Excessive amount of bilirubin in the blood; indicative of hemolytic processes due to blood incompatibility, intrauterine infection, septicemia, neonatal

renal infection, and other disorders. The inability of the newborn immature liver to handle bilirubin, a byproduct of red cell breakdown about 48 to 72 hours after birth. An organ that is one that is turned inside out like a rubber glove.

hyperbilirubinemia

physiologic jaundice

exstrophy

The use of artificial drugs, such as Pitocin or Prostaglandin hormone, Induction to enhance or stimulate labor. split or opening in the roof of the mouth Discoloration of the skin in irregular areas; may be seen with chilling, poor perfusion, or hypoxia. Bleeding into the subcutaneous tissue in the perineal area caused by episiotomy, labor and delivery is called? A Latin word that means top of the head, the top of the baby's head comes first at delivery, is called? An excess of amniotic fluid, leading to over distention of the uterus. Frequently seen in diabetic pregnant women, even if there is no coexisting fetal anomaly. Also called polyhydramnios. Another term used to describe postpartal or following the birth. Yellow pigmentation of body tissues caused by the presence of bile pigments. Fibrous connections of opposed joint surfaces, as in the skull It may occur during pregnancy (usually after the 20th week of gestation) or within 48 hours after childbirth. The presence of excessive amniotic fluid surrounding the unborn infant. Inflammation of the breast cleft palate mottling

postpartum hematoma

vertex

hydramnios

puerperal physiologic jaundice

sutures eclampsia

polyhydramnios

mastitis

An abnormal accumulation of cerebrospinal fluid (CSF) in the brain. hydrocephalus The fluid (the CSF) is often under increased pressure which can compress (squeeze) and damage the brain. Normal newborn reflex elicited by inserting a finger or nipple in the newborn's mouth, resulting in forceful, rhythmic sucking. Inflammation of the bladder is called? Tiny white papules appearing on the face of a neonate as a result of unopened sebaceous glands; they disappear spontaneously within a few weeks. The normal duration of pregnancy EFM (electronic fetal monitoring) test of the well-being of the fetus during contractions deliberately stimulated with oxytocin. When should peek-a-boo be achieved? A hemolytic blood disease of newborn that can be seen less than 24 hours after birth. Degenerative process in chorionic villi, giving rise to multiple cysts and rapid growth of the uterus with hemorrhage. sucking reflex

cystitis milia

term stress test

1 year old pathologic jaundice

hydatidiform mole

A major complication of pregnancy. Its cause is unknown; it occurs eclampsia more often in the primigravida and is accompanied by elevated blood pressure, albuminuria, oliguria, tonic and clonic convulsions, and coma Hemolytic disease of the newborn characterized by anemia, jaundice, Erythroblastosis fetalis enlargement of the liver and spleen, and generalized edema. Caused by isoimmunization due to Rh incompatibility or ABO incompatibility. Toxemia of pregnancy, characterized by hypertension, albuminuria, and edema. reflex that occurs when the sole of the foot is touched a physical split or separation of the two sides of the upper lip preeclampsia

plantar grasp reflex cleft lip

ability to live outside the uterus, is 24 weeks A surface-active mixture of lipoproteins secreted in the alveoli and air passages that reduces surface tension of pulmonary fluids and contributes to the elasticity of pulmonary tissue.

viability surfactant

A maternal temperature of 38C (100.4F) or higher on any 2 of the puerperal first 10 postpartal days, excluding the first 24 hours. The temperature is to be taken by mouth at least 4 times per day. first fetal movements felt by the mother Moving of the fetus and uterus downward into the pelvic cavity. quickening lightening

reflex elicited by stroking the lateral side of the foot from heel to toe Babinski reflex reflex that occurs when newborns have a sense of falling; startle reflex The process of starting labor by artificial means. occurs when the infant is searching for food morro

Induction rooting reflex

Abnormal implantation of the placenta in the lower uterine segment. placenta previa Classification of type is based on proximity to the cervical os: totalcompletely covers the os; partial-covers a portion of the os; marginal-is in close proximity to the os. the foot is turned in sharply and the person seems to be walking on their ankle talipes

Excessive growth of a fetus in relation to the gestational time period. large for gestational age (LGA) Instruments used by physicians when assistance is needed to move the baby through the birth canal. This term is sometimes familiarly called "water on the brain." The fusing together of two or more digits that separation is possible by surgery. The line of darker pigmentation extending from the umbilicus to the pubis noted in some women during the later months of pregnancy Forceps:

hydrocephalus syndactylism

linea nigra

Surgical delivery or surgical removal of the fetus Pinpoint red lesions. A follow up after delivery of hydratiform mole is done that should fall but if ramins high this is known as? The Latin word for clubfoot The treatment of jaundice by exposure to light urethral opening on the ventral (lower) surface of the penis heat lost when water is changed to vapor Yellow-white gelatinous material surrounding the vessels of the umbilical cord. Infection caused by a single-celled parasite named toxoplasma gondii. Part or all of the brain is missing, the skill is flat and newborns live for only short time.

cesarean section Petechiae choriocarcinoma

talipes phototherapy hypospadius evaporation Wharton's jelly

toxoplasmosis

anencephaly

Delivery of the baby other than headfirst. Most breech deliveries are Breech birth buttocks first. first fetal stool refers to any state in which thyroid hormone production is below normal meconium hypothyroidism

Narrowing (stenosis) of the outlet of the stomach so that food cannot pyloric stenosis pass easily from it into the duodenum, resulting in feeding problems and projectile vomiting. Relationship of the presenting fetal part to an imaginary line drawn between the pelvic ischial spines The temporal rim of the eyelids; the angle at either end of the slit between the eyelids station

outer canthus

reflex that occurs when a finger or small object is placed in the newborns hand

palmar grasp reflex

Maternal discharge of blood, mucus, and tissue from the uterus; may lochia last for several weeks after birth. heat lost by direct contact with a cooler object After childbirth or delivery conduction postpartum

Fine, downy hair found on all body parts of the fetus, with the lanugo exception of the palms of the hands and the soles of the feet, after 20 weeks' gestation. The condition when the umbilical cord becomes wrapped around the nuchal cord fetus neck. The structure connecting the placenta to the umbilicus of the fetus and through which nutrients from the woman are exchanged for wastes from the fetus umbilical cord

Postural reflex seen in the newborn. When the supine infant's head is tonic neck reflex turned to one side, the arm and leg on that side extend while the extremities on the opposite side flex. Also called the fencing position obtained by holding newborns with the feet touching the table A nonabsorbable suture or ring placed around the cervix is called? When to measure head circumference? stepping reflex cerclage every visit to 2 years old; annually to age 6 lightening

The sensation the mother feels when the baby "drops" down or gradually settles into the pelvis. Dark green or black material present in the large intestine of a fullterm infant; the first stools passed by the newborn. This term means outside. heat lost by the movement of air Very few have symptoms from this parasite because the immune

meconium

ectopic convection toxoplasmosis

system usually keeps the parasite from causing illness.

Excessive fullness - usually referring to the breasts. Forceps are designed to fit the babys head and the mothers pelvis The presence of an extra finger or toe is called? The insufficient or uncoordinated contractions that do not produce effective dilation are called? small white cysts, may be present on the palate of neonates A condition seen in neonates of large body size and high birth weight, as those born of prediabetic and diabetic mothers. Born after the completion of the 42 week of gestation.

engorgement Forceps: ploydactylism uterine inertia

Epsteins pearls macrosomia

Postterm

Difficult labor due to mechanical factors produced by the fetus or the dystocia maternal pelvis, or due to inadequate uterine or other muscular activity. Inadequate weight or growth for gestational age; birth weight below the tenth percentile. small for gestational age (SGA)

heat lost by transfer to cooler objects that are nearby, but not in direct radiation contact abnormal deep attachment of the placenta to the uterine wall (decidua) such that the chorionic villi invade abnormally into the myometrium placenta accreta

Active and compassionate therapies intended to comfort and support palliative care those with short life expectancies A fungal infection of the oral mucous membranes caused by Candida thrush albicans. Most often seen in infants; characterized by white plaques in the mouth. Implantation of the fertilized ovum outside the uterine cavity; common sites are the abdomen, fallopian tubes, and ovaries. Also called oocyesis. ectopic pregnancy

Inflammation of a vein wall resulting in thrombus The fetus lies across the uterus and when the membrane ruptures usually results in a shoulder presentation. Partial or total premature separation of a normally implanted placenta. rebounding of the fetus against examiners fingers, when examiner puts two fingers into the vagina and pushes upward on the uterus the nasal rim of the eyelids; the angle at either end Delivery of the baby through an incision in the abdomen and uterus. white pinpoint spots resembling white heads Any infant born before 37 week of gestation. Blood-tinged mucus from the vagina in the newborn female infant; caused by withdrawal of maternal hormones that was present during pregnancy. Excessive vomiting during pregnancy, leading to dehydration and starvation.

thrombophlebitis transverse lie

abruptio placentae

ballottement

inner canthus cesarean delivery milia Preterm pseudo menstruation

hyperemesis gravidarum

This alternative to forceps delivery, a round, soft plastic cup is placed vacuum extraction on the fetal head and suction is applied to ease the fetus out. A congenital malformation (a birth defect) in which the rectum is a blind alley (a cul-de-sac) and there is no anus. a birth defect in which part of esophagus is not hollow (blank) imperforate anus

esophageal atresia version

Umbilical cord that becomes trapped in the vagina before the fetus is prolapsed cord born. This occurs when the women expels all during delivery such as placenta and fetus. products of conception

Pink, serous, and blood-tinged vaginal discharge that follows lochia rubra and lasts until the seventh to tenth day after birth. A congenital failure of one or both nasal passages to open A protective cheese like whitish substance made up of sebum and desquamated epithelial cells that are present on the fetal skin. Simply means that the cervix is unable to support a pregnancy The new born with a complication is considered compromised or what? The inflammation of the eyes in the newborn A woman who has never been pregnant. Medical management including manual rotation of the fetus before another type of help is needed? Any blood loss from the uterus between 500 and 1,000 milliliters within 24 hours after delivery is called? outward movement of the nostrils

lochia serosa

choanal atresia vernix caseosa

premature cervical dilation high risk newborn

Ophthalmia neonatorum nulligravida version

postpartum hemorrhage

nasal flaring

Question
Diabetes Insipidus Nursing Considerations

Answer
Goal is identification of the disorder Parents need instruction on the disease and treatment. Treatment is lifelong. Parents and older children need instructions on how to prepare and administer the DDVAP. Child should wear a medic alert bracelet. A nutritious diet. Avoid caffeine, alcohol and smoking. Peptic Ulcer Disease Nursing Considerations Promote healing through encouraging the family. Educate the child and family on the role of stress and the development of ulcers. IV prostaglandin E1 to keep the PDA open balloon cath. Arterial switch procedure may be performed in the first few weeks of life (transects the great artery and anastomosing the main pulmonary artery. Intra-arterial baffle repairs and rastelli procedure.

What can the nurse teach the PUD patient?

TGA

What is the treatment for hyperglycemia? What is the earliest sign of Hirschsprung's disease? Hernia Manifestations

Regular insulin. Failure to pass meconium stools. Unilateral or bilateral. Symptom free. Irritability, fretfulness, & constipation. Vomiting & severe abdominal pain if strangulated. Persistent high (103-105 F) fever that drops rapidly as the rash appears. Macupapular rash is non-pruritic and blanches easily. Incubation Period: 515 days. Contagious Period: until rash fades. Rotavirus Neonates require stabilization with mechanical ventilation and inotropic support preoperatively. Norwood procedure: anastomosis of the main pulmonary artery. Bidirectional Glenn shunt: performed at 3-6 months of age to relieve cyanosis. Transplantation Maintain sufficient Hgb levels. Provide sufficient RBC. Transfusions are necessary. An iron chelating agent is given with oral supplements of vitamin C. A splenectomy may be necessary. Page 871 Localized narrowing near the insertion of the ductus arteriosus which results in increased pressure. This is a benign condition unless child is immunocompromised. Isolation not required. May last 1-3 weeks. Prevention: None. The child is isolated until antibiotic therapy has been administered for at least 24 hours. Suggests the presence of two major manifestations or two minor manifestations such as fever and arthralgia with evidence of Strep. infection indicates a high priority for RF Streptococcus Viridians Lower doses of medications are often indicated due to the slower excretion

Signs & Symptoms Roseola

___________is the most common cause of serious gastroenteritis. HLHS Treatment

Beta-Thalassemia Therapeutic Management Goals

Coarctation of the Aorta Definition:

Fifth Disease Interventions

The physician is treating a child with meningitis with a course of antibiotic therapy. The nurse assures the parents that the child will be out of isolation when Modifications of the Jones criteria is?

____________ is the most common cause of bacterial endocarditis. Medication for Elderly Patients

of drugs by the older adult Normal doses may actually cause toxicity Many drugs cause confusion in the elderly Sudden confusion necessitates review of the medication regime Obstructive Uropathy Obstruction of normal flow of urine. Calculi (stones). Tumors. Strictures. Scarring. Congenital or acquired. Partial or complete. One or both kidneys affected. Antihypertensives Nursing Implications Lab Test Monitor BUN, creatinine, and electrolyte levels periodically Serum potassium, BUN and creatinine may be , whereas sodium levels may be . If BUN or serum creatinine concentrations occur, dose reduction or withdrawal may be required. Monitor CBC Sickle Cell Disease Therapeutic Management Treat conditions that enhance sickling. Treat medical emergencies. Prevention = maintaining hemodilution. Medical management is supportive and symptomatic. Rest. Hydration. Electrolyte replacement. Analgesics. Blood transfusion. Antibiotics. Preschoolers perception of urinary Surgery May perceive the treatment as punishment. Separation anxiety during hospitalizations peak at this age. Explain preventive strategies to parents. Body image of child must be maintained when surgery delayed beyond infancy. Leukemia Nursing Care Assist with administration of blood products. Pain relief. Minimize risk of infection. Prevent hemorrhage. Promote rest & reduce fatigue. Prevent skin breakdown. Stimulate appetite. Help child & family cope. Hodgkins Disease Pathophysiology A malignancy of the lymph system. May metastasize Presence of ReedSternberg cells. Non-Hodgkins lymphoma is more prevalent in children less than 14 years. Hodgkins disease is prevalent in adolescence and increases in 15 to 19 years A child with a wart on his finger. The mother states she tried several times Warts may increase in size if you to remove the wart, but it just keeps getting larger. Why is this phenomenon manipulate them. Their course is occurring and as the nurse taking care of this child, what education provide unpredictable, but most warts tend to to the mother? disappear on their own. If the parent is concerned, she should seek medical advice and let the provider

choose a course of action to remove the wart. Chickenpox Interventions Trim fingernails to prevent scratching. Do not remove scabs prematurely. Administer calamine lotion. Isolate from others. Do not let food sit out for more than two hours, check meat with fork to make sure it is not pink, quickly freeze all ground beef. Normally passes first meconium stool within 24 36 hours after birth. Meconium plugs are caused by meconium with reduced water content. Meconium ileus is an actual obstruction of the small intestines by abnormal meconium. Vertebral Anorectal Cardiovascular Limb Postoperatively, teach child to support neck when changing positions. Teach signs of hypoparathyroidism: Causes hypocalcemia. Chvosteks sign. Trousseau sign. Tetany. Unstable atoms damage DNA antioxidants fight the damaging effects by blocking the chemical reactions which cause free radicals Vitamins C and E, and provitamin A (beta-carotene)under investigation Avoid direct contact with blood or blood products. Identify high-risk mothers and newborns. Educate concerning need for vaccination. Prevention of Hep B At nighttime, closest to bedtime because this is when there is a natural physiologic release of GH. Select needle and syringe appropriate to the following: Amount of fluid to be administered. Viscosity of fluid to be administered. Amount of tissue to be penetrated. Max volume to be admin is determined on the muscle used. Care of the burn wound is the primary responsibility of the nurse. Cleaning the wound. Debriding. Applying topical ointments and dressings. Standard precautions must be adhered to in order to decrease the

What should the nurse teach the parents on how to prevent diarrhea?

Constipation in the Newborn

VACTERL: Hyperthyroidism Nursing Considerations

Free Radicals

Hepatitis B Interventions:

When should growth hormone injections be given?

Prepare medications for Injection

Nursing Role during the Management and Rehabilitation Phase

risk of cross-contamination. Guidelines for IM, SQ, ID Medications Insert needle quickly. Avoid tracking any medication through superficial tissues. Aspirate for blood. Inject medication slowly (over 20 seconds). Remove needle quickly. Apply firm pressure. Apply Band-Aid. cyanotic, tetralogy of Fallot Complications: Water intoxication. Hyponatremia. Hyperkalemia. Hypertension. Anemia, seizures and cardiac failure with progression. Childs Appearance: Not clean, tired, no energy. Lack of food, no breakfast. Alone. Needs medical attention. Refers to a condition in which large, fluid-filled cysts form in place of healthy kidney tissue in the fetus. This is inherited as an autosomal recessive trait Meal planning. Insulin and signs of hyper & hypoglycemia. Properly dispose of needles. Supervise blood glucose monitoring Purchase glucometer Record info and take record to all appointments wear shoes with socks, sandals or walk barefoot Is the transfer of gastric contents into the esophagus. Infants and children especially prone include: Premature infants. Infants with bronchopulmonary dysplasia. Children with tracheoesophageal or esophageal atresia repair. Children with neurologic A slipping of one part of the intestine into another portion of the intestine below it ("telescoping of the bowel"). The intestinal obstruction can strangulate and burst causing peritonitis. boys, usually ages 3 months to 3 years of age Use pain perception scales and observe behavior. Prepare child and family for procedures and preoperative teaching. Pain management. Prevention of infection. Early ambulation.

Blue spells or tet spells are _________ acute episodes and are associated with ___________ defect. Acute Renal Failure Therapeutic Management

Neglect

Polycystic kidney

Educate parents and child on DM

Gastroesophageal Reflux

Intussusception Pathophysiology

Appendicitis Treatment & Nursing Care

UTIs Treatment Antibiotic therapy

Guidelines for IM, SQ, ID Medications Determine the site of injection: Vastus lateralis:

Stage 1 hypertension Aging Theories: Immune System Decline

Initiated on the basis of identification of the pathogen. Childs history of antibiotic use. Location of infection. Largest muscle in infants / small child. Max amount of volume administered Infant: < 0.5 mL. Toddler: < 1 mL. Pre-School: < 2 mL. Needle Size: 5/8 to 1 inch needle. BP readings between 95th- 99th % immune system--most important mechanism for preserving health immune bodys defenses + bodys vulnerability to infection/cancer Misidentification of normal cells attack healthy cells aging process Decreased vision associated with aging Administering the drug through a straw will diminish an unpleasant taste. Having the child hold his nose is helpful, as bad taste is associated with the smell of the drug. Keeping hot liquids out of reach. Secure tablecloths Reduce hot water thermostats to a max of 120 degrees F. Test water before placing your child in it. Formulas, pastries and hot liquids should be reheated with caution; Test them prior Suspected based on manifestations: Excessive salivation and drooling. Three Cs: coughing, choking, cyanosis. Apnea. Increased respiratory distress after feeding. Abdominal distension. The exact type is based on chest films FALSE report all suspected cases to the appropriate authorities. The inability of the heart to pump an adequate amount of blood to the systemic circulation at normal filling pressures to meet the metabolic demands of the body. Beta blockers. ACE inhibitors. Diuretics. Appropriate nutrition Plan meals with child. Encourage small, frequent meals. Serve meals around medication schedules. Prepare highprotein, high-calorie foods. Educate

Presbyopia The nurse can minimize the problem of an unpleasant-tasting drug by:

Patient Teaching on Preventing Complications

EA & TEF Diagnostic Evaluation

True False: The law actually prescribes that a health care professional must only report confirmed cases of abuse to the appropriate authorities. Congestive Heart Failure

Pharmacologic interventions for systemic Hypertension? Crohns Disease Nursing Considerations

child and family on medication regimes. Support family and child. What type of growth and development impact does surgery of the urinary or Treatment perceived as punishment, genital tract have on a preschooler? separation anxiety during hospitalization, body image disturbance. What should children do if their clothes are on fire? Stop, drop and roll. Why is BP cuff size important in getting accurate readings in children? Cuffs that are too small will give a falsely high reading while cuffs that are too large will give a falsely low reading. RICE stands for Rest, Ice, Compression and Elevation and is used to help control bleeding episodes. Major differences include preparation of the child for the procedure and teaching ostomy care to the child and family. Preparation includes simple language together with illustrations and a replica model. Death in children with either thermal burns or complications in the respiratory tract; Bacterial pneumonia is the most common cause of respiratory failure with pediatrics. High blood pressure bounding pulses in arms weak or absent femoral pulses and cool lower extremities. Decreased: DI Diabetes Insipidus. Increased: SIADH; Syndrome of Inappropriate Antidiuretic Hormone secretion. A highly infectious fungal infection transmitted from person to person or from infected animals to persons; seen in school-age children. Because it can be too tiring for the child and may cause cyanosis due to exhaustion. Pruritus. Pain or tenderness. Burning or stinging. Alterations in sensation. Increased sensation. Decreased sensation. When the lesion appeared. Whether it occurred with food or other substances. Whether it is related to activity. Describes a group of rare disorders that result in an elevation of

What does RICE stand for and when should it be used?

Ostomies

Pulmonary problems are a major cause of

Coarctation of the Aorta Signs and Symptoms:

Posterior Pituitary Problems

Tinea Capitis

Why would you want to minimize crying?

Skin Lesions Diagnostic Evaluation

PAH

Preschool pain distraction

Nodule If a skin problem is related to a _______ ______, laboratory studies are performed to identify that causative factor. Assessment of Cardiac Patients should include?

pulmonary artery pressure above 25 mmhg at rest after the neonatal period. Band-Aid after injection. Assistance for IM injection. Tell the child it is all right to make noise or cry out during the injection. His or her job is to try not to move the extremity. Elevated firm deeper in dermis than papule systemic disease Accurate Hx. Include details about the mothers pregnancy and birth Hx. Inspect nutritional state. Color. Chest deformities. Unusual pulses. Respiratory status. Clubbing of fingers(late stage) Antibodies given to help reduce Kawasaki Disease The presence of two major manifestations or one major and two minor manifestations. Children tested for streptococcal antibodies (antistreptolysin-O) titer, elevated or rising in children with RF. Rejecting. Isolating. Terrorizing. Ignoring. Corrupting. Verbally assaulting. Over pressuring the child. Strict isolation required. Utilize negative pressure room if available. Restrict number of caregivers. Prevention: Routine smallpox vaccine is no longer recommended unless traveling into high-risk countries. 20-60% VSDs closes spontaneously during the 1 yr. of life Median sternotomy with cardiopulmonary bypass. Moderate to large defects are repaired with Dacron patch placed over opening. May be closed using devices during cardiac catheterization. Antibiotics Focus is on observation and reporting episodes. Teach feeding techniques. After episodes have stopped, offer fluids. Position the child on their side

Gamma Globulin Rheumatic Fever Diagnostic Evaluation

Emotional abuse may include:

Smallpox Interventions

Ventricular Septal Defect (VSD) Treatment

________ are frequently associated with diarrhea. Vomiting Nursing Considerations

What are the manifestations of head lice?

What is pulmonary artery banding?

Signs & Symptoms of Whooping Cough

Changes Associated with Aging Reproductive System

Warning Signs Demonstrated by Parents

Dysarthria Aplastic Anemia Etiology

or semi-reclining to prevent aspiration. Emphasize need to wash teeth or rinse mouth after vomiting. Pruritus of the scalp, grayish-white eggs (nits) firmly attached to hair shafts near the scalp, and excoriations from itching and pustules may be seen about the face. Hair becomes matted with foul odor. Through a thoracotomy, a strip of woven prosthetic material is passed around the pulmonary artery to constrict it. This reduces the volume and pressure of pulmonary blood flow, thus relieving symptoms of congestive heart failure Begins with cold-like symptoms, fever, cold, and cough. Spells of coughing, accompanied by a noisy gasp for air that creates "whoop. Contagious Period: 5-21 days (average 10d). Infectious Period: several weeks. Female breasts hang flat against chest male breasts due to testosterone Require increased stimulation to cause arousal during intercourse Penis and testes/vagina size Prostate vaginal lubrication & epithelial thinning Parents knowledgeable about illness, procedures and treatments. Parents very interested in interacting with the health care team. Parents overly attentive toward child. Family members with similar symptoms. Difficulty speaking Can be primary or secondary. Fanconi syndrome occurs. Aplastic Anemia Factors Infection. Irradiation. Drugs. Exposure to household or industrial chemicals. Idiopathic. Multidisciplinary. Specialized facility. Chemotherapeutic agents with steroids. Antibiotics, sedatives & analgesics. Bone marrow transplant. Blood transfusions. TPN. True.

Leukemia Treatment

T / F The sex organs of the child do not mature until the onset of puberty.

Inhalation Injury

Pediatric AIDS Nursing Care

Water Balance & Dehydration Hodgkins Disease Nursing Care

Trauma to the tracheobronchial tree often follows inhalation of heated gases and toxic chemicals produced during combustion. Support child and family with grieving process. Encourage discussion of feelings related to the stigma of AIDS. Education concerning longterm compliance with prescribed medication. Nurse should be alert for central nervous system involvement. Dehydration occurs when the total output exceeds the total intake. Symptomatic relief. Education. Prevent over fatigue. Inform adolescents of side effects of treatment. Age appropriate emotional support. Endocrine system supplemented by maternal hormones Swelling of breasts & genital changes. Hormone disturbances during childhood. Congenital hypothyroidism. Type I Diabetes. Bp. readings over 99th % plus 5mm Hg Is a protrusion of part of the abdominal contents into the groin.

Endocrine System of a Child Newborn

Stage 2 hypertension Inguinal hernia

Once a patient has been diagnosed with bacterial endocarditis, what must be Preventative measures include done in order to prevent recurrence prior to invasive procedures? prophylactic antibiotic therapy 1 week prior to procedures. Scarlet Fever Interventions Respiratory precautions. Bed rest; quiet activity. Teach regarding prevention of streptococcal infections. Prevention: Penicillin therapy is given for 10 days; Culture/treat streptococcal infection. Diagnostic Evaluation for Anemia includes Decreased RBCs, HgB and Hct. Fatigue, lack of energy and pallor. Impetigo Pathophysiology An infectious disease of the skin caused by staphylococci or by group A beta-hemolytic streptococci. It results when the organism comes in contact with a break in the skin. To avoid pressure ulcers and contractures. 80%

Why are range of motion exercises and proper positioning important? Minimal change nephritic syndrome (MCNS), found in approximately______ of cases.

How can diaper dermatitis be prevented? Munchausen by Proxy

Frequent diaper changes and exposure to air and light. Is illness that one person fabricates or induces in another person. It is done usually to gain the attention of the medical professionals. Use safety precautions. Apply EMLA topically over site if time permits. Caused by a parasite or "itch mite." Spread by close personal contact, including sexual relations. Rarely transmitted by fomites. Dilated cardiomyopathy. Hypertrophic cardiomyopathy. Restrictive cardiomyopathy. Upper arm. Lower abdomen. Anterior thigh. Amount of volume administered: < 0.5mL. Needle Size: 3/4 to 5/8 inch needle. Needle Gauge: 23 - 26. Abrasions Percentage of weight loss, increased pulse, irritability and lethargy, dry mucous membranes, absence of tears, sunken eyes or fontanel and delayed capillary refill. Cool affected area Soft lightweight clothing and bed linen NO scratching Mittens Keep fingernails short antipruritic medications Treat pain with nonpharmacological measures or mild analgesia. Handheld nebulizers. Nursing responsibility Erythema Ecchymosis Petechiae Primary lesions Secondary lesions Thermal. Chemical. Electrical. Age incidence of serious cognitive deficits memory long-term -- intact short-term -- fails Respond slowly to interview questions hearing or anxiety slows responses Clinical depression is mistaken for dementia History of bleeding episodes, evidence of X-linked inheritance and lab findings.

Guidelines for Injections Scabies

Secondary factors: Anthracycline toxicity. Hemochromatosis. Duchene muscular dystrophy. Kawasaki disease. Collagen diseases. Thyroid dysfunction. Cardiomyopathy Divided into 3 categories Guidelines for IM, SQ, ID Medications Subcutaneous Site

_________ are the most common epidermal injuries. What are the signs of dehydration?

What can the nurse teach the patient regarding symptom relief?

Aerosol Therapy Skin Lesion Terms Types of Burns Changes Associated with Aging Cognition

Hemophilia Diagnostic Evaluation

Leukemia is classified according to? Physical Care Elimination:

Type urinary frequency/ constipation Place call button within reach of patient Assist with trips to the bathroom at night Use commodes and bedpans or urinals prn physical activity, fluid & fiber intake Encourage a regular time for evacuation A blood test that identifies ReedSternberg cells. How to take BP at home When to contact provider. Medications. Follow-up. Compliance. Referrals. Didanosine (DDI), Nevirapine, and Invirase or Ritonavir are sometimes used. Antimicrobial therapy and antipyretics given for active infections. Supportive measures for other symptoms. Preventing the transmission of the virus. Provide supportive care t Maintain a high level of suspicion. Prevent bleeding by preventing trauma. Educate the family. Use an extra soft toothbrush. Medical alert bracelet. It is a surgical procedure in which the pyloric muscle is incised to enlarge the opening to allow food to pass. Study of aging, including physiological, psychological and social aspects Current research is seeking: actual cause of aging ways to extend quantity & quality of life They need to avoid caffeine, chocolate and spicy foods because they may aggravate their symptoms.

What is a definitive test for Hodgkin's lymphoma? Education of child and parent for systemic hypertension includes?

Pediatric AIDS Treatment and Nursing Care

Hemophilia Nursing Considerations

What is pyloromyotomy?

Gerontology

When teaching an adolescent about GER, how do they need to adapt their diets?

Congenital Defects that Increase Pulmonary Blood Flow

Genitourinary Surgery Nursing Care

Abnormal openings between the atria, allowing blood from the higher pressure left atrium to flow into the lower pressure right atrium. Tub baths may be contraindicated. Dressings to "private parts" inspected daily. Restrictions on play activities, such as straddle toys (tricycles, rocking horse).

Nursing Alert

Hyperthyroidism Diagnosis Development of Manifestations

The extra fluid given to administer IV medications and flush the tubing must be included in the calculation of the childs total fluid intake, particularly in the young children or those with unstable fluid balance. Emotional liability. Physical restlessness. Voracious appetite with weight loss. Tachycardia, hypertension and widened pulse pressure. Dyspnea on exertion. Exophthalmos. Goiter. Heat intolerance. Systolic murmurs.

Thalassemia trait, What is some Discharge planning for EA TAF?

This produces a mild microcytic anemia.

Teach skills to care for infant at home. Signs of respiratory distress. Signs of constriction of the esophagus: Poor feeding. Dysphasia. Regurgitation of undigested food. Crohns Manifestations include: Abdominal pain. Weight loss. Fever. Anorexia. Rectal bleeding. Anal fistulas. What are some of the complications a child with ARF can experience? Hyperkalemia, hypertension, fluid overload, anemia, seizures and cardiac failure. The nurse explains that for stability of the IV insertion site in an infant A superficial scalp vein is the injection younger than 9 months of age, the insertion site is the site for administering IV medication to infants younger than 9 months of age. Patient Teaching for wound care should include? Wash hands Do not put on anything that is not ordered Open wounds are covered with a dressing Remove with care Apply pressure if laceration is bleeding Clean and examine wound Do NOT open blisters Hypopituitarism Diagnostic Evaluation Chief complaint is short stature. An MRI of the brain detects pituitary abnormalities or lesions. Plasma growth hormone is examined. Endocrine studies are done. Hypothyroidism. Hypersecretion of cortisol. Gonadal aplasia. Children have_______ ______, leading to a more serious depth of burn with thinner skin lower temperatures and short exposure. Staphylococcal Infections Common bacteria that are found in dust and on the skin. Under normal conditions, it does not present a problem to the healthy body.

Voiding pressure study:

Acne Vulgaris Pathophysiology

Two Major Categories of Systemic Hypertension? Why are UTIs more common in girls?

Comparison of detrusor contraction pressure, sphincter electromyelogram and urinary flow. Inflammation of the sebaceous glands and hair follicles in the skin. Peak incidence at puberty; more common in males. Genetic factors and stress play a part. Course may be brief or prolonged. Premenstrual acne is not uncommon. Essential. Secondary. Shorter urethra and/or location near anus. Wearing nylon underwear. Use of bubble baths. Urine retention and vaginitis. Incest or other sexual abuse. On the same scale at the same time each day. A radiopaque catheter that is passed through the femoral artery directly into the heart and large vessels. Prepare for tests Note signs of exertion: Tachycardia and palpitations Tachypnea Dyspnea and shortness of breath Hyperpnea or breathlessness Dizziness or lightheadedness Diaphoresis Urinalysis. (proteinuria is an indicator) Renal function panel. Lipid profile. CBC. Electrolytes. May take forms from simple erythema to scales, blister, and ulcerations, depending on the cause. A beefy red rash in diaper area may be indicative of a candida infection. Captopril (Capoten): given three times a day. Enalapril (Vasotec): given two times a day. Is the transfer of gastric contents into the esophagus. True. with onset of puberty Encourage compliance. Facilitate recovery. Provide support. Prevent disease. During home care, Tx should be focused on rest and adequate nutrition. Educate children on

How are weights measured? What is a cardiac catheterization?

Anemia Nursing Considerations

Labs for Systemic Hypertension include?

Diaper Dermatitis Manifestation

Angiotensin-Converting Enzyme (ACE) inhibitors

Gastroesophageal Reflux T / F Infants are more susceptible to fluid volume excess and dehydration. Sex organs mature when? Rheumatic Fever Nursing Care

Pyloric Stenosis Treatment and Nursing Care

The nurse can decrease cardiac demand for CHF patients by:

Sickle Cell Disease occurs mainly in ____________. Sickle Cell Disease Pathophysiology

preventing spread of throat infections. Pts. with chorea need to be protected Pyloromyotomy. IV therapy. Thickened feedings. Burp before & during feedings. Daily weights. I & O. Frequent position changes. Monitor VS. Avoid overfeeding. Limit physical activity. Preserving body temperature. Treating infections. Reduce the effort of breathing. Prescribed medications to sedate an irritable child. African Americans. Features are a result of obstruction caused by the sickled RBCs and increased RBC destruction. Obstruction causes vaso-occlusion. Leads to hypoxia and cell death. Organisms enter the bloodstream: Via mouth after dental work. UTI. Heart from cardiac surgery. Directly. Lesions can break off and invade other tissue. Ovaries. Therapy is directed at retarding the rate of hormone secretion: Antithyroid drugs. Subtotal thyroidectomy. Ablation. Myth: Older adults live in nursing homes Fact: 90% of older adults live in own home Myth: Older adults are poor Fact: The median net worth of older households is over $60,000. The U.S. average for other households is $32,000 Treat symptoms by providing a quiet, unstimulating environment. Explain drug regimen. Educate the parents on signs of hypothyroidism. If surgery is anticipated, educate the parents on the administration of iodine After initial period, devitalized tissue must be removed Primary excision Debridement of partial-thickness burns Topical antimicrobial agents are applied Allograft-from human cadavers Xenograft-most often from pigs. Synthetic skin.

Bacterial Endocarditis Pathophysiology?

Female gonads: Hyperthyroidism Therapeutic Management

Myths Related to Aging

Hyperthyroidism Nursing Considerations

Burns Medical or Surgical Management

Urinary System of a Child

Oxygen Therapy Nursing Care Management and Rehabilitation Phase Comfort Management

Fluid of greater importance in infants and small children because it constitutes larger fraction of total body weight. more susceptible to trauma in children due to lack of fat Kidney function immature until 2 yr. old Primarily carried out in hospital setting. Medications as ordered prior to procedures. Relaxation techniques. Distraction therapy. Family participation. Explain all procedures in an age-appropriate manner. Tachycardia. Strawberry tongue, pinpoint rash. Circumoral pallor, desquamation. Incubation Period: 2-5 days. Contagious Period: during incubation and clinical illness, may become a carrier. Overproduction of immature WBCs cannot fight infection. Infiltration of WBCs of platelet forming centers in the marrow cause bleeding tendencies and weakening of bones Infiltration in spleen, liver and lymph glands results in diminished function Prevention. Exposure to light and air. Frequent diaper changes. Medicated powder or ointment. Cleanse diaper area. Avoid plastic pants. Super absorbent disposable diapers. Petrolatum, A&D ointment, or zinc oxide ointments. Where ventricles are dilated and contractility is greatly decreased. Most common category with children. Signs and symptoms: Tachycardia. Dyspnea. Hepatosplenomegaly. Fatigue. Poor growth. Emphasize the importance of hydration. Manage pain Apply heat & keep child on bed rest Observe signs and symptoms of transfusion reaction Be aware of spleen size Recognize other complications Support family ET intubation: Nasal, oral or direct tracheal. Use only uncuffed ET tubes in children < 8 years. Tracheostomy Made without an inner cannula.

Signs & Symptoms of Scarlet Fever

Leukemia

Diaper Dermatitis Treatment & Nursing Care

Dilated Cardiomyopathy

Sickle Cell Disease Patient Teaching and Interventions

Artificial Ventilation Artificial airways

Burns Therapeutic Management

Nursing Diagnoses

Healthy People 2010 for Aging

Beta-Thalassemia Diagnostic Evaluation

Testicles may appear _______at birth in proportion to size of newborn. Tracheostomy Good nursing care is

Complications include: Hemorrhage. Edema. Aspiration. Accidental decannulation. Minor burns can be treated on an outpatient basis. Cleanse the wound with mild soap and water. Cover it with an antimicrobial ointment. Do not disturb blisters unless they are the result of chemical contact. Change dressings as prescribed. Self-care deficit, bathing, feeding, dressing r/t weakness Risk for falls r/t age related changes Impaired physical mobility r/t age related changes Access to quality care Cancer Kidney disease Health communication Diabetes Heart disease/stroke Healthy People 2010 for Aging Disabilities Product safety Activity/fitness Community based programs HIV Substance abuse Hematologic studies: changes in RBCs. Low Hgb and Hct. Hgb electrophoresis. X-rays. Large May fail to move into the scrotum. Maintaining airway. Facilitating removal of secretions. Providing humidified air or oxygen. Cleansing the stoma. Monitoring the childs ability to swallow. Raise head of bed trach supplies at bedside including extra trach tubes/ties Failure to thrive. Large, bulky & frothy stools. Abdominal distention with atrophy of buttocks. Accept initial shock and disbelief, allow for period of grief. Repeat information in simple terms as often as necessary. Foster parent-child attachment, especially with newborns. Introduce parents to other families who have similarly diagnosed children Torn, stained, bloody underclothing. Pain on urination, swelling or itching in genitals. STDs, nonspecific vaginitis or HPV. Pregnancy in young adolescents. Difficulty walking or sitting.

Celiac Disease Manifestations

How can the nurse help parents and child adjust to CHD?

Sexual Abuse Childs Appearance

Symptoms for Meckel's diverticulum usually appear at what age? Diaper Dermatitis

Before 2 years old. Skin irritation caused by prolonged and repetitive contact with an irritant. Decreased hearing associated with aging Indomethacin (Indocin) closes patent ductus in newborns Left thoracotomy duct tied off Visual-Assisted Thoracoscopic Surgery (VATS) 3 small incisions on left side of chest; then a thorascope and instruments are used to place clip on ductus arteriosus. Abnormal state of motor and psychic hypoactivity Unknown, thought to be an auto immune system reaction to a virus. hour Primary emphasis is on treatment of burn shock and management of pulmonary status. Monitor vital signs. Urine output should be at least 1 to 2 mL/kg in children weighing < 30 kg. Urine output should be at least 30 to 50 mL/hr for a child >30 kg. Glomerulonephritis. Hemolyticuremic syndrome. Poor renal perfusion. Urinary tract obstructions. Acute renal injury. Severe dehydration. Rare defect characterized by failure of pulmonary veins to join the left atrium, insteas the veins are abnormally connected to the systemic venous circuit. Most constipation is due to environmental changes or normal development. The onset of constipation in the school-age child is due to environmental changes and stresses. Potassium, magnesium, and calcium. Renal and hepatic functions. Neonates: falsely elevated serum digoxin concentrations. Toxicity and Overdose: Therapeutic serum digoxin levels range 0.5 2 ng/mL. Drawn 6-

Presbycusis Patent Ductus Arteriosus (PDA) Treatment

Akinesia What is the cause of ITP? Evaluate extremities and check the pulse every _____ notify provider immediately if unable to palpate pulse. Severe Burn Nursing Care Acute Phase

Acute Renal Failure Conditions that cause ARF

Total anomalous Pulmonary Venous Connection

Constipation during Childhood:

Antiarrhythmics Nursing Implications Cont. Lab Test

8 hr after dose is administered. Dehydration can be caused by? Hypopituitarism results from a variety of conditions Lack of intake. Abnormal losses: Vomiting. Diarrhea. Developmental defects. Destructive lesions. Hereditary disorders. Functional disorders. Anterior Pituitary Problems Myth: All old people become senile Fact: Decline is not inevitable, creativity and intelligence do not change Myth: Older adults are isolated and alone Fact: Most older adults have at least weekly contact with family and have friends Isolate. Bed rest. Observe for respiratory distress. Position; physiotherapy. Range of movement exercises. VSD (Ventricular Septal Defect) Nephrotic syndrome refers to a number of different types of kidney conditions that is distinguished by the presence of marked amounts of protein in the urine, edema, and hypoalbuminemia. Inflammation of the skin involving sebaceous glands. Protective or jealous. Comes from all levels of society. Parents have an estranged relationship. Have difficulty showing concern towards their child. During hospitalization, the parents do not become involved in the childs care. Failure of fetal ductus arteriosus to completely close within first few weeks after birth. A child diagnosed with celiac disease must restrict foods containing what? Gluten. VATER: vertebral, anorectal, tracheoesophageal and renal. VACTERL: vertebral, anorectal, cardiovascular, tracheoesophageal, renal and limb abnormalities that may be present with children who have EA/TEF.

Myths Related to Aging

Polio Interventions

What defect is a left to right shunt? Nephrotic Syndrome Pathophysiology

Seborrheic Dermatitis Sexual Abuse Parents or caretakers behavior

Patent Ductus Arteriosus (PDA)

Celiac Disease Treatment & Nursing Care

What does VATER and VACTERL stand for?

Why is water balance important in newborns?

Anemia

Hemophilia Most Common Forms: Uses for Central Line

Infants needs are greater and they are more vulnerable to alterations. Newborns lose a large amount at birth and maintain a larger amount of extracellular fluid than the adult. Children have a greater surface area. Increased metabolic rates and heat p There is a reduction in the number of RBCs or amount of hemoglobin is below normal. Factor VIII deficiency. Factor IX deficiency. Von Willebrand disease. Long term administration of meds. Chemotherapy. Total parental nutrition (TPN). Maintenance. Fluid resuscitation. Acute volume expander. Characterized by an increase in heart muscle mass without an increase in cavity size. Symptoms include: Chest pain. Dysrhythmias. Syncope. Chest x-rays show enlarged heart. ECG shows ST-T changes. Surgery of the urinary or genital tract impacts growth and development. Inappropriate responses, conflicting stories with the child, excessive delay in seeking treatment, repeated visits to the emergency room with injuries to the child. An acute systemic vasculitis. Antiseptics. May be caused by many things. If iron supplies do not meet demand, iron deficiency results. Alkaline urine favors pathogens. Retention of urine= medium for growth. Vesicoureteral reflux. cardiac output, vital capacity & pulmonary elasticity bp & respiratory rate Aorta & arteries stiffen Circulatory system less efficiently to activity & exercise irregular pulse, SOB with exertion, postural hypotension, impaired arterial circulation Penicillins. Sulfonamide (trimethoprim and sulfisoxizole in

Hypertrophic Cardiomyopathy

Genitourinary Surgery What are 3 behaviors from parents or caretakers which may be considered warning signs for child abuse?

Kawasaki Disease? What things can delay wound healing? Iron Deficiency Anemia Pathophysiology

Chemical and physical factors which increased risk of UTIs?

Changes Associated with Aging Cardiovascular/Pulmonary Systems

Common antiinfectives agents used for UTI include:

combination). Cephalosporins. Nitrofurantoin. What two defects are necessary for survival with hypoplastic left heart syndrome? Hyperlipidemia Patent foramen ovale and patent ductus arteriosus. Excessive lipids hypercholesterolemia refers to excessive cholesterol in the blood. Both are believed to play a role in producing atherosclerosis which eventually can lead to coronary heart disease. focuses on screening and management of lipids Initial phase-monitor cardiac status. Assess for signs of CHF. Symptomatic relief such as using cool cloths, unscented lotions and soft, loose clothing. Educate parents on suspending all immunizations. Reinforce teaching on recognition of problems. Instruct parents and children that recurrence is most likely within 1-2 months after infection and is often asymptomatic. Monitor vital signs. Periodic follow-up for urine cultures. Vaso-occlusive Splenic sequestrationAplastic -without RBC Hyperhemolytic-accelerated RBC breakdown.(jaundice) Care is directed at: Identifying children with symptoms. Educating parents. Providing care for the child undergoing surgery. Teaching older children and adolescents that caffeine, chocolate, and spicy foods may aggravate symptoms. Weight management. Three small incisions on left side of chest; then a thorascope and instruments are used to place clip on ductus arteriosus. Infection Hypertension: Monitor blood pressure and pulse frequently during initial dose adjustment and periodically during therapy. Notify health care professional of significant changes. Assess patient for signs of angioedema (dyspnea, facial swelling).

Kawasaki Disease Nursing Care?

Nursing Care for UTIs Teach parents about medications

Types of Sickle Cell Crises

Gastroesophageal Reflux Nursing Considerations

Visual-Assisted Thoracoscopic Surgery (VATS) is?

_______is the chief danger during the acute phase. Nursing Implications ACE Inhibitor Assessment

Idiopathic Thrombocytopenic Purpura

What is emotional abuse?

Tetralogy of Fallot (TOF) Pathophysiology

Decrease Cardiac Demands by?

German Measles

TGA (Transposition of the Great Artery)

What are the common symptoms of skin lesions?

What can a nurse do to minimize skin discomforts for a child with Kawasaki Disease? What is a murmur? Kawasaki disease is also known as _______ _________ _____ ________. Acute Renal Failure Manifestations

An acquired platelet disorder that occurs in childhood. Characterized by: Thrombocytopenia: excessive destruction of platelets. Emotional abuse refers to the deliberate attempt to destroy or significantly impair a childs selfesteem or competence. An abnormal opening in the intraventricular septum. Stenosis of the pulmonary artery decreases blood flow to the lungs. Dextraposition of the aorta. Obstruction of flow to the pulmonary artery. Limit physical activity Preserving body temperature Treating infections Reduce the effort of breathing Prescribed medications to sedate irritable child Improve Tissue Oxygenation and Decrease Oxygen Consumption Use supplemental oxygen as ordered. Primarily nasopharyngeal secretions of infected person; also present in blood, urine, and stool. Pulmonary artery leaves the left ventricle with no communication between the systemic and pulmonary circulations. Include pruritus that varies in intensity is the most common, pain or tenderness, burning or stinging and alterations in sensation. Provide cool cloths, unscented lotions and soft, loose clothing. Turbulent blood flow Mucocutaneous Lymph Node Syndrome Oliguria. Anuria. Nausea and vomiting. Drowsiness. Edema. Hypertension. Saliva of infected persons. Incubation Period: 14-21 days (average 18d). Contagious Period: prior to, and until all swelling subsides. Signs & Symptoms of Mumps The immediate treat: Airway compromise. Profound shock. During healing stages: Infection.

Mumps

Burns Complications

Signs & Symptoms of Hep A

What is the goal when treating skin disorders?

Hypopituitarism Therapeutic Management ORT

Fever. Anorexia. Headache. Abdominal pain. Malaise. Jaundice. Dark urine. Chalk-like bowel movements. To prevent further damage and complications and to manage discomfort while the tissue heals. Correcting underlying disease. Oral rehydration therapy DO NOT REHYDRATE WITH FRUIT JUICE SOFT DRINKS OR GELATIN!!! constitutes 10% of officially substantiated child maltreatment Sexual abuse is the use, persuasion, or coercion of any child to engage in sexually explicit conduct for producing any visual depiction of such conduct or rape, molestation, prostitution Caused by abnormal intestinal water and electrolyte transport. Chief function is regulation of volume and composition of body fluids and excretion of waste materials. Resistant to antibiotics. Low grade fever, malaise, anorexia, weight loss, cough, and night sweats. Positive tuberculin skin test. Immunocompromised patients, such as with AIDS, are at increased risk. Infants and children especially prone Premature infants. Infants with bronchopulmonary dysplasia. Children with tracheoesophageal or esophageal atresia repair. Children with neurologic disorders, cystic fibrosis or cerebral palsy. Child with GER A strong relationship between upper respiratory infections with groups A beta hemolytic streptococci and development of RF. Suppository is lubricated with watersoluble jelly or warm water. Quickly inserted into the rectum beyond the rectal sphincters. Buttocks are held together firmly

Sexual Abuse

Diarrhea Urinary System

Methicillin-Resistant Staphylococcus Aureus (MRSA) Signs & Symptoms of TB

Who is predisposed to Gastroesophageal Reflux?

Rheumatic Fever Etiology:

Rectal Medications

Aging Theories

Chronic Renal Failure Pathophysiology Uremic syndrome

What are the signs of Synthroid overdose?

Changes Associated with Aging Hearing

What should the nurse stress to an adolescent who is post-ostomy placement? Hemophilia Pathophysiology

It is not usually necessary to _____ the child unless you suspect viral infections such as chickenpox or measles. What is the maximum time that should be spent on one suctioning attempt? What type of diet should be encouraged for the child with Crohns disease? Diabetes Insipidus

Autophagocytosis energy needs + the potential for survival a cell eats part of itself lipofuscin - a brown colored residue cell shrinkage Ht /Wt ; atrophy tissues Anorexia, n/v Bruising. Bloody diarrhea. Stomatitis. Bleeding form lips and mouth. Intractable itching. Uremic frost. Deep respirations. Hypertension and CHF. Pulmonary edema. Signs of overdose include rapid pulse, dyspnea, irritability, fever, and sweating and weight loss. Presbycusis becomes more pronounced Senses of smell and taste are decreased Position sense and reaction time Decline gradually until age 70 then decline rapidly increases Decline causes accidents The nurse should stress to adolescents that the presence of the stoma need not interfere with activities. Factor VIII is needed for forming thromboplastin. Less factor VIII = more severe disease. Leads to patients bleeding longer but not faster. Isolate No more than 15 seconds. A well balanced, high-protein, highcalorie diet. Result of the hyposecretion of Antidiuretic hormone or vasopressin. Primary causes: Familial. Idiopathic. Secondary causes: Trauma. Tumors. Granulomatous disease. Infections. Vascular anomalies. Septicemia. Pneumonia. Osteomyelitis. Meningitis. Immature livers. Self-report (innocently). Little or no response to pain. Indiscriminate friendliness to strangers. Fear of being touched.

In the newborn Staphylococcal can cause What makes newborns more prone to jaundice? Warning Signs Childs Behavior

Smallpox Which type of DM is most common in children? Factors for Cardiomyopathy include

Virus. Type I. Familial or genetic causes. Infection. Deficiency states. Metabolic abnormalities. Collagen vascular disease. Scalded Skin Syndrome: Mild erythema. Sandpaper texture. Vesicles may appear. Rupture and peeling may occur. Instruct the parents on iron administration: Give as prescribed. Juice with the medication helps absorption. Opening near junction of superior vena cava and right atrium. May be associated with partial anomalous pulmonary venous connection. Assessments for signs of infection and skin breakdown. Clean around stoma with hydrogen peroxide and saline per unit protocol. Change ties daily. The first tube change is done by the surgeon and subsequent changes are done by nursing. unable Traditional dry dressings should not be used. Moist dressings increase rate of healing and decrease pain and inflammation. Balance must be achieved. Begin preparing for discharge early. Early evidence of skin breakdown or complications: Ribbon-like stools. Excessive diarrhea. Bleeding. Prolapse. Failure to pass stool or flatus. Notify provider. Erythema at site. Pain or burning at the site. Warmth over the site. Slowed infusion rate / pump alarm goes off. Infection. Acute: Usually self-limiting. Referred to as acute infectious gastroenteritis caused by a variety of viral, bacterial and parasitic pathogens. Chronic: Diarrhea lasting over 14 days. Caused by chronic conditions. Intractable diarrhea occurs in first

Staphylococcal Infections Manifestations

Iron Deficiency Anemia Nursing Considerations

Sinus venosus defect:

Tracheostomy Care Routine care includes

Injury to deeper tissues involves permanent cells which are _______to regenerate. Remove causative factors. Wound Dressings:

Ostomies Patient Teaching

Signs and Symptoms of Phlebitis

Diarrhea can be classified as?

Support of the Family- Child Abuse

Munchausen by Proxy Forms

Increase contractility and decrease afterload: digitalis glycosides

Chronic Renal Failure Signs and Symptoms

Patent Ductus Arteriosus (PDA) Manifestations

Intense itching is a problem in burn patients how can the nurse stop it?

What is the treatment for coarctation of the aorta? Wilms Tumor Nursing Care

Family planning. Protective services. Child care centers. Parenthood education Classes. Hotline to child shelters. Child advocates. Adding maternal blood to the childs urine to simulate hematuria. Presenting a fictitious medical history. Chronic poisoning of the child. It is very hard to confirm and requires a high index of suspicion to protect the children. CHF Digoxin is given orally or intravenously in divided doses over 24 hours to produce optimal effects. Digoxin (Lanoxin): slow and strengthen the heartbeat. Nausea. Weight loss. Facial edema. Malaise. Bone or joint pain. Dry or itching of the skin. Bruised skin. Sensory motor loss. Amenorrhea. Continuous "machinelike" murmur left second intercostal space. Full and bounding pulses due to "runoff" of aortic blood flow into pulmonary artery. Dyspnea with age. Wide range between systolic and diastolic blood pressure. Hypoxia Treat with a combination of H1 and H2 antagonists such as Zyrtec and Tagament. Apply moisturizers. Surgical repair. Anxiety related to surgical experience: Provide surgical tour. Encourage parents to remain. Explain anesthesia equipment. Determine childs vocabulary. Provide support and reassurance. Screening, education and support. Education parents and child: About cholesterol, HDLs and LDLs and triglycerides. Behavioral risk factors. Medications. Dietary changes. Keeping all appointments. Tx is primarily dietary. Restricting intake of cholesterol/fat If child does not respond to diet changes, drug therapy may be needed: Cholestyramine (Questran). Colestipol (Colestid). These 2 drugs are bile acid-resins or sequestrants

Hyperlipidemia Nursing Considerations

Hyperlipidemia Treatment

Improve Tissue Oxygenation and Decrease Oxygen Consumption in CHF patients by:

Dehydration Nursing Interventions

Ear Drops (Otic)

Chest Physiotherapy

Mumps Interventions

Restrictive Cardiomyopathy

Lymphatic system Incidence of Physical Abuse Recurrence of a UTI is most likely to occur within how many months? Ageism

Use supplemental oxygen as ordered. An oxyhood is preferred with young infants whereas a nasal cannula or face tent may be used with older infants and children. Cool humidification is necessary to counteract the drying effects of the oxygen. Observe: Vital signs. Skin color, temperature, turgor and presence of edema. Mucous membranes. Body weight. Sensory alterations and presence of thirst. Position: prone or supine with head turned to the appropriate side. In children younger than age 3 years the pinna is pulled down and back to straighten the ear canal. In the child older than 3 years, the pinna is pulled up and back. Postural drainage in combination with adjunctive techniques. Manual percussion and vibration. Contraindicated: Pulmonary hemorrhage. Pulmonary embolism. End-stage renal disease. Increased ICP. Osteogenesis imperfecta. Minimal cardiac reserves. Encourage fluids. Isolate. Ice compresses to neck for comfort. Prevention: Start complete series of polio vaccines in infancy. May require respirator care. Describes a restriction to ventricular filling caused by endocardial disease. Symptoms are those common with CHF. Drains regions of the body to lymph nodes. Approx. 1 million cases reported per year. Many cases are not reported. One to two months after termination of treatment. characterized as living in the past, sick, feeble, rigid, disagreeable, opinionated or demented some Americans believe life is over after middle age and they are no longer expected to remain physically or mentally healthy forces them to retire early

Pathophysiology of Kawasaki Disease?

Monitoring Oxygen Therapy Pulse Oximetry

Nursing Care for UTIs Patient teaching

What nursing interventions are appropriate to manage the pain a child experiences during a vaso-occlusive crisis? Wilms Tumor Nursing Care

Measles Interventions

The sign inside the crib of a child with Wilms tumor should state what? Name three causes of iron-deficiency anemia?

Initially extensive inflammation. Progresses to formation of coronary artery aneurysms. Apply to the great toe of an infant. Use index finger of a child. Pressure necrosis. Transcutaneous: Change site every 3 to 4 hours. Calibrate with site changes. Instruct females on importance of wiping front to back Emphasize avoiding bubble baths, water softeners, hot tubs or whirlpool baths. Explain the need for cotton underwear. Suggest drinking juices to maintain acidity Recommend frequent pad change Provide analgesics as ordered; notify the provider if medication is ineffective. High risk for deficient fluid volume related to patients age, surgery, catheters, refusal to drink: Regulate IV fluids. Accurate I & O. Daily weight. Record drainage output. Observe turgor & fontanels. Symptomatic care. Isolate and provide quiet activities. Utilize measures to reduce eyestrain caused by photophobia. Detailed oral care. "Do Not Palpate Abdomen.

Severe hemorrhage, inability to absorb iron, excessive growth requirements, inadequate diet, and GI bleeding r/t lactose intolerance. List three ways in which children can acquire the human immunodeficiency 1. Contact with an infected mother at virus (HIV). birth. 2. Sexual contact with an infected person. 3. Use of contaminated needles or contact with infected blood. Coarctation of the Aorta (COA) Treatment Anastomosis Graft replacement Closed heart surgery is performed because structures are outside of heart. Aorta will grow but graft will not. Balloon angioplasty If restenosis occurs after surgery for coarctation, a balloon can relieve the obstruction True or False: Treatment of high cholesterol is primarily through changing True. Medications are only used if the diet. there is no response from changing the diet. Lymphatic system includes Lymphocytes. Lymphatic vessels. Lymph nodes. Spleen. Tonsils,

adenoids, and thymus gland. Lymphocyte What are the signs of hypoparathyroidism and hypocalcemia that nurses need to be aware of when taking care of a child who is postthyroidectomy? Intertrigo Manifestations Signs include: Chvosteks sign, Trousseaus sign and Tetany. Patches of red, moist skin, and are usually along the neck and in the inguinal and gluteal folds. Condition is aggravated by urine, feces, heat, and moisture. Administer all vaccines Short term oxygen may be helpful. Exchange transfusions. Splenectomy. Ibuprofen or acetaminophen. Codeine. PCA. Steroids. Increased erythema. Edema. Purulent exudate. Pain. Increased temperature. ELISA and Western Blot not as reliable in diagnosing infants and young children. Based on clinical signs and symptoms defined by the CDC. Presence of risk factors associated with AIDS in the mother. Painless lump along neck. Unexplained low-grade fever, night sweats. Anorexia, unexplained weight loss, malaise. Rash & pruritus. Instruct pt. to take med as directed at the same time each day Warn patient not to discontinue therapy unless directed by health care professional. Instruct patient and family on correct technique for monitoring BP. check Bp at least weekly 5% of the population >85 years old Currently 90.5% White 9.5% Other races Monitor for signs of dehydration. Obtain accurate daily weights. Collect specimens as ordered. Protect the skin from excoriation. Support the child and family. What can the nurse teach the patient and family regarding diarrhea? Keep affected areas clean and dry. Expose the area to air and light. Maceration of the skin can lead to secondary infection. Becomes dysfunctional is no longer able to continue orderly synthesis of

Sickle Cell Disease Medication Management

Wounds Nursing Care Note signs of wound infection

Pediatric AIDS Diagnostic Evaluations

Hodgkins Disease Manifestations

Antihypertensives Patient Teaching

2050

Diarrhea Nursing Care

Intertrigo Treatment and Nursing Care

Aging Theories: Faulty DNA Replication

proteins. Gastroesophageal Reflux Signs and Symptoms Spitting up, regurgitation, vomiting. Excessive crying, irritability, arching of the back. Weight loss or failure to thrive. Respiratory problems. Heartburn or abdominal pain. Dysphagia. Esophagitis. Distract child with conversation. Apply a cold compress prior to injection. Toddler: Band-Aid if injection / distraction. Raised Serous Filled Lesion Is a protrusion of part of the intestines through the umbilical ring. Can occur anywhere and can be either single or multiples. Constipation Indigestion Flatulence saliva, gag reflex, digestive juices, and nutrient absorption & peristalsis Increased risk for aspiration Food remains in esophagus longer Colon cells atrophy When used for minor dermal procedures (venipuncture, IV cannulation, arterial puncture, lumbar puncture), apply the 2.5-g tube of cream (1/2 of the 5-g tube) to each 2 in. by 2 in. area of skin in a thick layer at the site. Antirheumatic agents. Corticosteroids. Nonsteroidal antiinflammatory drugs (NSAIDs). Fever, cough, and conjunctivitis. Koplik's spots. Maculopapular rash erupts. Incubation Period: 2-3 weeks. Contagious Period: from 4 days before to 5 days after rash appears. Based on clinical manifestations, history and biochemical factors. Initial signs and symptoms are vague: Loss of normal energy. Increased fatigue. Pallor. Elevated blood pressure. Have glycosuria, polyuria and history of weight loss or failure to gain despite appetite. Those with transient or persistent glycosuria. Those who display manifestations of metabolic acidosis with or without stupor or

Guidelines for IM, SQ, ID Medications Decrease pain perception:

Vesicle Umbilical hernia Verruca (warts) Changes Associated with Aging Gastrointestinal System

Implementation (topical) EMLA

There are several disorders which affect the musculoskeletal system. These disorders are treated with the following classifications of medications Signs & Symptoms of Measles

Chronic Renal Failure Diagnostic Evaluation

Diabetes Mellitus Those at risk for DM

coma. Ea. & TEF is suspected based on what manifestations? Excessive salivation and drooling. Three Cs: coughing, choking, cyanosis. Apnea. Increased respiratory distress after feeding. Abdominal distension. The exact type is based on chest films Concerned about effect of surgery on appearance and sexual ability. Fungus attacks hairs at their bases, causing them to break off close to the skin, loses pigment and leave circular, patches of balding areas (alopecia). Papules on the scalp become pustules, which progress to red scales. Contact with injurious agents. Hereditary factors. External factors. Systemic diseases. High dose antibiotics 2-8 weeks. Blood cultures. Preventative measures. Avoid exposing women in early months of pregnancy. Give plenty of rest and employ comfort measures. Antipyretics. Analgesics. Meticulous attention to I & O. Limit fluid intake as ordered. Be alert to complications: Changes in behavior. Neurologic involvement: Coma. Seizures. Alterations in LOC. Fever Weight loss Vomiting Increased voiding Foul-smelling urine Persistent diaper rash Blood from aorta (high pressure) is forced into pulmonary artery (lower pressure) to be reoxygenated in lungs and returned to left atrium and ventricle Increases workload on left side of heart PDA may be lifesaving in neonates with cyanotic heart disease And Diagnostic Testing X-ray examinations Tumor compress kidney tissue and are usually encapsulated. May cause hypertension. chest x-ray, ultrasound, bone surveys, liver scan and CT 1. Anthrax. 2. Smallpox. 3. Ebola virus.

Genitourinary Surgery Adolescents Tinea Capitis Signs and symptoms

Skin Lesions Result from causes such as

Endocarditis Therapeutic Management:

German Measles Interventions

Acute Renal Failure Nursing Considerations

UTIs Manifestations Symptoms Infants

PDA Pathophysiology

Wilms Tumor Pathophysiology

Name three biological agents used as weapons.

Roseola AV Canal Defect

Viral. Incomplete fusion of the endocardial cushions. Surgical repair consists of patch closure of the septal defect. Place mittens or other device on the child and keep their fingernails short, clean and trimmed. males 73, females 79 Blalock-Taussig procedure. Corrective surgery for all defects performed on older children with good results. IV prostaglandin E1 therapy. Proper amounts of fluid to flush the bladder. Encourage complete bladder emptying. Remind child to void frequently; anticipate incontinence. Accurate I & O. Teach child how to collect urine specimens. Presbyopia becomes more pronounced Visual acuity declines as structures of the eye degenerate Formation of cataracts Difficulty adjusting to glare of lights If >200mg/dl. phimosis Vaso-occlusive. 1. Pain relief. 2. Promote rest and reduce fatigue. Redness. Infiltration. Extravasation. Monitor I&O. Monitor daily weights. Assess peripheral edema. Auscultate lungs (rales, crackles) Promote compliance. Assist with coping. Foster adjusting. Observe for complications. Refer for genetic counseling. Support the family. Substance abuse. Upset home life. Disinterested, apathy. Isolation. Lack of social skills. Chronic illness. History of neglect. Dermabrasion. Oral contraceptives.

What nonpharmacological measures can be taken to prevent an infant or small child from scratching lesions? Implication of an Aging Society Life expectancy Tetralogy of Fallot (TOF) Treatment

Nursing Care for UTIs Teach prevention

Changes Associated with Aging Sight

Glucose tolerance test (GTT): Foreskin may be tight at birth, which could cause __________ What is the most common type of sickle cell crisis? Name two ways to provide appropriate nursing care for a child with leukemia. Antiarrhythmics Nursing Implications . Observe IV site for

Beta-Thalassemia Nursing Considerations

Neglect Parents or Caretakers Behavior

Acne Vulgaris Medical Treatment

Causes of Bacterial Endocarditis?

Congenital Heart Disease Patient Teaching

Burns Classification

Chronic Renal Failure Nursing Considerations

Ostium primum (ASD 1):

Emotional Abuse

Not transmitted by?

Topical Therapy Nursing Care

List 3 factors that predispose children to physical abuse.

Hypopituitarism Burns Therapeutic Management for Major burns:

Most common: streptococcus viridians. Staphylococcus aureus. Gram-negative bacteria. Fungi: candida albicans. Assess family's understanding of diagnosis. Written instructions regarding medication schedules and treatment protocols. Encourage family to verbalize questions, fears, and concerns Allow family to participate in care when appropriate Major: requires treatment at a specialized burn center. Moderate: may be treated in any hospital with expertise in burn care. Minor: may be treated as an outpatient. Risk for injury. Fluid volume excess. Altered nutrition: less than body requirements. Body-image disturbance. Altered family processes. Child and family need constant reassurance. Access graft, if necessary, under strict aseptic conditions. Opening at lower end of septum. May be associated with mitral valve abnormalities. Parent or caretakers behavior: Blames and belittles the child. Rejecting to child, withholds love. Unequal treatment to other children. Casual relationships. Living conditions. Blood, semen, vaginal secretions, and human milk all can transmit the AIDS virus. Wash hands prior to and after Plain water or Burrows solution may be used Hold dressing in place with Kerlix gauze Remove dressing Soaks are used for removal of crusts Baths are useful for antipruritic and antiinflammatory effects. They include: Multiple siblings. Premature babies. Difficult temperament. Hyperactive. Physically disabled. Illegitimate or unwanted. Is a disorder associated with deficient secretion of growth hormone. First priority: Airway management. Intubate if edema is suspected. Administer 100% O2 and get blood

gases. If full-thickness burns encircle chest, an escharotomy is done. Nephrotic Syndrome Nursing Care Emotional support for child & parents. Parent teaching of daily care. Teach signs to report. Good skin care. Turn frequently. Return to normal activity after acute phase. Strict I & O. Neutropenic precautions. Intravenous medications are frequently used for pediatric therapy. Often selected for: Immediately distributed to the tissues and prompt physiological action occurs. Dose is measured in units. Administered SQ bid Lispro, Regular, or NPH are given in combination. The insulin pump is designed to deliver fixed amounts of regular or Lispro insulin continuously. Do not remove for more than 1 to 2 hours at a time. Withdrawn. Regressive behavior like bedwetting or thumb sucking. Poor relationships with other children. Delinquent acts, runs away from home. Suicidal attempts or ideation. Fluid leaks into the subcutaneous tissue. Fluid leaking around catheter site. Site cool to touch. Solution rate slows are pump alarm registers down-stream-occlusion. Tenderness or pain: infant is restless or crying. Blood Glucose 330 Ph 7.3 bi carb less than 15 ketonurea Includes intentional physical abuse or neglect, emotional abuse or neglect, and sexual abuse of children, usually by adults. It is one of the most significant social problems affecting children. Assess application site for open wounds. Apply only to intact skin. Assess application site for anesthesia following removal of system and prior to procedure. Failure to thrive or developmental delays. Repeated respiratory infectious. Chronic ear infections and sinusitis. Chronic diarrhea. Recurrent fever. Anemia.

Intravenous Medications

Diabetes Mellitus Therapeutic Management

Sexual Abuse Childs Behavior:

Complications of Fluids Infiltration:

Diabetes Mellitus Testing Results Child Maltreatment

Nursing Implications for EMLA Assessment

Pediatric AIDS Manifestations

Roseola Interventions

Cystoscopy:

Leukemia Manifestations

Wilms Tumor Treatment

1980-2000 Oxygen Therapy Devices

Rest and quiet should be provided. Teach parents temperature reducing techniques and prevention of seizures. Prevention: none. Diagnosis of congenital abnormalities or acquired lesions in the bladder and lower urinary tract. Initial Phase: Low-grade fever. Pallor. Tendency to bruise. Leg & joint pain, pathologic fractures. Listlessness. Abdominal pain. Enlargement of lymph nodes. Combination of surgery, radiation therapy, and chemotherapy. Removal of kidney and tumor as soon as possible after diagnosed. Avoid handling of the abdomen to prevent the spread of disease. Chemotherapy and ration therapy after surgery older population has grown twice as fast as the rest of the population Oxygen Tent: 30% - 50%. Difficult to keep closed. Warm inside: Use cooling mechanism. Check temperature inside tent periodically. Anemia Chest PT is contraindicated for patients with pulmonary hemorrhages, pulmonary embolism, end-stage renal disease, increased ICP, osteogenesis imperfecta or minimal cardiac reserves. Kidneys Ureters Bladder Urethra Function of Kidneys (two) Management is directed towards: Detection. Treatment of the cause. Prevention of complications. Fluids are given. Antiemetic drugs may be given: Zofran. Reglan. Phenergan. Senescence the last stage in the life cycle causes a gradual degeneration of body processes rate is slowed by diet, exercise, stress reduction and health promotion Based on Clinical Manifestations: Unexplained fever. Anorexia, malaise and weight loss. Splinter hemorrhages under nails. Petechiae. CHF. Cardiac dysrhythmias. New murmur. EKG can visualize.

_________ is the most common hematologic disorder of infancy and childhood For which patients is chest PT contraindicated?

Components of the Urinary System Vomiting Therapeutic Management

The Older Adult (Late Adulthood)

Bacterial Endocarditis Diagnostic Evaluation?

Triage categories: Wilms Tumor

Immediate. Delayed. Minimal. Expectant. Bioterrorism An embryonic adenosarcoma. Common Associated with certain congenital anomalies particularly of the genitourinary tract. Two-thirds of growths are discovered before 3 years of age. Few or no symptoms during the early stages of growth Absence of ganglionic innervation of bowel. Lack of normal peristalsis. More common in boys. Familial tendency. A partial-thickness burn involves the epidermis and varying degrees of the dermis; they are painful. A fullthickness burn involves the entire epidermis and dermis and extends into subcutaneous tissue; since the nerve endings are burnt, often not painful. Provide oxygen as ordered. Prevent infections. Observe for signs of infections. Known as Cooley anemia which results in severe anemia that can lead to cardiac failure and death in early childhood without treatment. Skin or mucous membranes. Assessing for resulting edema and respiratory distress is a PRIORITY. The response, therapy, prognosis and disposition of the injured child are directly related to the amount of tissue destroyed. Local destructive therapy depending on location, type and number. Surgical removal. Electrocautery. Curettage. Cryotherapy. Most will disappear spontaneously. Infection of the valves and inner lining of the heart. Constriction or narrowing of aortic arch, or descending aorta. I&Os Daily weight. Implement seizure precautions. Instruct the child and parents on fluid restrictions. What is the different between DI and SIADH? Keep infant NPO. Notify the provider immediately if you suspect EA/TEF.

Hirschsprungs Disease

What is the difference between a partial-thickness and full thickness burn?

What brusing interventions can help prevent complications?

Thalassemia major

Burns

Verruca Management

Bacterial Endocarditis? Coarctation of the Aorta (COA) Syndrome of Inappropriate Antidiuretic Hormone Secretion Nursing Considerations

EA & TEF Nursing Considerations

Place a NG tube to low intermittent suction. Postoperative care: Leave Gtube open to air. Attempt oral feedings after order is written, using sterile water first. Aplastic Anemia Nursing Considerations Similar to the care of a child with leukemia: Prepare the family and child for procedures. Prevent complications from the severe pancytopenia. Emotional support. PUD Ulcers are described as? Gastric: Involve the mucosa of the stomach. Duodenal: Involve the pylorus or duodenum. Primary: Absence of predisposing factors and common in children over 6 years. Secondary: unknown cause What is the most important thing to remember when preparing to administer DDAVP must be thoroughly DDAVP? suspended in the oil that it is mixed with prior to administering it. Hypothyroidism Pyloric Stenosis Manifestations Symptoms at 2-3 weeks of age. Projectile vomiting. Constant hunger. Dehydration. Olive-shaped mass in RUQ. Seborrheic Dermatitis Nursing Care Teach parents how to shampoo football hold. Mild medications containing sulfur, salicylic acid, or hydrocortisone often prescribed. Managed best with the topical antifungal agent effective against Pityrosporan. Acute Renal Failure When kidneys suddenly are unable to regulate the volume and composition of urine appropriately. Principle features: Oliguria with azotemia, metabolic acidosis and diverse electrolyte imbalances. Chickenpox Primarily secretions of the respiratory tract of infected persons; to lesser degree skin lesions. Leukemia Diagnosis History & symptoms. Blood tests. Bone marrow aspiration. Spinal tap. Kidney & liver function tests. Bone Marrow Aspiration Nursing Care Approaching the child about Abuse Approach quietly and explain all treatments carefully. Allow child to express feelings through play. Keep direct questioning to a minimum and praise. Avoid speaking about the parents negatively in front of the child.

Chronic Renal Failure Diagnostic Laboratory tests

Children are at an increased risk for________when suffering from severe burns. ROTATEQ v Rotarix

Are used to detect biochemical disturbances and other tools help to establish the nature of the underlying disease and differentiate between other disease processes. Hypothermia. Human Bovine Reassortant Rotavirus Vaccine(2,4,6 months of age). Live Human Rotavirus Vaccine 2 doses Absent from school. Begs or steals. Substance abuse. Vandalism. Sexual misconduct. Hepatosplenomegaly. Oral candidiasis (thrush). Lymphadenopathy. No response to treatment of infections. Herpes viruses and cytomegalovirus. Child has "slapped check" appearance. Generalized rash appears, and then subsides. Rash may reappear if skin is irritated by sun or heat. Incubation Period: 4-14 days. Contagious Period: during incubation period. Heart defect or open pathway that produces SS indicating anatomical heart defect Intrauterine rubella exposure Diabetes mellitus maternal age Maternal drug ingestion. Exposure to environmental toxins and infections. Sibling/parent has Hx of CHD At least 5 Sustained fever Bilateral conjunctivitis. Fissured lips Strawberry tongue Inflammation of the mouth and pharyngeal airways Peripheral edema Erythema and desquamation of palms and soles. Polymorphous rash Enlarged lymph nodes Emotional abuse refers to the deliberate attempt to destroy or significantly impair a childs selfesteem or competence. adjust to heat and cold changes Dry, thin and flaky Wrinkling due to decreased skin elasticity Susceptible to irritation Liver spots appear on arms, hands or face Easily bruised due to capillary fragility Poor healing

Neglect Childs Behavior:

Pediatric AIDS Manifestations

Signs & Symptoms of Fifth Disease

Congenital Heart Disease Pathophysiology

Kawasaki Disease Clinical Manifestations?

Emotional Abuse

Changes Associated with Aging Skin

Rheumatic Fever Treatment Goals

Tinea Capitis Treatment & Nursing Care

Nutrition & Dietary Modifications

HSV Signs and symptoms:

Dehydration Nursing Care

Children less than __ years have a significantly high mortality rate. Acne Vulgaris lesions are most often located?

Eradicate Group A beta hemolytic streptococcal infection. Penicillin (PCN) is the drug of choice. Erythromycin (if allergic to PCN). Prevent permanent cardiac damage. Treat other symptoms: salicylates to control inflammation, fever and pain. Oral administration of Griseofulvin (Fulvicin, Grisactin). Exposure to sun is avoided. Treatment may be necessary for 8-12 weeks. Emphasize good health and hygiene. The infected child should not share grooming aids, or headgear. Children may go to sc Dietary insufficiencies may be caused by Loss of or changes in teeth Eating alone Fatigue Lack of money Diet nutrients calories Soft, ground, pureed and easy to digest foods if chewing or swallowing is impaired supplemental vitamins & minerals Grouped, burning and itching vesicles As healing. Progresses, vesicles dry and crust. May be accompanied by lymphadenopathy. Observe for signs and symptoms. Accurate measurement of intake and output. Observe: Urine color, frequency and volume. Stool volume and frequency. Vomit for volume, frequency and type. Sweating. 2 On the chin, cheeks, and forehead. Also develop on chest, shoulders, and upper back. Stop the burning process. Smother flames. Place injured child in horizontal position and roll in a blanket, rug or similar article without covering the head or face. Do not cool major burns Do not use wet dressings. Remove all clothing and jewelry. Periumbilical pain with Vomiting mucus diarrhea McBurneys point Guarding Rebound tenderness Pain on lifting the thigh while supine Elevated WBC Ultrasound/CT scans.

Burns Therapeutic Management

Appendicitis Manifestations

Rheumatic Fever

Intradermal, Subcutaneous, and Intramuscular Medications

What should the nurse consider regarding home care?

Pediculosis Capitis Pathophysiology

Celiac Disease Pathophysiology

Guidelines for IM, SQ, ID Medications Intradermal

Hematopoiesis in _____________ Common signs and symptoms of Hemophilia?

An inflammatory disease that occurs after infection with group A beta hemolytic streptococcal pharyngitis. It involves the joints, skin, brain, serous surfaces, and heart. Injections are a source of pain and fear for children. Recommended to give injections when other routes cannot be used. Ensure the parents and child is properly educated on dressing changes, expected results and side effects. Be aware that some children may experience alterations in selfesteem. Pediculus capitus of the scalp and hair. More common in females seen in school-age and day care age children. Transmitted from one person to another or by contact with personal items. Observation of the eggs attached to base of hair shafts. Leading malabsorption disorder in children. Inherited disposition. Symptoms at 1 year to 5 years of age. Site: ventral forearm. Amount of volume administered: < 0.5mL. Needle Size: 3/8 to 1/2 inch needle. Needle Gauge: 25 - 27. Adolescence.

Prolonged bleeding. Hemorrhage. Subcutaneous and intramuscular hemorrhages. Hemarthrosis. Hematomas. Spontaneous hematuria. Which of the following foods should the nurse recommend as a good source Potassium supplementation is required of potassium for a child receiving diuretics? with the use of some diuretics. Bananas, citrus fruits, bran, legumes, and peanut butter are some of the foods that are significant sources of potassium. Impetigo Treatment & Nursing Care Systemic antibiotics. Strict hand washing. Wash lesions 3-4 times daily. Bactroban ointment. Prevention. Compliance with treatment. Infant in newborn nursery isolated. Nephritis is complication of beta-hemolytic strep. What are the three forms of neglect? Physical neglect. Emotional neglect. Emotional abuse.

COA Pathophysiology Thyroid storm may occur

Increased pressure proximal to defect. Decreased pressure distal to defect.

From a sudden release of hormones Life threatening. Treat with additional antithyroid meds. Administer beta-adrenergic blocking agents. What is the most important thing to remember when accessing the graft of a You must maintain strict asepsis. child with CRF who is undergoing dialysis? Coarctation of the Aorta Complications Intussusception Treatment Stroke hypertension ruptured aorta aortic aneurysm and stroke. Medical emergency. Barium enema. Surgery if barium enema unsuccessful. Heart Failure. Digoxin toxicity. Vomiting. Bradycardia. Dysrhythmias. Increased respiratory effort. Hypoxemia. Cerebral thrombosis. Cardiovascular collapse. Do not eliminate insulin, but may need to adjust dosage depending on the severity of illness and appetite. Hyperglycemia contributes to dehydration. Management of DKA: Rapid assessment. Adequate insulin. Fluids. Electrolyte replacement. Document the description of the skin lesions and wounds. Note: Color. Shape. Distribution of lesions and wounds. When palpating the skin what should the nurse note? Clinical Manifestations: Anemia. Leukopenia. Decreased platelet count. Bone marrow aspiration. Maintain a high level of suspicion. Document factually and objectively. Review records to discover patterns. Be suspicious of delays in seeking medical care. Be suspicious of children who are upset about being discharged. If both eye ointment and drops are ordered, give drops first. Wait 3 minutes and apply ointment. This allows for both medications to work as prescribed. Wood's light.

Teach family to recognize signs of what complications?

Diabetes Mellitus Illness management

Skin Lesion Nursing Care Assess:

Aplastic Anemia Diagnostic Evaluation

Nursing Care for Sexual Abuse

Nursing Alert for Eye Drops

What is the ultraviolet light called used to diagnose Tinea Capitis?

Changes Associated with Aging Urinary System

Risk Factors

Nursing Considerations Adolescent:

Prevention of Chicken Pox

Systemic Hypertension Therapeutic Management?

Gastrointestinal System of a Child differs from an adult?

Beta-Thalassemia Pathophysiology

What is one nursing responsibility when caring for a child with anemia?

Hirschsprungs Disease Manifestations

bladder capacity by 50% frequency Incontinence abdominal pressure with coughing, sneezing, laughing, and lifting Inability to delay voiding Female ligaments & muscles stretched during pregnancy -unable to keep bladder suspended in bladder Children from large families. Younger children are at greater risk of death. Pre-term babies are at a greater risk of abuse. Temperament of parent and child. Often one child is singled out. Different children are at greater risk for Abuse Use more abstract rationale for medication. Include in decision making especially for long term medication administration. Vaccine is now routinely administered. Acyclovir (Zovirax) or immune globulin (VZIG) is given to immunosuppressed children who are exposed. Treating underlying causes. Nonpharmacologic interventions: Nutrition counseling. Weight reduction. Weight control. Exercise program. Counsel adolescents on effects of drug(cocaine), alcohol and tobacco use. Newborns resistance to infection incompletely developed. Infants stomach small & empties rapidly. Newborn produces little saliva. Infants have poor fat absorption and immature livers. Swallowing is reflex for 3 months Children have increased needs Partial or complete deficiency in the synthesis of hemoglobin. Compensatory increase in different chains. Increases the production of defective hemoglobin. Damages the RBC causing severe anemia. Prepare the child and family for lab tests, decrease tissue oxygen needs and prevent complications. Failure to pass meconium. Constipation. Ribbon-like stools. Abdominal distention. Anorexia. Vomiting. Failure to thrive. Shock. Enterocolitis.

Myth: Older adults are ill or disabled

Four Defects TOF

What is the surgical management of Coarctation of the Aorta?

An oxyhood is preferred with who and why?

Hypothyroidism Manifestations

Decreased urine output can be a sign of what? Sub acute bacterial endocarditis Repeated UTIs can result in?

Fact: Older adults have at least one chronic illness, but do not restrict their ability to manage their lives. 7 of 10 older adults report their health to be good or excellent Ventricular septal defect. Pulmonic stenosis. Overriding (dextrapositionto the right) aorta. Right ventricular hypertrophy. Thoracotomy with long segment stenosis. Secondary is percutaneous balloon angioplasty. Young infants whereas a nasal cannula or face tent may be used with older infants and children. Infant sluggish. Tongue enlarged. Skin dry. Hand & feet cold. Infant floppy. Hypotonic bowel causing constipation. Hair dry & brittle. Irreversible complications if untreated. Decreased cardiac output. Is an infection involving the valves and inner lining of the heart. Renal scarring, decreased renal function and can contribute to hypertension as an adult. A malignant disease of the blood forming organs of the body that results in an uncontrolled growth of immature white blood cells. Most common form of childhood cancer. More frequent in males between 2-6 years of age. Chromosomal abnormalities identified Observation Assist with diagnosis Poor weight gain or sudden increase in weight Poor feeding habits Frequent respiratory infections Unusual posturing Exercise intolerance Would rather sit than crawl or walk frequent rest after limited play periods Pyrethrin cream rinse kills both lice and nits Remove nits from the head with a fine-tooth comb dipped in a 1:1 solution of white vinegar and water followed by washing hair Position for ventilation Administer o2 IV access Cardiac monitor and pulse oximetry Assist in measures to

Leukemia

Congenital Heart Disease Nursing Care

Pediculosis Capitis Treatment

Congestive Heart Failure Nursing Considerations

What tests may show an enlarged appendix? Prevention of Polio

improve cardiac function Decrease cardiac demands Reduce respiratory distress Protect child from infections Maintain nutritional status Ultrasound or CT. Start complete series of polio vaccines in infancy. May require respirator care. Thick, adherent, oily, yellowish, crustlike scales on scalp and forehead. May involve the eyelids, external ear, and inguinal area. Lesions usually do not itch Skin beneath patches may be red. Seen in newborns, infants and at puberty. No family Hx Four.

Seborrheic Dermatitis Manifestation

How many defects are there in tetralogy of fallot? Hodgkins Disease Diagnosis

X-ray, body scan, lymphangiogram & node biopsy. Accurate Staging: I: Restricted. II: Two or more lymph nodes. III: Involves nodes on both sides of diaphragm. IV: Diffuse disease. What is the most important aspect of the assessment of the Congenital Heart Thorough and accurate Hx including Disease? prenatal! Cardiomyopathy __________ tissue may grow around ostomy site-it is not a sign of infection. The nurse explains to the anxious parents that the administration of an opioid analgesic to their 3-year-old is? abnormality in myocardium where cardiac contraction is impaired. Granulated Opioid analgesia does not have any greater respiratory depression than on an adult and the addiction risk is virtually nonexistent in children. It is an effective type of analgesia. Incubation Period: 15-50 days (average 25-30) Contagious Period: uncertain, virus may be shielded for 6 months in neonates. Avoid ingestion of fecal-contaminated water; swimming in contaminated water or shellfish from such water Allow parents to stay with child. First symptoms are red papules. Eventually become small vesicles or pustules surrounded by reddened area. When blisters break, surface is raw and weeping. May occur

Hepatitis A Prevention

How can the nurse support the parents of an anemic child? Impetigo Manifestations

anywhere; often in moist areas i.e. nose, mouth, neck, axilla and groin. Appendicitis Pathophysiology Inflammation of the appendix. Appendix may become gangrenous or rupture. Average age is 10 years. 1-3 weeks after strep infection. Periorbital edema upon awakening. Smoky brown or bloody urine. Decreased urine output, specific gravity w/albumin, RBCs and WBCs. Reduced serum complement. Hyperkalemia. Hypertension. During acute phase, monitor and support the childs core body temp: The environment should be maintained between 82-91 degrees F. Warm solutions, linens, occlusive dressings, heat shields, radiant warmer and warming blankets help. Overdose: Rapid pulse. Dyspnea. Irritability. Fever. Sweating. Weight loss. Inadequate: Fatigue. Sleepiness. Decreased appetite. Constipation.

Acute Glomerulonephritis Manifestations

Nursing Care Prevention of Complications

Hypothyroidism Medication

Warning Signs of Physical Abuse Aplastic Anemia Therapeutic Management

Bruises. Welts. Burns. Fractures. Bite marks. Accidents. Directed at restoring function of the marrow: Immunosuppression therapy. Replacement of bone marrow. Antilymphocyte globulin (ALG) or antithymocyte globulin (ATG). Hematopoietic stem cell transplantation. Urinalysis including culture and sensitivity. Renal/bladder ultrasonography. IV pyelogram. CT scan of kidneys. Complete assessment. Height and weight. Baseline vital signs with pulse oximetry. Assess pedal pulses. Prepare the child and family for procedure. Provide sedation medications as ordered. Child must be NPO. Make sure the child has IV access. Treat the underlying cause. Manage complications. Supportive therapy. Volume restoration. Foley to rule out urinary retention.

Genitourinary Tract Dysfunction includes an Assessment of kidney and urinary tract function and diagnoses of disease are based on several diagnostic tests including Nursing Considerations for the Cardiac Patient Pre-procedural Care:

Acute Renal Failure Therapeutic Management

Diabetes Mellitus

Lyme Disease Occurs in 3 stages

What type of enema solution should be administered to a child? Changes Associated with Aging Musculoskeletal System

Genetics: Type I is not inherited, but heredity has a role in its etiology. Type II has a strong correlation to heredity. Autoimmune mechanisms: An autoimmune process is involved with Type I. Stage 1: tick bite to development of erythema migrans at site. Stage 2: Most serious; systemic involvement of neurologic, cardiac and musculoskeletal systems Stage 3: Includes musculoskeletal pain that involves tendons, bursae, muscles and synovia Isotonic, like saline. Decreases in height, kyphosis, wide stance with standing and walking Hips and knees flexed Stiffness in weight bearing joints Limited in ROM, Clearly defined muscles due to loss of subcutaneous fat Flabby, thin muscles in arms and legs Parents are instructed to inspect the child's head regularly and children should be cautioned regularly against swapping caps, head scarves and combs. Protect self by wearing gloves and cap. Hepatomegaly & splenomegaly. Anemia despite transfusions. Lemonyellow skin. Petechiae & purpura. Ulcerations. Anorexia, N/V, weight loss Dyspnea Enlargement of kidneys & testicles Hematuria No longer able to maintain the normal chemical structure of body fluid child may be asymptomatic. Midway through, nephrons are destroyed and there are definite biochemical abnormalities. Endstage, kidneys are no longer able to maintain f/e balance. Thalassemia major known as Cooley anemia. 5 Anticoagulants.

Pediculosis Capitis Nursing Care

As Leukemia progresses:

Chronic Renal Failure Pathophysiology

Which form of Thalassemia is the most severe form with the potential to lead to death if untreated? Rehydration usually involves IV fluids containing ____% Saline Dysrhythmias are monitored and treated with

Hypopituitarism Nursing Care

Constipation

Acute Glomerulonephritis Pathophysiology

Describe the appearance of the urine from a child with acute glomerulonephritis? Immunization of Smallpox

Establishing the diagnosis and providing emotional support. Educate parents on treating the child according to their age and developmental levels. Educate parents on giving injections at bedtime. Provide assistance in setting realistic expectations. Constipation is an alteration in the frequency, consistency, or ease of passing stool. Obstipation is when there are long intervals between stools. Encopresis is constipation with fecal soiling. Constipation may be secondary to many organic disorders o Bright's disease. Allergic reaction to infection in the body. May appear after scarlet fever or skin infections, strep infections. Most common form in children; more in boys 3-7 years old. Glomerulus become inflamed/blocked May recover in 1014 days Smoky brown or bloody urine. Must remain alert to signs and symptoms of smallpox Education about need for immunizations. Nurse should check label for refrigeration needs. Educate parents and school about immunization schedules. Assess immunization status at every clinic visit. PREVENTION Home health nursing Educate parents/children Inform children what good touch is. Inform them, their body belongs to them. Secrets and surprises are not the same. Stay away from strangers. Remember that nice people can also be offenders. Initial observation (quick examination): Appearance. Respiratory effort. Skin color. Arterial Blood Gas (ABG). Fluoroscopy. Angiography. Cardiac catheterization. Non-invasive tests: Cardiac magnetic resonance imaging (MRI). Echocardiogram. Most occurs secondary to structural abnormalities or underlying pathologic processes. Most common

Nursing Interventions for Sexual Abuse

Bioterrorism

Congenital Heart Disease Diagnostic Tests

Etiology of Systemic Hypertension?

Side effects of Colestid include Acne Vulgaris Treatment & Nursing Care

cause is renal disease, followed by congenital, vascular and endocrine disorders. Constipation. Abdominal pain. GI bloating. Flatulence. Nausea. Antibacterial soaps & skin cleansers. Topical dermatologic agents. Vitamin A. Tetracyclines. Avoid oily makeup, moisturizers. Accutane for severe pustulocystic acne. Site: A large bore catheter that are inserted either percutaneously or by cut down and advanced into the superior or inferior vena cava. Umbilical line may be used in the neonate. Assess pedal pulses. Assess temperature and color of extremity. Vital signs per protocol. Observe dressing. Fluid intake. Hypoglycemia. If bleeding, apply direct continuous pressure 1 inch above the site. Bed rest for 4 to 6 hours. Clubbing of fingers and toes Cyanosis increases with age Feeding problems Growth retardation Frequent respiratory infections Dyspnea on exertion Polycythemia Paroxysmal hyper cyanotic episodes, or "tet" spells occur during the first 2 years of life Teach parents and caregivers to be aware of changes in heart rate, especially bradycardia. Instruct parents to take apical heart rate and notify physician if outside range. Review S & S of digoxin toxicity. Decrease CHF Increase cardiac output Explain the purpose OF occlusive dressing to patient and parents. Caution patient to avoid trauma to the area from scratching, rubbing, or exposure to extreme heat or cold temperatures Hydronephrosis is distention of the renal pelvis because of an obstruction. The pelvis of the kidney becomes enlarged and cysts form. This may eventually damage renal nephrons, resulting in deterioration of the kidneys.

Central Venous Line

Nursing Considerations for the Cardiac Patient Post-procedural Care:

Tetralogy of Fallot (TOF) Manifestations

Antiarrhythmics Nursing Implications Patient Teaching

EMLA Cont. Patient/Family Teaching

Obstructive Uropathy Pathophysiology

What are the three formed elements of blood? Hypothyroidism Nursing Care

Erythrocytes, leukocytes and thrombocytes. Teach pt. may experience Reversible hair loss. Insomnia. Aggressiveness. Schoolwork may decline during first few months of therapy. Instruct that this is temporary. A change in the LOC Rising or falling WBC Hypo or hyperthermia A loss of progression of wound healing Increasing fluid reqs Hypoactive or absent bowel sounds. A rising or falling blood glucose level. Tachycardia. Tachypnea Thrombocytopenia Observe for respiratory, cardiac, and CNS involvement. Identify contacts for treatment. Intravenous antibiotics and antitoxin. Isolate. Prevention: DPT vaccine to all infants. Tachycardia. Sweating. Decreased urine output. Fatigue, weakness and restlessness. Anorexia. Decreased peripheral pulses. Decreased blood pressure. Gallop rhythm. Cardiomegaly. Pulmonary Congestion Caused by: Infections. Tumors. Trauma of the CNS. Vertebral Tracheoshageal AnorectalRenal 1-3 weeks to reach therapeutic effect. Do not discontinue because the replacement for hypothyroidism is lifelong. Consult physician prior to giving other meds. Parents should be aware of side effects of medications. Biological stress is caused by physical, psychological and social changes Weakening of the defense mechanisms associated with the stress response due to aging eventually leads to death has a diminished blood supply occurs before 6 moths Graphic comparison of bladder pressure as a function of volume. As disease progresses: Decreased appetite. Less interest in normal activities. Increased or decrease urine

Signs and Symptoms of infection during the Acute Phase

Diphtheria Interventions

How does CHF Impair Myocardial Functioning

Syndrome of Inappropriate Antidiuretic Hormone VATER: Hypothyroidism Treatment

Aging Theories: Wear & Tear Response

A strangulated hernia Cystometrogram: Chronic Renal Failure Diagnostic Evaluation

______________regulates production. Systemic Hypertension IV Medication Administration

output. Pallor. Sallow, muddy appearance to skin. Headaches. Muscle cramps. Erythropoietin Consistent elevation of blood pressure. Check for compatibilities with IV solution and other IV medications. Flush well between administrations of incompatible drugs. IV medications are usually diluted. Constipation may result from organic causes. Often constipation is due to dietary practices. Microscopic functional unit of kidneys. Source: human parvovirus B19 (HPV). All shunt left to Right (no signs of cyanosis) Caused by infection with the poliovirus. Incubation Period: 7 14 days. Contagious Period: 1 week for throat secretions; 4 weeks for feces. A multidisciplinary team focuses on preventing infection, closing wounds and managing complications. Directed at adequate scalp and hair hygiene. Shampooing areas with a mild shampoo on a regular basis. Oil may be massaged into scalp to soften crusts, night prior to washing. Rinse scalp well. Use soft brush to remove particles. Occurs when there is a deficiency in the secretions of the thyroid gland. Patent ductus arteriosus. Diagnose extent of kidney disease. Narrow therapeutic range. Medication errors. Have second practitioner check dose and order. Monitor therapeutic drug levels. The infant or child is already critically ill with precipitating disorders. Significant lab measurements guide

Constipation during Infancy:

NephronFifth Disease Acyanotic Heart Defects ASD VSD PDA Polio

Nursing Care Management and Rehabilitation Phase

Seborrheic Dermatitis Treatment

Hypothyroidism Pathophysiology Which defect may be necessary to sustain life in neonates with a cyanotic heart defect? Renal biopsy Antiarrhythmics Nursing Implications Implementation High Alert

Acute Renal Failure Diagnostic Evaluation

therapy: BUN. Serum creatinine. pH. Sodium. Potassium. Calcium. Which position is recommended for a child with GER? POOP POOP POOP Chronic Renal Failure Therapeutic Management The upright prone position. (&*&*(^%^$^!#&^$*(*#~)_()#*(!# Protein is restricted while sodium and water and not initially limited. Growth hormone may counteract growth failure. Dental defects are common. Correct anemia. Treat infections with antimicrobials. Aggressive dialysis or kidney transplant. discharge from respiratory tract of infected person. airborne; contact with an infected person. Incubation Period: 2-10 weeks. Contagious Period: after treatment when cough subsides. Paralysis on one side of the body Lethargy. Failure to thrive. Vomiting Provide help in restraining child is uncooperative. Explain briefly what will be done. Expose injection site. Position child for injection. Have medication at room temperature. Fluid is restricted, yet there is little or no effect on urine formation. If test is positive, child is given Vasopressin (Pitressin). Medical terminology for chafing; dermatitis occurring in folds of skin. epidermis is thinner and blisters easily. 10-15, 35-45 Based upon the amount of weight the child has lost. If weight is unknown, based upon LOC Response to stimuli Decreased skin turgor capillary refill Increased heart rate Sunken eyes/ fontanel Newborn screening. Sickledex. Hemoglobin electrophoresis.

Whooping Cough Tuberculosis

Hemiplegia Early signs of an inborn error of metabolism in the newborn include? Guidelines for IM, SQ, ID Medications Administer medication

Diagnostic Evaluation DI

Intertrigo Skin of Younger Children: HGB and HCT Levels Dehydration Diagnostic Evaluation

Sickle Cell Disease Diagnostic Evaluation

_____ may vary from a small pin hole to complete absence of the septum. Scarlet Fever _______usually result in rapid, uneventful healing and recovery. Intussusception Manifestations

VSD Source: Group A beta-hemolytic streptococcus. Superficial Sudden, severe abdominal pain. Loud cry, straining efforts, kicks & draws legs in. Vomiting. Diminished flatus & BMs. Currant jelly stools. Febrile. Shock. Rigid abdomen.

What is sebum? Child Abuse Other related services

A fatty substance secreted from the sebaceous follicles. Financial assistance. Employment services. Transportation. Emotional support and long term follow-up. Curious about sexual differences and may masturbate. Guidance and preparation to minimize negative impact on growth and development. AGE The childs needs are basically the same as those of any hospitalized child. Do not become a substitute parent. The goal is to provide a role model for the parents in helping them to relate positively and constructively to their child. Impaired Myocardium Functioning. Pulmonary Congestion. Systemic Venous Congestion. Goals: Relieve discomfort. Promote healing. Prevent complications & recurrence. Isolate, bed rest. Provide abdominal support during coughing spell. Refeed child if he/she vomits. Observe for airway obstruction. Isotonic: Primary form in children. Shock is greatest threat. Hypotonic: Electrolyte deficit exceeds water deficit. Hypertonic: Proportionately larger loss of water in excess of electrolyte loss. Most dangerous.

Genitourinary Surgery 3-6 year olds:

Remember ___ when considering etiology of skin manifestations. Points to Remember concerning Child Abuse

Congestive Heart Failure Groups

Peptic Ulcer Disease Therapeutic Management

Whooping Cough Interventions

Types of Dehydration

Physical Care Immobility causes

Wounds

chest expansion hypostatic pneumonia Pressure ulcers muscle tone loss Interventions Promote active or passive exercises Provide with supplies Allow sufficient time for completion Structural or physiologic disruptions. Wounds can be classified as?

What is the nurse primarily responsible for when taking care of a child with The nurse is responsible for GU dysfunction? recognizing the signs and symptoms, obtaining the appropriate urine and blood specimens as ordered and maintaining strict I & O. Eye Drops (Optic) Position: supine or sitting with head extended. Instruct child to look up. Pull the lower lid down. Rest hand holding the dropper with the medication on the childs forehead to reduce risk of trauma to the eye. Diarrhea Diagnosis: Lab tests: CBC, Electrolytes, Creatinine and Blood urea nitrogen. Stool cultures. Staphylococcal Infection Treatment & Nursing Care Antibiotics. Ointments. Strict isolation. Respiratory assessments include Breath sounds. Work of breathing. Vital signs. Security of trach ties. Type and amount of secretions. Supportive. Supplemental oxygen. Bed rest. IV fluids. Treat underlying cause. In 2004 over 2. 9 million cases were referred for possible abuse. 50% from professionals. 1/2 ruled out. 1/3 ruled in. Chest Pain, Fever Cough Tachypnea Wheezing Hypoxia sequelae The nervous system and the endocrine system. Bone marrow aspirate; Kidney and liver function tests; Spinal tap; Blood tests; X-rays. Educate parents of high-risk children on: Need for prophylactic antibiotic therapy. Signs and symptoms of infection. Signs and symptoms of complications.

Therapeutic Management of Anemia

Incidence of Child Abuse

Acute chest syndrome is another complication, signs and symptoms include? Most significant __________ is rheumatic heart disease. What are the two major systems that control and monitor the functions of the body? Name three diagnostic tests associated with leukemia.

Nursing Considerations for Endocarditis?

Tinea Capitis Diagnostic Evaluation

Signs & Symptoms of Smallpox

Herpes Simplex Virus Treatment and Nursing Care

What is the surgery called to repair a hernia? What is the difference between obstipation and encopresis?

Clinical history and appearance. Observation with an ultraviolet light (Some stains glow green under a Wood's light). Microscopic examination of the affected hairs. Child appears toxic. Macules, papules, pustules, and scabs appear. Only one stage of the lesion at time is present on the body. Incubation Period: 7-17 days (average 12d). Contagious Period: highly contagious (CDC notification required). Topical therapy can shorten duration and reduce severity of symptoms. Oral antivirals will shorten duration and reduce severity. Acyclovir. Valacyclovir (Valtrex) is used mainly for type II. It reduces pain and stops viral shedding. Herniorrhaphy. Obstipation is when there are long periods between stools whereas encopresis is the lack of stools. a disorder where the blood does not clot normally and any injury can cause bleeding, pattern is demonstrated as X-linked recessive so it affects males almost exclusively, but is transmitted by symptom free females via a defective gene on the X chromosome. HIV attacks lymphocytes. Imbalance between the helper T cells that support the immune system, and the suppressor T cells that shut it down. Over time, the number of helper cells drops. Anticipatory guidance is the psychological preparation of a patient for a stressful event by explaining what will happen and the probable outcome. The nurse is active in detection, diagnosis, and therapy in many settings. BP measurement. Vaccine at 15 months. If exposed without vaccine, gamma globulin may be given after exposure. Vitamin A is recommended to reduce morbidity.

Hemophilia

Pediatric AIDS Pathophysiology

The nurse using anticipatory guidance to prepare a 5-year-old for an IM injection will say:

Systemic Hypertension Nursing Considerations?

Prevention of Measles

IV Administration Catheter occlusion

Decrease preload in CHF patients by: Hypoplastic Left Heart Syndrome (HLHS)

Fluid will not infuse or unable to flush. Frequent pump alarm. Flush line. Check line for kinks.. Look to see that there is fluid in the IV bag or buretrol. Slow IV rate. Remove air from tubing with syringe. Diuretics underdevelopment of the left side of the heart, resulting in an absent or nonfunctional ventricle and hypoplasia of the ascending aorta. Maintain proper body alignment. Positioning and splinting involved extremities. Active and passive physical therapy. Encouraging passive movement. fecal soiling Fifth disease. A small blind pouch near the ileocecal valve fails to disappear completely and may be connected to the umbilicus by a cord. A fistula may form. Susceptible to inflammation. More common in boys. The most common congenital malformation of the GI tract. Blue or Gray HbS Nutritional Support: Well-balanced, high-protein, high-calorie diet. Enteral formulas. TPN. Identify high-risks parents early: Use questionnaires. Observe the motherinfant bonding process. Look at the social, financial, and parental history. A lack of interest, indifference, or negative comments about the baby may be significant. Edema: characteristic symptom. Pale. Listless. Irritable. Poor appetite. Albumin & RBCs in urine. Decreased albumin in RBCs. FLUIDS- Compensate for water and sodium lost. Reestablish sodium balance. Restore circulating volume.

Nurses are responsible for preventing contractures how?

Encopresis What is the disease that causes a "slapped cheek" appearance? Meckels Diverticulum Pathophysiology

What color may infants with CHD appear? When the child inherits predominately_____, they have sickle cell anemia. Crohns Disease Therapeutic Management

Nursing Considerations for Sexual Abuse

Nephrotic Syndrome Manifestations

Burns Therapeutic Medical Management of Major Burns

Scabies Manifestations

3 categories of Burns? Depression and Suicide

Provide adequate perfusion. Correct acidosis. Improve renal function. CRYSTALLOID solutions are used initially. After 24 hrs. COLLOID solution Female mite burrows under the skin and lays eggs, leaves feces; makes a tunnel sometimes seen under the skin. Visible by microscopic examination. Lesion- thrives in moist body folds. Pruritus is intense, especially at night. Superficial. Partial-thickness. Fullthickness. Incidence is high Assess for alcohol consumption, anger, hopelessness, helplessness, anhedonia interest in friends/social activities, energy, suicidal thoughtsreport to supervisor . wafer, zinc oxide Dry, thin, gray & balding Nails: Thick, brittle & yellowed Teeth Gums recede and teeth loosen Fall out due to poor oral hygiene Jaw bones shrink Observe for signs and symptoms of dysfunction Obtain specimens Strict I &O Usually asymptomatic at birth, but signs of heart failure eventually manifest. Loud harsh systolic murmur with palpable thrill. Poor feeding. Cyanosis (late sign- due to reversal of shunt). Pulmonary congestion. Surveillance cultures and monitoring help determine when antibiotics are started. Some sedation and analgesia is required. Morphine or Versed with Fentanyl. Plasma. Formed Elements: Erythrocytes. Leukocytes. Thrombocytes. Thinning vaginal mucous infections Report any signs of infection to physician Good perineal care and use of disposable pads help keep the patient clean and comfortable

Skin can be protected with a _______ or a barrier substance such as____ _________ Changes Associated with Aging Hair:

Nursing Considerations

Ventricular Septal Defect (VSD) Manifestations

Burns Therapeutic Management Medications

Blood Components include?

Physical Care

Obstructive Uropathy Treatment and Nursing Care Age related stress

Wood's light: Guidelines for IM, SQ, ID Medications Deltoid

Toddler unable to attain toilet training. School-aged child may have distorted body image. Adolescent may have lower self-esteem and concern about sexuality. nits will fluoresce white. More rapid absorption than gluteal regions. Older children: site selection as with an adult patient. Amount of volume administered: 0.5 to 1 mL. Needle Size: to 1 inch needle. Blood pressure in arms will be 20 mmHg higher than in legs. Bounding pulses in upper extremities. Signs of heart failure. Leg cramping on exertion in older children. Epistaxis. CHF Early recognition & diagnosis are essential. Screening test at birth. Synthetic hormone administration. Monitor hormone levels. Take meds at same time. Teach parents not to interchange brands. Papule. Via incubator. When low levels are needed. Oxyhood. Can supply the highest concentration. Nasal cannula. Can supply about 50%. Mask. Not well tolerated by children. Erythema migrans which appears as annular red rings.

Coarctation of the Aorta (COA) Manifestations

______most frequently occurs secondary to structural abnormalities that result in increased blood pressure within the heart. Hypothyroidism Treatment & Nursing Care

A circular reddened area on the skin that is elevated describes what type of rash? Can deliver oxygen in different ways

What is the characteristic rash that is noted on children with lyme disease? Signs and Symptoms UTIs Older Children:

Urinary frequency Pain during micturition Onset of bedwetting Abdominal pain Hematuria Vomiting Signs and Symptoms with renal involvement: Fever Chills Flank pain Many children asymptomatic. Meds to control Crohns inflammation include: Corticosteroids. Sulfasalazine. Antibiotics to treat complications and fight bacteria. The psychosocial needs of the child with a severe burn and family should be Child will be frightened, attended to how? uncomfortable and confused. Family may experience different degrees of guilt. Consistent information is essential. Staff must show a caring, compassionate attitude.

Scabies Treatment & Nursing Care

You expect a newborn has EA/TEF. What is the first thing you should do?

Munchausen by Proxy Warning Signs

Nursing Care Approaching the Parents

Hirschsprungs Disease Treatment & Nursing Care Therapeutic Management of Iron Deficiency Anemia

Scabicide. Treat all who had contact with child. Wear gloves. Instruct family. Treat bedding and clothing. The first thing you should do is stop oral feedings, then notifies the provider immediately. Unexplained, prolonged, recurrent or extremely rare illness. Discrepancies between clinical findings and history. Illness unresponsive to treatments. Signs and symptoms occurring only in the parents presence. Parents experience loss and mourn when children are placed in foster homes. This is a time of crisisremain open to the parents. Maintain a non-judgmental attitude at all times. Dont assume that you know who did it. Surgically corrected. Temporary colostomy. Avoid tap water enemas. Diet counseling and iron supplements. Supplement with iron-fortified infant formula and cereal. Transfuse if severely anemic. Headache, fever. Stiff neck and stiff back. Paralysis. efficiency of urination. Isolate newborn from infected mother. Identify contacts. Isolate using a special mask. Prevention: early detection by tuberculin skin test (PPD). INH Rifampin PZA IM every day two months Symptoms before 2 years. Painless bright red or dark red bleeding. Abdominal pain. Barium enema for diagnosis. Offer choices: offer syringe or medicine cup. Praise / reward / stickers. School-Age: Concrete explanations. Give choices. Interact with child whenever possible. Medical play. Instruct patient or parent in proper application. Provide a diagram of location for application. Educate family and child: Disease. When to seek intervention. Give meds as ordered. Recognize signs

Signs & Symptoms of Polio Uroflowmetry: Tuberculosis Interventions

Meckels Diverticulum Manifestations

Nursing Considerations Preschool

Home Care Issues for EMLA

Sickle Cell Disease Nursing Care

and symptoms of impending crises. Treat the child normally. PUD Medications Antacids. H2 receptor antagonists: Cimetidine (Tagamet). Rantidine (Zantac). Famotidine (Pepcid). Proton pump inhibitors: omeprazole (Prilosec, Prilosec OTC). lansoprazole (Prevacid). Begins with mild fever. Macules, papules, vesicles, and pustules. Scabs form later. Incubation Period: 2-3 weeks. (Test Question) Contagious Period: probably 1 day prior to eruption of lesions to 6 days after crusts form on vesicles. Chemical cautery Cryosurgery Ultraviolet therapy Laser therapy Acne therapy Dermabrasion Chemical peels Antibiotics Antifungal agents Staphylococcus Aureus. Flat non palpable round lesion Late Stage hypoxia Marrow of long bones. Called Graves Disease. Associated with an enlarged thyroid gland and exophthalmos. Wear light clothing Tuck pant legs into socks and wear long-sleeved shirts tucked in Avoid grass and shrubbery where ticks live. Insect repellents with DEET are pest, but should be used cautiously and not on face, hands or any areas of irritated skin Is common and is usually selflimiting. Complications occur when it leads to dehydration and electrolyte disturbances, malnutrition, aspiration and Mallory-Weiss syndrome. Dietary modifications: Increase the amount of carbohydrates in infants formula will often relieve the problem. Increase amounts of fiber and fluids. Differentiate between acute and chronic constipation.

Signs & Symptoms of Chicken Pox

Other topical therapies

What is the organism responsible for causing scalded skin syndrome? Macule Clubbing of fingers normally indicates what? Formation of Blood starts in the _____________ Hyperthyroidism

Lyme Disease Nursing Considerations

Vomiting

Constipation Nursing Care

What might a PDA lead to if left untreated? Hyperthyroidism Diagnosis Development of Manifestations

Right sided cardiac heart failure. Acute onset of thyroid storm: Severe irritability and restlessness. Vomiting and diarrhea. Hyperthermia. Hypertension and severe tachycardia. Diagnosis is based on increased levels of T4, T3 with suppressed TSH. The tissues of the gastrointestinal tract fail to separate properly from the respiratory tract in utero. May occur in combination or separate. Fatal without early diagnosis and treatment. duct tied off (ligated) or divided. opening near center of septum. Not on the Eye the surface is darkened by melanin. The best environment depending on the wound. Moist environment is preferred over dry because of recent research. Incubation Period: 4-6 weeks. Contagious Period: unknown; spread by direct contact only. Low grade fever. Malaise. Jaundice. Enlarged spleen. respiratory tract secretions, blood, and urine of infected person. Monitor apical pulse for 1 full minute Withhold < 70 bpm (child). Withhold < 90 bpm (infant). Notify physician of changes in rate, rhythm, and quality of pulse. Heart rates varies in children depending on age Special problems may occur including: Respiratory complications. Provide a pacifier for non-nutritive sucking to prevent oral aversions. Support the parents. Common cold with purulent nasal discharge. Malaise, sore throat. White or gray membrane forms in the throat, causing respiratory distress.

Esophageal Atresia (EA) and Tracheoesophageal Fistula (TEF)

Left thoracotomy is? Ostium secundum (ASD 2): When teaching a mother how to administer eye drops, where should the nurse tell her to place them? Open comedones (blackheads) Factors that influence wound healing

Signs & Symptoms of Mono

Measles Antiarrhythmics: Digitalis Glycosides Nursing Implications

EA & TEF Nursing Interventions

Signs & Symptoms Diphtheria

Incubation Period: 2-5 days. Contagious Period: usually 2 weeks. Blalock Taussig Shunt operation which provides blood flow to the pulmonary arteries from the left or right subclavian artery via a tube graft. Sometimes avoided because of pulmonary artery distortion. 21% of the population will be over 65 decreases Erythema Lesions Pustule Scab Pathognomonic Right-sided failure. Left-sided failure. Signs and symptoms are not indicative of which category of defect the child has. Goal of treatment: Assess imbalance. Oral rehydration. Avoid fruit juices or caffeinated soft drinks Maintenance fluid therapy. (5% dextrose in water.) Reintroduction of an adequate diet Once under control, investigate and treat cause of diarrhea. Difficulty swallowing Hypoglycemia signs and symptoms Most commonly in response to increased activity without increased food Children should carry a source of glucose Nutrition Exercise Glucagon for hypoglycemia. Is a chronic inflammation that involves all layers of the bowel wall. apply thick coat of petroleum jelly (Vaseline) followed by manual removal of remaining nits. Type I: Cold sores and fever blisters on mouth or face. Type II: Genital blisters. Cover so that there is a thick layer underneath the occlusive dressing. Dont spread out or rub in the cream. Smooth the dressing edges carefully and ensure it is secure to avoid leakage.

2030: Severe anemia _____________ peripheral resistance. A term used to describe a lesion or symptom that is characteristic of a specific illness. Two Categories of CHF

Diarrhea Therapeutic Management

Dysphagia Diabetes Mellitus Therapeutic Management

Crohn's Disease Manifestations

Pediculosis Capitis Treatment For eyebrow and eyelash involvement

Herpes Simplex Virus Two types

EMLA Implementation

Nursing Care for Verruca

Atrial Septal Defect (ASD) Treatment

Aplastic Anemia

Idiopathic Thrombocytopenic Purpura (ITP) Diagnostic Evaluation

Sickle Cell Anemias main Sign is? Diagnosis of CHF Pt. Teaching of Elderly

Caution parents not to try to remove wart. Apply topical anesthetic at least 30 45 mins prior to removal. dacron patch closure of moderate to large defects Median sternotomy with cardiopulmonary bypass is usually performed before school age. ASD 2 may also be closed using devices during cardiac catheterization. At some centers, still in clinical trials. a bone marrow failure condition in which the formed elements of blood are simultaneously depressed. Based on manifestations: Easy bruising, petechiae, ecchymosis. Bleeding from mucous membranes, epistaxis, bleeding gums and internal hemorrhage. Hematomas over lower extremities. Test to rule out other disorders. PAIN!! Based on symptoms. Chest x-ray. EKG time to process new ideas Use slow distinct speech Allow time for ?s Visual aides--clear and large Use pt.s knowledge & past experiences to facilitate learning new information Objectives of treatment are: Eliminate current infection. Identify contributing factors to reduce risk of recurrence. Prevent systemic spread of the infection. Preserve renal function. Neglect is the failure of a parent or other person legally responsible for the childs welfare to provide for the childs basic needs. 3 forms: Physical neglect. Emotional neglect. Emotional abuse. prophylactic antibiotics to prevent bacterial endocarditis. Extravasation of drug into surrounding tissue. Immediate reaction to drug. Increased fluid volume. Low sodium levels. Anorexia and nausea. Stomach cramps. Irritability and personality changes. Changes in level of consciousness. Seizures.

UTIs Treatment

Child Neglect

VSD Medical Treatment Adverse effects of IV medication administration Syndrome of Inappropriate Antidiuretic Hormone Secretion Manifestations

Pyloric Stenosis Pathophysiology

Gender genetically determined at time of fertilization.

Nephrotic Syndrome Facts

Congestive Heart Failure Nursing Diagnoses

Systemic Hypertension Diagnostic Evaluation?

What are the two most common signs and symptoms of VSD? Nephrotic Syndrome Treatment Goals

Narrowing of the lower end of the stomach occurs related to hypertrophy of the circular muscles of the pylorus or by spasms of the sphincter. A congenital anomaly that is more common in boys and has a hereditary tendency. Y chromosome essential for development of testes and their hormones. More common in males. Most often in children 2-8 years old. Prognosis: good in steroid-responsive patients. Most pts. have periods of relapse until the disease resolves itself. Decreased cardiac output. Ineffective breathing pattern. Fluid volume excess. Activity intolerance. Risk for infection. Altered family processes. Infants and young children: Irritability. Head-banging or head-rubbing. May wake up screaming at night. Adolescents and older children: Frequent headaches. Dizziness. Changes in vision. Loud harsh Systolic murmur and failure to thrive by 6 months. Minimize edema: Administer medications designed to reduce proteinuria and consequently edema. Steroid therapy: prednisone for 1-2 months. Prevent infection: Examine site of punctures, wounds, pierced ears, body piercings Prompt antimicrobial therapy Source: oral secretions, spread by direct contact only. Lab tests. Stool studies. GI series. all of them can occasionally be ineffective because of resistance of organisms. Acute Phase - child is typically very irritable. Sub-acute phase- resolution of fever greatest risk for aneurysms. Convalescent phase- all signs have resolved but lab values have not returned to normal. 6-8 weeks. is the deliberate infliction of physical injury on a child.

Infectious Mononucleosis Crohn's Disease Diagnostic Evaluation Several antimicrobial drugs are available for treating UTI

Kawasaki Disease Phases

Physical Abuse

Diabetes Insipidus Manifestations

What is a complication of beta-hemolytic streptococcal infections? Tetralogy of Fallot (TOF) Obstructive Uropathy Treatment and Nursing Care Psychosocial Issues

Polyuria. Polydipsia. First sign: enuresis. Infants are irritability that is relieved with feedings of water. Nephritis. tetralogy means "four". Parents of newborn grieve loss of perfect child & concerned about future. Incorporate appropriate psychological interventions into daily care. Emotional support for parents. Teach parents to prevent infections. Maybe congenital or acquired. A reducible hernia can be put back into place by gentle pressure. incarcerated hernia cannot be reduced.

Hernia Pathophysiology

Crohns Surgical Management : Intestinal resections. Children with Intussusception may have bowel movements containing blood and mucus and no feces. What are these called? Define hemophilia EA & TEF Therapeutic Management Currant-jelly stools. A genetic disorder where blood does not clot normally. surgical emergency. Maintain airway and pouch must be decompressed. Upon suspicion, keep infant NPO, start an IV and place in position to prevent aspiration. Surgical correction consists of dividing the fistula and doing an end-to-end anastomosis. Symptomatic in the first week of life with cyanosis and CHF. Fatal in the first months of life without interventions. Treat disorder. Reduce itching. Decrease external stimuli. Apply external heat or cold. Primarily supportive. Restrict activity. Treat symptoms. Splenectomy if ITP has persisted for >1 yr. IV gamma globulin. Salicylate therapy. Warfarin (Coumadin) therapy. Median sternotomy with cardiopulmonary bypass. Pulmonary artery banding. Prophylactic antibiotics. Prognosis. Follow-up care.

Hypoplastic Left Heart Syndrome (HLHS) Manifestations:

Skin Lesions Therapeutic Management Topical Therapy

Idiopathic Thrombocytopenic Purpura (ITP) Cont. Therapeutic Management Kawasaki Disease Treatment?

Congenital Heart Disease Treatment

Peptic Ulcer Disease Signs and Symptoms

Prevention of Whooping Cough Urinary Tract Infections

Epigastric abdominal pain. Nocturnal pain. Oral regurgitation. Heart burn. Weight loss. Hematemesis. Melana. PUD Diagnostic Studies vaccine in infancy (DPT). Diphtheria Infection of the urinary tract may involve urethra, bladder, kidneys, pelvis, and ureters. Midstream urine if child toilet trained. Catheterization as needed. Not collected from diaper. Primary therapy: replacing missing clotting factor. Corticosteroids. NSAIDS with caution. Regular exercise is encouraged. Prophylactic infusions of factor VIII concentrate. Each gender has gonads and accessory organs. Gonads produce sex cells and hormones that affect reproductive organs and other body systems. Decrease in bp without appearance of excessive side effects. Decrease in S/S of CHF Decrease in development of overt CHF Reduction of risk of death or development of CHF following MI. Decrease in progression of diabetic nephropathy (captopril). Surgery. Well-tolerated & simple. Routine postoperative care. First

Urine culture on a child

Hemophilia Therapeutic Management

Reproductive System

Antihypertensives Evaluation

Hernia Treatment & Nursing Care Congenital Heart Disease is a principle cause of death during the ____year of life. Acute Renal Failure Manifestations

If any of the following signs of hyperkalemia are present, it is an emergency: Serum potassium > 7 mEq/L. Presence of ECG abnormalities: Prolonged QRS. Depressed ST segment. High peaked T waves. Bradycardia. Heart block. True or False: Child abuse refers to the clinical condition of a child who has TRUE. received physical abuse or neglect? Palliative pulmonary artery banding in symptomatic infants to equalize shunting until old enough for surgery. Educate the family on measures to control bleeding

What should the nurse teach the parents regarding hemophilia?

Gastroesophageal Reflux Therapeutic Management

Clinical manifestations of Inhalation Injury

Cardiomyopathy Therapeutic Management

Beta-Thalassemia

Congenital Heart Disease Nursing Care Obstructive Uropathy Treatment and Nursing Care:

depends on severity: No treatment if thriving. Small frequent feedings with thicker formula and positioning. Medications if persistent: H2 agonists. Proton pump inhibitors. Nissen fundoplication Nissen Fundoplication may not be present until 24 to 48 hours after inhaling the gasses Wheezing. Increased secretions. Hoarseness. Wet rales Treatment is directed towards correcting the underlying problem or managing the symptoms. Medications are given such as: Digoxin. Diuretics. Beta Blocker: propranolol (Inderal). CalciumChannel blocker: verapamil (Calan). Refers to inherited blood disorders characterized by deficiencies in the rate of production of specific globin chains in Hgb. Occurs most often in persons leaving near the Mediterranean sea. Give medications. Maintain nutrition. Prevent infection. Urinary diversion. Surgery may cause apprehension in parents. Physical care r/t urinary stoma: Hygiene problems. Skin problems. Difficulty with child care. swollen. Labia minora may protrude beyond labia majora. Newborns may be cyanotic Abnormal heart sounds may be observed. Restrict activity to decrease demand on the heart. Treat as you would treat a child with CHF. Prepare the patient and family for postoperative period. responsible for inflammatory process of acne. syringe or medication cup should be used to ensure accurate dosage measurement. Use of a household teaspoon or tablespoon may result in dosage error because they are inaccurate. Infant / child may cry and refuse to take the medication or spit it out.

Genitals of preterm female appear _____________ TGA Signs and Symptoms Cardiomyopathy Nursing Considerations

Closed comedones (whiteheads) Nursing Alert for PO

What infection is responsible for triggering rheumatic fever? Safety

Group A beta hemolytic streptococci. Provide safe environment Bed is in lowest position Night lights assist with orientation and help prevent falls Side rails up on one side Place call bells within reach Safety thyroxine (T4) and triiodothyronine (T3). lesions Rest and supportive treatment; isolation if required. Provide school tutoring to maintain grade level. Prevention of Mono (comedones) Limited activity Urine exam Sodium and fluid restriction; foods high in potassium are restricted during oliguria. Prevention of nosocomial infection. Maintain strict i&os. Monitor vs. Outpatient care requires follow-up blood and urine tests Anesthesia may be more profound with 90 min-2 hr application. Check the patients identification name band. this is an asymptomatic form. Oral route is preferred for administering medications to children whenever possible. GI tract provides a vast absorption area for meds. Caused by the spirochete that enters the skin and bloodstream through the saliva and feces of ticks, especially deer ticks. Ostium primum (ASD 1). Ostium secundum (ASD 2). Sinus venosus defect. Defective or absent vocal function NOT SAFE for infants and small children due to muscle is insufficiently developed. (Children under 5 years.) Amount of volume

The thyroid gland controls the rate of metabolism in the body by producing? Acute responses create edema, vesicles and vascular dilation which leads to Infectious Mononucleosis Interventions

Inflamed lesion ________is a plug of keratin, sebum and bacteria. Acute Glomerulonephritis Treatment and Nursing Care

EMLA should be applied? The nurse approaches a group of school-age patients to administer medication to Sam Hart. To identify the correct child, the nurse should do which of the following? Thalassemia minor Oral Medications

Lyme Disease

Three Types of Congenital Defects

Aphasia Guidelines for IM, SQ, ID Medications Dorsogluteal

1.5 to 2 mL. Needle Size: to 1 inch needle. Obstipation Iron Deficiency Anemia Long intervals between poops Most prevalent nutritional disorder. Children 12 to 36 months are at highest risk. Premature infants are at risk. Confusion. Weakness. Cardiac irregularities. Seizures. Be alert to changes in respiratory function Restlessness. Irritability. Increased work of breathing. Alterations in blood gas values. Principal lesions include comedones, papules, and nodulocystic growths Thermal injuries produce both a local and systemic effect. With a major burn > 30% TBSA, there is a systemic response. Anemia is the result of heat destruction of red blood cells, hemolysis and trapping of red blood cells in the damaged cells. Purulent Fluid dermatitis

Nursing Care during the Acute Phase the nurse should monitor for?

Acne Vulgaris Manifestations Burns Pathophysiology

Pustule More than half of the dermatologic problems in children are forms of _______

What type of solutions is used for fluid resuscitation of a burn patient during Crystalloids are used. the initial 24 hours? Nursing Care for Idiopathic Thrombocytopenic Purpura Supportive. Teach family to limit activity. Teach family not to use aspirin or NSAIDS. Observe post operatively for: Hypertension. Abdominal pain associated with nausea and vomiting. Leukocytosis. Gastrointestinal bleeding or obstruction. Administer medications per orders. No frequent bathing dries skin Daily partial baths & biweekly tub baths best Showers are preferred overall Stalls provide a safer in and out than tubs Provide more thorough rinsing of soap from skin Esophageal pH monitoring. An upper GI series. Diagnosis is best made during the early stages by recognizing the

Coarctation of the Aorta (COA) Nursing Care

Physical Care Bathing and Hygiene

GER Diagnostic Lyme Disease Diagnosis & Therapeutic Management

Diabetes Insipidus Therapeutic Management

Purpura Verruca can appear?

characteristic rash. Therapeutic Management: Children >8 years are treated with oral Doxycycline. Children < 8 years are treated with Amoxicillin. replacement of vasopressin using desmopressin acetate Can be given Po, nasal or injectable. suspended in oil Signs of Od: Water intoxication signs. Anorexia and nausea Stomach cramps Irritability and changes in personality Seizures Changes in LOC a discoloration caused by petechiae. Usually well circumscribed. Appear gray or brown. Papules are raised, firm with a roughened texture. use wheat bran or whole grain breads if fresh fruits and vegetables are too difficult 6-8 glasses of water Skin and Nail Care circulation injuries and infection have a prolonged healing time Post bathing cream or lotion for dry skin Toe nails trimmed Invasion of the GI tract Increased intestinal secretions Dehydration, Acid-base imbalance, Shock 5th leading cause of death in the US of children under 15 years old. AIDS transmission: Oral, anal or vaginal sex with someone infected. Sharing drug needles and syringes with an infected person. Blood transfusions contaminated with the virus. Dilated, hypertrophic and restrictive cardiomyopathy. worsening symptoms despite medical therapy. CV: bradycardia and dysrhythmias. GI: N, V, Anorexia. Call Poison Control or local emergency room for overdose. Control the inflammation. Obtain long-term remission. Promote normal growth and development. Normal lifestyle. Educate the newly diagnosed child and family. Child should wear a medic alert bracelet.

Nutrition & Dietary Modifications

Diarrhea Pathophysiology

Pediatric AIDS

Name the three categories of cardiomyopathy. Heart transplantation may be needed for children with Signs and Symptoms of OD DIG

Crohns Disease Therapeutic Management Goals

Diabetes Mellitus Nursing Considerations

Urodynamics IV Administration Type of Fluids:

determines the rate of urine flow by volume and pressure. Glucose. Electrolytes. Normal Saline or lactated ringers. Albumin / plasma / frozen plasma. A broad term that refers to the clinical condition in young children who have received serious physical abuse, neglect, or maltreatment. Generally from a parent or foster parent. Tell the child to drink juice or milk after distasteful medication. Older child can take medication from a syringe, pinch their nose, or drink through a straw to decrease the input of smell, which adds to the unpleasantness of oral medications. blood from left atrium flows across a patent foramen ovale into right atrium where it mixes with desaturated blood. Blood flows to right ventricle and into pulmonary artery. Descending aorta receives mixed blood from PDA to supply systemic circulation HbA and HbS this is manifested as Splenomegaly and moderate to severe anemia. High risk ineffective airway clearance related to poor cough effort associated with post anesthesia, postoperative immobility, pain: Turn, cough, and deep breathe. Frequent vital signs. Teach splinting. Teach i/s bladder spasms & pain Often due to chemical irritation. When medications are given by direct intravenous injection, or by bolus (directly into the line) it is important to give them at the prescribed rate. Always check the site for infiltrate before giving an IV medication. Dig and ACE inhibitors immediately all infants should receive vaccine, with boosters at preschool age. All children should be immunized prior

Battered Child Syndrome:

Nursing Tip for PO

HLHS Pathophysiology:

When the child inherits both_____ and _______, they are said to have the sickle cell trait. Thalassemia intermedia Wilms Tumor Nursing Considerations

IV Administration Phlebitis

Increase contractility and decrease afterload of CHF patients: Children are fitted with an appliance _________after surgery. German Measles Prevention

to starting school with MMR vaccine. Hepatitis A Diarrhea Etiology Most are spread by fecal-oral route through contaminated water or food and is spread from person to person. Rotavirus is the most common cause of serious gastroenteritis. baby boomers begin to reach age 65 Careful monitoring of the older adult taking antipsychotics, hypnotics, antihypertensives and cardiovascular drugs and narcotic analgesics is essential Antidepressants must be taken for 6-8 weeks before effects are seen; systemic venous return is directed to the lungs without a ventricular pump through surgical connections between the right atrium and the pulmonary artery. Boys, 2 - 8 years old. Family teaching should begin as soon as it is recognized that the child will go home with the trach. Teaching should be short. Use identical supplies that the child will go home using if possible. Teach infant and child CPR. Minimal. BUN, uric acid and creatinine. Hepatitis A vaccine is recommended for children traveling to endemic areas. Injection of gamma globulin gives temporary immunity when exposed. Vaccine is required for all children in some states. Education on disease & treatment. Caution against vigorous scrubbing. Understanding support. Include parents. E. Coli The major difficulty is in gaining children's cooperation. Explain that the medication is not painful. May

2011: Medication for Elderly Patients

Modified Fontan procedure?

Nephrosis is more common in which gender? Is more prevalent at what ages? Tracheostomy Care Teaching

Which triage category requires outpatient care only? Blood tests Hepatitis A Prevention:

Patient teaching for Acne?

UTIs 80% caused by __ ____. Optic, Otic, and Nasal Medications

Congenital Heart Disease Signs and Symptoms

Childs Appearance and Behavior of Child Abuse

Diagnostic Evaluation of the Cardiac Patient inlcudes?

ASD Manifestations:

Postural Drainage

Oral Medication Nursing Considerations Infant

Hodgkins Disease Treatment Senile Tracheostomy Care Suctioning

cause unpleasant sensations. Parental involvement can decrease level of anxiety in the child. Cyanosis. Pallor. Cardiomegaly. Pericardial rubs. Murmurs. Additional Heart Sounds (S3 or S4). Discrepancies between apical and radial pulses Tachypnea Congenital Heart Disease Clinical Manifestations Cont. Dyspnea. Grunting. Digital clubbing. often less obvious than other forms of maltreatment. Behavior is best indicator. Childs Behavior: Extremes: Unusually pleasant or disruptive. Adult behavior or overly young for age. Behind in age in physical, emotional, or intellectual development. ECG: most commonly used. Echocardiography: non-invasive and painless. Cardiac catheterization: most invasive. May be asymptomatic. Systolic murmur heard over left intercostal space. Pulmonary congestion. Indicated whenever excessive fluid or mucus is not being removed by normal activity and cough. Performed three to four times daily, before meals and when it follows other respiratory therapy. hold hands away from face. Place in small amount of apple sauce or cereal. Put in nipple without formula. DO NOT ADD MEDICATION TO FORMULA. Given by oral syringe or dropper. Have parent help. Stay in room while parent gives PO Radiation therapy. Chemotherapy: MOPP. ABVD. Splenectomy. State of physical and mental deterioration associated with Carry out as often as needed. Pressure should be no higher than 100mmHg. The catheter should be the diameter of the trach tube. Insert just beyond the end of the trach tube. Limit to no more than 15 seconds. Abrasions.

What is the most common epidermal wound in children?

Definitive Treatment of Therapeutic Management Burns Therapeutic Management

Growth Hormone replacement. Successful in 80 90%. Assess the victims condition when flames are out; start CPR Cover the burn with a clean cloth. Transport the child to a mtf Establish the largest bore IV catheter and administer 100% O2 Provide reassurance and psychological support to the family and child Source: blood or blood products contaminated with HBV; exchange of blood or anybody secretion; intimate physical contact; mother to infant. Signs & Symptoms of Hep B Mild fever and sore throat. Maculopapular rash. Enlarged glands at back of neck. Incubation Period: 23 weeks. Contagious Period: 7 days prior until rash fades, about 5 days after. spasmodic reactions the onset is gradual sometimes can occur in children who are not diagnosed with RF. an abnormal opening in the intraventricular septum; may vary from a small pinhole to complete absence of the septum. Congenital heart disease which are anatomic abnormalities present at birth. Acquired heart disease occurs after birth. Head hyper extended over pillow or bed to prevent strangling sensation caused by medication trickling into the throat. At birth, pressure in left atrium exceeds that in right atrium, causing blood to flow from left to right. Oxygenated blood is forced from left atrium (high pressure) to right atrium (low pressure) which recirculates through the lungs. Improve cardiac function. Remove accumulated fluid and sodium. Decrease cardiac demands. Improve tissue oxygenation. Improve Cardiac Function Mix with small amount of juice or fruit. Use simple terms to explain while they are getting medication. Be

Hepatitis B

Signs & Symptoms of German Measles

Chorea

Ventricular Septal Defect (VSD)

Cardiac disorders in children are divided into two major groups?

Nose Drops (Nasal)

ASD Pathophysiology:

Therapeutic Management Goals of CHF

Nursing Considerations Toddler

Skin Lesions Goal of Therapy What are common signs for hypoglycemia?

firm, dont offer too many choices. Use distraction: offer syringe or medicine cup. Parent may give Stickers/rewards Prevent further damage. Prevent complications. Manage discomfort. Irritability, difficulty speaking, shaky feeling, dizziness, sweating and tachycardia. blood flows from higher-pressure left ventricle (oxygenated blood) to lower pressure right ventricle (unoxygenated blood). Promote maximum renal function Maintain body f&e balance Treat systemic complications. Promote as active and normal a life as possible. Child can do whatever activities they can tolerate Provide sufficient calories for growth. Iron turns: Stools tarry. Vomiting and diarrhea can occur. Liquid iron may stain teeth: Give medication with a syringe, straw or dropper. Use Ztrack method to administer IM and do not massage site. 3/5 female (60%). 3/4 one parent (87%). 11% sexual abuse cases committed by male (parent, relative or other). the growth of organisms that causes urinary tract infection. Abdominal distention. Diarrhea. Electrolyte and metabolic deviations. Testes. Each state has its own laws. Any professional is obligated by law to report suspected abuse to CPS. Any person can report child abuse. Clinical manifestations of SCA vary greatly in severity and frequency. Sickle cell crisis is a period of exacerbation of symptoms and is painful and can be fatal. Zygote, 4 cell stage(2d), Morula(3d),early blastocyst(4d), implantation(6d)

VSD Pathophysiology:

Chronic Renal Failure Therapeutic Management Goals

What should the nurse teach the patient regarding the iron supplement?

Perpetrators Statistical Facts

Urine that is not excreted promptly can promote Monitor children on Enteral feedings for intolerance how?

Male gonads: Have difficulty coping with stress and controlling anger. Are socially isolated and have no available support systems. Have low self-esteem. Regulatory Agencies United States Childrens Bureau Child Protective Services UCMJ Regulatory Agencies Tissue Effects of Sickle Cell Anemia

Name the 4 stages between oocyte and implantation

Embryonic stage fetal stage 1951, Lady Euphame Macalyane

3rd week 9th week Burned at the stake on castle hill in Edinburgh, Scotland seeking relief from the pains of child birth ides of magnetizing a woman during child birth, to give birth while asleep. First OB anesthetic..Ether 19 jan 1847 Wrote a Book on OB Simpson's forceps and book on witch craft First physician anesthetist, chloroform, queen victoria 1st OB anesthetic in US Ether 1847 Ether 1842-wife's delivery 1900-1940's scopolamine-morphine Cyprane, Penthrane, N2O & O2 SAB/OB 1900 1902 Procaine 1908 1926 1884 1928 described pain pathways of uterine contraction

Dr. grupert Lyons, France April, 19, 1836 John Young Simpson Charles D Meigs James Young Simpson John Snow Nathan Keep Crawford Long Twilight sleep Duke Inhalers contain Dr. Oskar Kreis 1st C/S with SAB Einhorn 1905 1st Pudendal Block 1st Paracervical block Koller Eye Block Sinal Anes OB Cleland 1928

First reported labor epidural Lidocaine (year) % increase in body weight during pregnancy Uterus ?kg Amniotic fluid ?kg Fetus/Placenta ?kg Blood volume ?kg Interstitial fluid? kg New fat and protein? kg

1931 1943 17% or 12kg Uterus 1kgAmniotic fluid 1 kg Fetus4 kg Placenta 4 kg Blood volume 2 kg Interstitial fluid 2 kg New fat and protein 4kg Diaphragm elevation, reduced FRC, capillary engorge. of airways, progesterone induced tracheal and bronchial dilation, chest expands A/P and transverse diameters Decreases-airway resis, TPR,TC,ERV, RV, FRC IncreasesMV,AV,TV,RR,ILC,O2 consumption No change VC, CC APO2 ^10mmHg. APH no change. APCO2 decrease by 10mmHg ABG: chronic hypervent/resp alk lung volume during expiration at which airways begin to close in dependent zones of the lungs closing capacity will exceed FRC(dec. 20% supine), which means the mother is at risk for hypoxemia. terminal alveoli perfused but not ventilated(VQ mismatch) sensitizes resp center to CO2, Resp stimulant, reduces airway resistance due to relaxant effect on bronchial smooth muscle MV rises 19-50% by term RR ^9%TV ^28%O2 consumption ^40-60% Right, facilitates O2 unloading to fetus A smaller more fragile airway, smaller ETT careful suctioning more edematous and edema of the vocal cords decreased FRC, so decreased O2 storage,& decrease CO when supine decreased 25-40%

Pulmonary Anatomic changes

Pulmonary Physiologic changes

In pregnancy base line arterial PO2 increase/decrease by ?mmHg? Arterial PH? Arterial PCO2? Closing volume

In supine position what happens to a preg. womans closing volume

Progesterone's effect on the respiratory system

Ventilatory changes during pregnancy The oxy hb curve shifts R/L during a normal pregnancy Additional edema around the airways during pregnancy causes In Preeclampsia we can expect the airway Hypoxia and Hypercarbia are more pronounced ^O2 demand b/c? MAC inc. or dec?

hyperventilation w/ pain during labor inc/dec uterine BF Pain relief during labor does what to oxygenation and ventilation? RR during pregnancy c/t labor TV ml preg vs. labor MV L/M preg vs. labor PaCO2 preg vs. Labor PaO2 preg vs. Labor compare preg. abg to non preg Significance to the anesthetist

Uterine BF decreases 25% w/ hypocarbia normalizes oxygenation and decreases MV and O2 consumption preg.-15 Labor-22-70 preg-480-680 Labor-650-2000 preg.-7.5-10.5 labor-9-30 preg- 31mmHg Labor-15-20 preg-105mmHg Labor-100-108 preg. 7.44,30,107,20 non.7.44,40,100,24 smaller ETT, induction rate increased(MAC, FRC,&RR)decreased O2 reserve CONSTRICTION UMBILICAL & UTERINE ARTERIES. FETAL ACIDOSIS HYPOCAPNIA MATERNAL HEMOGLOBIN DISSOCIATION CURVE TO THE LEFT (metabolic alkalosis) left increased BV Increased CO(40-50%) due to ^ SV(30%) in 1st half of preg and ^SV and HR(15-20%) in 2nd half..SVR decreased ^prostacyclin(vasodilator)progesterone low resistance placental circulation blood viscosity BV increases 35-50% plasma volume increases 45% and RBC mass only 20%, viscosity is reduced True True false DBP dec.10-20mmHg, SBP dec. 0-15mmHg,MAP dec.15mmHg

Maternal hyperventilation Fetal effects

oxy hgb dis curve of the fetus is to the L or R of moms? CV system BV, CO,SVR changes in preg

Why is the SVR decreased?

Explain physiological anemia of pregnancy

T/F RBC and plasma volume continue to increase late into third trimester There is no change in CVP T/F in a normal pregnancy Blood pressure is increased 10-20% T/F

Average EBL at C/S EDG changes during pregnancy

500-1000 Left axis deviation, minor ST, T and Q wave changes and minor arrhythmias (reversible) premature ectopic atrial and ventricular depolarizations and sinus tachy changes in cardiac ion channel conduction, increase in heart size, changes in autonomic tone, hormonal fluxes SV decreases dramatically, CO decreases and HR increases IVC compression and aortoilliac obstruction after 24 weeks gest. alternative circulation azygous vein/paravertebral system**compensatory decrease in sympathetic tone and HR **arterial side compression NO maternal symptoms placental BF decreases Femoral flow vs. Brachial flow-BP normal in arm, low in femoral, causing early or late decells in baby plasma protein decreases so colloid osm. pressure decreases. Leukocyte count increases 12k-20k. All factors increase except XI and XIII. enhanced fibrinolysis Pulm edema, drug sensitivity, high risk of DVT and PE withhold all food during labor greater use of regionals antacidsempty stomach prior to GA competant administration of GA treat all preg pts. as full stomach from 8 weeks gest - 6 weeks postpartum.*gastric contents more acidic (pH.<2.5) and >25ml, more likely aspirated no particulate antacids use Bicitra defined risk as >25ml gastric volume and pH.<2.5 ^gastric acid production and pepsin secretion. dec. gastric emptying(w/opioids)incompetence of lower esoph sphincter tone. anatomic

most common dysrhythmias of pregnancy

mechanisms for ECG changes in pregnancy

What happens to SV, HR, CO when transitioning from supine in the first stage of labor to lithotomy in the second stage during contractions 2 components of aortocaval compression IVC compression

aortoilliac compression

Changes in blood constituents

Effects of Blood constituent changes Mendelsohns recommendations

Clinical implications for risk of aspiration

Roberts and Shirley recommendations

risk factors for aspiration in pregnancy

displacement opioid related aspiration risks Diminished gastric emptying Diminished LES tone Diminished protective airway reflexes Diminished response to hypoxemia/Hypercarbia Ranitidine (Zantac)Metoclopromide (Reglan)Oral sodium citrate, 0.3M Bicitra RSI with Cricoid Pressure Anatomical positioning Endotracheal intubations beyond 8-12 weeks and up to 6 weeks post-partum NO nasal intubations Gastric suctioning prior to emergence Awake extubations Decrease size of endotracheal tubes URETERS DILATE WK 12 - (a state of hydronephrosis may occur in 80% of women by mid-pregnancy)RBF & GFR INCREASE 50% (^renal blood flow)^Total protein & urinary albumin excretion ^ excretion of glucose^ bicarbonate excretion ^UTI, glycosuria, aldosterone ^total body water and Na levels, normal lab studies may indicate renal problems(bun/Cr should be lower) preeclampsia has proteinuria caused by glomerular damage. Oliguria is a consequence of arteriolar damage and spasm which may lead to acute tubular necrosis. MINOR INCREASES IN SGOT & LDHBLOOD FLOW UNCHANGEDPLASMA CHOLINESTERASE LEVELS INCREASESCOLLOID ONCOTIC PRESSURES decrease COAGULATION FACTORS INCREASE HYPERCOAGULABILITY HEPATIC PROTEIN INCREASE BUT DILUTED IN INCREASE PLASMA VPROL0NGATION OF Sux AND chloroprocaine progest Dec. Biliary motility ^chol.^risk GB disease NEURAL SENSITIVITY TO LOCAL ANESTHETICS INCREASES, RELATED TO PROGESTERONEENGORGEMEN T OF EPIDURAL VEINS,

Agents for aspiration prophylaxis

Airway Management in the Pregnant Patient

Renal system changes

Renal implications

Significance to the Anesthetists (renal)

HEPATIC SYSTEM

CLINICAL IMPLICATIONS HEPATIC SYSTEM

CENTRAL NERVOUS SYSTEM

Anesthetic Requirements implications of CNS in Pregnancy

Dose of LA and Mac changes CLINICAL IMPLICATIONS of reduced LA and MAC

DECREASES EPIDURAL & SUBARACHNOID SPACESMAC DECREASES 25 - 40% Swelling of epidural veins decreases volume of CSF in vertebral column. Labor induced increases in CSF pressures. Increased neurosensitivity to local anesthetics. LA dose dec. 20-30%MAC decreased 25-40% Progesterone and Beta-endorphins systems contribute to decreased anesthetic requirements increased risk for LA toxicity non preggers 50-100cc 70Gpreggers 700cc 1100G change in BP uterine vasc. resistance UAP-UVP/UVR inside myometrium outside uterus true hypogastric increases decreases blood flow in the pelvis is preferentially redistributed toward the uterus during a contraction Uterine Contractions Hypertonus Hypotension Hypertension Vasoconstriction, endogenous Vasoconstriction, exogenous most sympathomimetics(alpha-adrenergic) Exception ephedrine(beta)

increase in uterine BF UBF is directly proportional to UBF is inversely proportionate to UBF= Placenta increta Placenta excreta Uterine vasculature is not auto regulated T/F If they can't stop bleeding after birth what artery do they tie off? common iliac inc. or dec. BF to the uterus External iliac inc. or dec. BF to the uterus describe "steal phenomenon"

When is the best time to administer an opioid to mom and avoid baby getting doped up Factors Causing Decreased Uterine Blood Flow

Vasopressor of choice

ephedrine stimulates what receptors to get what outcome

Why would you choose not to use phenylephrine?

Regional anes effect on uterine BF At what dose might propofol start to have an effect on UBF What effect does Thiopental have on UBF What effect does 1.5-2 mg/kg of Ketamine have on UBF? inhalation agents effect on UBF hyperventilation effect on uterine BF Function of placenta

Ephedrine b/c it won't cause vaso constriction of uterine arteriesdue to release of NO Beta adrenergic for inc. CO as opposed to vasoconstriction although it has been found to decrease umbilical cord PH 7.3-7.4 causes uterine artery constriction & bradycardia, but it does leave umbilical cord PH higher than ephedrine causes a sympathectomy which dec. UBF 2mg/kg none up to 5mg/kg decreased UBF, use 1mg/kg none if kept at 1 MAC or lower..>than 1 MAC dec. UBF decreases Produces hormones to sustain pregnancy Protects fetus from the maternal immune system Allows for active & passive transport of nutrients & metabolites 500g disk shaped 20cm 3cm thick higher concentration, low ionization, higher lipid solubility, and lower MW. low protein binding. If it passes BBB it will pass placenta. carrier mediated lipid soluble molecules-more stereo specific temp regulated movement of any substance across a call membrane-a.a. proteins-sim to translocation-Na/K atpase pump transport immunoglobulins, larger macromolecules, inc. energy to get across low so it passes through placenta easily. Can cause ion trapping if distressed fetus

Size of placenta drug placental transfer. What will cross

Facilitated transport

Active transport

pinocytosis

lidocaine protein binding?

Marcaine protein binding? LA of choice for fetal distress ion trapping

High. Doesnt pass, but takes too long. chloroprocaine if the fetus is in metabolic acid. when the LA or opioid enters fetal circ it quickly becomes ionized in low PH and cannot cross back out. builds up>toxic Thiopental decrease temp regulation and hypotonia of baby No highly ionized quaternary ammonium salts Robinol does not cross. Atropine and Scop do. Yes limited. Ionized quats cross--no ACE inhibitors during pregnancy increase reduced by causing hypotension and increased by relieving pain, Dec symp activity and dec.hypervent. If delivery will be within 1 hour or 4 hours after administration. Also can accumulate and cause seizures

What induction agent should you use to treat a seizure in mom Why wouldn't you use Benzos NDMR cross placenta? anticholinergic of choice opioids cross placenta? Anticholinesterase crosses? antihypertensives/vasopressors Mag sulfate effect on UBF Regional anesthesia effect on UBF

Meperidine timing for adm during labor