PEDS FINAL REVIEW

mucositis

WHAT: painful inflammation and ulceration of the mucous membranes lining the mouth, throat, and sometimes the GI tract

S/S: Redness, swelling, or ulcerations in the mouth, lips, or tongue, pain or burning sensation, difficulty eating, swallowing, or talking, increased drooling in younger children, and bleeding gums

INTERVENTIONS: promote good oral hygiene, pain control, maintain hydration and nutrition, and frequent oral care

hypoplastic left heart syndrome

WHAT: Severe congenital heart defect where the left side of the heart is underdeveloped.

The left side cannot pump oxygenated blood effectively to the body

S/S: cyanosis, tachypnea/tachycardia, oliguria, pallor, hypotension, and lethargy

INTERVENTIONS: IV prostaglandins for keeping the PDA open, IV fluids and I/O monitoring

potty training in children

-usually starts between 18-24 months

-key sign of readiness:: having a BM "behind door" (in private)

autism management

-Use simple, concrete language and short sentences

-Allow extra time for the child to process and respond

-Give one instruction at a time

-Provide a quiet, low-stimulation setting

-maintain consistency

-Cluster care to reduce repeated stress

neutropenic precautions

immunocompromised, strict hand washing, private room, no raw veggies/fruits, daily baths, visitors are restricted

congenital heart defects for children (most common)

1) ventricular septal defect (poor growth/HF)

2) atrial septal defect (often asymptomatic)

3) patent ductus arteriosus (murmurs/bounding pulse)

4) tetrology of fallot (cyanotic spells)

5) coarctation of aorta (BP higher in arms than legs)

scabies

contagious skin disease transmitted by the itch mite

-wash ALL bedding and have family members be treated as well (with permethrin)

RSV

respiratory syncytial virus

-causes nasal congestion, mild cough, and fever

-respiratory support, hydration, and contact/droplet precautions and antipyretics can be used

gallbladder disease

WHAT: cholelithiasis-gallstones

S/S: RUQ abdominal pain, jaundice, heart burn, food intolerance, and N/V

INTERVENTIONS: NPO diet, (once tolerated, low-fat diet), and surgery if needed

infants are obligate NOSE breathers until about ________ months

6

when does the babinski reflex integrate?

12 months

bladder capacity of children

age in years + 2 = oz

hemodialysis vs. peritoneal dialysis

Hemodialysis: is done in a clinic, uses graft or fistula, blood is filtered outside of the body by dialyzer, for more severe cases

Peritoneal: done at home, tube placed into abdomen as an access point, fluid is filled in the abdomen where waste will be pulled out into waste bag, more flexible

normal newborn HR

110-160 bpm

septic arthrtitis

WHAT: Infection of a joint space (commonly the hip or knee in children), usually caused by bacteria such as Staphylococcus aureus

S/S: fever, joint pain, limited ROM, and poor appetite

INTERVENTIONS: joint aspiration, IV ABX's, analgesics, and monitor vitals

never place any object under a cast. True or false?

true

(if itchy, use a blow dryer with cold air to help)

RICE

rest, ice, compression, elevation

tumor lysis syndrome

WHAT: A potentially life-threatening metabolic complication resulting from rapid destruction of malignant cells, releasing intracellular contents into the bloodstream

(can develop from chemotherapy for cancers with rapid cell turnover)

S/S: electrolyte imbalances (hyperkalemia, etc.), N/V, lethargy, seizures, acute renal failure

INTERVENTIONS: hydration therapy, cardiac monitoring, seizure precautions, allopurinol, and supportive care

muscular dystrophy

WHAT: A group of inherited disorders characterized by progressive muscle weakness and degeneration

S/S: Frequent falls, difficulty running or climbing stairs, muscle weakness, Gower’s sign: child uses hands to “walk” up their legs to stand, waddling gait

INTERVENTIONS: promote mobility, respiratory support, cardiac monitoring, and prevent aspiration/assess swallowing status

VSD

ventricular septal defect

S/S: Signs of heart failure: tachypnea, poor feeding, diaphoresis, poor weight gain, and fatigue

INTERVENTIONS: promote small/frequent meals, diuretics, monitor oxygen and respiratory status, and surgery if needed

acute pancreatitis

WHAT: inflammation of the pancreas

S/S: epigastric pain, fever, N/V, abdominal distention, and decreased bowel sounds

INTERVENTIONS: analgesics, NPO diet, and monitoring vitals

tetrology of fallot

WHAT: congenital heart defect with 4 components

1. VSD

2. Pulmonary Stenosis

3. Overriding Aorta

4. Ventricular Hypertrophy

S/S: cyanosis spells, clubbing, and murmurs

INTERVENTIONS: knee-chest position, administer oxygen/morphine, and surgery

coarctation of the aorta

WHAT: congenital cardiac condition characterized by a narrowing of the aorta

S/S: HTN in arms, weak/absent femoral pulses, heart murmur

INTERVENTIONS: monitor BP in all extremities, assess pulses regularly, and prepare for surgery

you should NOT pop baby acne. True or false?

true, do not pick or pop it

adolescent's biggest concern is their ___________

image/appearance

skin vs. skeletal traction

Skin = attached to boot/cast

Skeletal = attached to pins that are inserted into bone (for more stabilization for severe cases)

eardrops in infants/children

younger than 3 years old--> pinna down and back

older than 3--> up and back

myelmeningocele

both the spinal cord and meninges protrude

gross motor skills vs. fine motor skills

gross motor skills--> large movements such as running and jumping

fine motor skills--> develop after and are smaller movements such as pincer grasp and writing

Erik Erickson's stages of psychosocial development

Trust versus Mistrust (Infancy)

Autonomy versus Shame and Doubt (Toddler Years)

Initiative versus Guilt (Preschool Years)

Industry versus Inferiority (Elementary Years)

Identity versus Role Confusion (Adolescence)

Intimacy versus Isolation (Young Adulthood)

Generativity versus Stagnation (Middle Age)

Integrity versus Despair (Retirement Years)

patent ductus arteriosus

WHAT: passageway between the aorta and the pulmonary artery remains open after birth

S/S: continuous murmur, signs of HF, poor feeding

INTERVENTIONS: indomethacin, monitor respiratory and cardiac status, and surgical ligation needed if indomethacin fails

a VP shunt drains CSF from the ventricles to the ______________

peritoneal cavity

you must obtain ________ before administering ________ for sepsis treatment

blood cultures --> before antibiotics

keep a child's cast _______ and _________

dry and elevated

congenital heart defect screening:

-Pulse ox in right hand and EITHER foot (within 24 hours of birth)

-more than a 3% difference between hand and foot needs further evaluation

adults develop pressure injuries faster than children. true or false?

false (children can develop pressure injuries faster due to thinner skin and less fat)

newborn respiratory rate

30-60 breaths/min