Term
|
Definition
- The family is seen as a whole
- If there is a change to one part of the family the whole family is affected
- The family unit as a whole is more important than the individual members |
|
|
Term
|
Definition
- Stressful events (positive or negative) are unavoidable
- Family uses coping mechanisms to respond too stress
- Too much stress can overwhelm a family and cause physical or emotional breakdown among family members |
|
|
Term
| Developmental Family Theory |
|
Definition
- A family goes through predictable developmental stages
- At each stage each family member must perform certain specific tasks
- The behavior at a previous stage can affec future stages |
|
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Term
|
Definition
The near to far directional trend in growth
Ex. development of limb buds is followed by development of fingers and toes |
|
|
Term
|
Definition
The head to tail directional trend in growth
Ex. infants get structural control over their heads before they get control of their trunk and extremities |
|
|
Term
| Erikson's psychosocial theories in chronological order |
|
Definition
Trust vs. Mistrust
Autonomy vs. Shame, Self Doubt
Initiative vs. Guilt
Industry vs. Inferiority
Identity vs. Role Confusion |
|
|
Term
| What is the change in length from birth to 12 months? |
|
Definition
| Length will increase by 50% |
|
|
Term
| Contributors to childhood obesity |
|
Definition
- Sugary drinks and less healthy food availability
- Advertising of less health foods
- Lack of PE in school
- No safe or appealing place to be active in the community
- Increasing portion size
- Lack of breastfeeding support
- Television and media |
|
|
Term
| How is body image learned? |
|
Definition
Significant others exert the most impact on child's body images.
Cultural norms also play a role.
Infants receive input about their bodies through self-exploration and sensory stimulation from others |
|
|
Term
| How is self-esteem learned? |
|
Definition
Learned by one's social groups and individuals perceptions of how they are valued by others.
It changes with development.
Meaningful relationships |
|
|
Term
|
Definition
Give the scale to a patient and have them point to the face and the place they are having pain
Ages 3-8 |
|
|
Term
|
Definition
| Topical anesthetic used to make procedures less painful for the pediatric patient. Important for atraumatic care |
|
|
Term
| Lifelong psychological affects pain can have on children |
|
Definition
Less likely to seek medical care in the future
Experience higher levels of pain later on
Make more of a fear of pain and doctors |
|
|
Term
| What do child life specialists do? |
|
Definition
| Help the families and kids feel more comfortable in the hospital. They help explain procedures and use distraction techniques during procedures. |
|
|
Term
|
Definition
| Providing care to kids using interventions that eliminate or minimize the psychological and physical distress for the child |
|
|
Term
| 3 ways to provide atraumatic care |
|
Definition
Prevent or minimize separation from parent
Promote sense of control
Minimize or prevent bodily injury and pain |
|
|
Term
| Why are kids particularly vulnerable to the stress of hospitalization? |
|
Definition
It is a change from the usual state of health and environmental routine.
Children have limited coping mechanisms to resolve stressors |
|
|
Term
|
Definition
From middle infancy throughout the preschool years.
3 stages:
Protest: aggressive reaction: crying and screaming
Despair: crying stops, depression, child less active
Detachment: superficially look adjusted but really a sign of resignation, not content |
|
|
Term
| If a child was born full term weighing 7lb how much would they weigh at one year? |
|
Definition
|
|
Term
|
Definition
| When the child has not differentiated himself from the outside world and regards all sources of pleasure as originating within himself. |
|
|
Term
| When should solid food be introduced? |
|
Definition
|
|
Term
| What can develop is solid food is introduced too soon? |
|
Definition
| Excessive weight gain, increased predisposition to allergies, and iron-deficiency anemia |
|
|
Term
| When should dental cleaning by the primary care provider begin? And what should be used? |
|
Definition
| When the primary teeth erupt. They should be cleaned with a damp cloth. |
|
|
Term
| Why is milk a bad source of iron? |
|
Definition
| Milk products bind to free iron and prevent absorption. |
|
|
Term
| What are current recommendations for Vit D consumption for first year of life? |
|
Definition
|
|
Term
| What disease is there no "maternal immunity?' |
|
Definition
|
|
Term
| Which vaccines should not be administered to a person that is immunocompromised and why? |
|
Definition
| MMR, Varicella vaccine, and Rotavirus. Because these are live vaccines. |
|
|
Term
| When should children be placed in front facing car seats? |
|
Definition
| Keep toddlers in rear-facing seats until 2 years of age, or until they reach max height and weight for their seat. Studies have found that children under 2 yrs are 75 percent less likely die or be severely injured in a car crash. |
|
|
Term
| Why do toddlers have tantrums? |
|
Definition
| Toddlers are more comfortable asserting their authority but their brain development is such that their ability to control their behavior, control and understand their feelings and use logic are only barely starting to emerge. |
|
|
Term
| What are the 5 markers signaling a child's readiness to toilet train? |
|
Definition
1. Bladder readiness
2. Bowel readiness
3. Cognitive readiness
4. Motor readiness
5. Psychological readiness |
|
|
Term
| What are the 7 main types of injuries associated with early childhood? |
|
Definition
1. Motor vehicles
2. Drowning
3. Burns
4. Accidental poisoning
5. Falls
6. Choking and suffocation
7. Bodily injury |
|
|
Term
| What is the special form of tooth decay in infants and young children? And why does it occur? |
|
Definition
| Called early childhood caries or baby bottle tooth decay. It occurs when a child is routinely given a bottle of milk or juice at naptime or bedtime or uses the bottle as a pacifier while awake. |
|
|
Term
| What is a convertible car seat? |
|
Definition
| They can be used rear-facing and then "convert" to be used forward-facing. |
|
|
Term
| What is the major gross motor skill acquired during toddlerhood. |
|
Definition
| Development of locomotion |
|
|
Term
| What kind of opportunities are children exposed to in preschools and daycare centers? |
|
Definition
-Opportunities for learning group cooperation
-Adjusting to sociocultural differences
-Coping with frustration, dissatisfaction, and anger
-Feelings of success, self-confidence, and personal competence
-Learning from activities provided |
|
|
Term
| What is more important than structured learning at this age? |
|
Definition
| Social climate, type of guidance, and attitude toward the children |
|
|
Term
| What is one of the most commonly used developmental screening tools? |
|
Definition
| Denver developmental screening test 2 |
|
|
Term
| What are the significant changes that occur in regards to Moral Development during the school age years? |
|
Definition
| Children 6 to 7 years of age know the rules and behaviors expected of them, but do not understand reasons behind them. Older children are able to judge an act by the intention that prompted it rather than just its consequences. |
|
|
Term
|
Definition
| Children learn that simply altering objects arrangement in space does not change certain properties of the environment. |
|
|
Term
| What are the events of puberty caused by? |
|
Definition
| Hormonal activity under the influence of the central nervous system. |
|
|
Term
|
Definition
| A scale of physical development measured based on external primary and secondary sex characteristics |
|
|
Term
| What are the physiologic changes during adolescence during response to exercise? |
|
Definition
| Performance improves, especially in boys, and the body is able to make the physiologic adjustments needed for normal functioning after exercise is complete. |
|
|
Term
| Within the intimacy of the group what does the adolescent achieve? |
|
Definition
| Support in learning about themselves, consideration for the feelings of others, and increased ego development. |
|
|
Term
| What risk factors do children have to make them prone to vitamin D deficiency |
|
Definition
1. Vitamin D poor diets
2. Breast fed infants
3. Obese children
4. Those with certain medical conditions (CF, DM, IBD) |
|
|
Term
| How much dietary calcium is absorbed in kids with vitamin D deficiency? |
|
Definition
|
|
Term
| What conditions result from low calcium levels? |
|
Definition
Seizures
Heart rhythm abnormalities |
|
|
Term
|
Definition
| A disease in children caused by vitamin D deficiency. Characterized by imperfect calcification, softening, and distortion of the bones typically resulting in bowed legs |
|
|
Term
| What foods can you get vitamin D from? |
|
Definition
| Fish, milk, fortified cereals, pork, eggs, mushrooms, ricotta cheese |
|
|
Term
| Children who are vegetarians are more likely to suffer from what? |
|
Definition
Professor stressed: protein deficiency
The book said: inadequate growth, poor digestibility of bulky, natural foods, deficiencies in vitamin B6, nacin, riboflavin, vitamin D, calcium, and zinc |
|
|
Term
| Where do vegetarians get their daily intake of protein from? |
|
Definition
| Grains, legumes, milk products, seeds |
|
|
Term
|
Definition
| A deficiency in vitamin C |
|
|
Term
|
Definition
| A deficiency of protein with an adequate supply of calories leading to thin, wasted extremities and a prominent abdomen from edema |
|
|
Term
|
Definition
| General malnutrition of calories and protein leading to a gradual wasting and atrophy of body tissues, especially subcutaneous fat |
|
|
Term
| Difference between food allergy and sensitivity |
|
Definition
| An allergy is an adverse health effect rising from a specific immune response. A sensitivity is an adverse health effect that does not have an immunological mechanism |
|
|
Term
| What are the 4 types of allergic reactions |
|
Definition
Systemic
GI
Respiratory
Cutaneous |
|
|
Term
| How long does a food allergy take to occur? |
|
Definition
| After the food has been ingested one or more times. It can come on immediately (minutes to hours) or be delayed (2-48 hours) |
|
|
Term
| What are the 3 most common food allergies? |
|
Definition
|
|
Term
| What other conditions are children with allergies likely to have? |
|
Definition
| Asthma and other allergic conditions |
|
|
Term
|
Definition
1. Remove from plastic tube, grasp unit with dominant hand, black tip down
2. Jab it at a 90degree angle against thigh (even through clothes) and hold it there for 10 seconds
3. Massage the area for 10 seconds |
|
|
Term
| Regurgitating vs. spitting up |
|
Definition
Reguritating: vomiting- forceful, effortless ejection of food from stomach
Spitting up: pushing out of what is in the mouth with the tongue |
|
|
Term
|
Definition
Characterized by unconsolable and excessive crying in otherwise health infants
Usually a benign condition that resolves on its own in 4-5 months |
|
|
Term
| What are the symptoms of colic? |
|
Definition
| Crying that lasts at least 3 hours a day on at least 3 days a week over at least 3 months |
|
|
Term
| Theories of causes of colic |
|
Definition
1. Gut problem associated with cow's milk allergy
2. Behavioral problems
3. Excessive crying in an extreme of the normal
4. Collection of different entities |
|
|
Term
| What are the 2 different types of failure to thrive? |
|
Definition
Organic: something physiologically wrong with the body not allowing them to take in the nutrients they need
Inorganic: psychosocial factors |
|
|
Term
|
Definition
The sudden death of an infact younger than 1 year that remains unexplained after a complete postmortem exam.
The third leading cause of infant death and the leadign cause of postneonatal deaths
Kids sleep on their backs now to prevent |
|
|
Term
| What are do children get the chickenpox and MMR vaccine? |
|
Definition
|
|
Term
| What disease do you really not want to get during pregnancy? |
|
Definition
|
|
Term
|
Definition
- Occurs in response to upper respiratory tract infections
- Serous (watery) drainage, inflamed conjunctiva, swollen eyelids
- Self limiting, removal of accumulated secretions |
|
|
Term
|
Definition
- Accounts for most cases in children
- Purulent drainage, crusting of eyelids, inflmed conjunctiva, swollen eyelids
- Treated with topical antibiotics |
|
|
Term
| Nursing care for infant with bacterial conjunctivitis |
|
Definition
| Keep the eye clean. Remove accumulated secretions before putting in medicine. Be mindful of infection of other family members. |
|
|
Term
| What causes the anal itching of pinworms? (gahhhhh) |
|
Definition
| Movement of the worms on the skin and mucus membranes of the anus |
|
|
Term
| How many kids get brought to the ER for taking medicine on their own |
|
Definition
| 165 kids a day or 60,000 a year |
|
|
Term
| How many kids die each year from accidental overdose? |
|
Definition
|
|
Term
| Which category of drug is responsible for the most fatalities? |
|
Definition
|
|
Term
| What is IPECAC and what are the current recommendations for use? |
|
Definition
| It's an emetic (makes you vom). Not recommended for routine treatment of poison ingestion bc some poisonings can be made worse by vomiting |
|
|
Term
| Why is lead poisoning a problem in the U.S.? |
|
Definition
| Lead used to be added to paint. There's still some in older homes and in lead-contaminated soil. Kids put everything in their mouth. |
|
|
Term
| What are the symptoms of lead poisoning? |
|
Definition
- Abdominal pain, vomiting, constipation
- Headaches
- Difficulty thinking, concentrating, making decisions
- Loss of appetite and weight loss
- Pale skin, fatigue, muscle weakness
- Slow or delayed growth in kids
- Personality changes, mood swings, trouble sleeping
- Seizures or coma |
|
|
Term
| What are the risk factors for lead poisoning? |
|
Definition
| Living in or regularly visiting a house built before 1950. Having a sibling or playmate who has had lead poisoning |
|
|
Term
| Risk factors of child abuse: parental characteristics |
|
Definition
| Younger parents, single-parent families, socially isolated with few supportive relationships, additional stressors such as low-income with little education, substance abuse, low self-esteem |
|
|
Term
| Risk factors of child abuse: characteristics of child |
|
Definition
Age: birth to 1 year
Unwanted, brain-damaged, hyperactive, physically disables, premature infants (failure to bond at birth), increased physical needs, irritability |
|
|
Term
| Risk factors of child abuse: environmental characteristics |
|
Definition
| Chronic stress, divorce, poverty, unemployment, poor housing, frequent relocation, alcoholism, drug addiction, substitute caregivers |
|
|
Term
| What is enuresis and how do you manage it? |
|
Definition
Bedwetting
Manage with medications, complementary and alternative therapys, restriction of fluids near bedtime, avoiding caffeine, purposeful interruption of sleep to void, motivational therapy, devices designed to awaken child at initiation of voiding |
|
|
Term
|
Definition
Repeated voluntary or involuntary passage of feces of normal consistency in inappropriate places
Must not be caused by a physiologic affect |
|
|
Term
| Why does encopresis happen? |
|
Definition
| Constipation, abnormalities in digestive tract, voluntary retention of stool, emotional problems |
|
|
Term
| Primary vs. secondary amenorrhea |
|
Definition
Primary: it never happened when it should have
Secondary: it stopped when it shouldn't have |
|
|
Term
| Primary vs. secondary dysmenorrhea |
|
Definition
Praimry: painful menses not related to any pelvis diseases or conditions
Secondary: painful menses with a pathological condition |
|
|
Term
| American Cancer Society and USPSTF pap smear guidelines |
|
Definition
Testing begins at 21
Ages 21-29 pap smear every 3 years
Ages 30-65 pap smear plus HPV test every 5 years
65: no more testing |
|
|
Term
|
Definition
- No big smiles or other warm, joyful expressions by 6 months or after
- No back and forth sharing of sounds, smiles, or other facial expressions by 9 months
- No babbling by 12 months
- No back and forth gestures by 12 months
- No words by 16 months
- No meaningful, 2-work phrases by 24 months
- Any loss of speech, babbling, or social skills at any age |
|
|
Term
|
Definition
- 15% of cases a specific gene cause identified
- Environmental influences: advanced paternal age, maternal illness during pregnancy, extreme prematurity, certain difficulties during birth |
|
|
Term
| Common behaviors of Asperger syndrome |
|
Definition
- Limited or inappropriate social interactions
- Robotic or repetitive speech
- Challenges with nonverbal communication
- Tendency to discuss self rather than others
- Inability to understand social/emotional issues or nonliteral phrases
- Lack of eye contact or reciprocal conversation
- Obsession with specific, often unusual topics
- One-sided conversations
- Awkward movements or mannerisms |
|
|
Term
| How is Aspergers diagnosed |
|
Definition
| Can remain undiagnosed until child or adult begins to have serious difficulties in school, workplace, or social lives |
|
|
Term
| What are the current reported rates of youth suicide |
|
Definition
For ages 10-24 suicide is the 3rd lead cause of death
Results in 4600 deaths a year |
|
|
Term
| What accounts for the majority of acute illnesses in children? |
|
Definition
| Respiratory tract infections |
|
|
Term
| The etiology and course of respiratory infections are influenced by what 4 things: |
|
Definition
a. Age
b. Size
c. Resistance
d. Seasonal Variations |
|
|
Term
| Major anatomic and physiologic differences between the adult and young child with regards to the resp tract: |
|
Definition
-The diameter of the airways in young children and subject to considerable narrowing from edematous mucous membranes and increased production of secretions
-The relative short and open Eustachian tube in infants and young children allows pathogens easy access to the middle ear |
|
|
Term
| An example of a seasonal respiratory infection: |
|
Definition
Mycoplasmal infections occur more often in autumn and early winter.
Ex/ flu vaccine |
|
|
Term
| What is respiratory distress? |
|
Definition
| Respiratory distress is difficulty breathing and the psychological experience associated with such difficulty, even if there is no physiological basis for experiencing such distress |
|
|
Term
| 5 signs of respiratory distress in an infant |
|
Definition
1. Tachypnea
2. Abdominal breathing
3. Intercostal and subcostal retractions
4. Cyanosis
5. Head bobbing |
|
|
Term
| 4 physiological differences that infants have in regards to airway and breathing: |
|
Definition
1. More compliant chest wall
2. Greater reliance on diaphragm over intercostal muscle
3. Smaller and fewer alveoli than adults
4. Smaller and collapsible intrathoracic airways |
|
|
Term
| 80%-90% of all cases of pharyngitis are caused by this? |
|
Definition
| A virus (but we treat with an antibiotic; important to treat because don’t want it to get into the blood. Don’t want to get rumatic fever and scarlett fever; and acute glamerial nephritis.) |
|
|
Term
| Would you recommend over the counter cough medicine for a child? |
|
Definition
I would recommend that they not administer over-the-counter cough and cold medications (OTC-CCM) to children under 2 years of age because serious and potentially life-threatening side effects can occur
**Don’t want to suppress expectorants of mucus – best not to treat |
|
|
Term
| What are one of the roles of tonsils? |
|
Definition
| important part of lymphatic system - help to fight off infections |
|
|
Term
| 3 nursing interventions post a child's tonsilectomy: |
|
Definition
a. Until the child is fully awake place him on his abdomen or side to faciltate drainage of secretions
b. Restrict foods and fluids until the child is fully alert and there are no signs of hemorrhage
c. Provide pain relief by administering analgesics at regular intervals even during the night. Can give them rectally or through IV |
|
|
Term
| most obvious early sign of bleeding in a child that has just had a tonsillectomy and adenoidectomy: |
|
Definition
| Observing the throat directly for evidence of bleeding using a good source of light. |
|
|
Term
| When do children receive tubes in their ears? |
|
Definition
| for chronic ear infections. |
|
|
Term
|
Definition
| inflammation of the middle ear without reference to etiology or pathogenesis |
|
|
Term
| clinical manifestations of otitis media: |
|
Definition
- Crying
- Fussiness, restlessness, irritability especially on laying down
-Tendency to rub, hold, or pull affected ear
-Rolling head from side to side
-Difficulty comforting the child
-Loss of appetite, refusal to feed |
|
|
Term
| What is the safe dose of oral amoxacillin? |
|
Definition
| 80-90 mg/kg/day divided twice daily. |
|
|
Term
| Why is croup so much more predominant in infants and small children? |
|
Definition
| Small diameter of airway and more at risk for significant narrowing with inflammation |
|
|
Term
|
Definition
| a general term applied to a symptom complex characterized by hoarseness, a resonant barking cough, varying degrees of inspiratory stridor, and varying degrees of respiratory distress resulting from swelling or obstruction in the region of the larynx |
|
|
Term
| Which of the 4 types of croup syndromes is predominantly caused by a bacterial infection? |
|
Definition
|
|
Term
| Why are fluids a treatment for croup? |
|
Definition
| IV fluids are given in order to maintain adequate hydration of the child because they may be unable to take oral fluids. |
|
|
Term
| What is the only product available in the U.S. for the prevention of RSV? |
|
Definition
| Palivizumab (Synagis), a monoclonal antibody given monthly in an IM injection to prevent hospitalization associated with RSV. |
|
|
Term
| Do all children receive the treatment available for RSV? |
|
Definition
| No they do not because it has to be received in a monthly IM injection. |
|
|
Term
| Who are candidates for RSV treatment? |
|
Definition
| infants born before 32 weeks gestation, infants with chronic lung disease, infants born at less than 35 weeks gestation who attend day care or have a sibling under 5 years, children younger than 2 who have hemodynamically significant congenital heart disease, and children with severe immunodeficiencies |
|
|
Term
|
Definition
| Respiratory syncytial virus (RSV), which causes infection of the lungs and breathing passages, is a major cause of respiratory illness in young children. |
|
|
Term
|
Definition
| RSV is highly contagious and can be spread through droplets containing the virus when someone coughs or sneezes. It also can live on surfaces (such as countertops or doorknobs) and on hands and clothing, so it can be easily spread when a person touches something contaminated. |
|
|
Term
| 3 main changes that occur within the airway in individuals having asthma: |
|
Definition
a. Inflammation – Makes airway tissue irritated, red, swollen
b. Bronchoconstriction/spasm – Tightening of muscles that surround airways reduced
c. Increase in secretion of mucus - further blocks the airway |
|
|
Term
| What is a peak flow meter? |
|
Definition
| a portable, inexpensive, hand-held device used to measure how air flows from your lungs in one “fast blast.” In other words, the meter measures your ability to push air out of your lungs. |
|
|
Term
| What is/are the pathophysiology of Cystic Fibrosis? |
|
Definition
a. Increased viscosity of mucous gland secretions
b. a striking elevation of sweat electrolytes
c. an increase in several organic and enzymatic constituents of saliva
d. abnormalities in autonomic nervous system function |
|
|
Term
| What is the primary factor that is responsible for many of the clinical manifestation of Cystic Fibrosis? |
|
Definition
| Mechanical obstruction caused by the increased viscosity of mucous gland secretions. |
|
|
Term
| Why do children with Cystic Fibrosis need to take pancreatic enzymes? |
|
Definition
| Because in the pancreas, the thick secretions block the ducts, eventually causing pancreatic fibrosis. This blockage prevents essential pancreatic enzymes from reaching the duodenum, which causes marked impairment in the digestion and absorption of nutrients. |
|
|
Term
| When are pancreatic enzymes taken with regards to eating? |
|
Definition
| The pancreatic enzymes are administered with meals and snacks to ensure that digestive enzymes are mixed with food in the duodenum. |
|
|
Term
| The influenza virus has a peculiar affinity for what type of cells and where? |
|
Definition
| Epithelial cells of the respiratory tract mucosa |
|
|
Term
| What impact does the peculiar infinity that the influenza virus has affect children? |
|
Definition
Children have smaller airways. More susceptible to flu.
Also because of where it targets! |
|
|
Term
| Classic first symptom of appendicitis? |
|
Definition
| Right lower quadrant pain |
|
|
Term
|
Definition
| A point midway between the anterior superior iliac crest and the umbilicus. Where the most intense point of pain r/t appendicitis is located. |
|
|
Term
| What are the signs of perforation related to acute appendicitis? |
|
Definition
| Sudden relief from pain followed by a subsequent diffuse increase in pain. |
|
|
Term
| what two interventions related to acute appendicitis you must avoid? And why? |
|
Definition
| Should not administer laxatives/enemas or apply heat to the area. Such measures stimulate bowel motility and increase risk of perforation. |
|
|
Term
| Difference between Ulcerative Colitis and Crohn’s Disease |
|
Definition
| The inflammation found with UC is limited to the colon and rectum with the distal colon and rectum the most severely affected, while in Crohn’s Disease the chronic inflammatory process involves any part of the GI tract from the mouth to the anus but most often affects terminal ileus. |
|
|
Term
| 4 goals of therapeutic management of Ulcerative Colitis and Crohn’s Disease: |
|
Definition
1) Control the inflammation
2) obtain long-term remission
3) promote normal growth and development
4) allow as normal a lifestyle as possible. |
|
|
Term
| How does mesalamine work in treating CD or UC? |
|
Definition
| The exact mechanism of action is not nknown but is believed to work by blocking the activity of cyclooxygenase and lipoxygenase, thereby, reducing the production of prostaglandins which decreases inflammation in the colon and symptoms associated with ulcerative colitis. |
|
|
Term
| Problems children with cleft palate/ cleft lip have prior to surgery? |
|
Definition
| She swallows air when she drinks, cries, suckles on anything |
|
|
Term
| Problems associated problems with Cleft lip or Palate? |
|
Definition
| The infant is unable to create suction in the oral cavity that is necessary for feeding. Speech impairment, recurrent otitis media leading to hearing loss, and improper tooth alignment can also occur. |
|
|
Term
| Clinical manifestations of hypertrophic pyloric stenosis? |
|
Definition
| usually develops in the first 2 to 5 weeks of life, causing projectile nonbilious vomiting, dehydration, metabolic alkalosis, and growth failure |
|
|
Term
| why do children die as a result of pyloric stenosis? |
|
Definition
| Dehydration since the child cannot digest food and is constantly vomiting. |
|
|
Term
| What is intussusceptions? |
|
Definition
| The most common cause of intestinal obstruction in children between the ages of 3 months and 3 years, and it occurs when on segment of bowel telescopes into another segment, pulling the mesentery with it. |
|
|
Term
| Classic triad of intussusception symptoms? |
|
Definition
| Abdominal pain, abdominal mass, bloody stools |
|
|
Term
| What indicates that the intussusception has reduced itself? |
|
Definition
| Passage of normal brown stool. |
|
|
Term
| What is Short Bowel Syndrome? |
|
Definition
| A malabsorptive disorder that occurs as result of decreased mucosal surface area, usually because of extensive resection of the small intestine. |
|
|
Term
| Most important component of nursing care for a child having Short Bowel Syndrome? |
|
Definition
| Administration and monitoring of nutritional therapy. |
|
|
Term
|
Definition
-Oxygen (O2) and Carbon Dioxide (CO2) exchange
-Regulation of Acid Base Balance |
|
|
Term
|
Definition
| Compensated state that may precede respiratory failure, the patient is able to maintain adequate gas exchange by increasing breathing rate and depth |
|
|
Term
| Signs/Symptoms of Resp Distress |
|
Definition
-Diaphoresis
-Pallor/cyanosis
-Nasal Flaring
-Tachypnea
-Noisy Breathing
-Retracting
-Grunting |
|
|
Term
| Examples of obstructions that cause respiratory failure? |
|
Definition
-Foreign body (vomitus)
-Infection (i.e. epiglottitis)
-Tonsils/adenoids
-Laryngospasm |
|
|
Term
| Restrictive causes for respiratory failure? |
|
Definition
-Thick secretions, foreign body
-Infection (Pneumonia)
-Alveolar rupture (pneumothorax)
-Chemical pneumonitis
-Pleural effusion
-Near-drowning event |
|
|
Term
| What comes after respiratory failure? |
|
Definition
|
|
Term
| Upper Respiratory Tract Illnesses: |
|
Definition
-URI or URTI
-Nasopharyngitis
-Pharyngitis
-Tonsillitis
-Influenza
-Otitis Media
-Infectious Mononucleosis |
|
|
Term
|
Definition
| A retraction is a medical term for when the area between the ribs and in the neck sinks in when a person with asthma attempts to inhale. Retractions are a sign someone is working hard to breathe. |
|
|
Term
|
Definition
| a technique that assesses the extent and symmetry of chest movement |
|
|
Term
|
Definition
| a radiologic sign found on a frontal neck radiograph where subglottic tracheal narrowing produces an inverted "V" shape within the trachea itself. The presence of the steeple sign supports a diagnosis of croup. |
|
|
Term
| Outpatient treatment for patient with LARYNGEOTRACHEOBRONCHITIS? |
|
Definition
-antipyretic
-hydration
-humidified air
-oral corticosteroids |
|
|
Term
| Inpatient treatment for patient with LARYNGEOTRACHEOBRONCHITIS? |
|
Definition
-racemic epinephrine (bronchodilator)
-humidified air
-oral corticosteroids |
|
|
Term
| treatment for patient with severe LARYNGEOTRACHEOBRONCHITIS? |
|
Definition
| -endotracheal intubation for patient's with PaCO2 levels >45 |
|
|
Term
| Are antibiotics used to treat croup? |
|
Definition
| usually not because most are caused by viruses, not bacteria. |
|
|
Term
|
Definition
-barking cough
-inspiratory stidor
-hoarseness |
|
|
Term
|
Definition
obstructive inflammatory process of the epiglottis (the flap at the base of the tongue that keeps food from going into the trachea)
*Due to its place in the airway, swelling of this structure can interfere with breathing, and constitutes a medical emergency.
MEDICAL EMERGENCY |
|
|
Term
| 3 clinical observations that are predictive of epiglottitis? |
|
Definition
1. abscess of spontaneous cough
2. drooling
3. agitation
*Can also see fever, sore throat, strider, chills, shaking, cyanosis |
|
|
Term
| A common cause of swelling of the epiglottis? |
|
Definition
H. influenzae bacteria
*Can also be caused by other bacteria or viruses |
|
|
Term
| What vaccine has reduced the incidences of epiglottitis? |
|
Definition
| Due to the H. influenzae type B vaccine which children routinely receive at a young age. |
|
|
Term
| For those not receiving Synagis, what is the treatment for patient's with RSV receive? |
|
Definition
| Airway management and fluids |
|
|
Term
|
Definition
-Inflammatory response initiated in airways
-Involves mast cells, eosinophils and T lymphocytes
-End result means increased mucous production, inflammation to lower airways and bronchospasm |
|
|
Term
| Symptoms of Reactive Airway Disease? |
|
Definition
RAD = Asthma
-Wheezing
-Dry cough (tight)
-Prolonged expiratory phase
-Restless
-Fatigue
-Tachypnea |
|
|
Term
|
Definition
-Chronic inflammatory disorder of airways
-Bronchial hyperresponsiveness
-Episodic
-Limited airflow or obstruction that reverses spontaneously or with treatment |
|
|
Term
|
Definition
-Inhalants
-Airborne pollens
-Stress
-Weather changes
-Exercise
-Viral or Bacterial agents
-Food additives |
|
|
Term
| Long term asthma medications |
|
Definition
-Corticosteroids-(inhaled) pulmicort
-Cromolyn sodium (Intal)
-Mast Cell Stabalizer
-Immunomodulators-(Xolair) decrease IgE response
-Leukotriene modifiers-(Accolate)
-LABA’s (long acting bronchodilator) -Serevent or Salmeterol (12 hours)
-Methylxanthines-theophylline |
|
|
Term
|
Definition
| Primarily responsible for the bronchoconstriction |
|
|
Term
|
Definition
| In chronic, more severe cases of asthma, general bronchial hyperreactivity (or smooth muscle twitchiness) is largely caused by eosinophils |
|
|
Term
| Examples of medications for quick relief for asthma relief |
|
Definition
-Anticholinergics(Atrovent) –blocks constriction (parasympathetic)
-SABA-Short acting bronchodilators (Albuterol)-stimulates dilation (sympathetic) RESCUE
-Systemic corticosteroids-> Methylprednisolone/Solumedrol |
|
|
Term
|
Definition
Inherited autosomal recessive trait
Cystic Fibrosis Transmembrane Conductance Regulator
critical loss of chloride ion transport
upsets the sodium and chloride ion balance
disrupts the normal, thin mucus layer that is easily removed by cilia lining the lungs and other organs
thick, sticky secretions
pool in bronchioles = atelectasis
clogs pancreatic ducts, impairs digestion & absorption of nutrients
leads to biliary cirrhosis
retarded G & D, delayed puberty
Terminal, median age is 37 |
|
|
Term
| Cystic Fibrosis Management/Treatment |
|
Definition
Mucolytics, bronchodilators, kalydeco
Antibiotics for infections
Chest PT
Avoid pulmonary Txs after meal |
|
|
Term
| The "Flutter" Mucous Clearing Device |
|
Definition
| he Flutter is a handheld device designed to facilitate clearance of mucus in hypersecretory lung disorders. Exhalation through the Flutter results in oscillations of expiratory pressure and airflow, which vibrate the airway walls (loosening mucus), decrease the collapsibility of the airways, and accelerate airflow, facilitating movement of mucus up the airways. |
|
|
Term
| Management of GI problems |
|
Definition
Assess nutritional status
Provide high protein & calorie diet
Administer pancreatic enzymes
Vitamins (esp. fat soluble) |
|
|
Term
|
Definition
Allergies to foods
Over-eating
Persistent coughing
Intestinal obstruction
Viral illness |
|
|
Term
|
Definition
|
|
Term
|
Definition
Fever, Nausea, Vomiting, Freq diarrhea
**Very contagious - passed through fecal oral route or indirect contact
Symptoms appear 1-3 days post contact
Between Nov and April most commonly seen - seasonal
Monitor for dehydration!!
Give electrolytes as treatment and may need IV!
No specific tx- usually recover on their own
Lasts roughly for 3-7 days |
|
|
Term
|
Definition
| increase in number and watery stools |
|
|
Term
|
Definition
| Viral, Bacterial, Food, infection and stress |
|
|
Term
| Chronic causes of diarrhea |
|
Definition
| Malabsorption, defects, allergies and inflammation |
|
|
Term
| Complications of diarrhea |
|
Definition
| Dehydration, acid-base imbalance, shock |
|
|
Term
|
Definition
-Alteration in frequency and consistency of passing stool
-Majority of children with idiopathic constipation
-Early childhood due to environmental changes and control over bodily functions
-Self perpetuating |
|
|
Term
|
Definition
-Congenital Aganglionic Megacolon
Absence of ganglion cells in one or more segments of the colon
-Etiology not fully understood |
|
|
Term
| Symptoms of Hirschsprungs Disease |
|
Definition
Symptoms
-Don’t pass meconium
-Distention
-Ribbon like stools |
|
|
Term
|
Definition
| -relaxation or incompetence of the lower esophageal sphincter |
|
|
Term
| Symptoms of G.E. Reflux Disease |
|
Definition
Signs and symptoms:
Vomiting
Weight loss
Respiratory Problems (RAD)
GI Bleeding |
|
|
Term
| 3 inflammatory disorders: |
|
Definition
Appendicitis
Ulcerative Colitis
Chron’s Disease |
|
|
Term
|
Definition
Signs and symptoms:
-abdominal pain-per umbilical to right lower quadrant
-local rebound tenderness
-vomiting
-constipation or diarrhea |
|
|
Term
|
Definition
| Muscle around the pylorus enlarges and leads to obstruction during the first three months of life |
|
|
Term
|
Definition
Signs and Symptoms
Projectile Vomiting-No Bile
Hunger
Weight Loss
Dehydration with F/E Disturbances
Increased Abdominal distention with peristaltic waves
Palpable Olive Shape Tumor in Epigastric Area |
|
|
Term
| Pre/Post Operative Problems for Pyloric Stenosis |
|
Definition
Pre-op Problems
-Emphasis is on restoring and correcting fluid and electrolyte problems
Post-op Problems
-Infant may still vomit
-Advancing diet as tolerated
-Rare to have complications
**Diagnosed usually by ultrasound |
|
|
Term
|
Definition
-Telescoping of one portion of the intestine into another
-Frequent cause of intestinal obstruction
-Child can become acutely ill with fever and signs and symptoms of peritonitis |
|
|
Term
| Diagnosing Intussusception |
|
Definition
-made by x ray, ultrasound, or barium enema (Using Air enema currently), which may also un-telescope the bowel
-Surgery if b.e is not successful |
|
|
Term
|
Definition
**Disorders of the pituitary gland depend on the location of the lesion or physiologic abnormality.
-Growth hormone deficiencies
-Precocious Puberty
-Diabetes Insipidus
-SIADH |
|
|
Term
|
Definition
|
|
Term
|
Definition
| Diabetes type I and type II |
|
|
Term
| Growth Hormone Deficiency: Hypopituitarism |
|
Definition
| Failure of the pituitary to produce sufficient growth hormone to sustain normal growth in children |
|
|
Term
| Growth Hormone Replacement |
|
Definition
-GH products are currently labeled for use in “children who have growth failure due to an inadequate secretion of normal endogenous growth hormone”
-Administered at night to correspond with normal release time of GH |
|
|
Term
| Management of Growth Hormone Deficiency |
|
Definition
-GH Replacement
-Children should be managed by a pediatric endocrinologist
-Height and weight is obtained every 3 months and plotted on the growth chart
-Bone age study yearly |
|
|
Term
|
Definition
-Development of sexual characteristics before the usual age of onset of puberty.
Girls
-Breast development, pubic hair, and/or menses before 8 years
Boys
-Secondary sexual characteristics before age 9
**Tanner Scale: true precocious puberty is characterized by 2 signs of puberty |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| Diabetes Mellitus has 2 types: |
|
Definition
Type I Diabetes
Type II Diabetes |
|
|
Term
| Diabetes Mellitus / Type 1 |
|
Definition
Lack of insulin production in the pancreas.
Under 20 years of age
Peak incidence between 10 and 14 years. |
|
|
Term
|
Definition
Elevated blood glucose leads to osmotic diuresis. (polyphagia, polyuria and polydipsia)
Protein and fat breakdown lead to weight loss- as much as 30%
Accumulation of ketones causes a drop in pH. (metabolic acidosis) and spilling of ketones in the urine |
|
|
Term
| Diagnostic Tests for DM Type I |
|
Definition
Blood glucose levels greater than 200 mg/dL
Urine sample reveals glucosuria and possible ketonuria.
Glucose tolerance test would reveal low insulin levels in the face of elevated glucose levels. |
|
|
Term
| Interventions for DM Type I |
|
Definition
Administration of insulin
Blood glucose levels
Initially before every meal
Every am when diabetes under control
Dietary management / refer to nutritionist
Glycosylated hemoglobin / reflects average glucose concentration for preceding 2 to 3 months. (A1C) |
|
|
Term
| Glycosylated hemoglobin A1C |
|
Definition
| HbA1c is a lab test that shows the average level of blood sugar (glucose) over the previous 3 months. It shows how well you are controlling your diabetes. |
|
|
Term
| Target Blood Glucose Levels |
|
Definition
Target levels
Toddler and preschool: 100 to 180 mg/dL
School-age: 90 to 180 mg/dL
Adolescents (13 to 19 years): 90 to 130 mg/dL |
|
|
Term
|
Definition
Short acting – often used to cover extra carbohydrate consumption
Combination of regular and intermediate-acting insulin
Morning and evening dosing
Children on mixed insulin dosage schedules tend to experience hypoglycemic episodes at 11:30 and 2:30 as peaking of insulin occurs. |
|
|
Term
|
Definition
Rapid onset
Shaky feeling, hunger
Dizziness
Headache
Vital signs
-Shallow respirations
-tachycardia
Tremors |
|
|
Term
| Lab values for Hypoglycemia |
|
Definition
Glucose = low, below 60
Ketones = negative
Urine output
Normal
sugar negative
negative ketones |
|
|
Term
| Treatment of Hypoglycemia |
|
Definition
| Simple concentrated sugars such as honey by mouth(older than 1 year), hard candy, sugar cubes, or glucose tablets will elevate the blood sugar immediately. Orange juice or sugar containing soda or fruit drink. (Blood Glucose less than 70 mg/dL) |
|
|
Term
|
Definition
-Using rapid-acting or Lispro insulin
-Infusion pump (8 to 10 years of age)
-Night time snack
-Check blood glucose before bedtime. -Make sure the blood glucose is 100 – 120 mg/dL before going to bed
-Do not skip snacks
-Eat an extra snack on days of strenuous exercise |
|
|
Term
| Symptoms of Hyperglycemia and DKA |
|
Definition
Symptoms:
-Onset = gradual
-Lethargic, confused, weak
-Thirsty
-Abdominal pain often with nausea and vomiting
-Signs of dehydration
-Vital signs: deep, rapid respirations, fruity acetone breath, and weak pulses |
|
|
Term
| Hyperglycemia associated with diabetic ketoacidosis is defined as a blood glucose measurement equal to or greater than: |
|
Definition
|
|
Term
| Symptoms of Diabetes KetoAcidosis |
|
Definition
Altered level of consciousness
Dehydration
Electrolyte disturbances
Dysrhythmias
Shock
Complete vascular collapse |
|
|
Term
| Life management of Diabetes |
|
Definition
Management by endocrinologist
Insulin
Blood sugar monitoring
Diet
Exercise
Screen for retinopathy: ophthalmologic exam annually |
|
|
Term
|
Definition
Vital component to management of child with diabetes.
May decrease the amount of insulin required.
Enhances insulin absorption.
Important for normal growth and development. |
|
|
Term
|
Definition
-85% of children with Type 2 are obese
-Age of onset is middle to late puberty- around 13 years
-Minority populations have an especially high rate of type 2 diabetes
-Strong family history |
|
|
Term
| Type 2 Diabetes Assessment |
|
Definition
Obesity: BMI greater than 30 (normal range is 15 to 17 in the pediatric population)
Waist to hip ratio: apple shape
Acanthosis nigricans: hyper-pigmentation and thickening of the skin into velvety irregular folds in the neck and flexural areas
Hypertension
+ family history of type 2 diabetes
Ethnicity |
|
|
Term
|
Definition
Glucose-lowering agent: drugs that improve insulin sensitivity
**Used with diet and exercise to control blood sugar in patients with type 2 diabetes. May be used alone or with other medicines. |
|
|
Term
| Examples of Age-Related Skin Manifestations |
|
Definition
Infants: “birthmarks”
Early childhood: atopic dermatitis
School-age children: ringworm
Adolescents: acne |
|
|
Term
|
Definition
Common peds skin problem
Treated with topical antibiotic if localized to small area
Bacterial: strep or staph
Wash crust off with soap and water and apply topical antibiotic
May be treated with oral antibiotics
if it has spread (still wash lesions)
Very contagious!!!!!!! |
|
|
Term
|
Definition
Superficial infections that live on the skin
AKA dermatophytoses, tinea
Transmission from person to person or from infected animal to human
Examples: tinea capitis, tinea corporis, tinea pedis, candidiasis |
|
|
Term
|
Definition
Inflammatory reaction of skin to chemical
Initial reaction in the exposed region
Characteristic sharp delineation between inflamed and normal skin
Primary irritant
Sensitizing agent
Examples: diaper dermatitis, reaction to wool, reaction to specific chemical |
|
|
Term
|
Definition
A type of pruritic eczema that begins during infancy
Hereditary tendency
Often associated with history of food allergies, allergic rhinitis, and asthma |
|
|
Term
|
Definition
Pathophysiology and clinical manifestations
Usually from irritation of urine and feces
Detergents inadequately rinsed from clothing
Chemical irritation (especially from diaper wipes)
Nursing considerations: alter wetness, pH, and fecal irritants
Differentiate from Candidiasis of diaper area (Candidiasis has characteristic excoriated red papules with satellite lesions |
|
|
Term
|
Definition
Adverse drug reactions are most often seen in skin (rashes most common reaction)
May be immediate or delayed following administration of drug
Treatment: discontinue drug, antihistamines, corticosteroid therapy if very severe |
|
|
Term
|
Definition
Predominantly in adolescents
Pathophysiology
Involves hair follicle and sebaceous glands
Black heads
Therapeutic management
General measures/overall health
Medications |
|
|
Term
|
Definition
Toddlers: hot water scalds
Older children: flame-related burns
Child abuse
Child with matches or lighters accounts for 1 in 10 house fires |
|
|
Term
|
Definition
| Lyme disease is caused by infection with a spiral-shaped bacterium called Borrelia burgdorferi. |
|
|
Term
|
Definition
Between three days to several weeks after being bitten by an infected tick, 70-90% of people develop a circular or oval rash, called erythema migrans (or EM), at the site of the bite. To qualify as an EM, the rash must be at least two inches in diameter.
The EM rash does not itch or hurt so if it is not seen, it may not be noticed.
"bulls eye" appearance |
|
|
Term
| Complications of Lyme Disease |
|
Definition
| Lyme disease may cause headache, fever, muscle and joint aches, and a feeling of tiredness. If left untreated, Lyme disease may progress to affect the joints, nervous system, or heart several weeks to months after the tick bite |
|
|
Term
|
Definition
is the surgical operation performed for the reconstruction of the eardrum (tympanic membrane) and/or the small bones of the middle ear (ossicles)
-Tympanoplasty can be performed through the ear canal (trascanal approach), through an incision in the ear (endaural approach) or through an incision behind the ear (postauricular approach). |
|
|
Term
|
Definition
| Inflammation of skin and subcutaneous tissues with intense redness, swelling, and firm infiltration. |
|
|
Term
|
Definition
Oral or parenteral antibiotics
rest and immobilization of both affect area and child
hot, moist compresses to area |
|
|
Term
| What accounts for the majority of acute illnesses in children? |
|
Definition
| Respiratory tract infections |
|
|
Term
| The etiology and course of respiratory infections are influenced by what 4 things: |
|
Definition
a. Age
b. Size
c. Resistance
d. Seasonal Variations |
|
|
Term
| Major anatomic and physiologic differences between the adult and young child with regards to the resp tract: |
|
Definition
-The diameter of the airways in young children and subject to considerable narrowing from edematous mucous membranes and increased production of secretions
-The relative short and open Eustachian tube in infants and young children allows pathogens easy access to the middle ear |
|
|
Term
| An example of a seasonal respiratory infection: |
|
Definition
Mycoplasmal infections occur more often in autumn and early winter.
Ex/ flu vaccine |
|
|
Term
| What is respiratory distress? |
|
Definition
| Respiratory distress is difficulty breathing and the psychological experience associated with such difficulty, even if there is no physiological basis for experiencing such distress |
|
|
Term
| 5 signs of respiratory distress in an infant |
|
Definition
1. Tachypnea
2. Abdominal breathing
3. Intercostal and subcostal retractions
4. Cyanosis
5. Head bobbing |
|
|
Term
| 4 physiological differences that infants have in regards to airway and breathing: |
|
Definition
1. More compliant chest wall
2. Greater reliance on diaphragm over intercostal muscle
3. Smaller and fewer alveoli than adults
4. Smaller and collapsible intrathoracic airways |
|
|
Term
| 80%-90% of all cases of pharyngitis are caused by this? |
|
Definition
| A virus (but we treat with an antibiotic; important to treat because don’t want it to get into the blood. Don’t want to get rumatic fever and scarlett fever; and acute glamerial nephritis.) |
|
|
Term
| Would you recommend over the counter cough medicine for a child? |
|
Definition
I would recommend that they not administer over-the-counter cough and cold medications (OTC-CCM) to children under 2 years of age because serious and potentially life-threatening side effects can occur
**Don’t want to suppress expectorants of mucus – best not to treat |
|
|
Term
| What are one of the roles of tonsils? |
|
Definition
| important part of lymphatic system - help to fight off infections |
|
|
Term
| 3 nursing interventions post a child's tonsilectomy: |
|
Definition
a. Until the child is fully awake place him on his abdomen or side to faciltate drainage of secretions
b. Restrict foods and fluids until the child is fully alert and there are no signs of hemorrhage
c. Provide pain relief by administering analgesics at regular intervals even during the night. Can give them rectally or through IV |
|
|
Term
| most obvious early sign of bleeding in a child that has just had a tonsillectomy and adenoidectomy: |
|
Definition
| Observing the throat directly for evidence of bleeding using a good source of light. |
|
|
Term
| When do children receive tubes in their ears? |
|
Definition
| for chronic ear infections. |
|
|
Term
|
Definition
| inflammation of the middle ear without reference to etiology or pathogenesis |
|
|
Term
| clinical manifestations of otitis media: |
|
Definition
- Crying
- Fussiness, restlessness, irritability especially on laying down
-Tendency to rub, hold, or pull affected ear
-Rolling head from side to side
-Difficulty comforting the child
-Loss of appetite, refusal to feed |
|
|
Term
| What is the safe dose of oral amoxacillin? |
|
Definition
| 80-90 mg/kg/day divided twice daily. |
|
|
Term
| Why is croup so much more predominant in infants and small children? |
|
Definition
| Small diameter of airway and more at risk for significant narrowing with inflammation |
|
|
Term
|
Definition
| a general term applied to a symptom complex characterized by hoarseness, a resonant barking cough, varying degrees of inspiratory stridor, and varying degrees of respiratory distress resulting from swelling or obstruction in the region of the larynx |
|
|
Term
| Which of the 4 types of croup syndromes is predominantly caused by a bacterial infection? |
|
Definition
|
|
Term
| Why are fluids a treatment for croup? |
|
Definition
| IV fluids are given in order to maintain adequate hydration of the child because they may be unable to take oral fluids. |
|
|
Term
| What is the only product available in the U.S. for the prevention of RSV? |
|
Definition
| Palivizumab (Synagis), a monoclonal antibody given monthly in an IM injection to prevent hospitalization associated with RSV. |
|
|
Term
| Do all children receive the treatment available for RSV? |
|
Definition
| No they do not because it has to be received in a monthly IM injection. |
|
|
Term
| Who are candidates for RSV treatment? |
|
Definition
| infants born before 32 weeks gestation, infants with chronic lung disease, infants born at less than 35 weeks gestation who attend day care or have a sibling under 5 years, children younger than 2 who have hemodynamically significant congenital heart disease, and children with severe immunodeficiencies |
|
|
Term
|
Definition
| Respiratory syncytial virus (RSV), which causes infection of the lungs and breathing passages, is a major cause of respiratory illness in young children. |
|
|
Term
|
Definition
| RSV is highly contagious and can be spread through droplets containing the virus when someone coughs or sneezes. It also can live on surfaces (such as countertops or doorknobs) and on hands and clothing, so it can be easily spread when a person touches something contaminated. |
|
|
Term
| 3 main changes that occur within the airway in individuals having asthma: |
|
Definition
a. Inflammation – Makes airway tissue irritated, red, swollen
b. Bronchoconstriction/spasm – Tightening of muscles that surround airways reduced
c. Increase in secretion of mucus - further blocks the airway |
|
|
Term
| What is a peak flow meter? |
|
Definition
| a portable, inexpensive, hand-held device used to measure how air flows from your lungs in one “fast blast.” In other words, the meter measures your ability to push air out of your lungs. |
|
|
Term
| What is/are the pathophysiology of Cystic Fibrosis? |
|
Definition
a. Increased viscosity of mucous gland secretions
b. a striking elevation of sweat electrolytes
c. an increase in several organic and enzymatic constituents of saliva
d. abnormalities in autonomic nervous system function |
|
|
Term
| What is the primary factor that is responsible for many of the clinical manifestation of Cystic Fibrosis? |
|
Definition
| Mechanical obstruction caused by the increased viscosity of mucous gland secretions. |
|
|
Term
| Why do children with Cystic Fibrosis need to take pancreatic enzymes? |
|
Definition
| Because in the pancreas, the thick secretions block the ducts, eventually causing pancreatic fibrosis. This blockage prevents essential pancreatic enzymes from reaching the duodenum, which causes marked impairment in the digestion and absorption of nutrients. |
|
|
Term
| When are pancreatic enzymes taken with regards to eating? |
|
Definition
| The pancreatic enzymes are administered with meals and snacks to ensure that digestive enzymes are mixed with food in the duodenum. |
|
|
Term
| The influenza virus has a peculiar affinity for what type of cells and where? |
|
Definition
| Epithelial cells of the respiratory tract mucosa |
|
|
Term
| What impact does the peculiar infinity that the influenza virus has affect children? |
|
Definition
Children have smaller airways. More susceptible to flu.
Also because of where it targets! |
|
|
Term
| Classic first symptom of appendicitis? |
|
Definition
| Right lower quadrant pain |
|
|
Term
|
Definition
| A point midway between the anterior superior iliac crest and the umbilicus. Where the most intense point of pain r/t appendicitis is located. |
|
|
Term
| What are the signs of perforation related to acute appendicitis? |
|
Definition
| Sudden relief from pain followed by a subsequent diffuse increase in pain. |
|
|
Term
| what two interventions related to acute appendicitis you must avoid? And why? |
|
Definition
| Should not administer laxatives/enemas or apply heat to the area. Such measures stimulate bowel motility and increase risk of perforation. |
|
|
Term
| Difference between Ulcerative Colitis and Crohn’s Disease |
|
Definition
| The inflammation found with UC is limited to the colon and rectum with the distal colon and rectum the most severely affected, while in Crohn’s Disease the chronic inflammatory process involves any part of the GI tract from the mouth to the anus but most often affects terminal ileus. |
|
|
Term
| 4 goals of therapeutic management of Ulcerative Colitis and Crohn’s Disease: |
|
Definition
1) Control the inflammation
2) obtain long-term remission
3) promote normal growth and development
4) allow as normal a lifestyle as possible. |
|
|
Term
| How does mesalamine work in treating CD or UC? |
|
Definition
| The exact mechanism of action is not nknown but is believed to work by blocking the activity of cyclooxygenase and lipoxygenase, thereby, reducing the production of prostaglandins which decreases inflammation in the colon and symptoms associated with ulcerative colitis. |
|
|
Term
| Problems children with cleft palate/ cleft lip have prior to surgery? |
|
Definition
| She swallows air when she drinks, cries, suckles on anything |
|
|
Term
| Problems associated problems with Cleft lip or Palate? |
|
Definition
| The infant is unable to create suction in the oral cavity that is necessary for feeding. Speech impairment, recurrent otitis media leading to hearing loss, and improper tooth alignment can also occur. |
|
|
Term
| Clinical manifestations of hypertrophic pyloric stenosis? |
|
Definition
| usually develops in the first 2 to 5 weeks of life, causing projectile nonbilious vomiting, dehydration, metabolic alkalosis, and growth failure |
|
|
Term
| why do children die as a result of pyloric stenosis? |
|
Definition
| Dehydration since the child cannot digest food and is constantly vomiting. |
|
|
Term
| What is intussusceptions? |
|
Definition
| The most common cause of intestinal obstruction in children between the ages of 3 months and 3 years, and it occurs when on segment of bowel telescopes into another segment, pulling the mesentery with it. |
|
|
Term
| Classic triad of intussusception symptoms? |
|
Definition
| Abdominal pain, abdominal mass, bloody stools |
|
|
Term
| What indicates that the intussusception has reduced itself? |
|
Definition
| Passage of normal brown stool. |
|
|
Term
| What is Short Bowel Syndrome? |
|
Definition
| A malabsorptive disorder that occurs as result of decreased mucosal surface area, usually because of extensive resection of the small intestine. |
|
|
Term
| Most important component of nursing care for a child having Short Bowel Syndrome? |
|
Definition
| Administration and monitoring of nutritional therapy. |
|
|
Term
|
Definition
-Oxygen (O2) and Carbon Dioxide (CO2) exchange
-Regulation of Acid Base Balance |
|
|
Term
|
Definition
| Compensated state that may precede respiratory failure, the patient is able to maintain adequate gas exchange by increasing breathing rate and depth |
|
|
Term
| Signs/Symptoms of Resp Distress |
|
Definition
-Diaphoresis
-Pallor/cyanosis
-Nasal Flaring
-Tachypnea
-Noisy Breathing
-Retracting
-Grunting |
|
|
Term
| Examples of obstructions that cause respiratory failure? |
|
Definition
-Foreign body (vomitus)
-Infection (i.e. epiglottitis)
-Tonsils/adenoids
-Laryngospasm |
|
|
Term
| Restrictive causes for respiratory failure? |
|
Definition
-Thick secretions, foreign body
-Infection (Pneumonia)
-Alveolar rupture (pneumothorax)
-Chemical pneumonitis
-Pleural effusion
-Near-drowning event |
|
|
Term
| What comes after respiratory failure? |
|
Definition
|
|
Term
| Upper Respiratory Tract Illnesses: |
|
Definition
-URI or URTI
-Nasopharyngitis
-Pharyngitis
-Tonsillitis
-Influenza
-Otitis Media
-Infectious Mononucleosis |
|
|
Term
|
Definition
| A retraction is a medical term for when the area between the ribs and in the neck sinks in when a person with asthma attempts to inhale. Retractions are a sign someone is working hard to breathe. |
|
|
Term
|
Definition
| a technique that assesses the extent and symmetry of chest movement |
|
|
Term
|
Definition
| a radiologic sign found on a frontal neck radiograph where subglottic tracheal narrowing produces an inverted "V" shape within the trachea itself. The presence of the steeple sign supports a diagnosis of croup. |
|
|
Term
| Outpatient treatment for patient with LARYNGEOTRACHEOBRONCHITIS? |
|
Definition
-antipyretic
-hydration
-humidified air
-oral corticosteroids |
|
|
Term
| Inpatient treatment for patient with LARYNGEOTRACHEOBRONCHITIS? |
|
Definition
-racemic epinephrine (bronchodilator)
-humidified air
-oral corticosteroids |
|
|
Term
| treatment for patient with severe LARYNGEOTRACHEOBRONCHITIS? |
|
Definition
| -endotracheal intubation for patient's with PaCO2 levels >45 |
|
|
Term
| Are antibiotics used to treat croup? |
|
Definition
| usually not because most are caused by viruses, not bacteria. |
|
|
Term
|
Definition
-barking cough
-inspiratory stidor
-hoarseness |
|
|
Term
|
Definition
obstructive inflammatory process of the epiglottis (the flap at the base of the tongue that keeps food from going into the trachea)
*Due to its place in the airway, swelling of this structure can interfere with breathing, and constitutes a medical emergency.
MEDICAL EMERGENCY |
|
|
Term
| 3 clinical observations that are predictive of epiglottitis? |
|
Definition
1. abscess of spontaneous cough
2. drooling
3. agitation
*Can also see fever, sore throat, strider, chills, shaking, cyanosis |
|
|
Term
| A common cause of swelling of the epiglottis? |
|
Definition
H. influenzae bacteria
*Can also be caused by other bacteria or viruses |
|
|
Term
| What vaccine has reduced the incidences of epiglottitis? |
|
Definition
| Due to the H. influenzae type B vaccine which children routinely receive at a young age. |
|
|
Term
| For those not receiving Synagis, what is the treatment for patient's with RSV receive? |
|
Definition
| Airway management and fluids |
|
|
Term
|
Definition
-Inflammatory response initiated in airways
-Involves mast cells, eosinophils and T lymphocytes
-End result means increased mucous production, inflammation to lower airways and bronchospasm |
|
|
Term
| Symptoms of Reactive Airway Disease? |
|
Definition
RAD = Asthma
-Wheezing
-Dry cough (tight)
-Prolonged expiratory phase
-Restless
-Fatigue
-Tachypnea |
|
|
Term
|
Definition
-Chronic inflammatory disorder of airways
-Bronchial hyperresponsiveness
-Episodic
-Limited airflow or obstruction that reverses spontaneously or with treatment |
|
|
Term
|
Definition
-Inhalants
-Airborne pollens
-Stress
-Weather changes
-Exercise
-Viral or Bacterial agents
-Food additives |
|
|
Term
| Long term asthma medications |
|
Definition
-Corticosteroids-(inhaled) pulmicort
-Cromolyn sodium (Intal)
-Mast Cell Stabalizer
-Immunomodulators-(Xolair) decrease IgE response
-Leukotriene modifiers-(Accolate)
-LABA’s (long acting bronchodilator) -Serevent or Salmeterol (12 hours)
-Methylxanthines-theophylline |
|
|
Term
|
Definition
| Primarily responsible for the bronchoconstriction |
|
|
Term
|
Definition
| In chronic, more severe cases of asthma, general bronchial hyperreactivity (or smooth muscle twitchiness) is largely caused by eosinophils |
|
|
Term
| Examples of medications for quick relief for asthma relief |
|
Definition
-Anticholinergics(Atrovent) –blocks constriction (parasympathetic)
-SABA-Short acting bronchodilators (Albuterol)-stimulates dilation (sympathetic) RESCUE
-Systemic corticosteroids-> Methylprednisolone/Solumedrol |
|
|
Term
|
Definition
Inherited autosomal recessive trait
Cystic Fibrosis Transmembrane Conductance Regulator
critical loss of chloride ion transport
upsets the sodium and chloride ion balance
disrupts the normal, thin mucus layer that is easily removed by cilia lining the lungs and other organs
thick, sticky secretions
pool in bronchioles = atelectasis
clogs pancreatic ducts, impairs digestion & absorption of nutrients
leads to biliary cirrhosis
retarded G & D, delayed puberty
Terminal, median age is 37 |
|
|
Term
| Cystic Fibrosis Management/Treatment |
|
Definition
Mucolytics, bronchodilators, kalydeco
Antibiotics for infections
Chest PT
Avoid pulmonary Txs after meal |
|
|
Term
| The "Flutter" Mucous Clearing Device |
|
Definition
| he Flutter is a handheld device designed to facilitate clearance of mucus in hypersecretory lung disorders. Exhalation through the Flutter results in oscillations of expiratory pressure and airflow, which vibrate the airway walls (loosening mucus), decrease the collapsibility of the airways, and accelerate airflow, facilitating movement of mucus up the airways. |
|
|
Term
| Management of GI problems |
|
Definition
Assess nutritional status
Provide high protein & calorie diet
Administer pancreatic enzymes
Vitamins (esp. fat soluble) |
|
|
Term
|
Definition
Allergies to foods
Over-eating
Persistent coughing
Intestinal obstruction
Viral illness |
|
|
Term
|
Definition
|
|
Term
|
Definition
Fever, Nausea, Vomiting, Freq diarrhea
**Very contagious - passed through fecal oral route or indirect contact
Symptoms appear 1-3 days post contact
Between Nov and April most commonly seen - seasonal
Monitor for dehydration!!
Give electrolytes as treatment and may need IV!
No specific tx- usually recover on their own
Lasts roughly for 3-7 days |
|
|
Term
|
Definition
| increase in number and watery stools |
|
|
Term
|
Definition
| Viral, Bacterial, Food, infection and stress |
|
|
Term
| Chronic causes of diarrhea |
|
Definition
| Malabsorption, defects, allergies and inflammation |
|
|
Term
| Complications of diarrhea |
|
Definition
| Dehydration, acid-base imbalance, shock |
|
|
Term
|
Definition
-Alteration in frequency and consistency of passing stool
-Majority of children with idiopathic constipation
-Early childhood due to environmental changes and control over bodily functions
-Self perpetuating |
|
|
Term
|
Definition
-Congenital Aganglionic Megacolon
Absence of ganglion cells in one or more segments of the colon
-Etiology not fully understood |
|
|
Term
| Symptoms of Hirschsprungs Disease |
|
Definition
Symptoms
-Don’t pass meconium
-Distention
-Ribbon like stools |
|
|
Term
|
Definition
| -relaxation or incompetence of the lower esophageal sphincter |
|
|
Term
| Symptoms of G.E. Reflux Disease |
|
Definition
Signs and symptoms:
Vomiting
Weight loss
Respiratory Problems (RAD)
GI Bleeding |
|
|
Term
| 3 inflammatory disorders: |
|
Definition
Appendicitis
Ulcerative Colitis
Chron’s Disease |
|
|
Term
|
Definition
Signs and symptoms:
-abdominal pain-per umbilical to right lower quadrant
-local rebound tenderness
-vomiting
-constipation or diarrhea |
|
|
Term
|
Definition
| Muscle around the pylorus enlarges and leads to obstruction during the first three months of life |
|
|
Term
|
Definition
Signs and Symptoms
Projectile Vomiting-No Bile
Hunger
Weight Loss
Dehydration with F/E Disturbances
Increased Abdominal distention with peristaltic waves
Palpable Olive Shape Tumor in Epigastric Area |
|
|
Term
| Pre/Post Operative Problems for Pyloric Stenosis |
|
Definition
Pre-op Problems
-Emphasis is on restoring and correcting fluid and electrolyte problems
Post-op Problems
-Infant may still vomit
-Advancing diet as tolerated
-Rare to have complications
**Diagnosed usually by ultrasound |
|
|
Term
|
Definition
-Telescoping of one portion of the intestine into another
-Frequent cause of intestinal obstruction
-Child can become acutely ill with fever and signs and symptoms of peritonitis |
|
|
Term
| Diagnosing Intussusception |
|
Definition
-made by x ray, ultrasound, or barium enema (Using Air enema currently), which may also un-telescope the bowel
-Surgery if b.e is not successful |
|
|
Term
|
Definition
**Disorders of the pituitary gland depend on the location of the lesion or physiologic abnormality.
-Growth hormone deficiencies
-Precocious Puberty
-Diabetes Insipidus
-SIADH |
|
|
Term
|
Definition
|
|
Term
|
Definition
| Diabetes type I and type II |
|
|
Term
| Growth Hormone Deficiency: Hypopituitarism |
|
Definition
| Failure of the pituitary to produce sufficient growth hormone to sustain normal growth in children |
|
|
Term
| Growth Hormone Replacement |
|
Definition
-GH products are currently labeled for use in “children who have growth failure due to an inadequate secretion of normal endogenous growth hormone”
-Administered at night to correspond with normal release time of GH |
|
|
Term
| Management of Growth Hormone Deficiency |
|
Definition
-GH Replacement
-Children should be managed by a pediatric endocrinologist
-Height and weight is obtained every 3 months and plotted on the growth chart
-Bone age study yearly |
|
|
Term
|
Definition
-Development of sexual characteristics before the usual age of onset of puberty.
Girls
-Breast development, pubic hair, and/or menses before 8 years
Boys
-Secondary sexual characteristics before age 9
**Tanner Scale: true precocious puberty is characterized by 2 signs of puberty |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| Diabetes Mellitus has 2 types: |
|
Definition
Type I Diabetes
Type II Diabetes |
|
|
Term
| Diabetes Mellitus / Type 1 |
|
Definition
Lack of insulin production in the pancreas.
Under 20 years of age
Peak incidence between 10 and 14 years. |
|
|
Term
|
Definition
Elevated blood glucose leads to osmotic diuresis. (polyphagia, polyuria and polydipsia)
Protein and fat breakdown lead to weight loss- as much as 30%
Accumulation of ketones causes a drop in pH. (metabolic acidosis) and spilling of ketones in the urine |
|
|
Term
| Diagnostic Tests for DM Type I |
|
Definition
Blood glucose levels greater than 200 mg/dL
Urine sample reveals glucosuria and possible ketonuria.
Glucose tolerance test would reveal low insulin levels in the face of elevated glucose levels. |
|
|
Term
| Interventions for DM Type I |
|
Definition
Administration of insulin
Blood glucose levels
Initially before every meal
Every am when diabetes under control
Dietary management / refer to nutritionist
Glycosylated hemoglobin / reflects average glucose concentration for preceding 2 to 3 months. (A1C) |
|
|
Term
| Glycosylated hemoglobin A1C |
|
Definition
| HbA1c is a lab test that shows the average level of blood sugar (glucose) over the previous 3 months. It shows how well you are controlling your diabetes. |
|
|
Term
| Target Blood Glucose Levels |
|
Definition
Target levels
Toddler and preschool: 100 to 180 mg/dL
School-age: 90 to 180 mg/dL
Adolescents (13 to 19 years): 90 to 130 mg/dL |
|
|
Term
|
Definition
Short acting – often used to cover extra carbohydrate consumption
Combination of regular and intermediate-acting insulin
Morning and evening dosing
Children on mixed insulin dosage schedules tend to experience hypoglycemic episodes at 11:30 and 2:30 as peaking of insulin occurs. |
|
|
Term
|
Definition
Rapid onset
Shaky feeling, hunger
Dizziness
Headache
Vital signs
-Shallow respirations
-tachycardia
Tremors |
|
|
Term
| Lab values for Hypoglycemia |
|
Definition
Glucose = low, below 60
Ketones = negative
Urine output
Normal
sugar negative
negative ketones |
|
|
Term
| Treatment of Hypoglycemia |
|
Definition
| Simple concentrated sugars such as honey by mouth(older than 1 year), hard candy, sugar cubes, or glucose tablets will elevate the blood sugar immediately. Orange juice or sugar containing soda or fruit drink. (Blood Glucose less than 70 mg/dL) |
|
|
Term
|
Definition
-Using rapid-acting or Lispro insulin
-Infusion pump (8 to 10 years of age)
-Night time snack
-Check blood glucose before bedtime. -Make sure the blood glucose is 100 – 120 mg/dL before going to bed
-Do not skip snacks
-Eat an extra snack on days of strenuous exercise |
|
|
Term
| Symptoms of Hyperglycemia and DKA |
|
Definition
Symptoms:
-Onset = gradual
-Lethargic, confused, weak
-Thirsty
-Abdominal pain often with nausea and vomiting
-Signs of dehydration
-Vital signs: deep, rapid respirations, fruity acetone breath, and weak pulses |
|
|
Term
| Hyperglycemia associated with diabetic ketoacidosis is defined as a blood glucose measurement equal to or greater than: |
|
Definition
|
|
Term
| Symptoms of Diabetes KetoAcidosis |
|
Definition
Altered level of consciousness
Dehydration
Electrolyte disturbances
Dysrhythmias
Shock
Complete vascular collapse |
|
|
Term
| Life management of Diabetes |
|
Definition
Management by endocrinologist
Insulin
Blood sugar monitoring
Diet
Exercise
Screen for retinopathy: ophthalmologic exam annually |
|
|
Term
|
Definition
Vital component to management of child with diabetes.
May decrease the amount of insulin required.
Enhances insulin absorption.
Important for normal growth and development. |
|
|
Term
|
Definition
-85% of children with Type 2 are obese
-Age of onset is middle to late puberty- around 13 years
-Minority populations have an especially high rate of type 2 diabetes
-Strong family history |
|
|
Term
| Type 2 Diabetes Assessment |
|
Definition
Obesity: BMI greater than 30 (normal range is 15 to 17 in the pediatric population)
Waist to hip ratio: apple shape
Acanthosis nigricans: hyper-pigmentation and thickening of the skin into velvety irregular folds in the neck and flexural areas
Hypertension
+ family history of type 2 diabetes
Ethnicity |
|
|
Term
|
Definition
Glucose-lowering agent: drugs that improve insulin sensitivity
**Used with diet and exercise to control blood sugar in patients with type 2 diabetes. May be used alone or with other medicines. |
|
|
Term
| Examples of Age-Related Skin Manifestations |
|
Definition
Infants: “birthmarks”
Early childhood: atopic dermatitis
School-age children: ringworm
Adolescents: acne |
|
|
Term
|
Definition
Common peds skin problem
Treated with topical antibiotic if localized to small area
Bacterial: strep or staph
Wash crust off with soap and water and apply topical antibiotic
May be treated with oral antibiotics
if it has spread (still wash lesions)
Very contagious!!!!!!! |
|
|
Term
|
Definition
Superficial infections that live on the skin
AKA dermatophytoses, tinea
Transmission from person to person or from infected animal to human
Examples: tinea capitis, tinea corporis, tinea pedis, candidiasis |
|
|
Term
|
Definition
Inflammatory reaction of skin to chemical
Initial reaction in the exposed region
Characteristic sharp delineation between inflamed and normal skin
Primary irritant
Sensitizing agent
Examples: diaper dermatitis, reaction to wool, reaction to specific chemical |
|
|
Term
|
Definition
A type of pruritic eczema that begins during infancy
Hereditary tendency
Often associated with history of food allergies, allergic rhinitis, and asthma |
|
|
Term
|
Definition
Pathophysiology and clinical manifestations
Usually from irritation of urine and feces
Detergents inadequately rinsed from clothing
Chemical irritation (especially from diaper wipes)
Nursing considerations: alter wetness, pH, and fecal irritants
Differentiate from Candidiasis of diaper area (Candidiasis has characteristic excoriated red papules with satellite lesions |
|
|
Term
|
Definition
Adverse drug reactions are most often seen in skin (rashes most common reaction)
May be immediate or delayed following administration of drug
Treatment: discontinue drug, antihistamines, corticosteroid therapy if very severe |
|
|
Term
|
Definition
Predominantly in adolescents
Pathophysiology
Involves hair follicle and sebaceous glands
Black heads
Therapeutic management
General measures/overall health
Medications |
|
|
Term
|
Definition
Toddlers: hot water scalds
Older children: flame-related burns
Child abuse
Child with matches or lighters accounts for 1 in 10 house fires |
|
|
Term
|
Definition
| Lyme disease is caused by infection with a spiral-shaped bacterium called Borrelia burgdorferi. |
|
|
Term
|
Definition
Between three days to several weeks after being bitten by an infected tick, 70-90% of people develop a circular or oval rash, called erythema migrans (or EM), at the site of the bite. To qualify as an EM, the rash must be at least two inches in diameter.
The EM rash does not itch or hurt so if it is not seen, it may not be noticed.
"bulls eye" appearance |
|
|
Term
| Complications of Lyme Disease |
|
Definition
| Lyme disease may cause headache, fever, muscle and joint aches, and a feeling of tiredness. If left untreated, Lyme disease may progress to affect the joints, nervous system, or heart several weeks to months after the tick bite |
|
|
Term
|
Definition
is the surgical operation performed for the reconstruction of the eardrum (tympanic membrane) and/or the small bones of the middle ear (ossicles)
-Tympanoplasty can be performed through the ear canal (trascanal approach), through an incision in the ear (endaural approach) or through an incision behind the ear (postauricular approach). |
|
|
Term
|
Definition
| Inflammation of skin and subcutaneous tissues with intense redness, swelling, and firm infiltration. |
|
|
Term
|
Definition
Oral or parenteral antibiotics
rest and immobilization of both affect area and child
hot, moist compresses to area |
|
|
Term
| Complication of Diabetes Mellitus? |
|
Definition
| Could include cataracts and kidney stones |
|
|
Term
| Difference between type 1 diabetes and type 2? |
|
Definition
| Type 1 diabetes comes from the destruction of the pancreatic beta cells, the cells that produce insulin leading to an absolute insulin deficiency. Type 2 diabetes arises from insulin resistance in which the body fails to use insulin properly combined with relative (rather than absolute) insulin deficiency. People with type 2 can range from predominantly insulin resistant with relative insulin deficiency to predominantly deficient in insulin secretion with some insulin resistance. |
|
|
Term
| What are the two forms of type 1 diabetes? |
|
Definition
1. Immune-mediated DM
2. Idiopathic type 1 |
|
|
Term
| What is Immune-mediated DM? |
|
Definition
| results from an autoimmune destruction of the beta cells. Typically starts in children or young adults who are slim, but it can arise in adults of any age. |
|
|
Term
| What is Idiopathic type 1? |
|
Definition
| a rare form of the disease that has no known cause |
|
|
Term
| Type of onset for type I and type II diabetes? |
|
Definition
Type 1 onset: abrupt
Type 2 onset: gradual |
|
|
Term
| Presenting symptoms of type I and type II diabetes? |
|
Definition
Type 1: 3 common Ps: polyuria, polydipsia, polyphagia
Type 2: May be related to long term complications: kidney damage, blurred vision, etc |
|
|
Term
| Nutritional Status for type I and type II diabetes? |
|
Definition
Type 1: underweight
Type 2: overweight |
|
|
Term
| Insulin (natural) for type I and type II diabetes? |
|
Definition
Type 1: pancreatic content: usually known
Serum insulin: low to absent
Primary resistance: 80-85%
Type 2: pancreatic content: >50% normal
Serum insulin: high or low
Primary resistance: <5% |
|
|
Term
| Therapy - type I and type II diabetes? |
|
Definition
Type 1: insulin therapy always effective, diet and oral agents ineffective
Type 2: Insulin used in 20-30% of patients, oral agents and diets are often effective |
|
|
Term
| Ketoacidosis - type I and type II diabetes? |
|
Definition
Type 1: common
Type 2: infrequent |
|
|
Term
| Why is it that individuals with type 2 diabetes infrequently have diabetic ketoacidosis? |
|
Definition
| DKA results from a shortage of insulin. Patient’s with type 2 diabetes make insulin, however they have a shortage of production. Patient’s with type 1 diabetes have a insulin deficiency due to the destruction of pancreas islets, so they are more at risk for an insulin shortage. |
|
|
Term
| Difference between onset of hypoglycemia and hyperglycemia? |
|
Definition
Hypoglycemia: Rapid (minutes)
Hyperglycemia: Gradual (days) |
|
|
Term
| Difference between mood of hypoglycemia and hyperglycemia? |
|
Definition
Hypoglycemia: Labile, irritable, nervous, weapy
Hyperglycemia: Lethargic |
|
|
Term
| Difference between Mental Status of hypoglycemia and hyperglycemia? |
|
Definition
Hypoglycemia: Difficulty concentrating, speaking, focusing, coordinating; nightmares
Hyperglycemia: Dulled sensorium, confusion |
|
|
Term
| Difference between inward feeling of hypoglycemia and hyperglycemia? |
|
Definition
Hypoglycemia: Shaky feeling, hunger, headache, dizziness
Hyperglycemia: Thirst, weakness, nausea & vomiting, abdominal pain |
|
|
Term
| Difference between skin of hypoglycemia and hyperglycemia? |
|
Definition
Hypoglycemia: Pallor, sweating
Hyperglycemia: Flushed, signs of dehydration |
|
|
Term
| Difference between Mucous membranes of hypoglycemia and hyperglycemia? |
|
Definition
Hypoglycemia: Normal
Hyperglycemia: Dry, crusty |
|
|
Term
| Difference between Respirations of hypoglycemia and hyperglycemia? |
|
Definition
Hypoglycemia: Shallow, normal
Hyperglycemia: Deep, rapid |
|
|
Term
| Difference between pulse of hypoglycemia and hyperglycemia? |
|
Definition
Hypoglycemia: Tachycardia, palpitations
Hyperglycemia: Less rapid, weak |
|
|
Term
| Difference between breath odor of hypoglycemia and hyperglycemia? |
|
Definition
Hypoglycemia: Normal
Hyperglycemia: Fruity, acetone |
|
|
Term
| Neurologic differences between hypoglycemia and hyperglycemia? |
|
Definition
Hypoglycemia: Tremors
Hyperglycemia: Diminished reflexes, paresthesia |
|
|
Term
| Difference between Ominous signs of hypoglycemia and hyperglycemia? |
|
Definition
Hypoglycemia: Late – hyperreflexia, dilated pupils, seizure, shock, coma
Hyperglycemia: Acidosis, coma |
|
|
Term
| Difference between Blood glucose of hypoglycemia and hyperglycemia? |
|
Definition
Hypoglycemia: Low <60 mg/dl
Hyperglycemia: High >= 250 mg/dl |
|
|
Term
| Difference between urine output of hypoglycemia and hyperglycemia? |
|
Definition
Hypoglycemia: Normal
Hyperglycemia: Polyuria (early) to oliguria (late) |
|
|
Term
| Visual Differences between urine output of hypoglycemia and hyperglycemia? |
|
Definition
Hypoglycemia: Diplopia
Hyperglycemia: Blurred vision |
|
|
Term
| 3 main tasks of after diagnosis of type 1 diabetes in children |
|
Definition
a. Achieve metabolic stabilization
b. Prevent complications
c. Provide support to the child and family – and to educate them how to manage the disease |
|
|
Term
| which age group has the most trouble adjusting to the diagnosis of type 1 diabetes |
|
Definition
|
|
Term
| What is the nursing care management of Hypopituitarism? |
|
Definition
| Identifying children with growth problems. The nurse may be a key person in helping establish a diagnosis. |
|
|
Term
| What does child and family support consist of in regards to hypopituitarism? |
|
Definition
| Children undergoing hormone replacement require additional support. The nurse should provide education for patient self-management during the school-age years. Nursing functions include family education concerning medication preparation and storage, injection sites, injection technique, and syringe disposal. |
|
|
Term
| Why do infants form blisters more readily than adults? |
|
Definition
| In infants and small children, the epidermis is loosely bound to the dermis. This poor adherence causes the layers to separate easily during an inflammatory process to form blisters. |
|
|
Term
| What are more than half of the problems in children forms of? |
|
Definition
|
|
Term
|
Definition
| A general term that describes an inflammation of the skin. |
|
|
Term
| 2 examples of what might cause dermatitis? |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| A group of closely related filamentous fungi that invade primarily the stratum corneum, hair, and nails. |
|
|
Term
| What is the nursing management for lyme disease? |
|
Definition
| The major thrust of nursing care should be educating parents to protect their children from exposure to ticks. Children should avoid tick-infested areas or wear light-colored clothing so that ticks can be spotte easily, tuck pant legs into socks, and wear a long-sleeved shirt tucked into pants when in wooded areas. Products with DEET should be applied sparingly |
|
|
Term
| What causes diaper dermatitis? |
|
Definition
| Prolonged and repetitive contact with an irritant. |
|
|
Term
| What is Candida albicans? |
|
Definition
|
|
Term
| what type of rash does candida albicans present with in the diaper area? |
|
Definition
| Chronic diaper dermatitis and should be considered in diaper rashes that are recalcitrant to treatment. |
|
|
Term
| What is a common medication prescribed for candida albicans? |
|
Definition
| Antifungal topical medication (nystatin) or oral medication (fluconazole) |
|
|
Term
| What are the three nursing interventions at altering in regards to diaper dermatitis? |
|
Definition
| Nursing interventions are aimed at altering the three factors that produce dermatitis: wetness, pH, and fecal irritants. |
|
|
Term
|
Definition
| Sickle cell anemia is a genetic disease that affects hemoglobin. Under low oxygen conditions the hemoglobin sticks together causing long fibers that make the red blood cells change to a sickle shape. This causes them to get stuck in blood vessels causing parts of the body to not receive the oxygen they need. |
|
|
Term
|
Definition
| The red blood cells change shape causing the bone marrow to try to make more cells to make up for the loss, but it cannot keep up which causes anemia. The shape causes the cells to clump and cut off block flow in the vessels. As a result children’s growth is delayed, they are fatigued, and they have extreme pain. |
|
|
Term
| What causes pain in patients with SCA? |
|
Definition
| Because of the blockage the tissues are not getting enough oxygen. They must switch to anaerobic respiration. The fatigue is because anaerobic respiration does not produce as much energy as the cells normally would. The pain is because of the lactic acid that is a byproduct of anaerobic respiration. This pain is made worse because the reduced circulation means that the lactic acid remains in the tissues. |
|
|
Term
|
Definition
| Characterized by ischemia that causes mild to severe pain that can last from minutes to days |
|
|
Term
| SCA: Sequestration crisis |
|
Definition
| The pooling of a large amount of blood usually in the spleen and infrequently in the liver that causes a decreased blood volume and ultimately shock. |
|
|
Term
|
Definition
| Diminished RBC production usually caused by viral infection that may result in profound anemia |
|
|
Term
| SCA: Hyperhemolytic crisis |
|
Definition
| An accelerated rate of RBC destruction characterized by anemia, jaundic, and reticulocytosis |
|
|
Term
| SCA: Acute chest syndrome |
|
Definition
| Clinically similar to pneumonia. It is presence of new pulmonary infiltrate and may be associated with chest pain, fever, cough, tachycardia, wheezing, and hypoxia |
|
|
Term
|
Definition
| Common genetic disorder where there is a deficiency in the rate of production of specific globin chains in hemoglobin. When it disintegrates it damages RBCs causing severe anemia. |
|
|
Term
| B-Thalassemia: Goals of treatment and nursing care |
|
Definition
Goals: Provide therapy to maintina Hgb high enough to have enough RBCs to support normal normal growth and development. Do this by giving frequent blood transfusions.
Nursing care: Promote compliance with transfusion treatment, assist the child with their anxiety, help the parents adjust, and monitor for transfusion reactions. |
|
|
Term
|
Definition
| Type of bone marrow failure where the formation of formed elements of the blood (leukocytes, thrombocytes, and Hgb) are all depressed. It can be primary (congenital, autosomal recessive) or secondary (acquired). Goal of therapy is to restore function of the bone marrow. |
|
|
Term
| Goal of therapeutic treatment of hemophilia |
|
Definition
| Replace missing clot factor. |
|
|
Term
| 2 most common misconceptions about pathophysiology of leukemia |
|
Definition
-In the acute form of leukemia, the leukocyte count is low, even though leukemia is an overproduction of WBCs
-There is a misconception that the immature cells deliberately attack and destroy the normal blood cells or vascular tissue, but in fact cellular destruction happens by infiltration and subsequent competition for metabolic elements |
|
|
Term
| Nursing care of child with leukemia |
|
Definition
| Therapeutic regime itself causes a lot of unpleasant and dangerous symptoms for the child. These symptoms must be managed to make the child more comfortable and as safe as possible. |
|
|
Term
| Absolute Neutrophil Count |
|
Definition
-The number of neutrophil granulocytes present in the blood.
-To calculate the total percent of neutrophils you multiply the WBC count by the percent of neutrophils. |
|
|
Term
| What are the current statistics of pediatric cancers? |
|
Definition
-11,630 children under the age of 15 will be diagnosed with cancer in 2013
-1310 children are expected to die from cancer in 2013
-Cancer is the leading cause of death by disease in children 1-14 years of age
-There is an 80% 5 year survival rate for cancer |
|
|
Term
| Most common pediatric cancer |
|
Definition
| Leukemia (about 1/3 of cases of cancer in children) |
|
|
Term
| Which cancer has the best and worst prognosis? |
|
Definition
-AML has the worst prognosis
-Hodgkin Lymphoma has the best prognosis |
|
|
Term
|
Definition
-Inadequate supply of dietary iron
-Children 12-36 months at greatest risk |
|
|
Term
| Sickle Cell Anemia Etiology |
|
Definition
-Inherit the HgbS gene from each parent
-If only one gene for Hgbs then have sickle cell trait
-Normal adult hemoglobin partially or completely replaced by hemoglobin S |
|
|
Term
|
Definition
| Hereditary, chronic, hemolytic disorder. It predominately affects African-Americans but also people of Mediteranean decent. Under certain conditions, RBCs will assume a crescent or sickle shape |
|
|
Term
| Signs and symptoms of a patient with sickle cell anemia (not in crisis) |
|
Definition
-Growth retardation
-Chronic anemia
-Delayed sexual maturation
-Marked susceptability to infection and sepsis |
|
|
Term
| Signs and symptoms of sickle cell anemia (in crisis) |
|
Definition
-Severe pain
-Muscle spasms
-Hot, swollen joints, fever
-Hematuria
-Paralysis, seizure, coma
-Severe abdominal pain and distension
-Later jaundice d/u hemolysis
-Crisis may be fatal r/t cerebral infracting & cardiac complications |
|
|
Term
|
Definition
Enmeshing of sickling cells block microcirculation intermittenly
-Hypoxia results then tissue edema then ischemia and possible tissue death
--Extremities-swollen
--Cerebrum stroke |
|
|
Term
|
Definition
-High mortality rate
-Cause usually result of lung tissue damage from vasoocclusion
-Infiltrates develop appears as Respiratory Distress
-Poor oxygenation to tissues-cell death results |
|
|
Term
| Diagnosing and treatment of sickle cell disease |
|
Definition
-Most states mandatory newborn screening
-Sickledex-screening test
-Electrophoresis
Treatment:
-Aimed at preventing sickling
-Short term O2 therapy
-Analgesics
-Bedrest
-Bone marrow transplant
-Hydration |
|
|
Term
| Nursing care for sickle cell |
|
Definition
Educate parents about disease
-Don't fly in under-pressurized planes
-Don't exercise in high altitudes
-May use PCN G prophylactically |
|
|
Term
| Thalassemia and treatment |
|
Definition
Problem with production of Hemoglobin in RBC. Do not have enough hemoglobin or RBCs to transport O2 throughout the body.
-Frequent blood transfusions
-Hemosiderosis can result: defective RBCs stored in various organs |
|
|
Term
|
Definition
| Form of iron overload disorder. It is an accumulation of iron in the liver and/or heart but also endocrine organs, in patients who receive frequent blood transfusions (such as those with Thalassemia, Sickle cell disease, anemia, or myedysplastic syndrome) |
|
|
Term
| ITP (Idiopathic thrombocytopenic purpura) |
|
Definition
| -Idiopathic: cause is unknown; Thrombocytopenic: blood does not have enough platelets; Purpura: excessive bleeding/bruising |
|
|
Term
| Relationship between ITP and immune system |
|
Definition
-Antibodies destroy platelets
-Antibodies see platelets as bacteria and work to eliminate them
-ITP is preceded by a viral illness (URI, varicella, smallpox/measles vaccine, mononucleosis, flu) |
|
|
Term
|
Definition
Hemophilia A: classic
Hemophilia B: Christmas disease
Von Willabrands Disease |
|
|
Term
|
Definition
-Spontaneous bleeding
-Bleeding into joints and associated pain adn swelling
-Gastrointestinal tract and urinary tract hemorrhage
-Blood in the urine or stool
-Prolonged bleeding from cuts, tooth extraction and surgery |
|
|
Term
|
Definition
-Spontaneous bleeding
-Bleeding into joints and associated pain adn swelling
-Gastrointestinal tract and urinary tract hemorrhage
-Blood in the urine or stool
-Prolonged bleeding from cuts, tooth extraction and surgery |
|
|
Term
| Interventions for Hemophilia |
|
Definition
-Replace the factor as ordered by physician
-Manage pain utilizing analgesics as ordered: no salicylate products.
-Maintaining joint intergrity during acute phase: immobilization, elevation, ice.
-Physical therapy to prevent flexion contraction and to strengthen muscles and joints
-Provides opportunities for normal growth and development |
|
|
Term
| 2 clinical consequences of congenital heart defects in pediatrics |
|
Definition
1. Heart failure: inability for the heart to pump an adequate amount of blood to the systemic circulation
2. Hypoxemia: Referes to an arterial oxygen tension that is less than normal and can be identified by a decreased arterial saturation or a decreased PaO2 |
|
|
Term
| What are some factors of acquired cardiac disorders in pediatrics? |
|
Definition
-Infection
-Auto-immune responses
-Environmental factors
-Famial tendencies |
|
|
Term
| Which heart defect has the worst prognosis? |
|
Definition
| Hypoplastic left heart syndrome--some centers reporting mortality rates of about 10%, but a lot mulitcenter series reports a mortality rate of about 30% |
|
|
Term
| Those with chronic hypoxemia develop what two physiologic changes? |
|
Definition
1. Polycethemia: an increased number of RBCs, increased the oxygen carrying capacity of the blood. It increases of the blood and crowds out clotting factors.
2. Clubbing: a thickening and flattening of the tips of the fingers and toes |
|
|
Term
| What is "Blue spell" or "tet spell" |
|
Definition
| Hypercyanotic spells, and they may occur in any child whose heart defect includes obstruction to pulmonary blood flow and communication between the ventricles. The infant becomes acutely cyanotic and hyperpneic because sudden infundibular spasm decreases pulmonary blood flow and increases right-to-left shunting. |
|
|
Term
|
Definition
| An inflammatory disease that affects the cardiovascular system and causes damage to blood vessels in the body. The cause is unknown and it usually presents in children under 5 years of age. |
|
|
Term
| What are hallmark signs of Kawasaki Disease? |
|
Definition
| Has 3 phases, the acute phase, subacute phase, and convalescent phase. To diagnose, children must have a fever for more than 5 days along with 4 of 5 clinical criteria which are: 1. Changes in the extremities (acute phase: edema, erythema of the palms and subacute: soles or peeling of the hands and feet); 2. Bilateral conjunctival inflammation without exudate; 3. Changes in the oral mucous membranes, such as erythema of the lips, oropharyngeal reddening, or “strawberry tongue”; 4. Polymorphous rash; 5. Cervical lymphadenopathy (one lymph node >1.5 cm) |
|
|
Term
| 2 types of cardiovascular dysfunction in children |
|
Definition
-Congenital: monitor for heart failure, hypoxemia
-Acquired: Occurs after birth, seen in normal heart or abnormal heart |
|
|
Term
| Classification of heart defects |
|
Definition
1. Acyanotic:
-Raised pulmonary blood flow (Atrial septal defect, ventricular septal defect, patent ductus arteriosus, atrioventricular canal)
-Obstruction to blood flow from ventricles (Coarctation of aorta, Aorta stenosis, pulmonic stenosis)
2. Cyanotic
-Lowered pulmonary blood flow (Tetralogy of fallot, tricuspid atresia)
-Mixed blood flow (Transposition of great arteries, total anomalous pulmonary venous return, truncus arteriosus, hypoplastic left heart syndrome) |
|
|
Term
| Symptoms of cardiac dysfunction in child/infant |
|
Definition
-Heart murmur
-tires while eating
-FTT, low weight for height
-Sweats while eating (diaphoretic)
-Cyanosis, worsens with feeding or activity level, pallor
-Irritable weak cry
-Clubbing
-Difference in peripheral pulses
Additional symptoms in the older child:
-Chest pain
-Decreased activity level
-Syncope
-Abnormal growth chart pattern |
|
|
Term
| Vital signs in the child with cardiac dysfunction |
|
Definition
-HR: tachycardia in the absence of fever, crying, or stress
-Tachypnea, even with rest, chest retractions indicate respiratory distress, possibly resulting from congestive heart failure |
|
|
Term
|
Definition
-Pressures on the left side of the heart are normally higher than pressures in the right side of the heart
-If there is an abnormal opening in the septum between the right and left sides, blood flows from left to right |
|
|
Term
| Clinical manisfestations of left to right shunt |
|
Definition
-The infant is not cyanotic
-Tachycardia due to pushing increased blood volume
-Cardiomegaly due to increased workload of the heart
-Dyspnea and pulmonary edema due to the lungs receiving blood under high pressure from the right ventricle
-Increased number of respiratory infections due to blood pooling in the lungs promoting bacterial growth |
|
|
Term
|
Definition
-Occurs when pressure in the right side of the heart is greater than the left side of the heart (resistance of the lungs is abnormally high; pulmonary artery is restricted)
-Deoxygenated blood from the right side shunts to the left side
-Hole in septum + obstructive lesion = deoxygenated blood from the right side of the heart shunts to the left side of the heart and out into the body |
|
|
Term
| Clinical manisfestations right to left shunts |
|
Definition
-Hypoxemia: the result of decreased tissue oxygenation
-Polycythemia: increased RBC production due to the body's attempt to compensate for the hypoxemia
-Increase viscosity of the blood = heart has to pump harder
-Potential complications include thrombus formation due to sluggish circulation, or brain abscess or stroke due to un-oxygenated blood bypassing the filtering system of the lungs |
|
|
Term
| Examples of diagnosis r/t shunts |
|
Definition
-Left to right shunts: Atrial septal defect, ventricular septal defect
-Right to left shunts: Pulmonary stenosis; tetralogy of fallot |
|
|
Term
|
Definition
-Major manifestation of cardiac disease
-Under 1 yr of age due to congenital anomaly
-Over 1 yr with no congenital anomaly may be due to acquired heart disease |
|
|
Term
| Clinical manifestations of Heart Failure |
|
Definition
-Systemic venous congestion: weight gain, hepatomegaly, edema, jugular vein distension
-Pulmonary venous congestion: tachypnea, dyspnea, cough, wheezes
-Compensatory response: tachycardia, cardiomegaly, diaphoretic, fatigue, failure to grow |
|
|
Term
| Nursing interventions for Heart failure |
|
Definition
-Fluid restriction
-Diuretics: Lasix (potassium wasting) or Aldactone (potassium sparing)
-Bed rest
-Oxygen
-Small frequent feedings: soft nipple with supplemental NG for adequate calorie intake
-Pulse oximeter
-Sedatives if needed |
|
|
Term
|
Definition
-Digoxin increases the force of the myocardial contraction
-Take an apical pulse before every dose of digoxin. If bradycardia is detected. General rule is: <90-110 beats/min for infant and toddler; <70 beats in the older child (toddler-adolescent); <60 beats in the adolescent
-Call physician before administering the drug |
|
|
Term
| Signs of Digoxin Toxicity |
|
Definition
-Bradycardia/Dysrythmia
-Arrhythmia
-Nausea, vomiting, anorexia
-Dizziness, headache
-Weakness and fatigue |
|
|
Term
| Ventricular septal defect |
|
Definition
-Opening in the ventricular septum
-Left-to-right shunt
-Right ventricular hypertrophy
-Deficient systemic blood flow |
|
|
Term
|
Definition
-Congenital narrowing of the descending aorta
-80% have aortic-valve anomalies
-Difference in BP in arms and legs (severe obstruction) |
|
|
Term
|
Definition
-Obstruction of blood flow from right ventricle
-Hypertrophy of right ventricle
-If severe cyanosis due to right-to-left shunt |
|
|
Term
|
Definition
-Most common cardiac malformation responsible for child over 1 year
-4 Components
1. VSD
2. Pulmonary stenosis: narrowing of pulmonary valve
3. Overriding of the aorta: aortic valve is enlarged and appears to arise from both the left and right ventricles instead of the left ventricle
4. Hypertrophy of right ventricle: thickening of the muscular walls because of the right ventricle pumping at high pressure |
|
|
Term
| Clinical manisfestations of tetralogy of fallot |
|
Definition
-Dependent on degree of right ventricular outflow obstruction
-Right-to-left shunt
-Clubbing of digits
-"Tet" spells: treated by flexing knees forward and upward
-Severe irritability due to low oxygen levels |
|
|
Term
|
Definition
-Unknown origin; inflammation of vascular system
Symptoms:
-High fever
-Conjunctivitis: no drainage
-Strawberry tongue
-Edema of hands and feet
-Reddening of hands and feet
-Reddening of palms and soles
-Lymph node swelling |
|
|
Term
| Interventions for Kawasaki diseas |
|
Definition
-Intravenous gamma globulin
-High dose of ASA while in hospital
-Low dose of ASA upon discharge
-Base-line echocardiogram to assess coronary artery status |
|
|
Term
|
Definition
-Poorly understood inflammatory disease
-Most often late school age children and adolescents
-Involves joints, skin adn heart (specifically mitral valve)
-If we can treat strep throat, we can treat |
|
|
Term
|
Definition
-Self-limiting disorder where there is aseptic necrosis of the femoral head. Cause is unknown.
-Children 2-12 years, but most common in boys between 4-8 years. Most affected kids have a skeletal age below their chronological age.
-Has an insidious onset. May have limp on affected side or hip soreness, ache, or stiffness
-4 radiographic stages |
|
|
Term
|
Definition
-Cast that immobilizes the hip
-Complete evaporation of water froma hip spica cast made with older type plaster materials can take 24-48 hours while fiberglass dries in minutes. |
|
|
Term
| Interventions for hip spica cast |
|
Definition
-Turn the child at least every 2 hours to help cast dry evenly
-Body part should be elevated to prevent compartment syndrome
-Sensation and movement should be checked below the cast
-The prone position should be used for self-feeding from a small table placed next to dining room table |
|
|
Term
| What is causing a marked increase in skeletal injury in school age and adolescent children? |
|
Definition
| -Increased amount of training done by young athletes leads to overuse injuries. Overuse injuries account for nearly half of all injuries evaluated in pediatric sports medicine. |
|
|
Term
| Major differences in pediatric MSK system |
|
Definition
-Children's bones are less dense, more porous and pliable (bones break easier, and will bow and cause torus or buckle fractures)
-Childrens bones grow from an epiphyseal plate (damaging growth plate can affect growth)
-Ligaments and tendons are stronger than bones until puberty (broken bones more common than sprains)
-Fractures heal much quicker in children than adults
-Normal bone remodeling process can correct malalignment making near anatomic reductions less important in children than adults |
|
|
Term
| Treatment for developmental dysplasia of the hip in infants to 6 months |
|
Definition
| The hip joint is maintained by dynamic splinting in a safe position with the proximal femur centered on the acetabulum in an attitude of flexium. Pavlik harness is most widely used. It is worn continuously and works the hip into a more abducted, reduced position. If it difficult to maintain stable reduction then a hip spica cast is applied. |
|
|
Term
| What is the treatment for developmental dysplasia of the hip in infants greater than 6 months to 18 months |
|
Definition
| Dislocation is usually not recognized until child stands and walks. A surgical closed reduction is performed and the child is placed in a spica cast for 12 weeks. |
|
|
Term
|
Definition
| Common birth defect, occurs in males twice as much as females. Can involve one foot or both. Affected foot looks as though it has been turned inward at the ankles. |
|
|
Term
| Gold standard treatment for moderate to severe scoliosis? |
|
Definition
| Bracing is the gold standard for moderate curvatures in growing children |
|
|
Term
| Hematogenous osteomyelitis |
|
Definition
| When a bloodborne bacterium causes an infection in the bone. Most often occurs due to infected lesions, upper respiratory tract infections, otitis media, tonsilitis, abscessed teeth, pyelonephritis, and infected burns. |
|
|
Term
|
Definition
| Group of permanent disorders of the development of movement and posture, causing activity limitation that are attributed to non-progressive disturbances that occurred in the developing fetal or infant brain. |
|
|
Term
| Most common type of cerebral palsy |
|
Definition
| "Spastic CP": represents an upper motor neuron muscular weakness. Characteristic physical signs are increased stretch reflexes, decreased muscle tone, and weakness. |
|
|
Term
| Cerebral palsy is defined as being non-progressive. What does this mean? |
|
Definition
| A chronic, nonprogressive disease is considered a static condition. The neurological disturbances occurred in the developing fetus and are not acquired otherwise. CP itself can be considered non-degenerative. |
|
|
Term
| What is the prognosis for children having cerebral palsy? |
|
Definition
Depends on type and severity of the condition.
-Children with mild-moderate involvement (85%) have the capability of achieving ambulation between the ages of 2 and 7 years.
-30-50% of children with CP have significant cognitive impairments, and an even higher percentage have mild cognitive impairments, and an even higher percentage have mild cognitive and learning deficits. |
|
|
Term
| When a clinician states that the child has spina bifida, what are they referring to? |
|
Definition
| Spina bifida myelomeningocele |
|
|
Term
| Difference between meningocele and myelomeningocele spina bifida? |
|
Definition
| Spina bifida meningocele is a visible defect defect involving the failure of the osseous spine to close due to an external saclike protrusion that encases the meneges and spinal fluid but no neural elements. Spina bifida myelomeningocele has the same definition except the saclike protrusion contains the meninges, spinal fluid, and nerves. |
|
|
Term
| Arnold Chiari Malformation |
|
Definition
| It is a consolation of neurologic findings, the most important of which is herniation of the hindbrain down into the cervical portion of the neck. This interferes with cerebrospinal fluid circulation and is the principle driver in the cause for hydrocephalus. |
|
|
Term
|
Definition
| If hydrocephalus is causing the baby to be symptomatic, a neurosurgeon will put a shunt in through the skull into the ventrical of the brain to decompress the fluid in the brain caused by hydrocephalus. The shunt will then be threaded under the skin, over the chest and down to the abdomen. |
|
|
Term
| Why are children with spina bifida more prone to latex allergies? |
|
Definition
| Because of repeated exposure to latex products during surgery and procedures. Therefore, such children should not be exposed to latex products from birth onward to minimize the occurrence of latex hypersensitivity. |
|
|
Term
| Nursing care of the unconcious child |
|
Definition
Respiratory
-Adequate airway always priority
-CO2 potent vasodilating effect
-Positioning to prevent aspiration
-Frequent suctioning
Nutrition and hydration
-Ensure not to overhydrate
Medications
-Cause of unconsciousness depends on drugs: seizure-anti epileptics; cerebral edema-osmotic diuretics
Thermoregulation
-Medically induced hypothermia decreases metabolic demands |
|
|
Term
| 3 major causes of brain damage in children |
|
Definition
-Falls
-Motor vehicle accidents
-Bicycle injuries |
|
|
Term
|
Definition
-Lumbar puncture to diagnose
-Pain managment especially in first 24 hours, Tylenol with codeine often given
-Safety measures I.e. seizure precautions
-Very specific and focused Neurological assessments to including vital signs
-Fluid and nourishment determined by child's status |
|
|
Term
|
Definition
-Most common and treatable disorder in children and can occur with a wide variety of conditions involving the CNS
-Epilepsy: a condition with two or more unprovoked seizures
-Seizures: symptom of underlying disease, head trauma, meningitis, hypoxia |
|
|
Term
| Diagnosing and treatment of seizures |
|
Definition
-EEG: most useful diagnostic tool
-Drug therapy: raise the threshold for neuronal excitability
-Other treatments: Diet changes, nerve stimulation, surgery |
|
|
Term
|
Definition
-Cause uncertain
-Most often seen in children 12-30 months
-Occur during temperature rise
-Usually do not last long
-Usually no antiepileptic medication but rather antipyretic therapy |
|
|
Term
|
Definition
-Imbalance of production and absorption of CSF in the ventricular system
-Dandy-Walker and Arnold-Chiari malformations: complex disorders that have difference causes and mechanisms and begin at different times in the embryonic period. |
|
|
Term
|
Definition
| Congenital brain malformation involving the cerebellum |
|
|
Term
| Nursing care management of ventralperitoneal shunt |
|
Definition
-Monitoring for increased intracranial pressure
-Positioned on unoperative side of shunt
-Often kept flat to avoid too rapid reduction of intracranial fluid
-Observe for abdominal distension
-Accurate I&O
-Teaching |
|
|
Term
| What are Piaget's developmental theories about? |
|
Definition
|
|
Term
| What are the 4 parts of Piaget's theory? |
|
Definition
-Sensorimotor
-Preoperational thought
-Concrete Operational
-Formal Operations |
|
|
Term
|
Definition
-Ages birth-24 months
-Experiences world through senses and interactions
-Lacks object permeance
-Stranger anxiety |
|
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Term
|
Definition
| The object exists even when it is no longer visible |
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Term
|
Definition
| When a child is exposed to an individual who is unfamiliar to them |
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Term
|
Definition
-24 months- age 7
-First use of representational thoughts and symbols
-Ability to pretend
-Lacks logical reasoning
-egocentrism
-transductive |
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Term
|
Definition
| The inability to put oneself in place of another |
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Term
|
Definition
| "All women with big bellies have babies"(reasoning from specific cases to general) |
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Term
|
Definition
-Age 7-11
-Increased logic (reasoning and thinking)
Ex/ Reasoning- the girl shares her doll with her friend since she has 2 dolls and her friend has none
Ex/ Thinking - the apple is still an apple even when it is cut in half |
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Term
|
Definition
age 11- young adult (adulthood)
-ex/ Thinking - if all dogs back, then the adolescent can deduce that his dog will bark too
-Ex/ Problem solving - If Adam had more money than Ben, and Ben had more money than Cara, then the adolescent would conclude that Adam has more money than Cara |
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Term
| What are Freud's development theories about? |
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Definition
|
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Term
| What are the 5 parts of Freud's theory? |
|
Definition
-Oral
-Anal
-Phalic
-Latency
-Genital |
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Term
|
Definition
-Birth to 1 year
-A child's primary source of pleasure is through the mouth: Sucking, biting, chewing, vocalizing |
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Term
|
Definition
- ages 1-3 years
-Children gain a sense of mastery and competence by controlling bladder and bowel movements
-Climate of potty-training can have lasting effects on children's personality |
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Term
|
Definition
-Ages 3-6 years
-The libido's energy is focused on the genitals. Children begin to identify with their same-sex parent.
-Genitals, Exploration, opposite sex parent, curious of dissimilarities in opposite sex |
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Term
|
Definition
-Age 6-12 years
The libido's energy is suppressed and children are focused on other activities such as school, friends and hobbies
-More interest in same sex parent
-Same gender play "boys have cooties"
-Ex/ child begins to elaborate on previously acquired traits and skills
-Ex/ The child focuses his/her energy into acquiring more knowledge |
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Term
|
Definition
-Age 12-18 years
-Children begin to explore romantic relationships.
-Sexual interest
-Genitals are major source of sexual tensions and pleasures
-Energy towards friendships and preparing for marriage |
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Term
| What are Erikson's developmental theories about? |
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Definition
|
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Term
| What are the 8 parts of Erikson's theory? |
|
Definition
-Trust vs Mistrust
-Autonomy vs Shame, Self doubt
-Initiative vs guilt
-Industry vs inferiority
-Identity vs role confusion
-Intimacy vs isolation
-Generativity vs stagnation
-Ego integrity vs despair |
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Term
|
Definition
-Birth - 1 year
-Children learn to either trust or mistrust their caregivers.
-Faith in the environment vs suspicion, fear of future
-GOAL: Faith and optimism |
|
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Term
| Autonomy vs Shame, Self-Doubt |
|
Definition
-Age 1-3 years
-Children develop self-sufficiency by controlling activities such as eating, toilet training and talking.
-Independence driven, realize can control self, environment, body; encouragement of decision-making whether good or bad vs shame and doubt when made to feel inadequate or self-conscious
GOAL: Self control and will power |
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Term
|
Definition
-Ages 3-6 years
-Children begin to take more control over their environment.
-Strong imagination, exploration; encourage self-established activities while teaching limitations
GOAL: Direction and purpose |
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Term
|
Definition
-Age 6- 12 years
Children develop a sense of competence by mastering new skills.
-Ability to carry out tasks to completion, learn to compete and cooperate, learn rules, need real achievements
GOAL: Competence |
|
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Term
| Identity vs Role confusion |
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Definition
-Age 12-18 years
-Children develop a personal identify and sense of self.
-Changes in body instigate mistrust in their bodies, overly concerned of how others see them, struggle to fit in
GOAL: Devotion to values and fidelity to others |
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Term
|
Definition
| Young adults seek out romantic love and companionship. |
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Term
|
Definition
| Middle-aged adults nurture others and contribute to society. |
|
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Term
|
Definition
| Older adults reflect on their lives, looking back with a sense of fulfillment or bitterness. |
|
|
Term
| What are Kohlberg's developmental theories about? |
|
Definition
|
|
Term
| What are the 3 parts of Kohlberg's theory? |
|
Definition
-Preconventional level
-Conventional
-Post Conventional |
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Term
| Preconventional level (Kohlberg) |
|
Definition
-Ages 1-6 years
-Punishment and obedience
-At first bad behavior is determined by it's consequences.
-Later, children figure out that good behavior consists of which satisfied their own needs |
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Term
| Conventional level (Kohlberg) |
|
Definition
Ages 6-12 years
1st Moral = praise from teachers, peers, parents, etc
2nd Moral = conforming to rules and norms of society
-Obeys authority figures
Ex/ Child listens to parent when parents says to go to bed
Ex/ Child raises his/her hand to speak in class |
|
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Term
| Post Conventional level (Kohlberg) |
|
Definition
Ages 12-18
Individual judges own moral standards
-Justice and human rights with respect for the dignity of persons as individuals
-Emphasis on changing law in terms of societal needs and rational considerations |
|
|
Term
| Sequence for assessing an infant? |
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Definition
| Check least traumatic to most traumatic last |
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Term
| Appropriate techniques for assessing a preschooler? |
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Definition
-Make yourself "small" to interact on their eye level
-Keep a safe distance from the child to allow them to evaluate them
-Approach should be slow and smooth
-Allow the child to assess the equipment prior to being examined |
|
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Term
| Difference between an adult and preschool assessment? |
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Definition
-Communicate with both parent and patient
-Assessment can be done on parent's lap rather than on table
-Allow the child to be fully clothed to protect modesty
-Perform exam distally (Hands, then arms etc.)
-Pull ear up and back when checking ears of children ages 3 and up. |
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Term
| What communication techniques should be used for a school age assessment? |
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Definition
| Explain the purpose of the equipment and the significance of the procedure. Teach about body function and care. |
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Term
| Examinations techniques for an infant? |
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Definition
-Examine with the infant in the parent's lap before ages 4-6 months, after able to sit alone, try to have patient in parents lap whenever possible.
-Completely underdress if the room temperature permits. Leave diaper on male infant. Gain cooperation with distraction, bright objects, rattles, talking.
-Proceed in usual head-to-toe direction. Perform traumatic procedures last (eyes, ears, mouth). |
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Term
| Examinations techniques for a toddler? |
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Definition
-Sitting or standing on or by parent. Prone or supine in parent’s lap.
-Have parent remove outer clothing. Remove underwear as body part is examined. Allow to inspect equipment- demonstrating use of equipment is usually ineffective.
-Inspect body area through “count fingers”, “tickle toes”. Use minimum physical contact initially. Introduce equipment slowly. |
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Term
| Examinations techniques for a preschooler? |
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Definition
-Prefer standing or sitting. usually cooperative prone or supine. Prefer parent’s closeness.
-Request self-undressing. Allow to wear underpants if shy. Offer equipment for inspection, briefly demonstrate use. Make up story about procedure (“im doing to see how strong your muscles are, [blood pressure]). Give choices whenever possible.
-If cooperative, proceed in head-to-toe direction. If uncooperative, proceed as with toddler. |
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|
Term
| Examinations techniques for a school age child? |
|
Definition
-Prefer sitting.
Cooperative in most positions. Younger child prefers parent’s presence. Older child may prefer privacy.
-Respect need for privacy. request self-undressing. Allow to wear underpants. Give gown to wear. Explain purpose of equipment and significance of procedure, such as otoscope to see eardrum. Teach about body function and care.
-Proceed in head-to-toe direction. May examine genitalia last in older child. |
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Term
| Examinations techniques for an adolescent? |
|
Definition
-Same as for school-age child. Offer option of parent’s presence
-Allow to undress in private. Give gown. Expose only to area to be examined. Respect need for privacy. Explain findings during examination. Matter of factly comment about sexual development. Emphasize normalcy of development.
-Same as older school-age child. May examine genitalia last. |
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Term
| Verbal vs Non-Verbal techniques |
|
Definition
Non-Verbal = a patient writing in a journal, a sony play station is brought into a 12 yr olds room, an 8 yr old draws a picture of himself in the hospital
Verbal = "sometimes when kids come into the hospital, they get very sad. does that ever happen to you?", "I want you to feel better so you can play outside today, but I am worried that without taking the medicine you won't be able to" |
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Term
| 10 benefits of Comfort Positioning: |
|
Definition
1.Requires fewer staff to be present
2.Helps prevent sharp incidents
3.Allows effective access to virtually all body parts
4.Can be adapted to suit the child and the procedure
5.Reduce emotional stress of the patient and the family by promoting physical contact with the caregiver
6.Provide the caregiver with an active role in supporting their child in a positive way
7.Facilitate a child’s feeling of control and ability to cooperate
8.Creates an environment for the staff to have a better frame of mind for accuracy
9.Establish a quicker recovery rate for the patient following the procedure
10.Allows for procedures to be done in an easier manner |
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Term
| Goal of the nurses on the pain management unit at the Children's Hospital in LA? |
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Definition
| To improve patient care while understanding and managing children's pain |
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Term
|
Definition
| To provide relief with minimal side effects |
|
|
Term
| Difference between pain in pediatric and adult populations? |
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Definition
| Children experience more pain than adults |
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Term
| Subjective and objective data used to establish pain in infants? |
|
Definition
a. Subjective: Information from parent
b. Objective: Increased heart rate, increased respiratory rate, Furrowed eyebrow, Pulling eyebrows in, Crying, Inconsolable |
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Term
| Biggest change in pain management? |
|
Definition
| Alternate therapies are used for pediatric patients |
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|
Term
| Alternate therapies for pediatric patients? |
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Definition
| Very few children receive a needle today now use patches and give drugs orally and through IV. These alternatives reduce medications and increase comfort. |
|
|
Term
| 3 examples of alternative distraction therapies for pediatric patients? |
|
Definition
1. Distraction - Bringing in a dog
2. Massage
3. Acupuncture |
|
|
Term
| 2 most concerning memories pediatric patients remember from their hospitalization? |
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Definition
|
|
Term
| How to address the concerning memories of pediatric patients as a nurse? |
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Definition
| Goal is to eliminate them. Keep the parents close to the child as much as possible. |
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|
Term
| Most reliable tool for measuring small doses? |
|
Definition
| Plastic disposable syringe/ tuberculin syringe |
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|
Term
| 4 ways to encourage a pediatric patient to take their oral medication? |
|
Definition
a.Give the child a flavored ice pop or small ice cube to suck to numb the tongue before giving the drug
b.Mix the drug with a small amount (~1 tsp) of sweet-tasting substance, such as honey (except in infants), flavored syrups, jam, fruit purees sherbert, ice cream.
c.Give a “chaser” of water, juice, soft drink, or ice pop after the drug
d.When the medication has an unpleasant taste, have the child pinch the nose and drink the medicine through a straw.
IM injections |
|
|
Term
| 3 sites for giving an IM injection to a pediatric patient? |
|
Definition
a. Vastus Lateralis
b. Ventrogluteal
c. Deltoid |
|
|
Term
| 1 gram of wet diaper equals how much urine? |
|
Definition
|
|
Term
| IV's should be placed where it allows the children the least amount of _____? |
|
Definition
|
|
Term
| Foot veins should only be used for children who are not _______? |
|
Definition
|
|
Term
| Scalp veins should only be used in children younger than _____ and only when other sites have been exhausted. |
|
Definition
|
|
Term
| What is an Intraosseous infusion? |
|
Definition
| Provides a rapid, safe, and lifesaving alternate route for administration of fluids and medications until intravascular access can be attained, especially in children who are 6 years of age and younger. |
|
|
Term
| What is LMX and EMLA Cream? When are they used? |
|
Definition
1. Numbing Cream - LMX is faster acting (30 min vs 1 hour for EMLA), Darker skin will take longer for it to work.
2. Used for IVs, PICC lines, LPs |
|
|
Term
| 3 distraction techniques for a pediatric patient? |
|
Definition
| Toys, books, Ipad, smart phone |
|
|
Term
|
Definition
| Adventitious breath sound |
|
|
Term
| 5 Signs of increased work of breathing? |
|
Definition
1. Accessory muscle use
2. Nostril flaring
3. Grunting
4. Skin color
5. O2 Sat |
|
|
Term
|
Definition
|
|
Term
| One very common side effect of Albuterol? |
|
Definition
|
|
Term
| 3 symptoms of dehydration for an infant? |
|
Definition
| Sunken fontanels (or flat), dry mucus membranes, higher pulse/lower BP |
|
|
Term
| Why are infants more at risk for dehydration? |
|
Definition
| Kidneys are under-developed, increased surface area, higher % of body is water |
|
|
Term
| What education can you teach to a parent of a school-age child about MRSA and strep throat? |
|
Definition
| They are contagious. Keep small kids away. Have another family member stay with the other kids at home. |
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|
Term
Immunization for a toddler:
Location? Needle insertion angle? Size of needle? Explanation offered to child? |
|
Definition
| Vastus lateralis, 90 degrees, 25GX5/8, "You might feel a small pinch but we need to give you this so you won't get the flu" |
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Term
|
Definition
|
|
Term
| Documentation of an injection? |
|
Definition
Type of vaccine
Date given
Site
Funding source
Vaccine lot #
Date on vaccine
Initials |
|
|
Term
| Developmental Stages: Birth to 6 months |
|
Definition
-Nonverbal communication is key
a. Facial expressions
b. Tone of voice
- Appropriate toys:
a. Toys with noise like rattles, squeaky toys
b. Musical toys like mobiles
c. Toys with texture they can touch |
|
|
Term
| Developmental Stages: 6 to 18 months |
|
Definition
-Stranger anxiety
-Try to keep child with a caregiver
-Communication is mostly nonverbal but speak to the child anyway
-Use stimulating objects to catch attention for distraction or assessment
-Use head to toe approach
Appropriate toys:
a. Musical and noisy toys
b. Push pull toys
c. Stacking blocks
d. Books with rhymes |
|
|
Term
| Developmental Stages: 18 months to 3 years |
|
Definition
-More explorative but still shelter with parents
-Will understand more words than can say
-Constantly moving
-Play and curiousity are big motivators
-Use your tools and toys
- Toe to head approach
- Toilet training often includes lessons about modesty and improper touching. Respect these lessons; uncover child selectively for exam.
Appropriate toys:
a. wagons/tricycles
b. large crayons
c. stuffed animals/dolls
d. finger paints |
|
|
Term
| Developmental Stages: 3 years to 6 years |
|
Definition
- the "Disney" syndrome (Mrs. Shanley's term)
-Learning to explore and be independent, very curious!
-Can be talkative and enthusiastic
-Like to have choices
-Have "magical thinking" - play pretend
Appropriate toys:
a. kitchen sets
b. domestic items like phone, clock
c. small trucks, cars
d. building toys
e. felt markers
f. story books
g. paint and brushes |
|
|
Term
| Developmental Stages: 6 years to 12 years |
|
Definition
-Fear failure, inferiority
- want to be treated like a "big kid"
-body conscious and modest
-may feel pain intensely
-feel comfort with touching
- dont you babyish terms
-use common interests to build trust
-offer limited choices
-dont tell them not to cry
-"I have to pee" years,
Appropriate toys:
a. love a challenge and skill - board games, video games, puzzles
b. bigger bikes, roller skates, scooters
c. costumes, doll houses, fashion |
|
|
Term
| Developmental Stages: 12 years and up |
|
Definition
-Indentity and peer relationships are the key issues at this age
-Body image and future deformities and dysfunctions are very important
-Can be very dramatic
-Regressive behavior is common
-Respect modesty and privacy
-Direct yourself to the child as you would an adult
-Make eye contact
-Dont lie
Appropriate toys:
a. advanced board & card games, video games, DVDs
b. water gun |
|
|
Term
| What parents like and want: |
|
Definition
-Treat children as people
-Keep children as physically and emotionally comfortable as possible
-Treat every child as if they are the most special, beautiful, smartest child in the world
-A compliment to the child is a compliment to their parents |
|
|
Term
| Non Verbal Communications |
|
Definition
-What your face and body say are every bit as important as what your mouth says
-Make eye contact but dont hold it in a challenging manner
-Use eyebrows to exaggerate your expressions, especially for babies through elementary-age kids
-"High five" and tickling |
|
|
Term
| What is health promotion? |
|
Definition
| The process of enabling people to increase cover over, and to improve, their health. To reach a state of complete physical, mental, and social well-being, an individual or group must be able to identify and realize aspirations, to satisfy needs, and to change or cope with the environment |
|
|
Term
|
Definition
Activities that decrease the opportunity for illness and injury
EX/ immunizations, teaching about car safety seats |
|
|
Term
|
Definition
Early diagnosis and treatment of a condition to lessen severity
EX/ Developmental screening, vision and hearing |
|
|
Term
|
Definition
| Restoration to optimum function |
|
|
Term
|
Definition
| A national health promotion initiative dedicated to the principle that every child deserves to be healthy and that optimal health involves a trusting relationship between the health professional, the child, the family, and the community as partners in health practice |
|
|
Term
| Which diseases have been eradicated due to immunizations? |
|
Definition
|
|
Term
| Nurses role in health promotion pediatrics: |
|
Definition
-Guide to activities
-To promote development
-Keeping safety in mind |
|
|
Term
|
Definition
-Measurement used to assess pain for children between the ages of 2 months–7years or individuals that are unable to communicate their pain. The scale is scored between a range of 0–10 with 0 representing no pain. The scale has 5 criteria which are each assigned a score of 0, 1 or 2.
-Stands for Face, Legs, Activity, Cry, Consolability |
|
|
Term
| Faces Scale or Color Scale |
|
Definition
-Children between the ages of 3 and 8
-Usually have a word for pain
-Can articulate more detail about the presence and location of pain; less able to comment on quality or intensity
(Color scale assigns colors as mild, moderate, severe) |
|
|
Term
| Standard analog scale rating pain scale of 0 - 10. |
|
Definition
For children older than 8 years
Same as used in adutls |
|
|
Term
| Uses of sucrose for infants: |
|
Definition
-Can be used for procedures such as heel stick, venipuncture, catherization
-Effective analgesic in preterm and term infants (not effective beyond 3 months old)
-Dip pacifier in sucrose solution or give 0.2 mL to buccal area (May repeat but be cautious with many doses to younger infants |
|
|
Term
|
Definition
-Administer analgesia through most painless route
-Avoid IM Injections
-Oral and intravenous routes are preferred
a. Oral route for mild to moderate pain
b. Intravenous route for immediate pain relief and severe pain |
|
|
Term
| Organ systems to consider for med administration: |
|
Definition
Respiratory
Liver and kidney |
|
|
Term
|
Definition
-Mild to moderate pain
-No side effects of respiratory depression
-Highly effective when combined with opioids
-Acetaminophen
-NSAIDS
-Aspirin (No longer used in pediatrics bc of Reyes Syndrome) |
|
|
Term
|
Definition
-Antipyretic
-Mild analgesic
-Administer PO or PR
-Pediatric oral dose 10-15mg/kg/dose every 4 hours
-Onset 30 minutes
-Causes hepatic failure in overdose
a. Infant drops are MORE concentrated than the children's suspension
- Infant's Acetaminophen 80 mg/0.8mL
- Children's Acetaminophen 165 mg/5mL |
|
|
Term
|
Definition
-Antipyretic
-Analgesic for mild to moderate pain
-Anti-inflammatory
-COX Inhibitor-> Prostaglandin inhibitor
-Platelet aggregation inhibitor |
|
|
Term
| NSAIDs: Ibuprofen Antipyretic Dosing |
|
Definition
Dose 10 mg/kg/dose eery 6 hours
Onset 30-45 mins |
|
|
Term
| NSAIDs: Ketorolac (Toradol) Antipyretic |
|
Definition
-Intravenous NSAID (available PO)
-Onset 10 Minutes
-Monitor renal function
-Do not use more than 5 days
- Significant increase in side effects after 5 days |
|
|
Term
|
Definition
-Gastritis
- Prolonged use increases risk of GI bleed
- Still rare in pediatric patients compared to adults
-Nephropathy (ATN)
-Bleeding from patient anti-coagulation
-NSAID use contraindicated in active bleeding |
|
|
Term
|
Definition
-Moderate to severe pain
-Various routes of administration
-Different pharmacokinetics for different age groups
-Infants younger than 3 months have increased risk of hypoventilation and respiratory depression
-Low risk of addiction among children |
|
|
Term
|
Definition
All opioids have side effects that should be anticipated and managed:
Respiratory depression
Nausea, vomiting
Constipation
Pruritis
Urinary retention |
|
|
Term
| Patient Controlled Analgesia (PCA) |
|
Definition
| -Control of the button rests solely with the patient, NOT the parent |
|
|
Term
|
Definition
| Rash, tiredness, headache, fever |
|
|
Term
|
Definition
| Sore throat, mild fever, weakness, swollen glands in neck |
|
|
Term
|
Definition
| May be no symptoms unless bacteria enter the body |
|
|
Term
|
Definition
| May be no symptoms, fever, stomach pain, loss of appetite, fatigue, vomiting, jaundice, dark urine |
|
|
Term
|
Definition
| May be no symptoms, fever, headache, weakness, vomiting, jaundice, joint pain |
|
|
Term
|
Definition
| Fever, muscle pain, sore throat, cough, extreme fatigue |
|
|
Term
|
Definition
| Rash, fever, cough, runny nose, pinkeye |
|
|
Term
|
Definition
| Swollen salivary glands (under the jaw), fever, headache, tiredness, muscle pain |
|
|
Term
|
Definition
| Severe cough, runny nose, sore throat, fever, nausea, vomiting |
|
|
Term
|
Definition
| May be no symptoms, sore throat, fever, nausea, headache |
|
|
Term
|
Definition
| May be no symptoms, pneumonia |
|
|
Term
|
Definition
| Diarrhea, fever, vomiting |
|
|
Term
|
Definition
| Children infected with rubella virus sometimes have a rash, fever, swollen lymph nodes |
|
|
Term
|
Definition
| Stiffness in neck and abdominal muscles, difficulty swallowing, muscle spasms, fever |
|
|
Term
|
Definition
| Walking, running, climbing, jumping |
|
|
Term
|
Definition
Include refined eye-hand and muscle coordination
-Drawing, dressing, artwork, skillful manipulation |
|
|
Term
| 2 stages of the Preoperational Phase |
|
Definition
1. Preconceptual phase - 2 to 4 years
2. Intuitive thought phase - 4 to 7 years |
|
|
Term
| Preschool Psychosocial Development |
|
Definition
Erikson - Developing a sense of intiative
-Chief psychosocial task of the preschool period
-Feelings of guilt, anxiety, and fear may result from thoughts that diff from expected behavior
-Development of superego (conscience)
-Learning right from wrong: moral development |
|
|
Term
| Preschool Cognitive Development |
|
Definition
-Readiness for school
-Readiness for scholastic learning
-Successful achievement of cognitive goals at this stage is needed for learning, which is among the reasons children enter school at 5-6 years old
-Shifts from egoentric thought to social awareness
-Able to consider other viewpoints
-Egocentricity is still evident |
|
|
Term
| Preschool Moral Development |
|
Definition
-Basic level of moral judgement
-Punishment and obedience orientation
-Naive instrumental orientation: actions to satisfy one's own needs and less concern about the needs of others
-Concrete sense of justice and fairness |
|
|
Term
| Preschool Development of Body Image |
|
Definition
-Increasing comprehension of "desirable" appearances
-Aware of racial identity, differences in appearances, and biases
-Poorly defined body boundaries
a. Fear that if skin is "broken", all one's blood and "insides" can leak out
b. Frightened by intrusive experiences |
|
|
Term
| Preschool Development of Sexuality |
|
Definition
-Forms a strong attachment to the opposite-sex parent while identifying with the same-sex parent
-Become concerned with modesty
-Sex role limitation: "dressing up like Mommy or daddy"
-Sexual exploration is more pronounced |
|
|
Term
| Preschool Social Development |
|
Definition
-Individuation- separation process is completed
-Overcomes stranger anxiety and fear of separation from the parents
-Still needs parental security and guidance
-Security from familiar objects
-Play therapy is beneficial for working through fears, anxieties, and fantasies |
|
|
Term
| Preschool 4 different types of play |
|
Definition
-Associative play
-Imitative play
-Imaginative play and imaginative playmates
-Dramatic play |
|
|
Term
|
Definition
| a form of play in which a group of children participate in similar or identical activities without formal organization, group direction, group interaction, or a definite goal. The children may borrow or lend toys or pieces of play equipment, and they may imitate others in the group, but each child acts independently, as on a playground or among a group riding tricycles or bicycles. |
|
|
Term
|
Definition
| an imitative activity in which a child fantasizes and acts out various domestic and social roles and situations, such as rocking a doll, pretending to be a doctor or nurse, or teaching school. It is the predominant form of play among preschool children. |
|
|
Term
|
Definition
| -Dark, being left alone, animals, ghosts, objects or persons associated with pain, technique of desensitization to overcome fears |
|
|
Term
| Aggression in preschoolers |
|
Definition
Behavior that attempts to hurt another person or destroy property
May be influenced by biologic, sociocultural and familial variables
Factors that increase aggressive behavior include gender, frustration, modeling, reinforcement |
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|
Term
| Age of school age children? |
|
Definition
|
|
Term
| Height and Weight changes in school age children? |
|
Definition
Height increases by 2 inches per year
Weight increases by 2-3 kilograms per year
Males and females differ little in size |
|
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Term
| School age: Maturation of body systems |
|
Definition
-Bladder capacity increases
-Heart is smaller in relation to the rest of the body
-Immune system is increasingly effective
-Bones increase in ossification
-Physical maturity is not necessarily correlated with emotional and social maturity |
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Term
|
Definition
-2 years preceding puberty
-Typically occurs during preadolescence
-Varying ages from 9-12 years (in girls, it occurs about 2 years earlier than in boys)
-Average age of puberty is 12 years in girls and 14 years in boys |
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Term
| School age Psychosocial development |
|
Definition
-relationships center around same-sex peers
-Freud described it as the latency period of psychosexual development |
|
|
Term
| School age: Erikson - Developing a sense of industry |
|
Definition
-Eager to develop skills and participate in meaningful and socially useful work
-Acquires a sense of personal and interpersonal competence
-Growing sense of independence
-Peer approval is a strong motivator |
|
|
Term
| School age: Erikson- Inferiority |
|
Definition
-Feelings may derive from self or the social environment
-may occur if incapable or unprepared to assume the responsibilities associated with developing a sense of accomplishment
-all children feel some degree of inferiority regarding skills they cannot master |
|
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Term
| School age Piaget: Cognitive Development (Concrete operations) |
|
Definition
-Use thought processes to experience events and actions
-Develop an understanding of relationships between things and ideas
-Able to make judgements based on reason (conceptual thinking) |
|
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Term
| School age Kohlberg: Moral Development |
|
Definition
-Development of conscious and moral standards
-In a child ages 6-7 years, reward and punishment guide choices
-Older school-age child is able to judge an act by the intentions that prompted it
-Rules and judgements become more founded on the needs and desires of others |
|
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Term
| School age: Social development |
|
Definition
-Importance of peer group
-Identification with peers is a strong influence in a child gaining independence from parents
-Sex roles are strongly influenced by peer relationships |
|
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Term
| School age: Relationship with Families |
|
Definition
-Parents are the primary influence in shaping a child's personality, behavior, and value system
-Increasing independence from parents is the primary goal of middle childhood
-Children are not ready to abandon parental control |
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Term
|
Definition
Involves physical skill, intellectual ability, and fantasy
-Form groups, cliques, clubs, secret societies
-Rules and rituals
-See the need for rules in games they play
Ex/ Team play, quiet games and activities, ego mastery |
|
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Term
|
Definition
A conscious awareness of a variety of self-perceptions (ex/ abilities, values, appearances)
*Positive self-concept leads to feelings of self-respect, self-confidence, and happiness |
|
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Term
|
Definition
-Children like their physical selves less as they grow older
-body image is influenced by significant others
-increased awareness of "differences" may influence feelings of inferiority |
|
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Term
|
Definition
| A child who returns from school to an empty home because his or her parent or parents are away at work, or a child who is often left at home with little or no parental supervision. |
|
|
Term
| School age: Dental health |
|
Definition
-Stage begins with the shedding of the first deciduous teeth
-Eruption of permanent teeth |
|
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Term
|
Definition
-Middle childhood is the ideal time for formal sex education
a. life span approach
b. information on sexual maturity and process of reproduction
c. effective communication with parents |
|
|
Term
| Most common cause of severe injury and death in school-age children? |
|
Definition
Motor vehicle crashes- pedestrian and passenger
Bicycle injuries - benefits of bike helmets |
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Term
|
Definition
| Sexual maturity is achieved |
|
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Term
|
Definition
| 1-2 years after puberty; skeletal growth is complete and reproductive functions become established |
|
|
Term
|
Definition
| The time of growing into psychological, social, and physical maturation |
|
|
Term
| Adolescent: Sexual maturation |
|
Definition
-Tanner stages of sexual maturity
(Stages of development of secondary sex characteristics and genital development)
*Guide for estimating sexual maturity |
|
|
Term
| Adolescent: Physical growth |
|
Definition
-Dramatic increase in growth accompanies sexual maturation
-Adolescent growth spurt
a. 20% to 25% of total height is achieved during puberty
b. usually occurs within a 24-36 month period |
|
|
Term
| Adolescent: Physical changes |
|
Definition
-Size and strength of heart, blood volume, and systolic blood pressure increase
-Pulse rate and basal heat production decrease
-Adult valves for all formed elements of blood
-Respiratory volume and vital capacity increase
-Increased performance capabilities |
|
|
Term
| Adolescent: Psychosocial development - Sense of Identity (Erikson) |
|
Definition
-Early adolescent - group identity vs alienation
-development of personal identity vs role diffusion
-sex role identity
-emotionality |
|
|
Term
| Adolescent: Cognitive Development (Piaget) |
|
Definition
Formal operations period
Abstract thinking
a. think beyond present
b. mental manipulation of multiple variables
c. concerned about others thoughts and needs |
|
|
Term
| Adolescent: Moral development (Kohlberg) |
|
Definition
-Internalized set of moral principles
-Questioning of existing moral values and relevance to society
-Understand duty and obligation, reciprocal rights of others
-Concepts of justice, reparation |
|
|
Term
| Adolescent: Social development |
|
Definition
-Goal is to define one's identity independently from parental authority
-much ambivalence
-intense sociability; intense loneliness
-acceptance of peers |
|
|
Term
| Adolescent: Relationship with parents |
|
Definition
-role changes from "protection-dependency" to "mutual affection and equality"
-process involves turmoil and ambiguity
-struggle of privileges and responsibility
-Emancipation from parents may begin with the rejection of parents by the teenager |
|
|
Term
| Adolescent: Relationship with peers |
|
Definition
-Peer assume an increasingly significant role in adolescence ("best friend")
-Peers provide a sense of belonging and a feeling of strength and power
-Peers form a transitional world between dependence and autonomy
-Role of social media and advanced technology |
|
|
Term
| Adolescent: Development of Self Concept and Body Image |
|
Definition
-Feelings of confusion in early adolescence
-acute awareness of appearance, comparison of appearance with others
-blemishes and defects are magnified out of proportion
-matures to self-concept based on uniqueness and individuality |
|
|
Term
| Greatest cause of serious and fatal injuries in teens? |
|
Definition
|
|
Term
|
Definition
| A benign condition in which the infant is inconsolable and excessively cries |
|
|
Term
| What can infant colic lead to? |
|
Definition
| maternal stress, child abuse, or neglect |
|
|
Term
| 4 possible causes of colic? |
|
Definition
1. a gut problem associated with cow's milk allergy, lactose intolerance, intestinal flora, gut motility dysfunction
2. a behavioral problem due to inadequate parent infant interaction or to a difficult temperament of the infant
3. the notion that the excessive crying is the extreme limit of normal
4. a collection of different entities |
|
|
Term
| When does infant colic typically resolve? |
|
Definition
|
|
Term
|
Definition
| Compensated state that may precede respiratory failure, the patient is able to maintain adequate gas exchange by increasing breathing rate and depth. |
|
|
Term
| Signs and symptoms of respiratory distress |
|
Definition
-Diaphoresis
-Pallor/Cyanosis
-Nasal flaring
-Tachypnea
-Noisy breathing
-Retracting
-Grunting |
|
|
Term
| What is the difference in respiratory distress in a small child? |
|
Definition
-Smaller and shorter airways
-Airways easily blocked
-Hyper-reflexive = spasms
-Easily fatigued decreases cough
-Immune unsophisticated
-Limited alveolar surface area
-Poor/weak respiratory muscles
-Poor fluid volume control |
|
|
Term
| What are possible causes of obstructive respiratory failure? |
|
Definition
-Foreign body (vomitus)
-Infection (epiglottis)
-Tonsils/adenoids
-Laryngospasm |
|
|
Term
| What are possible causes for restrictive respiratory failure? |
|
Definition
-Thick secretions, foreign body
-Infection (Pneumonia)
-Alveolar rupture (pneumothorax)
-Chemical pneumonitis
-Pleural effusion
-Near-drowning event |
|
|
Term
| What are possible causes of primary ineffecient gas transfer respiratory failure |
|
Definition
-Anemia
-Hemorrhage
-Over-sedation
-Cerebral trauma |
|
|
Term
| Upper Respiratory Tract Illnesses |
|
Definition
-URI or URTI
-Nasopharyngitis
-Pharyngitis
-Tonsilitis
-Influenza
-Otitis Media
-Infectious mononucleosis |
|
|
Term
|
Definition
Treat with cool mist or steam therapy
-Can usually be treated at home |
|
|
Term
| Respiratory Syncitital Virus |
|
Definition
-80%-90% cause of bronchiolitis seen in infants
-Seasonal
-Treatment airway management and fluids
-Frequent hospitalization for infants (at risk infants receive Synagis) |
|
|
Term
|
Definition
Inflammatory reponse initiated in airways
-Involves mast cells, eosiniophils, and T lymphocytes
-End result means increased mucous production, inflammation to lower airways and bronchospasm
-When it keeps reocurring is means Asthma |
|
|
Term
|
Definition
-Chronic inflammatory disorder of airways
-Bronchial hyperresponsiveness
-Episodic
-Limited airflow or obstruction that reverses spontaneously or with treatment |
|
|
Term
|
Definition
-Inhalants
-Airborne pollens
-Stress
-Weather changes
-Exercise
-Biral or bacterial agents
-Food additives
-Lots of other things . . . |
|
|
Term
| Reccomendations for asthma care and management |
|
Definition
-Obtain objective tests, physical examination, patient history and patient report, to diagnose and assess the characteristics and severity of asthma and to monitor whether asthma control is achieved and maintained.
-Education for a partnership in asthma care
-Control of environmental factors and comorbid conditions that affect asthma
-Pharmacologic therapy |
|
|
Term
|
Definition
-Corticosteroids-(inhaled) pumicort
-Cromlyn sodium (intal)-Mast cell stabilizer
-Immunomodulators-(Xolair) decrease IgE response
-Leukotreine modifiers-(Accolate)
-LABA's (long-acting bronchodilator) Serevent or Salmeterol (12 hours)
-Methylxanthine-theophyline |
|
|
Term
|
Definition
-Anticholinergics (Atrovent)-blocks constriction (parasympathetic)
-SABA: short-acting bronchodilators (Albuterol)- stimulates dilation (sympathetic)
-Systemic corticosteroids-Methylprednisone/Solumedrol |
|
|
Term
|
Definition
Inherited autosomal recessive trait
-Cystic fibrosis transmembrane Conductance Regulator
--Critical loss of chloride ion transport
--Upsets the sodium and chloride ion balance
--Disrupts the normal, think mucus layer that is easily removed by cilia lining the lungs and other organs |
|
|
Term
| Problems associated with Cystic Fibrosis |
|
Definition
-Thick sticky secretions
-Pool in bronchioles = atlectasis
-Clogs pancreatic ducts, impairs digestion & absorption of nutrients
-Leads to biliary cirrhosis
-Retarded G & D, delayed puberty
-Terminal, median age is 37 |
|
|
Term
| Respiratory management for cystic fibrosis |
|
Definition
-Large amounts of mucous and increased viscosity increase likelihood of respiratory tract infections
-Recurrent pulmonary infection in the child with CF results in damage to the airways. (bronchiectasis)
-Mucolytics, brocnhodilators, kalydeco
-Antibiotics for infections
-Chest PT
-Avoid pulmonary treatments after meal |
|
|
Term
| GI management for Cystic Fibrosis |
|
Definition
-Assess nutritional status
-Provide high protein & calorie diet
-Administer pancreatic enzymes
-Vitamins (esp. fat soluble) |
|
|
Term
| Reasons for vomiting in children |
|
Definition
-Allergies to foods
-Over-eating
-Persistent coughing
-Intestinal obstruction
-Viral illness |
|
|
Term
|
Definition
Rotavirus is very common, especially in children under the age of 2
-Watery diarrhea most common symptom
-Other symptoms include vomiting and fever
-Passed through fecal-oral route
-Also can be passed through indirect contact such as child touches toy or if someone doesn't wash hands after changing a diaper
-Usually develops symptoms 1-3 days after contact
-No specific tx, children usually recover on own
-Can detect antigens in stool
-Diarrhea usually lasts 3-7 days
-Treatment with flavored oral rehydration
-May need IV
-Start back slow with diet (BRAT) |
|
|
Term
|
Definition
Congenital Aganglionic Megacolon
-Absence of ganglioncells in one or more segments of the colon
-Etiology not fully understood
-Symptoms: Dont pass menium; Distension; Ribbon like stools |
|
|
Term
|
Definition
Relaxation or incompetence of the lower esophageal sphincter
-Vomiting
-Weight loss
-Respiratory problems (RAD)
-GI bleeding |
|
|
Term
| 3 Inflammatory GI Disorders |
|
Definition
1. Appedicitis
2. Ulcerative Colitis
3. Crohn's disease |
|
|
Term
|
Definition
Signs and symptoms:
-Abdominal pain-per umbilical to right lower quadrant
-Local rebound tenderness
-Vomiting
-Constipation or diarrhea |
|
|
Term
|
Definition
Acute hepatitis
Cirrhosis
Biliary atresia
-Etiology unknown
-Healthy infant at birth
-Jaundice occurs within 2wk-2mo
-Alcohlic stools (puttylike, clay)
-Increased bilirubin levels |
|
|
Term
| 3 Structural defects in children (GI) |
|
Definition
-Cleft lip and palate
-Esophageal atresia
-Hernias |
|
|
Term
| Structural defects: Cleft lip and cleft palate |
|
Definition
Failure of the premaxillary adn maxillary processes to come together in fetal life
-Cleft lip surgery (first 3 months)
-Cleft palate repair (6mos to 5 yrs) |
|
|
Term
| Esophageal atresia with tracheoesophageal fistula |
|
Definition
-Esophageal atresia: the esophagus ends in a blind pouch or stops; does not connect with the stomach
-Tracheoesophageal fistula: a fistula is present connecting the esophagus with the trachea |
|
|
Term
| 3 GI Obstructive Disorders |
|
Definition
1. Hypertrophic pyloric stenosis
2. Intussusception
3. Malrotation |
|
|
Term
| Obstructive Disorders: Pyloric Stenosis |
|
Definition
Muscle around the pylorus enlarges and leads to obstruction during the first three months of life
-Projectile vomiting
-hunger
-Weight loss
-Dehydration with F/E Disturbances
-Increased Abdominal distention with peristalsic waves
-Palpable Olive Shape Tumor in Epigastric Area
-Diagnosed by ultrasound
-Emphasis on restoring and correcting fluid and electrolyte problems
-POst-op: Infant may still vomit, advance diet as tolerated, rare to have complications |
|
|
Term
|
Definition
Telescoping of one portion of the intestine into another
-Frequent cause of intestinal obstruction
Signs and Symptoms:
-Acute abdominal pain with tender abdomen
-Vomiting
-Normal stool to red currant jelly like stool (lovely!)
-Abdominal distention
-Sausage shape mass in riq
-Child can become acutely ill with fever and S&S fo peritonitis
-Dx is made by xray, ultrasound, or barium enema
-Surgery if b.e. is not successful |
|
|
Term
| Examples of age-related skin mansifestations |
|
Definition
-Infants: birthmarks
-Early childhood: atopic dermatitis
-School-age children: ringworm
-Adolescents: acne |
|
|
Term
|
Definition
-Common peds problem
-Treated with topical antibiotic if localized to small area
-Bacterial: strep or staph
-Wash crust off with soap andwater and apply topical antibiotic
-May be treated with oral antibiotics if has spread (still wash lesions)
-Very contagious |
|
|
Term
|
Definition
-Most communicable diseases of childhood have characteristic rash (rubeola, rubella, chicken pox)
-Other ex: verruca (warts), herpes simplex type |
|
|
Term
|
Definition
Superficial infections that live on the skin
-AKA dermatophytoses
-Transmission from person to person or from infected animal to human
-EX: tinea capitis, tinea corporis, tinea pedis, candidiasis |
|
|
Term
|
Definition
-Inflammatory reaction or skin to chemical
-Initial reaction in the exposed region
-Characteristic sharp delineation between inflamed and normal skin
-Primary irritant
-Sensitizing agent
-Ex: Diaper dermatitis, reaction to wool, reaction to specific chemical |
|
|
Term
|
Definition
A type of pruritic eczema that begins during infancy
-Hereditary tendency
-Often associated with history of food allergies, allergic rhinitis, and asthma |
|
|
Term
|
Definition
Pathophysiology and clinical manisfestations
-Usually from irritation of urine and feces
-Detergents inadequately rinsed from clothing
-Chemical irritation
-Nursing considerations: alter wetness, pH, and fecal irritants
-Differentiate from Candidiasis of diaper area (candidiasis has characteristic excoriated red papules with satellite lesions) |
|
|
Term
|
Definition
-Adverse drug reactions are most often seen in skin (rashes most common reaction)
-May be immediate or delayed following administration of drug
-Treatment: discontinue drug, antihistamines, corticosteroid therapy if very severe |
|
|
Term
|
Definition
-Predominately in adolescents
-Pathophysiology
--Involves hair follicles and sebaceous glands
--Black heads
-Therapeutic management
--General measures/overall health
--Medications |
|
|
Term
|
Definition
-Toddlers: hot water scalds
-Older children: flame-related burns
-Child abuse
-Child with matches or lighters accounts for 1 in 10 house fires |
|
|
Term
| Growth hormone deficiency |
|
Definition
-Hypopituarism
--Failure of the pituitary to produce sufficient growth hormone to sustain normal growth in children.
-Familial patterns
-Review growth charts
-GH products are currently labeled for use in children who have growth failure due to an inadequate of normal GH.
-Administered at night to correspond with normal release time of GH |
|
|
Term
| Growth hormone replacement management |
|
Definition
-Children should be managed by a pediatric endocrinologist
-Height and weight is obtained every 3 months and plotted on the growth chart
-Bone age study yearly |
|
|
Term
|
Definition
-Development of sexual characteristics before the usual age of onset of puberty.
Girls: Breast development, pubic hair, and/or menses before 8 years
Boys: Secondary sexual characteristics before age 9
-Tanner scale: true precocious puberty is characterized by 2 signs of puberty |
|
|
Term
| Pediatric blood glucose target levels |
|
Definition
-Toddler and preschool: 100 to 180 mg/dL
-School-age: 90-180 mg/dL
-Adolescents (13 to 19 years): 90 to 130 mg/dL |
|
|
Term
|
Definition
-Short-acting: often used to cover extra carbohydrate consumption
-Combination of regular and intermediate-acting insulin
-Children on mixed insuling dosage schedules tend to experience hypoglycemic episodes at 11:30 adn 2:30 as peaking of insulin occurs. |
|
|
Term
|
Definition
Symptoms:
-Rapid onset
-Shaky feeling, hunger
-Dizziness
-Headache
-Vital signs-shallow respirations, tachycardia
-Tremors
-Glucose = low, below 60
-Ketones = negative
-Urine output: normal, sugar negative, negative ketones |
|
|
Term
| Treatment of hypoglycemia |
|
Definition
Day time hypoglycemia:
-Simple concentrated sugars such as honey by mouth (older than 1 year), hard candy, sugar cubes, or glucose tablets will elevate the blood sugar immediately. OJ or sugar containing soda or fruit drink.
-Identify reason for hypoglycemia. In children it is often increase in activity without increase in food intake. |
|
|
Term
|
Definition
-Using rapid-acting or Lispro insulin
-Infusion pump (8 to 10 years)
-Night time snack
-Check blood glucose before bedtime. Make sure the blood glucose is 100-120 mg/dL before going to bed.
-Do not skip snacks.
-Eat an extra snack on days of strenuous exercise. |
|
|
Term
|
Definition
Symptoms: Lethargic, confused, weak
-Thirsty
-Abdominal pain often with nausea and vomiting
-Signs of dehydration
-Vital signs: deep, rapid respirations, fruity acetone breath, and weak pulses |
|
|
Term
|
Definition
-Altered LOC
-Dehydration
-Electrolyte disturbances
-Dysrrhythmias
-Shock
-Complete vascular collapse |
|
|
Term
| Life management of patients with DM |
|
Definition
-Management by endocrinologist
-Insulin
-Blood sugar monitoring
-Diet
-Exercise
-Screen for retinopathy: opthalmologic exam annually |
|
|
Term
| Exercise for those with Diabetes Mellitus |
|
Definition
-Vital component to management of child with diabetes
-May decrease the amount of insulin required.
-Enhances insulin absorption.
-Important for normal growth and development |
|
|
Term
|
Definition
-85% of children with Type 2 are obese
-Age of onset is middle to late puberty-around 13 years
-Minority populations have an especially high rate of type 2 diabetes
-Strong family history
-The rate of new cases among youth was 5.3 per 100,000 for type 2 diabetes |
|
|
Term
| Assessment of children with type 2 diabetes |
|
Definition
-Obesity: BMI greater than 30 (normal range is 15 to 17 in the pediatric population)
-Waist to hip ratio: apple shape
-Acanthosis nigricans: hyper-pigmentation and thickening of the skin into velvety irregular folds in the neck and flexural areas
-HTN
-+ family history of type 2 diabetes
-Ethnicity |
|
|
Term
| Interdisciplinary Interventions for children with DM type 2 |
|
Definition
-Comprehensive education on importance of regular exercise and how to self-monitor for blood glucose levels.
-Dietary management
-Glucose-lowering agent: drugs that improve insulin sensitivity such as Glucophage (Metformin)
-A few may need Insulin to initiate control |
|
|
Term
|
Definition
|
|
Term
| Biological development of infant |
|
Definition
- By year end grow ~1 foot and triple weight
- Develop 6-8 teeth
- Increased control over body
- Can discriminate sounds, images, and tastes |
|
|
Term
| Motor development of infant |
|
Definition
- Fine motor: develops pincer grasp
- Gross motor: can stand and walk |
|
|
Term
| Psychosocial development of infant |
|
Definition
- Trust vs. mistrust
- Primary narcissism |
|
|
Term
|
Definition
- Faith in the environment vs. suspicion
- Goal: faith and optimism |
|
|
Term
|
Definition
| Child has not differentiated himself from outside world. Don't recognize their surroundings besides how it affects them |
|
|
Term
| Cognitive development of infant |
|
Definition
- Sensorimotor stage
- Lacks object permanence
- Stranger anxiety |
|
|
Term
|
Definition
Experiences world through senses and interaction
- Occurs from birth to 24 months |
|
|
Term
|
Definition
Objects that leave the visual still exist
- Develops around 9-10 months |
|
|
Term
|
Definition
- Develops between 6-8 months
- Related to infants ability to distinguish between familiar and unfamiliar people |
|
|
Term
| Infant psychosexual development |
|
Definition
| Oral: sucking, biting, chewing, vocalizing |
|
|
Term
|
Definition
| 12 months to 36 months (1-3 years) |
|
|
Term
| Biological development of toddler |
|
Definition
- Proportional changes: chest circumference exceeds head circ
- Integrated function of senses: taste preferences
- Ability to control elimination patterns |
|
|
Term
| Motor development of the toddler |
|
Definition
- Major motor skill acquired: locomotion
- Increased manual dexterity: can draw circles by age 3
- General mastery of skills: dressing, playing, eating |
|
|
Term
| Psychosocial development of the toddler |
|
Definition
- Autonomy vs. shame and guilt
- Ritualism provides sense of comfort
- More comfortable in asserting autonomy |
|
|
Term
| Autonomy vs. shame and guilt |
|
Definition
- Independence driven
- Realize they can control environment, body
- Encouragement of decision making whether good or bad
- Shame and doubt: made to feel inadequate or self-conscious
- Goal: self control and will power |
|
|
Term
| Cognitive development of the toddler |
|
Definition
- 2-24 months: sensorimotor
- 2-7 years: preoperational |
|
|
Term
|
Definition
- First use of representational thoughts and symbols
- Ability to pretend
- Lacks logical reasoning
- Egocentrism: inability to put oneself in the place of others
- Transductive: "all women with big bellies have babies" |
|
|
Term
| Social development of toddler |
|
Definition
Play
- Gross and fine motor development through play
- Parallel play
- "No!" |
|
|
Term
| Moral development of toddler |
|
Definition
| Preconventional: bad behavior determined by the consequence of the action |
|
|
Term
| Psychosexual development of toddler |
|
Definition
| Anal: sphincter control-toilet training |
|
|
Term
|
Definition
|
|
Term
| Motor development of preschool |
|
Definition
- Strength and refinement of previously learned skills
- Locomotion further develops: running, jumping
- Increased manual dexterity: dressing, drawing |
|
|
Term
| Psychosocial development of preschool |
|
Definition
|
|
Term
|
Definition
- Strong imagination, exploration, encourage self-established activities while teaching limitations
- Goal: direction and purpose |
|
|
Term
| Cognitive development of preschool |
|
Definition
- Preoperational
- Symbols or words used to represent objects or people
- Magical thinking: believe their thoughts are all powerful
- Don't have much understanding of causality |
|
|
Term
| Social development of preschool |
|
Definition
- Play: associative play, imitative, dramatic, imaginative play most common
- Vocab increases dramatically |
|
|
Term
|
Definition
| Group play in similar or identical activities but without rigid organization or rules |
|
|
Term
| Moral development of the preschooler |
|
Definition
Preconventional: know an action is wrong because its consequences are bad, don't understand why logically
- Internalize parents morals |
|
|
Term
| Psychosexual development of preschooler |
|
Definition
| Phallic: exploration, curious of dissimilarities of opposite sex |
|
|
Term
|
Definition
|
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Term
| Biological development of school age |
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Definition
- Slow and steady pace of physical growth
- Respiratory and heart rate steadily decrease |
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Term
| Motor development of school age |
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Definition
- Strength and refinement of previously learned skills
- Locomotion continues to develop: riding a bike
- Prepubescense |
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Term
| Psychosocial development of school age |
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Definition
- Industry vs. inferiority
- Growing sense of independence
- Sense of accomplishment involves ability to cooperate, compete with others, and cope effectively with people |
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Term
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Definition
- Achieve a sense of interpersonal competence
- Intrinsic motivation
- Acquisition of skill a means for achieving personal success
- Goal: compentence |
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Term
| Cognitive development of school age |
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Definition
Age 6-10: concrete operational
Age 11-adolescent: formal operations |
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Term
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Definition
- Increased logic
- Thinking becomes socialized, can see other people's view points
- Reasoning is inductive, can solve concrete problems in a systematic fashion based on what they perceive |
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Term
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Definition
- Thinking is adaptable and flexible
- Can think in abstract terms and use abstract symbols
- Draw logical conclusions
- Can make hypotheses and test them |
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Term
| Social development of school age |
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Definition
- Cooperative play
- Peer group is very important, important in gaining independence from parent |
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Term
| Moral development of school age |
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Definition
6-10: conventional
11-12: Post conventional |
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Term
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Definition
Morals come from knowing what is expected of them, don't understand the concepts behind them
Obey authority figures |
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Term
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Definition
- Judge an act by its intentions, not just consequences
- Individual judges own moral standards
- Correct behavior defined by standards agreed on by society |
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Term
| Psychosexual development of school age |
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Definition
Latency
- More interest in same sex parents
- Same gender play "boys have cooties" |
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Term
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Definition
| Transition between childhood and adulthood |
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Term
| Biological development of adolescent |
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Definition
- Puberty
- All body organs now mature |
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Term
| Psychosocial development of adolescent |
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Definition
- Role identity vs. role confusion
- Group identity |
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Term
| Role identity vs. role confusion |
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Definition
- Develop a stable, coherent picture of oneself
- Establish a meaningful identity
- Take responsibility for ones actions
- Resolve questions of peer group first then individual identity
- Goal: devotion to values and fidelity to others |
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Term
| Cognitive development of adolescent |
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Definition
Formal operations
Ability to reason abstractly
Ability to think independently can lead to rebellion |
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Term
| Social development of adolescent |
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Definition
Less time with parents, more time with peers
Peer group very important
- From group they gain support in learning about themselves, consideration for the feeling of others, and increased ego development and self reliance |
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Term
| Psychosexual development of adolescents |
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Definition
- Sexual interest
- Genitals are major source of sexual tensions and pleasures
- Energy towards friendships and preparing for marriage |
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Term
| Moral development of adolscents |
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Definition
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