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Loading... Birth weight doubled by _____, tripled by _____. Birth length increased by 50% at _____. Posterior fontanel closes by _____. A child can socially smiles at _____. 6 months; 12 months 12 months 8 weeks (2 months) 2 months

A child should be able to turn head to locate 3 months sounds at _____. Moro reflex disappears around _____. 4 months

A child should be able to achieve steady head 4 months control at _____ of age. A child can turn completely over at _____ of 5 to 6 months age. A child can play peek-a-boo after _____ of age. A child should be able to transfers objects hand to hand at _____. A child develops stranger anxiety at _____. A child should be able to sit unsupported at _____. The infant crawls at _____. Fine pincer grasp appears at _____. A child should be able to waves bye-bye at _____. 6 months 7 months 7 to 9 months 8 months 10 months 10 to 12 months 10 months

A child should be able to walks with assistance at _____. The infant says a few words in addition to "mama" or "dada" at _____. From birth to one year, the baby explores environment by _____ and _____ means. From birth to one year is what stage of Erikson's theory?

10 to 12 months 12 months motor; oral Trust vs Mistrust (Developing a sense of trust) mobiles rattles squeaking toys picture books balls colored blocks activity boxes 30 months 2 years 12 - 18 months 18 months

What are some age-appropriate toys for hospitalized infants?

Birth weight quadruples by _____. Achieves 50% of adult height by ___. Anterior fontanel closes by _____. A child should be able to throw a ball overhand at _____.

The nurse tells a mother that her child should 24 months be able to kicks a ball at _____. A child should be able to feeds self with spoon and cup at _____. 2 years

Day time toilet training can usually be started 2 years of age around _____. A child should be able to speak two to three 2 years (24 months) word sentences at _____. A child should be able to speak three to four 3 years word sentences at _____ of age. A child should be able to states his/her own first and last name by _____. 2.5 to 3 years

Is temper tantrums common among toddlers Yes (1 to 3 years)?

What is the import developmental task of a toddler according to Erikson's theory?

Developing a sense of autonomy. board and mallet push/pull toys toy telephone stuffed animals storybooks with pictures Toddlers benefit from being taken to the hospital playroom, as mobility is very important to their development.

What are some age-appropriate toys for the hospitalized toddler?

What can the nurse do to promote the developemental task of a toddler?

Each year gain about 5 lbs What are the average weight and height gain and grows 2.5 to 3 for preschool children (3 to 5 years old)? inches. A child can use sissors at _____ of age. A child should be able to ties shoelaces at _____ of age. Visual acuity approaches 20/20 at _____. A preschool child thinking is _____ and _____. 4 years 5 years Preschool age (3 to 5 years) egocentric; concrete

A child should be able to use sentences of 5 3 to 5 years to 8 words at _____ of age. Preschool At this stage of developement, a child learns 3 to 5 years sexual identity (curiosity and masturbation Preschool common). At this stage of development, imaginary playmates and fears are common. Preschool (3 to 5 years)

At child at this development stage begins to Preschool stands erect with more slender posture. (3 to 5 years) At this stage of development, a child learns to Preschool run, jump, skip, and hop. (3 to 5 years) A child at this developmental stage learns colors and shapes. Preschool (3 to 5 years)

Therapeutic play. Toys and play for the hospitalized preschooler include: The _____ needs preparation for procedures. At this stage of development. the child appears to be bowlegged and potbellied. _____ are learning to name body parts and are concerned about their bodies. During hospitalization. painful procedures are not a punishment for misdeeds.Imaginary playmates and fears are common Preschool at this stage of development: (3 to 5 years) Aggressiveness at _____ is replaced by more 4 years. all primary teeth (20) are present.) _____ or medical play to allow the child to act out their experiences is helpful for _____. Developing a sense of initiative TODDLER (1 TO 3 YEARS) TODDLER (1 TO 3 YEARS) egocentricity. enforced separation Toddlers (1-3 years) toddler's . (3 to 6 years) Let child handle equipment or models of the equipment. Preschoolers Preschool (3 to 5 years) coloring books puzzles cutting and pasting dolls building blocks clay toys that allow the preschooler to work out hospitalization experiences. Preschool child's major developmental taks according to Erikson theory is: At this stage of development. independence _____ at 5 years. fear of mutilation from procedures is common." Simple preschooler explanations and basic pictures are helpful. He or she needs to understand what is and what is not going to be "fixed. Nursing implications of hospitalized (Explain that he/she did not preschoolers (3-6 years) needs to emphasize cause the illness and that understanding of the child's _____. At this stage of development.

(6 to 12 years) At this stage of development. toddlers (1 to 3 years) Normal gain in weight and height for school.Each year gain 4 to 6 pounds age child (6 to 12 years) are: and about 2 inches in height. present. a child learns to school-age child tell time and understands past. developing a school-age child sense of industry occurs at this stage: (6 to 12 years) A child should be able to write script at _____. school-age child (6 to 12 years) Socialization with peers becomes important school-age child at this stage of development: (6 to 12 years) A child's molars should erupt at _____. Security objects or favorite toys from home should be provided for _____. a child should school-age child be able to dresses self-completely. 6 years According to Erikson's theory. During this developmental stage. 8 years The hospitalized _____ may need more school-age child support from parents than they wish to admit. a child learns cause and effect relationships. school-age child (6 to 12 years) At this stage of development.from parents is the greatest threat to the (1 to 3 years) _____ psychological and emotional integrity. girls may experience menarche. school-age child . Maintaining contact with peers and school activities is important during hospitalization for a _____. school-age child (6 to 12 years) school-age child (6 to 12 years) school-age (6 to 12 years) At this stage of development. At this stage of development. Loss of primary teeth and eruption of most permanent At this stage of development fine and gross motor skills mature. egocentric thinking is replaced by social awareness of others. and (6 to 12 years) future.

14 15. close curtains during procedures.g. board games card games Toys for the hospitalized school-age (6 to 12 hobbies (such as stamp years) child include: collecting. etc. meaning they like to do and industry.. family connflict commonly occurs. Girls finish growth around _____. peer contact with both. 10 for girls).For school-age child. Boys catch up to girls' growth at age _____ and continue to grow. Illness. boys around _____. Girls' growth spurt during adolescent begins _____ than boys (may begin as early as ___ earlier. Participation in care and planning with staff fosters a involvement. abstract They can _____ and use _____ thinking. problem solve. 17 Adult-like thinking begins around age _____. _____ and _____ are important. or procedures which alter the adolescent body image can be viewed as devastating by the _____. sense of _____ and _____ for a school-age accomplishment child (6-12 years). _____ are also becoming important for this age child. puzzles. treatments. allow privacy during baths. and should be respected during hospitalization. Secondary sex characteristics begins at this developmental stage: At this stage of development. they need to maintain school. ADOLESCENCE (12 to 19 YEARS) ADOLESCENCE (12 10 19 YEARS) Hospilalization of adolescents disrupts _____ and _____ activities. 15. . Peers accomplish things. modesty e. privacy. and video games) School-age children are in Erikson's stage of _____.

those with known altered immunodeficiency. T or F MMR vaccines are administer _____ at separate sites.e. For this developmental group. teaching about procedures should include time without parents present. In times of measles epidemic. adolescent (12 to 18 years) adolescent here and now i. Adolescent: Major concern is change in body image.For this develpmental stage. Preschoolers: Fear body mutilation. 11 to 12 years or by _____ years. A child may have a light transient ___ 2 True subcutaneously rash . pregnant _____ and _____ women. to _____ or _____. 4 to 6. some assessment questions should be asked without parents' presence. eggs. When teaching adolescent needs. Measles vaccine is contraindicated for persons with history of anaphylactic reaction neomycin. MMR vaccine may be given to those with HIV and breastfeeding women. 15 months the MMR at _____.. Toddlers: Fear intrusive procedures. their cognitive development allows them to remember pain. it is possible to give measles protection at _____ and repeat 6 months. how will this affect me today? Infants: After 6 months. the focus should be on _____. Infants' concept of bodily injury: Toddlers' concept of bodily injury Preschoolers' concept of bodily injury School ages' concept of bodily injury: Adolescents' concept of bodily injury: MMR VACCINE Generally administered at _____ months of age and repeated at _____ 12 to 15. School age: Fear loss of control of their body.

weeks after administration of MMR vaccine. DTaP Vaccine administration begins at age ____, administer three doses at _____ intervals. 2 months; 2 months

DTaP Vaccine: Booster doses given at _____ 15; 18 months; 4 to 6 years. to _____; and at _____. DTaP Vaccine: administer _____ (separate site from other vaccine). intramuscularly

DTaP Vaccine is not given to children past the ______ birthday; they receive _____ which contains full strength protection 7th; Td against tetanus and lesser strength diphtheria protection. When pertussis vaccine is contraindicated, give _____, until 7th birthday. Contraindications to pertussis vaccine include: 1. _____ within 7 days of previous dose of DTP. 2. History of _____. 3. _____ symptoms after receiving the vaccine. 4. _____ allergic reactions to the vaccine. DT (full strength diphtheria and tetanus without pertussis vaccine)

Encephalopathy; seizures; Neurologic; Systemic

Parents should be instructed to begin _____ acetaminophen (Tylenol); 10 administration after the immunization to 15 (normal dosage is _____ mg/kg). IPV is recommended for all person under the 18 age of _____. IPV is administer at _____ of age and again 2 months; 4 months; 6 to 15 at _____ of age. Boosters are given at _____ , months; 4 to 6 years and _____. Administer IPV _____ or _____ at separate site. subcutaneously; IM

IPV is contraindicated for those with history of anaphylactic reaction to neomycin; streptomycin _____ or _____.

PRP-OPMs can be given as early as ____ of 2 months age. DaTP/Hib combinations should not be used as primary immunizations at ages ___, ___, 2; 4; 6 months or ___. Children at high risk who were not immunized with Hib previously should be immunized after age _____. Hib is administer ______. 5 intramuscularly

_____ offers protection against bacteria that causes serious illness (epiglottitis, bacterial meningitis, septic arthritis) in small children Hib or those with chronic illnesses such as sickle cell anemia. _____ offers protection against hepatitis B. Typically, given to all _____ prior to hospital Hepatitis B vaccine; discharge. newborns; 0; 18 Vaccinate all children _____ to _____ years of age. Hepatitis B vaccine is contraindicated for common baker's yeast persons with anaphylactic reaction to _____. Hepatitis B vaccine is administer trough _____ site at _____ , _____, and _____ of age. IM; 0 to 2 months; 1 to 4 months; 6 to 18 months

_____ offers protection against chickenpox. It is also a school entry requirement in 33 states. VARICELLA vaccine And it is safe for children with asymptomatic HIV infection. VARICELLA vaccine is administer at _____ 12 to 18 months; 12 months of age (must beat least _____). Give _____ and _____ vaccines on same day MMR; varicella or >30 days apart (separate site). Irritability, fever (<102 F), redness and soreness at injection site for 2 to 3 days are normal side effects of _____ and _____ administration.

DPT; IPV

Following immunization, call health care provider if _____, _____, or _____. Following immunization, a _____ on the thigh injection site and _____ the legs with each diaper change will decrease soreness.

seizures; high fever; highpitched crying occur warm washcloth; "bicycling"

Following immunization, acetaminophen (Tylenol) is administered orally every _____ 4 to 6; 10 to 15 hours (_____ mg/Kg). The common cold is not a contraindication for immunization. T or F A highly contagious, viral disease that can lead to neurologic problems or death. RUBEOLA (Measles) is transmitted by _____. RUBEOLA (Measles) is contagious mainly during the _____ which is characterized by _____ and _____ symptoms. True RUBEOLA (Measles) Direct contact with droplets from infected person. prodromal period; fever; upper respiratory

Photophobia Koplik's spots on the buccal Classic symptoms of RUBEOLA (Measles) mucosa. include: Confluent rash that begins on the face and spreads downward. Viral disease characterized by skin lesions. VARICELLA ZOSTER (Chicken Pox)

Chicken Pox lesions begin on the _____ and trunk; face; proximal spread to the _____ and _____. extremities Chicken Pox progresses through _____, _____, _____, and _____ stages. macular; papular; vesicular; pustular

Chicken Pox transmitted by ____, _____, or direct contact; droplet spread; _____. freshly contaminated objects Chicken Pox communicability end when _____. scabs have formed

Common viral disease which has teratogenic RUBELLA (German effects on fetus durina the first trimester of Measles) pregnancy.

freshly contaminated objects erythromycin pneumonia..RUBELLA (German Measles) is transmitted droplet. _____. RUBELLA (German Measles) rash disappears within _____. direct contact with by _____ and _____. infectious respiratory disease usually occurring in infancy. An acute. 3 days Pertussis (Whooping cough) gram-negative bacillus PERTUSSIS (Whooping Cough) begins with upper respiratory symptoms _____. PERTUSSIS (Whooping Cough) is treated with _____. A right to . PERTUSSIS (Whooping Cough) lasts from _____. Pertussis is caused by a _____. _____ is a paroxysmal state of the disease is PERTUSSIS (Whooping characterized by prolonged coughing and Cough) crowing or whooping upon inspiration. hemorrhage. droplet spread. seizures << first < prev1next >last >> Si de 3 Question Answer Loading. Differentiate between a right to left and left to A left to right shunt moves oxygenated blood back through pulmonary circulation. infected person RUBELLA (German Measles) is charcterized discrete red maculopapular by _____ starts on _____ and rapidly spreads rash. and _____. _____. PERTUSSIS (Whooping Cough) is transmitted by _____. entire body to _____. or _____. 4 to 6 weeks direct contact. face. PERTUSSIS (Whooping Cough) complications include _____..

A common characteristic of spastic cerebral palsy in infants. bleeding. Arrhytmia. heart failure? Give small. . and upward-outward slant of eyes. nausea. of Fallot. What are two objectives Reduce the workload of the heart and increase in treating congestive cardiac output. infant. respiratory cardiac problems in an distress and infections. causing cyanosis. Organize activities to workload of the heart. feet are plantar-flexed. weakness. disturb child only as indicated. legs are extended and crossed over each other. fatigue. Maintain a neutral intervention to reduce the thermal environment. List the common signs of Poor feeding. pulmonary stenosis. aspirin Simian creases in palms. What cardiac complications are associated with rheumatic fever? What medications are used to treat rheumatic fever? What are the physical features of a child with Down syndrome? Describe scissoring. and associated with tetralogy right ventricular hypertrophy. What position would best relieve the child Knee-chest position or squatting. hypotonia. Aortic valve stenosis and mitral valve stenosis Penicillin. phlebitis. protruding tongue. List the five risks in cardiac catherization. overriding aorta. obstruction of the arterial entry site. frequent feedings or gavage feedings. experiencing a test spell? Diarrhea.right shunt in cardiac disease. List the four defects VSD. Describe nursing Plan frequent rest periods. poor weight gain. edema and cyanosis. erthromycin. left shunt bypasses the lungs and delivers unoxygenated blood to systemic circulation. and What are common signs vomiting: the nurse should check for bradycardia of digoxin toxicity? prior to administration. perforation.

headache. Describe the signs and opisthotonos.What are two nursing Prevention of infection of the sac and monitoring priorities for a newborn for hydrocephalus (measure head circumference. irritability. unequal pupil response. chloramphenicol Flat or on either side Osmotic diuretics remove water from CNS to reduce cerebral edema. change in LOC. vomiting. What antibiotic are usually prescribed for bacterial meningitis? How is a child usually positioned after brain tumor surgery? Desribe the function of an osmotic diuretic. GI of Dilantin? distress Fever. with myelomeningocele? check fontanel. assess neurologic functioning). to stand. positive Kernig sign. ataxia. protect from injury. What nursing interventions increase intracranial pressure? Ampicillin. What is gower's sign? Gower's sign is an indicator of muscular dystrophy. penicillin. and seizures. signs even though very ill. seizure? What are the side effects Gingival hyperplasia. infant may not show all classic meningitis. motor dysfunction. guidance concerning growth and development. the child has to walk hands . neck stiffness. Suctioning and positioning. What teaching should parents of a newly shunted child receive? Irritability. vomiting. turning Describe the mechanism of inheritance of X-linked recessive trait Duchenne muscular dystrophy. List the signs and symptoms of increased ICP in older children. understanding that shunt should not be pumped and that child will need revisions with growth. and for a child experiencing a observe carefully. positive symptoms of a child with Brudzinski sign. State the three main goals in providing nursing care Maintain patent airway. dermatitis. Information about signs of infection and increased ICP.

What measurements reflect Weight. carrots. with an immunocompromised individual. and thyroid edema. brittle. and koplik spots on the buccal mucosa. and arm present nutritional status? circumference. By monitoring urine output. and elevated BUN. absence of tears. and apricots. A. Anemia: pale conjunctiva. and decreased urinary output. pale skin) C deficiency. How should burns in children be assessed? How can the nurse best evaluate the adequacy of By using lund browder chart. ridged.up legs << first < prev1next >last >> Si de 3 Question Answer Loading. Photophobia. fontanel. Identify food sources of Vit Liver. elevated be expected in a dehydrated hematocrit. This takes into account the changing proportions of the child's body. confluent rash that begins on the face and spread downward. pale skin color. child.. List the laboratory findings loss of bicarbonate/decreased serum ph. dry List the signs and symptoms mucous membranes. of iron deficiency. depressed of dehydration in an infant. List two contraindications to immunocompromised child or in a household live virus immunization. loss that can be expected that can of Sodium. loss of teeth. or spoonshaped nails.. peaches. weight loss. skinfold thickness. sweet potatoes. Poor skin turgor. List the signs and symptoms atrophy of papillae on tongue. loss of potassium. What disease occurs with Vit Scurvy ( sunken eyes. . spinach. List three classic sign of measles.

fluid replacement in children? How should a parent be instructed to child proof a house? What interventions should the nurse perform first in caring for a child who has ingested a poison? Describe the purpose of bronchodilators. Expiratory wheezing. Pancreatic enzyme replacement. To reverse bronchospasm. child with cystic fibrosis? List seven signs of respiratory distress in a pediatric client. and neurologic status. high protein. retractions. Why is genetic counseling Because the disease is autosomal recessive in important for the family of a its genetic pattern. What are the physical assessment findings for a child with asthma? What nutritional support should be provided for a child with cystic fibrosis? By being taught to lock all cabinets. rales. Monitor child's temperature. Assessment of the child's respiratory. assess in midst tent. Restlessness. and to examine the house from the child's point of view. flaming nostrils. tachypnea. diaphoresis. sitting. vomiting . cardiac. right cough. respiratory status. look at child inside tent. and signs of altered blood gases. and a moderate to low carbohydrate. with chin out and toungue protruding (tripod position) Why are IV fluids important The child is at risk for dehydration and acid for a child with an increased base balance. tachycardia. keep clothing dry. moderate to high fat diet. What position does a child with epiglottitis assume? Upright. respiratory rate? Children with chronic otitis media are at risk for Hearing loss/ conductive hearing developing what problem? What is the most common Hemorrhage. to safely store all toxic household items in locked cabinets. keep tent edges Describe the care of a child tucked in. fat-soluble vitamins. and grunting. frequent swallowing.

tearing eyes. urine. pallor. and clearing throat symptoms of this complication. burning. nitrogen Signs of iron deficiency Signs of B2 (riboflavin) deficiency Source of Iron Sources of B2 (riboflavin) Signs of Vitamin A (retinol) deficiency anemia. brittle/ridged nails. Cr. itchy.postoperative complication following a tonsillectomy? Describe the signs and fresh blood. hgb/hct. retarded growth and bone formation. << first < prev1next >last >> Si de 3 Question Answer Loading.. enriched cereal dry. fortified cereal. beef. defective tooth enamel. spinach. tissues from bone. decrease thyroid hormone formation Sources of Vitamin A liver. peaches. night blindness. thyroid edema redness of eyelid corners. hair or nutritional status? fingernail. eggs leafy green vegetables (broccoli. blood cells. When is iron deficiency most common? What is the best indicator of past nutrition? 12 -36 months and in females during childbearing years Height and head circumference How do you measure plasma. spinach. albumin.. liver. pork. rough skin. green beans). (retinol) apricots . pale conjuctiva. carrots. sweet potatoes. photophobia fortified formula.

respiratory failure or respiratory failure cardiac failure Asthma airway become edematous. chicken. increased infection risk. increased resp. foul of Cystic Fibrosis smelling bulky stools. cabbage. poor weight gain. becomes congested with mucous. oranges. cauliflower. airtrapping occurs in alveoli Nursing interventions for acute asthma rapid acting bronchodilators and steroids exacerbations Nursing interventions identify triggers. reduce allergens. salty tasting skin IV abx. steatorrhea. cereal.Signs of Vitamin C deficiency Sources of Vitamin C scurvy. increased pulse rate. diaphoresis Which happens first. pancreatic enzymes given with Cystic Fibrosis food/applesauce. yeast. fat soluble vitamins. spinach Signs of Vitamin B6 scaly dermatitis. smooth muscles constrict. recurrent respiratory Signs and symptoms infections. pulmonary congestion. decreased wound healing. anemia. dry rough skin. soybeans. broccoli. (pyridoxine) convulsions. increased loss of sodium and chloride in sweat meconium ileus at birth. peanuts. weight loss. rate. tomatoes. irritability strawberries. Asthma Action Plan maintanence at home What type of disease autosomal recessive disease that causes dysfunction is Cystic Fibrosis? of exocrine glands Systemic effects of cystic fibrosis lung insufficiency (most critical). use MDI. teach postural nursing interventions drainage and percussion . irritability. bleeding receeding gums. pancreatic insufficiency. bananas restlessness. monitor for asthma through peak flow meter. peripheral neuritis deficiency Sources of B6 (pyridoxine) Signs of respiratory distress meats. tuna.

wheezing and rales What is given to prevent RSV infections in Synagis (palivizumab) immunocompromised patients? isolation. mist tent. drooling. irritability. tripod position What intervention is Never put anything in the mouth because of the risk contraindicated in of complete airway obstruction epiglottitis? encourage prevention with HiB vaccine. NPO. nasal flaring. epiglottitis dysphagia. high fever. prepare for in epiglottitis intubation/tracheosomy. muffled voice. sore throat. IV abx. assess respiratory status. influenzae type B Causes of epiglottitis Signs and symtoms of rapid onset. HR Preschool RR. evaluate respiratory treatment for Bronchiolitis effectiveness Newborn RR. of bronchiolitis prolonged expiration. upright Nursing interventions position. high calories. HR Infant RR. HR Toddler RR. HR School Age RR. moderate fat content. HR RR: 30-60 HR:100-160 RR: 25-35 HR: 100-150 RR: 20-30 HR: 80-130 RR: 20-25 HR: 80-120 RR: 18-22 HR: 70-110 . Nursing interventions maintain hydration. restlessness. moderate carbohydrates rapid acute airway obstruction usually caused by H. nasal congestion. high protein.Cystic Fibrosis diet Pts will need 1.5x normal caloric intake. paroxysmal Signs and symptoms cough. poor eating. prepare for ICU admit Bronchiolitis viral infection of the bronchioles caused by RSV characterized by thick secretions upper respiratory symptoms.

monitor hearing loss Tonsilitis Risks of untreated Tonsilitis inflammation of tonsil (viral or bacterial) related to strep may lead to acute glomerulonephritis or rheumatic heart disease Signs and symptoms sore throat. HR RR: 16-20 HR: 60-90 Why are young children prone to ear The eustachian tubes are flattened infections? Otitis Media signs and symptoms fever. Tylenol. PDA blood flow defects Obstructive defects coarctation of aorta. TA . PDA. for tonsilitis ice chips. abx. VSD. ASD. enlarged tonsils. pain. fever. Post-surgical care of vomiting fresh blood. soft foods tonsillectomy and fluids. reduce body for otitis media temperature (warm tepid bath). clearing throat).Adolescent RR. AS Decreased pulmonary Tetralogy of Fallot blood flow Mixed blood heart defects TGV. possible of tonsilitis obstructed breathing Nursing interventions throat culture to determine cause. possible surgery. AS Cyanotic heart defects tetralogy of Fallot. Tylenol Monitor for post-op bleeding (frequent swallowing. transposition of great vessels Increased pulmonary ASD. TA. enlarged lymph nodes. warm salt gargles. ice collar for comfort When is highest risk of hemorrhage after first 24 hours. 5-10 days after surgery tonsillectomy? Acyanotic heart defects VSD. infant may pull at ear. drainage from ear (if eardrum is ruptured). vomiting and diarrhea Nursing interventions Abx as prescribed.

Cyanosis because unoxygenated blood is pumped into the systemic circulation. Hole between aorta and pulmonary artery. usually closes within 72 hours. Hypertension of upper extremities and decreased or absent pulses in lower extremities. Truncus Arteriousus. right ventricular hypertrophy One artery (truncus) rather than 2 arteries (aorta and pulmonary artery) arises from both ventricles Pulmonary artery leaves the left ventricle and the aorta exits from the right ventricle. Blood mixes in the R and L ventricles through a large VSD l/t cyanosis and increased pulmonary resistance. Oxygenated blood from LV to body is diminished Three T's of cyanotic Tetralogy of Fallot. Obstruction of blood flow from ventricles Aortic Stenosis (AS) immediately before/at/after aortic valve. decreased pulmonary Signs and symptoms circulation. heart disease Transposition of the great arteries What is tetralogy of Fallot? Truncus Arteriosus Transposition of the Great Arteries combination of four defects: VSD. Experiences tet spells or hypoxic of Tetralogy of Fallot episodes and relieved by squatting or put in the knee-chest position. Truncus Arteriosus Transposition of the Great Vessels Pulmonary artery and aorta do not separate. Mixed blood flow. Increased blood flow to the lungs l/t pulmonary Treatment and hypertension. Oxygenated blood from the aorta returns to the pulmonary artery.Atrial Septal Defect (ASD) Increased pulmonary blood flow. . consequences of ASD Can l/t CHF and atrial dysrhythmia.Pulm circulation arises from L vent and systemic circulation arises from R vent. requires surgery. Treatment and Surgical closure before school age recommended. Patent Ductus Arteriosus (PDA) Increased pulmonary blood flow. Require Indomethacin or surgical consequences of PDA closure. There is a hole between the atria. overriding aorta. pulmonary stenosis. oxygenated blood from LA is shunted to the RA and lungs. Coarctation of the Aorta Classic signs of coarctation of aorta Obstruction of blood flow from ventricles c/b narrowing of aorta.

fatigue. Assessment of child with CHD Check for murmur. FTT. bleeding. Maintain hydration to CHD prevent thrombus formation. Do NOT skip doses. and abdominal pain. blood entering the systemic system Therapeutic digoxin levels Digoxin administration Digoxin toxicity What exacerbates Digoxin toxicity? 0.8-2ng/ml Check for bradycardia and hold. diarrhea. When does birth length double When does the child sit unsupported 4 years 8 months When does a child achieve 2 years .. also. cyanosis. perforation.. fatigue. clubbing (>age 2). phlebitis. all blood entering Basic differences circulation is oxygenated between cyanotic and Acyanotic: abnormal circulation with unoxygenated acyanotic defects. respiratory infections Maintain nutrition status with small frequent meals Feeding a child with with high-calorie formula. not miss with meals Vomiting is early sign.Incompatible with life --> medical emergency give prostaglandin to keep ductus open. poor feeding. muscle weakness Hypokalemia << first < prev1next >last >> Si de 3 Question Answer Loading. anorexia. Risks of cardiac catheterization arrhythmias. arterial obstruction at entry site Cyanotic: abnormal circulation.

their coginitive development Infants alows them to remember pain Concepts of bodily injury: They fear intrusive procedures toddlers Concepts of bodily injury: They fear body mutilation Preschoolers Concepts of bodily injury: Fear loss of control of their bodies School age children Concepts of bodily injury: Major concern is a change in body image Adolescents What is a major cause of death in children and Accidents adolescents? What kind of children pose a serious threat to Children with German measles .50% of adult height When does a child throw a 18 months ball overhand When does a child speak two to three word 2 years sentences When does a child use scissors 4 years When does a child tie his 5 years or her shoes Which gender's growth spurt occurs first? Girls: as early as 10 years of age What kind of behavior is considered common in the Temper tantrum toddler? When does a child form his or her identify? Rebellion against family values is common for which age group? Adolescence Adolescence Concepts of bodily injury: After 6 months.

nerologic symtptoms after obtained prior to previous vaccine. sz. or obtain prior to the neomycin administration of MMR? Pertussus fatalities continue to occurr in which group in the US? Which type of administration method invalidates the mantoux test? Is the common cold a contraindication for immunization? Nonimmunized infants subQ rather than ID No Irritability Fever (<102) Redness and soreness at injection site for 2-3 days are normal for DTaP and IPV What type of teaching Call HCP if seizures. high fever.their unborn siblings? What kind of hx should be Hx of reactions. systematic alergic reactions administration of DPAT? What kind of hx should be Hx of anaphylactic reactions to eggs. or high pitched should be provided crying occurs following immunization? Warm washcloth on thigh injection site and bicycling the legs with each diaper change decreases soreness Tylenol is administered every 4-6 hrs (1015mg/kg) Where should milk be stored? How do you cook vegetables to preserve potency? In an opaque container Cook in a small amount of liquid Is it recomended to induce No. there is the risk of completely blocking the airway . it may cause more damage vomiting in children? Should you examine the throat of a child with epiglottitis? No.

prolonged or excessive. and whether there is a hx of any bleeding disorders in the family With cyanotic defects.Which is the priority of care regarless of age? Prior to tonsillectomy. polycythemia what condition is common Acyanotic: abnormal circulation but all blood entering the systemic circulation is oxygenated Cyanotic: abnormal circulation with unoxygenated blood entering the systemic circulation What is the difference between acyanotic and cyanotic? Are acyanotic or cyanotic defects more common Acyanotic with CHF children To conserve energy in children with heart defects. what Position child upright and supporting the lower nursing interventions jaw should be implemented What is the nursing goal in caring for a down syndrome child? What are the s/sx of IICP? What is essential so changed associated with Help the child reach his or her optimal level of functioning Opposite of shock: Decreased pulse. its important to know if there is a hx of bleeding. which labs should be known Patent airway! PT/PTT: in addition to this. what may be necessary to conserve energy? What are two objectives of tx CHF? Tube feedings Reduce the workload of the heart and increase CO What should be consistent Weighing the child on the same scale at the when frequently weighing same time of day so accurate comparisons can a child? be made When feeding a child with Preventing aspiration: cerebral palsy. decreased blood pressure Baseline of child's behavior and level of development .

a patients with infratentorial large tumor may require a child not be turned to tumors be positioned? the operative side What is the first sign of renal failure Decreased urinary output It is usually done before preschool years to When is the correction of allow for the achievement of sexual identity. the shunt has delicate valves and pumping can change pressures within the ventricles What is the most common cause of increased seizure Medication noncomplicance activity? Hydration status and IV therapy. to hypospadias done? avoid castration anxiety. and to facilitate toilet training Guilt What are typical patient Disappointment and family reactions to a Grief child with a Sense of loss malformation? Anger Alternation in nutrition: less than body What is an important requirements nursing diagnosis r/t cleft lip/palate & pyloric Cleft lip/palate: r/t decreased ability to suck stenosis? Pyloric Stenosis: r/t frequent vomiting Nutrition needs & electrolyte balance What are big problems for children with GI Younger children are more vulnerable to these problems? problems . there may be inappropriate ADH secretions causing cerebral edema and dilutional hyponatremia What is the most common presenting symptom with Headache a brain tumor? How should post-op Patients should be flat or turned to either side.IICP can be detected early? Should a shunt be pumped? No. What should the nurse monitor carefully with meningitis? With meningitis.

instead folic acid is given to stimulate RBC synthesis Epi and O2 to treat anaphylaxis What is used to reduce the Prednisone is frequently used in combination mitosis of lymphocytes? with antineoplastic drugs What is used to prevent renal damage? Allopurinol .an xanthineoxidase inhibitor How can you describe an infant with Good. Iron can be fatal in severe doses 6.Where should you take the temp of a child with Axillary temp megacolon? What are the Hgb norms for a: Newborn Infant Child Newborn: 14-24 Infant: 10-15 Child: 11-16 1. Do not give with dairy products What supplement is not given to sickle cell anemia? What needs to be available when administering lasparaginase? Supplemental Iron. Stools will be tarry 5. Give with citrus juice 3. Use dropper or straw to avoid discoloring What are teaching point of teeth administering iron? 4. Give on an empty stomach 2. quiet baby hypothyroidism? How should insulin be administered when a child Administer it in normal saline is in DKA? What type of fractures are Spiral fractures related to child abuse? What type of fractures put Fractures involving the epiphyseal plate limb growth at risk? What do you want to monitor with pin sites? s/sx of infection .

special concern? How is skeletal traction Skeletal traction is maintained by pins or wires applied? applied to the distal fragment of the fracture. rib hump.. How would the nurse conduct a scoliosis screening? Ask the child to bend forward from the hips with arms hanging free. Keep cast dry. wear a T-shirt under brace. Examine the child for a curve in the spine. brisk capillary refill. Do not turn child using an abductor bar. free neurovascular movement. and unequal dislocated hip in infants? leg lengths. . What is compartment syndrome? Damage to the nerves and vasculature of an extremity due to pressure. inability to move the compartment syndrome? extremity.. Prevent cast soilage during toileting or diapering. What discharge instructions should be included concerning a child with spica cast? Check child's circulation. symptoms of congenital limited abduction of the affected hip. and poor capillary refill.Does a brace correct or slow the progression of scoliosis? It slows the progression << first < prev1next >last >> Si de 3 Question Answer Loading. extremity. and equal pulses. What are the signs and Abnormal neurovascular assessment: cold symptoms of extremity. Do not place anything under cast. normal sensation of the afected assessment. What instructions should The child should be instructed to wear the brace a child with scoliosis 23 hours per day. severe pain. What are signs and Unequal skin folds of the buttocks. Ortalini sign. Why are fractures of the Fractures of the epiphyseal plate (growth plate) epiphyseal plates a may affect the growth of the limb. List normal findings in a Warm extremity. and hip asymetry.

Temper tantrums are common in the toddler. Normal growth and development knowledge is used to evaluate interventions and therapy.e. HESI HINTS Growth and Development Milestones When does birth length double? Answer: By 4 years When does the child sit unsupported? Answer: 8 months When does a child achieve 50% of adult height? Answer: 2 years When does a child throw a ball overhand? Answer: 18 months When does a child speak 2-3 word sentences? Answer: 2 years When does a child use scissors? Answer: 4 years When does a child tie his/her shoes? Answer: 5 years Be aware that a girl’s growth spurt during adolescence begins earlier than boys (as early as 10 years old). For example. and teaching about rhuematoid arthritis? medication management and side affects of drugs. perform back and abdominal exercises. modify clothing. The child should be encouraged to maintain normal activities as able. What care is indicated Prescribed exercise to maintain mobility.” or average behavior.recieve about the Milwaukee brace? check skin for irritation. i. “What behavior would indicate that thyroid hormone therapy for a 4month-old is effective?” You must know what milestones are accomplished by a 4- . for a child with juvenille splinting of affected joints.. considered “normal. Be aware that adolescences is a time when the child forms his/her identity and that rebellion against family values is common for this age group.

Following immunization. MMR: History of anaphylactic reaction to eggs or neomycin. Use facts and principles related to growth and development in planning teaching interventions. The common cold is not contraindication for immunization. meaning they like to do and accomplish things. neurological symptoms after previous vaccine. what teaching should the nurse provide to the parents? Irritability. . Pertussis fatalities continue to occur in unimmunized infants in the U. The nurse should counsel all expectant mothers. Acetaminophen (Tylenol) is administered orally every 4-6 hours (10-15 mg/Kg). Subcutaneous injection. Preschoolers: Fear body mutilation. Peers are also becoming important for this age child. Call health care provider if seizures. or systematic allergic reactions. Toddlers: Fear intrusive procedures.S. their cognitive development allows them to remember pain. This is possible for a preschooler to do and gives the child some sense of control. School age: Fear loss of control of their body. to be aware of the serious consequences of exposure to German measles during pregnancy. Pertinent history should be obtained prior to administering certain immunizations because reactions to previous immunizations or current health conditions may contraindicate current immunizations: DPT: History of seizures. School-age children are in Erikson’s stage of industry. A warm washcloth on the thigh injection site and “bicycling” the legs w/each diaper change will decrease soreness. One correct answer would be “has steady control” which is an expected milestone for a 4-month-old and indicates that replacement therapy is adequate for growth. invalidates the Mantoux test. especially those w/young children. For example: “What task could a 5-year-old diabetic boy be expected to accomplish by himself?” One correct answer would be to pick the injection sites. Age groups concepts of bodily injury: Infants: After 6 months. rather than intradermal. fever (<102 degrees F). redness and soreness at injection site for 2-3 days are normal side effects of DPT and IPV administration. Adolescent: Major concern is change in body image. or high -pitched crying occur. high fever.month-old. Children w/German measles pose a serious threat to their unborn siblings.

Add potassium to IV fluids ONLY w/adequate urine output. Child needs 150% of the usual calorie intake for normal growth and development. Polycythemia is common in children w/cyanotic defects. cook vegetables in small amount of liquid. When calculating a pediatric dosage.e. The child’s age directly influences the severity and management of these problems. do not put a tongue blade or any object in the throat. a patent airways is always a priority of care. Basic difference between cyanotic and acyanotic defects: Acyanotic: Has abnormal circulation. HINT: Weight expressed in kilograms should always be a smaller number than weight expressed in pounds.Common childhood problems are encountered by nurses caring for children in the community or hospital settings. the nurse should ask if there has been a history of bleeding. Infants may require tube feeding to conserve energy. regardless of age! Respiratory disorders are the primary reason most children and their families seek medical care. For normal cardiac rates in children. Cyanotic: Has abnormal circulation w/unoxygenated blood entering systemic .e. Therefore. see Respiratory in this chapter. Urinary output for infants and children be 1-2 ml/kg/hour. Nutritional Assessment: Teach proper cooking and storage to preserve potency. Store milk in opaque container. these disorders are frequently tested on the NCLEX-RN. i.. Use of syrup of ipecac is no longer recommended by the American Academy of Pediatrics.. or if there is a history of any bleeding disorders in the family. i. the nurse must often change the child’s weight from pounds to kilograms. prolonged/excessive. The heart rate of a child will increase w/crying or fever. Knowing the normal parameters for respiratory distress in children is essential! The nurses should be sure a PT and PTT have been determined prior to a tonsillectomy. all blood entering the systemic circulation is oxygenated. Do not examine the throat of a child w/epiglottitis due to the risk of completely obstructing the airway. More importantly. however. Teach parents that it is NOT recommended to induce vomiting in any way as it may cause more damage. In planning and providing nursing care.

during a seizure.circulation. It can cause traumatic damage to mouth/oral cavity. and pumping changes pressures within the ventricles. With meningitis. Do NOT use tongue blade. there may be inappropriate ADH secretions causing fluid retention (cerebral edema) and dilutional hyponatremia. Shock: Increased pulse. Position child upright and support the lower jaw. Headache upon awakening is the most common presenting symptoms of brain tumors. Suctioning. A large tumor may require that the child NOT be turned to the operative side. Increased blood pressure. Feed infants or child w/cerebral palsy using nursing interventions aimed at preventing aspiration. Most postoperative clients w/infractentorial tumors are prescribed to lie flat and turn to either side. The nursing goal in caring for children w/Down syndrome is to help the child reach his/her OPTIMAL level of functioning. straining. CHF is a common complication of congenital heart disease. The two objectives in treating CHF are to reduce the workload of the heart and increase cardiac output. and/or turning causes increased ICP. It reflects the increased workload of the heart resulting from shunts or obstructions. weigh client on the same scale at same time of day so that accurate comparisons can be made. Monitor hydration status and IV therapy carefully. Decreased blood pressure. Baseline data on the child’s USUAL behavior and level of development is essential so changes associated w/increased ICP can be detected EARLY. Do not pump shunt unless specifically prescribed. coughing. padded or not. Decreased urinary output is FIRST sign of renal failure. When frequent weighings are required. . Increased ICP: Decreased pulse. The shunt is made up of delicate valves. CHF: Congestive heart failure is more often associated w/acyanotic defects. The signs of increased ICP are the opposite of those of shock. Medication noncompliance is the most common cause of increased seizure activity.

less than body requirements. With each pregnancy. hemophilia. Don not give w/dairy products. Hydration is very important in treatment of sickle cell disease because it promotes hem dilution and circulation of red cells through the blood vessels. However. X-linked recessive trait: The trait is carried on the X chromosome. Nutritional needs and fluid and electrolyte balance are key problems for children w/GI disorders. grief. Children w/cleft lip/palate and those w/pyloric stenosis both have a nursing diagnosis “alteration in nutrition. for the disease to be expressed in their offspring. disappointment.g. keep away from children. all children of such parents CAN get the disease . and anger. Give w/citrus juices (vitamin C) for increased absorption. therefore. REMEMBER the Hgb norms. there is a 1:4 chance of the infant having the disease. Iron can be fatal in severe overdose. Typical parent/family reactions to a child w/an obvious malformation such as cleft lip/palate are guilt. The younger the child. Use dropper or straw to avoid discoloring teeth. or carriers of the recessive trait. castration anxiety. Stools will become tarry. sense of loss. usually affects male offspring. This is the transmission for sickle cell anemia. Important terms: . Remember: Autosomal recessive: Both parents must be heterozygous. cystic fibrosis. and toilet training.. Take axillary temperature on children w/congenital mega colon. Inherited bleeding disorders (hemophilia and sickle cell anemia) are often used to test knowledge of genetic transmission patterns. Pyloric stenosis is related to frequent vomiting. With each pregnancy of a woman who is a carrier there is a 25% chance of having a child w/hemophilia.NOT 25% of them. e. the more vulnerable they are to fluid and electrolyte imbalances and greater is the need for caloric intake required for growth. and phenylketonuria (PKU).Surgical correction for hypostasis is usually done before preschool years due to achieving sexual identity. If the child is male. Newborn: 14 to 24 g/dl Infant: 10 to 15 g/dl Child: 11 to 16 g/dl TEACH FAMILY ABOUT ADMINISTRATION OF ORAL IRON: Give on empty stomach (as tolerated for better absorption).” Cleft lip/palate is related to decreased ability to suck. she has a 50% chance of being a carrier. If the child is female. he has a 50% chance of having hemophilia.

. Knowledge of normal growth and development is important. particularly among Native-American. quiet baby” by the parents. Adolescence frequently causes difficulty w/management since growth is rapid and the need to be like peers makes compliance difficult. Early detection of hypothyroidism and phenylketonuria is essential in preventing mental retardation in infants. NutraSweet (aspartame) contains phenylalanine and should not therefore.Heterozygous gene (HgbAS) sickle cell trait. be given to a child w/phenylketonuria. Fractures in older children are common as they fall during play and are involved in motor vehicle accidents.S. A marked increase in type 2 DM has occurred recently in the U.. Folic acid is given orally to stimulate RBC synthesis. The anemia is not caused by iron deficiency. is also administered to prevent renal damage from uric acid build up during cellular lysis. The increasing rate of obesity in children is thought to be a contributing factor. There has been an increase in the number of children diagnosed with Type 2 diabetes. administer regular insulin IV as prescribed in normal saline. cognitive level of development. a xanthine-oxidase inhibitor. Allopurinol. African-American. An infant w/hypothyroidism is often described as a “good. Remember to consider the child’s age. Supplemental iron is not given to clients w/sickle cell anemia. Other contributing factors include lack of physical activity and a family history of Type 2 diabetes. Have epinephrine and oxygen readily available to treat anaphylaxis when administering I-asparaginase. Homozygous gene (HbSS) sickle cell disease. Spiral fractures (caused by twisting) and fractures in infants may be related to child abuse. Abnormal hemoglobin (HGBS) disease and trait. and psychosocial development when answering NCLEX-RN questions. Prednisone is frequently used in combination w/antineoplastic drugs to reduce the mitosis of lymphocytes. When child is in ketoacidosis. and Hispanic children and adolescents. since a lack of attainment can be used to detect the existence of these metabolic/endocrine disorders and attainment can be used for evaluating the treatment’s effect. Diabetes mellitus (DM) in children was typically diagnosed as insulin dependant diabetes (Type 1) until recently.

Fractures involving the epiphyseal plate (growth plate) can have serious consequences in terms of growth of the affected limb. Children do not like injections and will deny pain to avoid “shots. Corticosteroids are used short term in low doses during exacerbations. Monitor for signs of infection. *Ductus arteriosis CONSTRICTS CV Changes at Birth *Pulmonary vascular bed OPENS * Ductus arteriosis ____ *Pulmonary vascular resistance * Pulmonary vascular bed ____ DECREASES * Pulmonary vascular resistance *Systemic vascular resistance ____ INCREASES * Systemic vascular resistance ____ *Foramen ovale CLOSES d/t * Foramen ovale __ d/t ___ BLOOD FLOW FROM LEFT TO RIGHT ACYANOTIC congenital heart diseases that cause ↑ Pulmonary blood flow: _____ * A/V septal defects * Patent ductus arteriosus * Atrioventricular canal . Cleanse and dress pin sites as prescribed.” A brace does not correct the curve of a child w/scoliosis.. << first < prev1next >last >> Si de 3 Question Answer Loading.. Pin sites can be sources of infection. it only stops or slows the progression. Long-term use is avoided due to side effects and their adverse effect on growth. Skeletal disorders affect the infant’s or child’s physical mobility. Skin traction for fracture reduction should NOT be removed unless prescribed by healthcare provider. and typical NCLEXRN questions focus on appropriate toys or activities for the child who is on bedrest and/or immobilized.

Teach the parents signs of CHF._____ _____ ACYANOTIC congenital heart diseases that cause obstructed blood flow from ventricles: ____ ____ ____ CYANOTIC congenital heart diseases that cause ↓ Pulmonary blood flow: ____ ____ CYANOTIC congenital heart diseases that cause mixed blood flow: ____ ____ ____ ____ NCLEX After a pediatric client has a cardiac cath. Encourage fluids and regular diet. 2. which intervention would the nurse consider to be of highest priority during the immediate post procedure period? 4. * Coarctation of aorta * Aortic stenosis * Pulmonic stenosis * Tetralogy of Fallot * Tricuspid atresia * Transposition of great arteries * Total anomalous pulmonary venous return * Truncus arteriosus * Hypoplastic L heart syndrome . Monitor the site for signs of infection. Apply direct pressure to 1. 3. Which of the following home care instructions in included for a child postcatheterization? 1. Apply direct pressure to entry site of 15 minutes. 4. amounts of fluid. Encourage intake of small entry site of 15 minutes. NCLEX 1. Encourage fluids and regular diet.

4. Patent Ductus Arteriosus * Diagnosis . or “tet” spells.Continuous ____ below left ____ . They experience hypercyanotic.Dx with X-RAY. Prostaglandin E1 Patent Ductus Arteriosus * Diagnosis . They experience frequent respiratory infections. 4. They experience decreased or absent pulses in the lower extremities. 3. They experience hypercyanotic.PARALLEL circulation * Clinical manifestations .____ circulation * Clinical manifestations .SURGERY Transposition of the Great Arteries * Pathophysiology . or to as “blue tets.Initially appears NORMAL .____ blood enters ____ and ____ .Initially appears ____ . cardiac ___ * Treatment . 3. The condition is commonly referred 2.Dx with ____. 2.” “tet” spells. The child may return to school the next day.Continuous MURMUR below left CLAVICLE .UNOXYGENATED blood enters RA and RV .____ for preterm only . NCLEX Administration of which of the following drugs 4.INDOMETHACIN for preterm only . Encourage physical activities.____ develops within a few hours of life NCLEX Which of the following statements is correct for a child with tetralogy of Fallot? 1. cardiac ECHO * Treatment .2. The child can routinely bathe after returning home.CYANOSIS develops within a few hours of life .____ Transposition of the Great Arteries * Pathophysiology .

____itis . Truncus arteriosus Psychosocial Factors * ____ * ____ * ____ * ____ 1.____ on echocardiogram NCLEX When assessing a child with suspected Kawasaki disease.would be the most important in treating transposition of the great arteries? 1. Prostaglandin E1 NCLEX Which of the following cardiovascular disorders is considered acyanotic? 1. nausea.HIGH (not low) fever Kawasaki Disease * Pathophysiology . which of the . Tachycardia and dysrhythmia 2. Patent ductus arteriosus 2. Tetralogy of Fallot 3. Which assessment finding indicates to the nurse a toxic 3. and vomiting dose of digoxin? 1. Bradycardia. “Strawberry” tongue 1st sign .VASCULitis (BV inflamm) . Diuretics 3.____itis . Headache and diarrhea 3. Antibiotics 4.ECTASIA (dilation of tubular vessel) on echocardiogram 2. Bradycardia.PANCARDitis (inflamm of ALL structures of heart) . Tinnitus and nuchal rigidity Kawasaki Disease * Pathophysiology . Patent ductus arteriosus * Separation * Bonding * Feeding * Care NCLEX A 2-year-old child has a known cardiac defect and is in congestive heart failure. Tricuspid atresia 4. nausea. Digoxin 2. and vomiting 4.

Pink moist mucous membranes 4." NCLEX Which of the following statements best defines the term cardiogenic shock? 1. A reduction in circulating blood volume RESULTING IN GLOBAL HYPOPERFUSION 2.” 3. tarry stools are considered normal. Hypotension 3. Which of the following statements shows an understanding of the treatment plan? 1. A reduction in circulating blood volume 3. Inflow or outflow obstruction of the main bloodstream.” toothbrush. Decreased cardiac output CAUSES 2. NCLEX Which of the following signs is considered a late sign of shock in children? 1. Low-grade fever 2. Pale. mottled skin NCLEX 1. “My child can return to playing football next week. cool. Hypotension 3. Decreased cardiac output 2. “Black.” 2. Delayed capillary refill 4. “Strawberry” tongue 3. Bilateral conjunctival infection with yellow exudate NCLEX A nurse is giving discharge instructions to the parents of a child with Kawasaki disease. “My child should use a soft-bristled home. “A regular diet can be resumed at 3. Low-grade fever . Tachycardia 2.following symptoms is common? 1. “My child should use a softbristled toothbrush.” 4. Overwhelming sepsis and circulating bacterial toxins 4.

Maintain strict bed rest. call the physician. Low-grade fever 4. Administer an analgesic as needed. Give the child nothing by mouth. Which of the following interventions would be most 4. Tingling. Weight gain 2. Your child can take a complete the incision bath tomorrow. If the sterile adhesive strips over the incision fall off. To observe the child for signs of A chld with a cyanotic heart defect is increased intracranial pressure.A child with suspected bacterial endocarditis arrives at the emergency department. 4. To prevent the child from crying . Which of the following statements is most appropriate? 1. 4. In the discharge teaching. and numbness are normal sensations at the wound site. the nurse instructs the parents: 1. being discharged home to await surgical repair. NCLEX 2. Administer an analgesic as needed. Lotions and powders are acceptable. Take vital signs every 8 hours. fall off. 3. appropriate? 1. Increased hemoglobin level NCLEX A nurse is teaching wound care to parents after cardiac surgery. Bradycardia 3. If the sterile adhesive strips over 2. 4. itching. 2. 3. call the physician. NCLEX A child with an atrial septal repair is entering postoperative day 3. Which of the following findings is expected during assessment? 1.

CPP = MAP – ICP Keep above 60 Monro .__failure.at all. HEMATOMAS) • ISCHEMIC injury (STROKE. Monro . __failure. ABSCESSES. Normal ICP Adult ___-___ mm Hg Child ___-___ mm Hg (Accept values < ___ mm Hg) Cerebral Perfusion Pressure . Normal ICP Adult 3 . RENAL failure. another component must DECREASE or ICP will INCREASE.10 mm Hg (Accept values < 20 mm Hg) .15 mm Hg Child 0 . another component must ____ or ICP will ____. LIVER failure.__) • ____ problems (__natremia.__. 2. To identify growth and development milestones.__) • ____ injury (__. To observe the child for signs of increased intracranial pressure. HYPOXIA) • METABOLIC problems (HYPOnatremia. 3.Kellie Hypothesis – brain 80% – blood 10% – CSF 10% • If one component increases in volume.blood pressure gradient across the brain CPP = ____–____ Keep above ____ Causes of Increased ICP • ____ lesions (__. In cardiopulmonary resuscitation. the skull is a rigid compartment filled to capacity with non-compressible contents: – brain ____% – blood ____% – CSF ____% • If one component increases in volume.__acidosis) • Subarachnoid/intracerebral ____ Increased ICP • MASS lesions (TUMORS. 4.Kellie Hypothesis • Once sutures have fused.

____/____ alignment • Severe deterioration of LOC • VOMITING • PAPILLedema • POSTURing • Change in VITAL signs • Impaired brain stem REFLEXES S/S of Increased ICP in an INFANT • POOR feeding • IRRITABILity • HIGH-pitched cry • TENSE. ____ fontanel • ____ing • ____ scalp veins • ____ head circumference TX for Elevated ICP (slide#1) • 1st: ___'s! – Stabilize ____ .LOW-NORMAL CO2 – VASOactive drugs – DIURETICS (Osmotic/Loop) – HYPERosmolar therapy with 3% saline – Positioning: SUPINE. BULGING fontanel • VOMITing • DISTENDED scalp veins • INCREASED head circ TX for Elevated ICP (slide#1) • 1st: ABC’s! – Stabilize AIRWAY . HEAD/NECK alignment . HOB UP. HOB ___.____-____ CO2 – ____active drugs – ____ drugs (Osmotic/Loop) – ____osmolar therapy with ____% saline – Positioning: ____.• ____ Malfunction Diabetic Ketoacidosis) • Subarachnoid/intracerebral HEMORRHAGE • SHUNT Malfunction • PUPILLARY dysfunction • MOTOR weakness • SENSORY deficits • CRANIAL nerve palsies • HEADACHE pain • Deterioration in level of CONSCIOUSNESS • SEIZURE S/S of Increased ICP • ____ dysfunction • ____ weakness • ____ deficits • ____ nerve palsies • ____ pain • Deterioration in level of ____ • ____ LATE S/S of Increased ICP • Severe deterioration of ___ • ____ • ____edema • ____ing • Change in ____ signs • Impaired brain stem ____ S/S of Increased ICP in an INFANT • ____ feeding • ____ity • ____-pitched cry • ____.

nausea. nausea. lethargy. urine osmolality – Irritability. convulsions SIADH Tx/NSG interventions • ____ fluids • ____tonic saline • Monitor ____ • Accurate __&__ • Urine ____ • Daily ____ • ____ checks • ____ precautions S/S Diabetes Insipidus • Insufficient ___ Hormone • ____ diuresis • ____ osmolality • ____ urine specific gravity • ____ thirst • ____hydration DI Tx/NSG Interventions • Fluid ____ • Strict __&__ TX for Elevated ICP (slide#2) • SEDAtion • Maintain NORMAL temp • SURGERY • CSF Drainage • SEIZURE control • BOWEL regimen • Avoid clustering ACTIVITIES • Avoid ISOMETRIC exercises • Provide a CALM environment .____ H2O reabsorption – ____ serum osmolality – ____ serum Na (<110mEq/L) – ____ urine osmolality – Irritability.TX for Elevated ICP (slide#2) • ____tion • Maintain ____ temp • ____ • ____ Drainage • ____ control • ____ regimen • Avoid clustering ____ • Avoid ____ exercises • Provide a ____ environment Syndrome of Inappropriate ADH Secretion . serum osmolality – DEC. cramps. stupor. anorexia. cramps. osmolality • DEC.INC. convulsions SIADH Tx/NSG interventions • RESTRICT fluids • HYPERtonic saline • Monitor ELECTROLYTES • Accurate I&O • Urine SPECIFIC GRAVITY • Daily WEIGHT • NEURO checks • SEIZURE precautions S/S Diabetes Insipidus • Insufficient ADH • UNCONTROLLED diuresis • DEC. urine specific gravity • INSATIABLE thirst • DEhydration DI Tx/NSG Interventions • Fluid REPLACEMENT • Strict I&O . stupor. anorexia. serum Na (<110mEq/L) – DEC. lethargy. H2O reabsorption – DEC.

tubing. elastic Most common causative organisms of MENINGITIS (80%) • ____ • ____ • ____ MENINGITIS Tx/NSG Intervent. tires. glue.• Daily ____ • Urine ____ • Monitor ____ • Med: ____ Nursing Dx for pts with Neural Tube defects • Potential for ____ • Potential for ____ • Potential for ____ • Potential for ___ skin ___ • Altered ____ • Alteration in ___ processes • Daily WEIGHT • Urine SPECIFIC GRAVITY • Monitor ELECTROLYTES • Med: DDAVP (Desmopressin) Nursing Dx for pts with Neural Tube defects • Potential for infection • Potential for trauma • Potential for injury • Potential for impaired skin integrity • Altered body image • Alteration in family processes 50-70% of SB pts have an allergy to LATEX Treat ALL SB pts as if they have this 50-70% of Spina Bifida pts have an allergy allergy to _____ Found in: catheters. • Meds: ____ • ____ precautions • ____tion • Fluid ____ (how much?) • Monitor for increased ___ • ____ measures • ____ tests • Haemophilus influenza b (Hib) • Strep pneumoniae (pneumococcal) • Neisseria menigitidis (meningococcal) MENINGITIS Tx/NSG Intervent. tourniquets. balloons. tape. handles. • Meds: ABX • Isolation precautions • Ventilation • Fluid restriction (how much? 1/2 to 2/3) • Monitor for increased ICP • Comfort measures • Hearing tests . toys. gloves.

MED EMERG • Continuous ____ activity • Loss of ____ Causes of Cerebral Palsy • ____ birth • Perinatal ____ • ____ • Intrauterine ____ • Congenital ____ Anomalies • ____ Disorders Med/Nsg Interventions for CP • ____ training MENINGITIS residual effects • Deafness.MED EMERG • Continuous SEIZURE activity • Loss of CONSCIOUSNESS Causes of Cerebral Palsy • PREMATURE birth • Perinatal ASPHYXIA • INFECTION • Intrauterine ISCHEMIA • Congenital BRAIN Anomalies • METABOLIC Disorders Med/Nsg Interventions for CP • ADL training . blindness • Paralysis • Subdural effusions. hydrocephalus • Seizures • CP • Amputation (Meningococcal) Etiology of Seizures • Idiopathic • Infectious Process • Metabolic Imbalance • Fever • Brain Injury or Brain Tumor • Drug Intoxication • Subtherapeutic Drug Levels Seizure Types • Partial – Simple – Complex • Generalized – Tonic-Clonic – Absence – Atonic – Akinetic Status Epilepticus.MENINGITIS residual effects • ____ness. ____cephalus • ____ • ____ palsy • ____ (Meningococcal) Etiology of Seizures • ____pathic • ____ Process • ____ Imbalance • ____ (temp) • ____ Injury or ____ Tumor • ____ Intoxication • ____therapeutic Drug Levels Seizure Types • Partial – ____ – ____ • Generalized – ___-___ – A____ – A____ – A____ Status Epilepticus. ____ness • ____ • Subdural ____.

Prolonged jaundice * Treatment: Early Tx prevents Cretinism Pseudohermaphroditism = an Virilization = Development of male individual having internal secondary sexual characteristics reproductive organs of one sex and external sexual characteristics Adrenarche = the increase in activity resembling those of the other sex or of the adrenal glands just before being ambiguous in nature puberty NORMAL HGB VALUES Infant: __-__ g/dl 6-12 yr: __-__ g/dl 12-18 yr: __-__ g/dl Anemia (Hgb levels) – Mild: __ g/dl NORMAL HGB VALUES Infant: 9 – 14 g/dl 6-12 yr: 11.Prolonged ____ * Treatment: Early Tx prevents ____ Definitions: • Mobility assistance • Communication aids • Physical Therapy • Medication • Surgery Hypopituitarism: GHD Clinical manifestations * Short stature * Deteriorating or absent rate of growth * Higher weight-to-height ratio * Delayed bone age Congenital Hypothyroidism * Clinical manifestations .5 – 15.Large ____ fontanel .____ (bowels) .Constipation .Large posterior fontanel .• ____ assistance • ____ aids • ____ Therapy • ____ • ____ Hypopituitarism: GHD Clinical manifestations * ____ stature * ____ or ____ rate of growth * Higher ____-to-____ ratio * ____ bone age Congenital Hypothyroidism * Clinical manifestations .Umbilical ____ .5 g/dl 12-18 yr: 12 – 16 g/dl Anemia (Hgb levels) – Mild: 11 g/dl .Umbilical hernia .

toxic. postsplenectomy – Patient/Family Education Aplastic Anemia • Pancytopenia – Neutrophils < 500 – Platelets < 20. pharmacologic) Coagulation Disorders . toxic. allows excretion to occur (b/c RBC destruction from SCD -> ____ overload -> ____ deposited in tissues unless excreted . postsplenectomy – Patient/Family Education Aplastic Anemia • Pancytopenia – Neutrophils < ____ – Platelets < ____ – Hemoglobin (RBCS) ____ – Reticulocytes < ____% • Etiology – Primary (congenital): ____ – Secondary (acquired): ____ (viral. allows excretion to occur (b/c RBC destruction from SCD -> iron overload -> iron deposited in tissues unless excreted .– Moderate: __–__ g/dl – Severe: < __ g/dl SICKLE CELL complication STROKE (or high-risk for it) Tx: * ____ transfusion q ____ wks * Desferoxamine (____ therapy) binds ____.000 – Hemoglobin (RBCS) DEC. – Reticulocytes < 1% • Etiology – Primary (congenital): Fanconi’s anemia – Secondary (acquired): Injury (viral. pharmacologic) Coagulation Disorders – Moderate: 3 – 7 g/dl – Severe: < 3 g/dl SICKLE CELL complication STROKE (or high-risk for it) Tx: * Blood transfusion q 3-4 wks * Desferoxamine (Chelation therapy) binds iron.SC infusion 5 nts/week Beta-thalassemia Medical/Nursing Management • Medical Tx: – Chronic transfusions – Sometimes splenectomy – Bone marrow transplant • Nursing Issues: – Blood Transfusions – Chelation therapy – Risk of infection.__ infusion __ nts/week Beta-thalassemia Medical/Nursing Management • Medical Tx: – Chronic ____ – Sometimes ____ectomy – ____ transplant • Nursing Issues: – Blood Transfusions – ____ therapy – Risk of infection.

• ____ A (factor VIII) – aka classic hemophilia • ____ B (factor IX) – aka Christmas Disease • ____ C (factor XI) • ____ disease (vWF) Hemophilia A & B Lab Findings • Platelets: ____ • Bleeding time: ____ (clot formation) • PT (or INR): ____ (extrinsic pathway) • PTT: ____ (intrinsic pathway) Hemophilia A & B Medical/Nursing Management • Monitor for ____ episodes/complications • “First aid” for bleeding: – ____ – Administer ____containing product • ____ infusions – ____-derived or recombinant – DDAVP (Mild Hemophilia A) Hemophilia Patient/Family Education • Emergency treatment of bleeding • IV ____ administration • Anticipatory guidance: – ____ precautions – Physical activity – Monitoring for complications von Willebrand’s Disease • Hemophilia A (factor VIII) – aka classic hemophilia • Hemophilia B (factor IX) – aka Christmas Disease • Hemophilia C (factor XI) • Von Willebrand’s disease (vWF) Hemophilia A & B Lab Findings • Platelets: normal • Bleeding time: normal (clot formation) • PT (or INR): normal (extrinsic pathway) • PTT: prolonged (intrinsic pathway) Hemophilia A & B Medical/Nursing Management • Monitor for bleeding episodes/complications • “First aid” for bleeding: – RICE – Administer factorcontaining product • Factor infusions – Plasma-derived or recombinant – DDAVP (Mild Hemophilia A) Hemophilia Patient/Family Education • Emergency treatment of bleeding • IV factor administration • Anticipatory guidance: – Safety precautions – Physical activity – Monitoring for complications von Willebrand’s Disease .

epistaxis. residual) • ____ transplant • ____ response modifiers LYMPHOMA • From lymphoid and hematopoietic systems HODGKINs Disease – Older children/adolescents – Focal. easy bruising. debulk) • ____ (rapidly dividing cells) • ____ therapy (shrink. easy bruising. painless enlarged ____ tissue Dx: Node biopsy and staging Tx: Chemotherapy & radiation Atrial Septal Defect * Pathophysiology • vWf “transports” Factor VIII • Types: decreased. resect. and vWF replacement Differences in Adult and Child Cancer – Origin – Cause – Prevention and screening – Metastasis at diagnosis – Response to treatment – Cure rate Childhood Cancer Treatment Modalities • ____ (biopsy. epistaxis. abnormal or near absence of vWF • Results in : mucosal bleeding. menorrhagia • Treat with ____. resect. residual) • Bone marrow transplant • Biologic response modifiers LYMPHOMA • From lymphoid and hematopoietic systems HODGKINs Disease – Older children/adolescents – Focal. abnormal or near absence of vWF • Results in : mucosal bleeding. debulk) • Chemotherapy (rapidly dividing cells) • Radiation therapy (shrink. painless enlarged lymph tissue Dx: Node biopsy and staging Tx: Chemotherapy & radiation Atrial Septal Defect * Pathophysiology .• vWf “transports” Factor ____ • Types: decreased. and vWF replacement Find answers in book Childhood Cancer Treatment Modalities • Surgery (biopsy. menorrhagia • Treat with DDAVP.

____ ____ failure * Treatment .____ for ___ ___ failure .Symptoms? ____ .BOUNDING pulses.Fibers don’t respond to INCREASED O2 at birth * Clinical manifestations .Blood flow ____ to ____ .Sounds? ____ .PULMONARY congestion * Clinical manifestations .CONGESTIVE HEART failure * Treatment .May CLOSE by age TWO Patent Ductus Arteriosus * Pathophysiology .Heart ENLARGEMENT .Sounds? MURMUR .PULMONARY congestion * Clinical manifestations .LEFT to RIGHT shunt .Blood flow LEFT to RIGHT .CONGESTIVE HEART failure Elevate ICP • Hypercapnia • Hypoxemia • Respiratory Procedures • Vasodilating Drugs • Positioning • Valsalva Maneuver • Coughing • Emotional Upset • REM sleep • Arousal from sleep • Hyperthermia .Symptomatic? SOMETIMES ASYMPTOMATIC . WIDER pulse pressure .Symptomatic? SOMETIMES ASYMPTOMATIC .____ congestion * Clinical manifestations . ____ pulse pressure .Symptomatic? ____ ..____ ____ failure FACTORS KNOWN TO ELEVATE INTRACRANIAL PRESSURE .Symptomatic? SOMETIMES ASYMPTOMATIC .Symptomatic? ____ .CONGESTIVE HEART failure * Treatment .Blood flow LEFT to RIGHT .____ repair Ventricular Septal Defect * Pathophysiology .Blood flow ____ to ____ .____ pulses.____ congestion * Clinical manifestations .____ to ____ shunt .DIURETICS for CHF .Fibers don’t respond to ____ ____ at birth * Clinical manifestations .Heart ____ .____ ____ failure * Treatment .May ____ by age ___ Patent Ductus Arteriosus * Pathophysiology .SURGICAL repair Ventricular Septal Defect * Pathophysiology .

pallor. S&S infection – Leading cause of death in SCD pts < 5 yrs • Hemolytic/Aplastic: – Bone marrow failure SCD Medical/Nursing Management • Blood transfusion • PT teaching: Living with chronic illness • Pain Management . PCA.NSAIDS (motrin) • Adequate ____ • Adequate ____ • Support coping • Observe for complications Acute Lymphocytic Leukemia • Proliferation of abnormal lymphoblasts. bone pain. further ____ SICKLE CELL Life-threatening complications • Splenic Sequestration: – Trapping of blood in spleen. S&S infection – Leading cause of death in SCD pts < __ (#) yrs • Hemolytic/Aplastic: – ____ failure SCD Medical/Nursing Management • ____ transfusion • PT teaching: Living with chronic illness • Pain Management . __->__ transition (avoid ____) . bruising • 3 Treatment phases (chemo) – Induction (4 weeks) – Consolidation (6 months) – Maintenance (2 . can result in shock/rupture • Infection/____: – Fever.3years) • For relapse. causes pancytopenia • Presenting symptoms: ____. ____ (color). ____ pain. PCA.NSAIDS (motrin) • Adequate oxygenation • Adequate hydration • Support coping • Observe for complications Acute Lymphocytic Leukemia • Presenting symptoms: Fever.• Seizures • Clustering of Activities SICKLE CELL Life-threatening complications • ____ Sequestration: – Trapping of blood in ____. can result in shock/rupture • Infection/Sepsis: – Fever.3years) • For relapse.Opioids: ATC. IV -> oral transition (avoid meperidine) .Opioids: ATC. further chemo and bone marrow transplant . ____ing • TX: 3 Treatment phases (chemo) – Induction (4 weeks) – Consolidation (6 months) – Maintenance (2 .

____argy. SEIZUREs. or as in ALL • TX: – Induction phase – Intensive ____ • Increased incidence of ____ S/S of Hydrocephalus • Assess: ____ circ. bleeding. ____-pitched “neuro” cry. ____ (musc).and ____ transplant Acute Myelogenous Leukemia • ____ proliferation of ____ cells in ____ • Presenting symptoms: ____-like. ____ nerve dysfunction • ____ ventricles on CT/MRI Status Epilepticus Nursing Tx/Interventions 1. CONFUsion. ____ing. PAPILLedema. Safety precautions 3. ____ing. CRANIAL nerve dysfunction • ENLARGED ventricles on CT/MRI Status Epilepticus Nursing Tx/Interventions 1. ____ ALSO: • ____ diet • ____ Acute Myelogenous Leukemia • Malignant proliferation of myeloid cells n bone marrow • Presenting symptoms: Flu-like. LETHargy. Medications – Ativan or Valium – Dilantin (Phenytoin). ____sion. IRRITABILity. ____s. or as in ALL • TX: – Induction phase – Intensive chemotherapy • Increased incidence of DIC Hydrocephalus • Assess: HEAD circ. ____edema. HIGH-pitched “neuro” cry. ____ fontanel. ____ sutures • Same S/S as ICP – ____ache. ____ity. BULGING fontanel. ATAXIA (musc). Fosphenytoin – Tegretol – Depakote – Phenobarbital ALSO: • Ketogenic diet . ____ 2. ____ 3. SEPARATED sutures • Same S/S as ICP – HEADache. VOMITing. Stabilize airway! 2.

____ injections of ____ > Evaluation > ____ teaching re: ____ Acquired Hypothyroidism Clinical manifestations * ____ rate of growth * Weight ____ * ____ (bowels) * ____ skin * ____ or ____ hair * ____ (energy) * ____ intolerance * ____ of face.SQ injections of GH > Evaluation > Pt/Family teaching re:tx Acquired Hypothyroidism Clinical manifestations * Decreased rate of growth * Weight gain * Constipation * Dry skin * Thinning or coarse hair * Fatigue * Cold intolerance * Edema of face. ____ tremors NSG Management of GHD > Assessment > Nursing diagnoses . fine tremors . hands * ____ deep tendon reflexes * ____ puberty Tx = Med: ____ Hyperthyroidism Clinical manifestations * ____ rate of growth * Weight ____ despite ____ appetite * ____. moist skin * Tachycardia * Ophthalmic changes * Heat intolerance * Emotional lability * Insomnia.____ growth/developmt r/t inadeq ____ secretion .Delayed growth/developmt r/t inadeq GH secretion . eyes.Disturbed body image r/t short stature .Deficient knowledge r/t tx > Outcome identification > Planning/implementation .• Education NSG Management of GHD > Assessment > Nursing diagnoses . hands * Delayed deep tendon reflexes * Delayed puberty Tx = Med: Levothyroxine Hyperthyroidism Clinical manifestations * Increased rate of growth * Weight loss despite excellent appetite * Warm. eyes. ____ skin * ____cardia * ____ changes * Heat ____ * Emotional ____ * _____somnia.Deficient ____ r/t tx > Outcome identification > Planning/implementation .Disturbed ____ image r/t ____ stature .

____hydration. removed by ____ – Types of hgb: ____ and ____ – Hgb molecule has __(#) heme. ___osis(pH). states SICKLE-CELL pathophysiology • RBC sickling caused by: ___emia(O2). accelerated growth velocity. stress. # in inflamm. dehydration. Adrenal Hyperplasia Clinical manifestations * Male fetus: no phys changes * Female fetus: virilized external genitalia • Enlarged clitoris • Fusion of labial folds • Rugae appearance to labia • Pseudohermaphroditism * Children (often toddlers) present with: adrenarche. 4 globin chains • White Blood Cells – Early inflammatory response: neutrophils – Immunity: lymphocytes – Inflammatory/phagocytic: monocytes. . Tx: * Antithyroid medication * Radioactive iodine therapy * Subtotal thyroidectomy Congen.Tx: * ____ medication * ____ therapy * Subtotal ____ectomy Congen. hirsutism HEMATOLOGY • Red Blood Cells – Life span: 120 days. stress. acne. ____ism (hair) HEMATOLOGY • Red Blood Cells – Life span: ____ days. ____ bone age. macrophages • Platelets – Life span: 10 days – INC. acidosis. Adrenal Hyperplasia Clinical manifestations * Male fetus: ____ * Female fetus: virilized _____ • Enlarged ____ • Fusion of ____ • ____ appearance to labia • ____ism (genitals) * Children (often toddlers) present with: adrenarche. acne. ____ growth velocity. states SICKLE-CELL pathophysiology • RBC sickling caused by: hypoxemia. macrophages • Platelets – Life span: ____ days – ____ # in inflamm. removed by SPLEEN – Types of hgb: A (adult) and F (fetal) – Hgb molecule has 4 heme. __(#) globin chains • White Blood Cells – Early inflammatory response: neutrophils – Immunity: lymphocytes – Inflammatory/phagocytic: monocytes. advanced bone age.

abdomen. impair circulation -> pain. Epistaxis (nose ____). and eyes * ____. mouth) • Dx – History. contracted muscles (most common) * ____. Thromboplastin Generation test • Severity (based on % of factor) – Mild: __-__% of normal – Moderate: __-__% – Severe: < __% TYPES of Cerebral Palsy * ____.infection. Epistaxis. ____ dysfunction Hemophilia (A & B) • Clinical Manifestations: – Hemat____. Other bleeding (neck. falls/stumbles * ____. impair ____ -> pain. falls/stumbles * ATHETOID.constant. temp extremes • Sickled RBC destruction -> anemia • Accumulated RBCs in spleen -> spleen damage & fibrosis • Sickled RBCs obstruct capillaries/vessels. head. ____ extremes • Sickled RBC destruction -> ____ • Accumulated RBCs in spleen -> ____ damage & fibrosis • Sickled RBCs obstruct capillaries/____. uncontrolled motion of limbs. and eyes * RIGIDITY. interfering with coordination SICKLE CELL Life-threatening complications •____-occlusive episode: infection.poor sense of balance. mouth) • Dx – History. uncontrolled motion of limbs. contracted muscles (most common) * ATAXIC. interfering with coordination SICKLE CELL Life-threatening complications •Vaso-occlusive episode: . organ dysfunction Hemophilia (A & B) • Clinical Manifestations: – Hematomas.tense. Hem____.Intracranial ____. Thromboplastin Generation test • Severity (based on % of factor) – Mild: 5-35% of normal – Moderate: 1-5% – Severe: < 1% TYPES of Cerebral Palsy * SPASTIC.uncontrollable shaking. Hematuria. abdomen. head.tight muscles that resist effort to make them move * TREMOR. Other ____ (neck.constant.tense.tight muscles that resist effort to make them move * ____.poor sense of balance. Hemarthroses. Hemat____. Intracranial bleed.uncontrollable shaking.

____emia. ____ studies Aplastic Anemia • Dx's with: bone marrow aspirate. Middle China. Southeast Asia • RBCs w/ less ____ • Synthesis beta Hgb chain impaired • ____ in marrow destroyed • RBCs w/ less Hgb • Increased erythropoietin. Africa. neuro signs *Evaluate c transcranial doppler *Tx: blood transfusion q 3-4 wks Tx: Chelation therapy: Desferoxamine SC infusion 5 nts/week –Acute Chest Syndrome *S/S= pneumonia-like picture. South • Synthesis beta ____ chain impaired China. production but ineffective RBC • Bone marrow ____ (abnormal production multiplication of cells) • Bone marrow hyperplasia • Sequelae (a secondary • Sequelae: condition resulting from a – Severe anemia disease): – Impaired growth/ – Severe ____ development – ____ growth/ – Without treatment: death development by 5 – 6 years – Without treatment: ____ by 5 – 6 years Aplastic Anemia • Dx'd with: ____ aspirate.-PAIN due to ____ (acute. • RBCs in marrow destroyed but ineffective ____ • Increased erythropoietin. chronic) –____ *S/S= severe ____ache. pain *Tx= Transfusion or exchange transfusion. Africa. South • Mediterranean. Respiratory support Beta-thalassemia • Mediterranean. chromosome studies . chronic) –Stroke *S/S= severe headache. ____ support Beta-thalassemia -Pain due to ischemia (acute. pain *Tx= Transfusion or ____ transfusion. Southeast Asia East. ____ signs *Evaluate c transcranial ____ *Tx: ____ transfusion q 3-4 wks Tx: ____ therapy: Desferoxamine SC infusion __ nts/week –Acute ____ Syndrome *S/S= pneumonia-like picture. hypoxemia. Middle East.

edema. cyclosporin.5) drawn. •Retic count = 1.5 (norm = CBC. cyclosporin. if any.0) * What else do you need to assess? •segs:80%. generalized – Often advanced at dx • With mediastinal mass. Rates pain as 9/10 on 0-10 concerning? And. HR= 140. you expect? RR= 32. fever * When will you reassess? to 38. •WBC = 15. chest xray done. Wt = 45 kg * What kinds of medical orders do Admit VS: T= 38. generalized – Often advanced at dx • With mediastinal mass. why? scale.62.000 (norm = 4. * What are your initial nursing admitted from ER for fever and pain. bands = useful in planning care? 3 .4ax. pleural effusion. steroids) • Only cure is ____ • Nursing Management: – Potential for infection – Potential for injury – Inadequate tissue perfusion Tx: • Immunosuppressive therapy may induce remission (ATG. ? abdomen. bands:10% (norm * What other information would be segs = 54 . steroids) • Only cure is bone marrow transplant • Nursing Management: – Potential for infection – Potential for injury – Inadequate tissue perfusion 14 yo with sickle cell disease.5 – * What are your nursing priorities? 11. . now with 20 (norm =13-16/37-49) D5%/0.5-1. lymphadenopathy) – Pain. •CBC results: H/H = 7. of these results is room air. Has an implanted port in rt chest. Lymphoma • From lymphoid and hematopoietic systems NON-HODGKINs Lymphoma – Peak 7-11 years S/S: Depend on location (mediastinal mass. and blood cultures 0.5) Lymphoma • From lymphoid and hematopoietic systems NON-HODGKINs Lymphoma – Peak 7-11 years S/S: Depend on location (mediastinal mass. retic count. BP= 142/88. 02 sat 90% on * Which. also back and upper lobe opacity.0 / accessed in ER. actions? 3 day hx increasing chest pain. Infiltrate.45NS at 25 ml/hr.5. lymphadenopathy) – Pain.• Tx: • ____ therapy may induce remission (ATG. pleural effusion. Points to upper right chest as •CXR results show a right pain location. edema.

sympathetic ganglia • S/S: caused by compression on adjacent structures. mediastinum. lab tests (depending on location). ____therapy • Pre-op: monitoring. adrenal medulla. no ____ palpation (fragile outer capsule of tumor) • Postop: – Care as for major abd surgery. malaise • Dx: CT/MRI • Surgery to remove ____ or ____. markers present. large abd incision – Fluids. BMT risk of respiratory distress and superior vena cava syndrome • Treatment with multi-agent chemotherapy • High risk of tumor lysis syndrome Wilms Tumor • Arises in kidney. radiation (stage III). BP. ____uria. extent of spread (62% have ____) • Treatment: surgical removal. malaise • Dx: CT/MRI • Surgery to remove tumor/kidney. pain. extent of spread (62% have mets) • Treatment: surgical removal. lab tests (depending on location). primordial cells • S/S: ____ swelling. BP. pain Neuroblastoma • From neural crest cells: – brain. primordial cells • S/S: abdominal swelling. chemo • Pre-op: monitoring. biopsy • Staging: based on age. pain Neuroblastoma • From neural crest cells: – brain. histology. pelvis. adrenal medulla. mediastinum. ____ BP. BMT . intensive ____. ____ • Dx: scans. radiation (stage III). histology. no abdominal palpation (fragile outer capsule of tumor) • Postop: – Care as for major abd surgery.risk of ____ distress and superior vena cava syndrome • Treatment with multi-agent ____ • High risk of ____ lysis syndrome Wilms Tumor • Arises in ____. BP. intensive chemo. biopsy • Staging: based on age. markers present. metastases • Dx: scans. hematuria. sympathetic ganglia • S/S: caused by ____ on adjacent structures. INC. large abd incision – Fluids. pain. pelvis.

What is the leading cause of death in infants? What level of preventative care is a child wearing a helmet? How does Erikson describe school age children? How do children intrepret blood being taken from them? Birth Defects Congenital Anomalies Secondary 6-12 years initiave vs guilt learn to carry out tasks want to be good at things Make a hole in them and their insides will come out.. . ____ c child .Nursing diagnoses ~ ____ Cardiac output ~ Fluid volume ____ ~ Imbalanced nutrition: ____ than body reqs .Evaluation and family ____ CHF * Treatment: .Evaluation and family TEACHING << first < prev1next >last >> Question Answer Sid e3 Loading.____ support * Nursing management .Meds: DIURETICS .Positive ____ .NUTRITIONAL support * Nursing management .1st: ____ ~ ____ assessment ~ ____ support.____ identification and planning .Meds: ____ .SURGERY .Positive INOTROPES (↑CO) .OUTCOME identification and planning .1st: ASSESSMENT ~ PHYSICAL assessment ~ FAMILY support.____ .. INTERACTION c child .CHF * Treatment: .Nursing diagnoses ~ DECREASED cardiac output ~ Fluid volume EXCESS ~ Imbalanced nutrition: LESS than body reqs .

Hips POP when ortiloni maneuver is preformed. Big head with rapid increase in diameter Vomit sleepy irritability seizures downward deviation of eyes (sunsetting) Appear 2-3 weeks after infection Slightly raised temperature swollen glands rash of pink spots that start on face conjunctivitis Symptoms of hydrocephalous Symptoms of Rubella .Can grasp large objects but Fine and gross motor skills for a 5 monthj not small ones old? Roll from belly to back What is a big danger with small children and foods? How do you give ear drops to a small child? How do you give vitamin K? Rational for potty training at 2 years? What age and weight can a car seat be turned forward facing? At what age are testicular tumors more likely? Choking Pull ear down and back IM Their bodies are not ready until they are two. Age one year 20 pounds Adolescents What accounts for 75% of all cases of spina Myelomeningocele bifida? What is myelomeningocele? Symptom of hip dysplasia What usually occurs with hip dysplasia? Back bone and spinal canal do not close before birth. neural tube disorders.

Symptoms of Roseola Persistant high temperature higher than 102 for 3-4 days in an otherwise well child lowered fever with onset of rash appears on trunk and spreads Begins in broken skin Usually with staph red macules-vesicles most common in nose and mouth wash with topical ointment 3x day oral or parenteral antibiotics Fungus clean environment wash in HOT water tx entire family with NIX or Kwell caused by Deer Tick bite Caused by spirochete stage 1 rash stage 2 most serious. involves neuro TX oral doxycycline. less than 8 is amoxicillin or penicillin firm PALPABLE elevation of skin less than 1 cm elevated lesion less than 1 cm filled with fluid eating disorder characterised by low body weight and body image distortion Virus usually HPV Intense puritis especially at night Fine grayish threadlike lines human parvovirus B 19 Impetigo How do you treat cellulitis? What causes ringworm? How to manage head lice? Lyme Disease Papule vesicle anorexia nervosa What causes a wart? S/S of scabies? What causes 5th disease? .

nontender mass increased abdominal girth HA with projectile vomiting causes obstruction in CSF circulation Causes increased ICP What injections will a 5 year old have? Most common form of childhood cancer? How is leukemia diagnosed? Wilm's Tumor Symptoms of brain tumor? Dehydration What should you watch for in a child using clotting problems because of diuretics? hypokalemia maybe no s/s of pain loss of movement stiffness loss of ROM avascular is arthritis disease of pelvic kidney It could lead to Rhumatic fever if untreated.Side effects of wearing a cast? muscle loss atrophy increased sensitivity What do you do with evulsed tooth if you do not want to put it back into your mouth put in cold milk or cold water until you can see a dentist? Hepatitis vaccine 1st injection 2nd one month later 3rd is 6 months from 1st DTaP IPV MMR Leukemia Bone marrow Aspiration Biopsy Lumbar Puncture most common malignant tumor of kidneys swelling or mass in abdomen firm. S/S of necrosis pyelonephrosis Why should you treat strep? .

Isotonic Dehydration How much fluid loss is there with mild dehydration? What causes diarrhea most often in children? loss of water and electrolytes in equal proportions Loss of less than 50ml/kg of fluid Rotavirus Respiratory compromise hypovolemic shock local infections sepsis little or no pain because of nerve damage Accidents next is homocide check for tenting color. dry. bruit ultrasound or MRI to Diagnose current jelly stools Avoid Wheat. moist? one of the biggest emergencies Trachea swells shut needs trach or will die malnutrition dehydration electrolyte imbalance tooth erosion damage to voice potential for gastric rupture abnormal narrowing in blood vessel or other tubal organ May be called stricture Noise over turbulent flow. Breast Buds Complications of 3rd degree burns in children What is the leading cause of death in adolescents? assess skin turgor? epiglottis Complications of bulemia Stenosis Intussusception How do you treat celiac disease? First signs of puberty in females? .

1 week after rash 4-14 days unknown blood/resp during high temp until after rash 5-15 days unknown 14-21 days 7 days before and 5 days after rash appears 14-21 days Hep B DTaP Hib Prevnar IPV MMR Varicella Communicability of 5th disease (Erythema Infectiosum) Incubation of transmission communicibality of roseola incubation transmission Chicken pox incubation Rubella communicability incubation .First signs of puberty in males? enlarged testicles 2 months 4 months 6-18 months 11-16 years 2 months 4 months 6 months 12-18 months 4-6 years 2 months 4 months 6 months 12-15 months 2 months 4 months 6 months 15 months 6 months 9 months 18 months 4-6 years 12-18 months 4-6 years 12-18 months Before onset of s/s.

transmission resp direct and indirect prevent with MMR Koplik's spots (bluish spots in mouth and oral mucosa Vitamin A decreases mortality and morbidity Disease is transmittable to others time between invasion of organism and outbreak of infection time between beginning and non specific s/s appearance of disease Time between time when s/s begin to disappear and complete return to wellness. measles communicability Incubation Period prodromal period illness stage convalescent .