefs

Sprained such as Soft tissue injury- It reduces edema formation

Spinal cord injury- CCU- nsg intervention- Monitor neurological status.

 Administer corticosteroids.
 Monitor for respiratory complications
 Monitor and maintain hemodynamic status
  Intervention- Implement a standing prescription to empty the bladder with a sterile in-and-out
Foley catheter.
 Nsg Interven-Implement a standing prescription to empty the bladder with a sterile in-and-out
Foley catheter, Monitoring for respiratory complications


Spina bifida- develop latex allergy- provide a latex-free environment.

 6 weeks pregnant- The concentration of alpha-fetoprotein in amniotic fluid can indicate the
presence of the defect prenatally.”
 Avoid using any latex product

Strabismus- amblyopia a type of blindness may result

surgery next week -how to prepare child- children who are prepared experience less fear and stress
during hospitalization

sudden infant death syndrome- risk - who sleep prone.

 who were premature.
 with prenatal drug exposure
 need further teaching- “I only smoke in the basement.”
 “I put my baby to sleep on her back.”

 “I make sure my baby wears a flannel sleeper and has two blankets to keep her warm in her crib.”
 “I always leave my baby’s favorite stuffed bunny rabbit in the crib to keep her from crying at
night.”

systemic lupus erythematosus (SLE)- Therapeutic mgt- corticosteroids to control inflammation

Tegaderm – occlusive dressing- large abrasion- maintain a moist environment for healing

Tetanus- It is an acute infectious disease caused by an exotoxin produced by an anaerobic gram-positive

bacillus.
 Therapeutic mgt- Antibiotics to control bacterial proliferation at the site of injury.

Tick- Rocky Mountain spotted fever c/m- fever.

 petechial rash.
 severe headache.

Thrombus prevention- immobilized- Change position frequently

Traction- in-service in orthopedic unit - Skin traction can be applied using a pulling mechanism
attached with adhesive material.
 Pins are commonly used with skeletal traction
Tracheostomy child parents insist on caring child - - expert in care of the child

Tracheoesophageal fistula- Excessive amount of frothy saliva in the mouth

Tonsillectomy-care - watch for continuous swallowing.

Urinary incontinence- from few days- possible urinary tract infection

urinary tract infection (UTI)- discharge instruct-Administer the oxybutynin chloride (Ditropan) as
prescribed
 Monitor for signs of a recurrent UTI
 Continue to perform the clean intermittent catheterizations (CIC) at home
 c/m- infant- Vomiting
Jaundice, Persistent diaper rash
Failure to gain weight


Ulcerative colitis- associated symptoms- Rectal bleeding

Diarrhea
 Joint pain
Anorexia
Unconscious- febrile 40.5- apply a hypothermia blanket
 Car accident- encourage the parents to hold, talk, and sing to her as they usually would

vesicoureteral reflux- associated- recurrent kidney infections

wet compresses or dressings to the skin- apply the desired solution on cotton gauze or soft cotton cloths
such as clean handkerchiefs.
Werdnig-Hoffmann disease (spinal muscular atrophy type 1)- s/s- Progressive weakness and
wasting of skeletal muscle

Wound- delay dysfunctional wound healing- Nutrition

 Hypoxemia
 Stress
 Corticosteroid therapy

Wilms’ tumour- nsg interven- best surgery- avoid abdominal palpation

 After surgery - Chemotherapy with or without radiation therapy may be indicated.”