Pediatric Nursing

Intracranial Pressure (ICP)

Normal range is 5-15 mmHg; ICP >15 mmHg is fatal and irreversible.

Cushing’s Triad

Components include Hypertension, Bradycardia, Bradypnea, and Widened pulse pressure (Normal:30-40 mmHg).

Early Signs of Increased ICP in Pediatrics

High-pitched cry and bulging fontanels, especially when crying.

Measuring Head Circumference in Pediatrics

Use a tape measure at the bedside every shift/q8 to monitor increases.

Avoiding Coughing and Sneezing

These actions can increase ICP in patients.

Phases of Grand Mal Seizure

Tonic phase (mild) and Clonic phase (severe).

Common Pediatric Seizure Type

Febrile Seizure, also known as "under five" seizure.

Most Dangerous Seizure Type

Status Epilepticus; can last 30 minutes or longer, risking brain damage.

Side Effect of Phenytoin

Gingival hyperplasia (enlargement of gums).

Last Resort Anticonvulsant

Valproates/Valproic Acid due to hepatotoxicity risk in pediatrics.

Patent Ductus Arteriosus (PDA)

Acyanotic cardiovascular condition.

Pathognomonic Sign of PDA

Machinery-like murmur.

Drug of Choice for PDA Closure

Indomethacin (Prostaglandin Inhibitor).

Secondary Drug for PDA

Ibuprofen if Indomethacin is ineffective.

Tetralogy of Fallot Defects

Pulmonary stenosis, Right ventricular hypertrophy, Overriding aorta, Ventricular septal defect.

Purpose of Squatting in Tetralogy of Fallot

Decreases venous return and cardiac workload, promoting cardiac rest.

Pathognomonic Sign of Tetralogy of Fallot

Tet spells, including irritability, blackouts, convulsions, pallor, and hypoxemia.

Surgical Palliative Management for Tetralogy of Fallot

Blalock Taussig Shunt.

Definitive Surgery for Tetralogy of Fallot

Brocks Procedure/Intracardiac Surgery with Balloon angioplasty and Dacron patch.

Key Signs of Kawasaki Disease

High spiking fever, Strawberry red tongue, Photophobia, Polymorphous rash, Palmar desquamation.

Pathognomonic Sign of Kawasaki Disease

Strawberry red tongue.

Primary Treatment for Kawasaki Disease

Immunoglobulins and Aspirin.

Gender More Affected by Cleft Lip

Males.

Surgical Procedure for Cleft Lip Repair

Cheiloplasty.

Rule of 10s in Cleft Lip Surgery

Patient must be 10 weeks old, weigh 10 lbs, WBC

Recommended Position After Cleft Palate Surgery

Prone position to prevent aspiration.

Erikson Stage for Infants (0-1 y/o)

Trust vs. Mistrust—Developing trust through consistent care.

Freud Stage for Infants

Oral stage—Focus on the mouth, high risk of aspiration.

Piaget Stage for Infants

Sensorimotor—Learning through senses.

Typical Play for Infants

Solitary play—Playing alone.

Common Fear in Infants

Stranger anxiety—Fear of unfamiliar people.

Erikson Stage for Toddlers (1-3 y/o)

Autonomy vs. Shame and Doubt—Encouraging independence.

Freud Stage for Toddlers

Anal stage—Focus on toilet training.

Piaget Stage for Toddlers

Pre-operational—Egocentric thinking.

Kohlberg Stage for Toddlers

Preconventional—Understanding punishment and obedience.

Typical Play for Toddlers

Parallel play—Playing side-by-side.

Common Fear in Toddlers

Separation anxiety—Fear of being away from parents.

Erikson Stage for Preschoolers (3-6 y/o)

Initiative vs. Guilt—Encouraging participation.

Freud Stage for Preschoolers

Phallic stage—Oedipal and Elektra complexes.

Piaget Stage for Preschoolers

Pre-operational—Egocentric thinking with symbol recognition.

Kohlberg Stage for Preschoolers

Preconventional—Focused on themselves.

Typical Play for Preschoolers

Associative/Cooperative play—Playing together.

Common Fear in Preschoolers

Fear of body mutilation or castration.

Erikson Stage for School-aged Children (6-12 y/o)

Industry vs. Inferiority