peds exam one

If respiratory depression

________ occurs with opioid use, naloxone hydrochloride should be used for reversal when oxygen and stimulation of the child are ineffective.

newborn displays

The ________ a decreased inflammatory response to invading organisms, contributing to an increased risk for infection.

Blood Pressure

________ is usually the last vital sign to become abnormal.

Full consciousness

________ (LOC)- awake, alert, oriented, interacts with environment.

Cerebral blood flow

________- 10 times amount of oxygen used by the rest of the body.

Infants

________ and toddlers sleep- Rapid transition to sleeping 10- 12 hours at night with 1- 2 naps during the day.

infant

Since the ________ has had limited exposure to disease and is losing the passive immunity acquired from maternal antibodies, the risk of infection is higher.

APVU

________ scale- A method of assessing the level of consciousness by determining whether the patient is awake and alert, responsive to verbal stimuli or pain, or unresponsive; used principally early in the assessment process.

Infant Nutrition

________- Breastfeeding up to 6 months preferred.

RSV

________- respiratory syncytial virus- a common cause of bronchiolitis, bronchopneumonia, and the common cold, especially in children (in tissue culture, forms syncytia or giant cells, so that cytoplasm flows together)

Child stressors

________ from life threatening illness- anxiety /fear of dying.

Neutrophils

________- A type of white blood cell that engulfs invading microbes and contributes to the nonspecific defenses of the body against disease.

Toddler

________: can't tell death from separation.

sudden high fevers

Febrile seizures- Seizures that result from ________, particularly in children.

full alertness

Obtunded- Less than ________ (altered level of consciousness), typically as a result of a medical condition or trauma.

Acute

________ pain-- Sudden onset and continuing for a limited period; experienced during and after procedures, postoperatively, from fractures, and from other bodily insults or injuries.

Antimicrobial stewardship

________- A coordinated program that promotes the appropriate use of antibiotics, which improves patient outcomes and reduces microbial resistance.

Adolescent

________: understands death, but sense of invincibility can conflict.

Intracranial hemorrhage

________- bleeding from ruptured vessels.

Reality

________ of vaccine- preventable disease passing out of living memory- causes imbalance in judgment.

Concussion

________- violent shaking up or jarring of the brain.

Eosinophils

________- a white blood cell containing granules that are readily stained by eosin.

Intraventricular cath

________- Tube placed in lateral ventricle or subarachnoid space; allows both pressure monitoring and drainage of excess CSF.

Wong Baker FACES

________ scale- a scale with drawings or pictures that clinicians use to assess pain in the cognitively impaired client.

Physiologic anorexia

________ in toddler- this is common and occurs round 18 months due to decreased metabolic demands.

Toddler nutrition

________- High metabolic demands of infancy slow down.

Craniostenosis

________ (kray- nee- oh- steh- NOH- sis)- a malformation of the skull due to the premature closure of the cranial sutures.

Preschooler

________: death is temporary, magical thinking about causation.

Nutrition

________ for infant and toddlers- Infant will triple birth weight by 1 year of age.

Macronutrients

________- carbohydrates, proteins, and fats.

Meningitis

________- inflammation of the meninges of the brain and spinal cord.

Otitis Media

________- inflammation of the middle ear.

Petechiae

________ are of particular concern if present below the nipple line.

Otalgia

________- pain in the ear.

Tachycardia

________ is a possible early sign of problems.

School Age Child

________: death is permanent; may assign guilt or blame.

Subdural hematoma

________- pertaining to below the dura mater, tumor of blood.

Obesity

________- A historic percentage of children are ________ and overweight.

Subarachnoid

________ bolt- placed just through skull to monitor ICP but does not allow for CSF drainage.

Stupor LOC

________- the client requires vigorous or painful stimuli (pinching a tendon or rubbing the sternum) to elicit a brief response;

Pediatric Assessment Triangle

________ (PAT)- Appearance, work of breathing and circulation to the skin.

Erythrocyte sedimentation rate

________ (ESR)- speed at which erythrocytes settle out of plasma.

Rebound headache

________- Due to withdrawal of analgesic medications (e.g., NSAIDs)

Glascow Coma Scale

________ (GCS)- Neurologic assessment of a patient's best verbal response, eye opening, and motor function.

immune system

Lymphocytes- The two types of white blood cells that are part of the body's ________: B lymphocytes form in the bone marrow and release antibodies that fight bacterial infections; T lymphocytes form in the thymus and other lymphatic tissue and attack cancer cells, viruses, and foreign substances.

control theory

Gate- ________- Gate control theory refers to a gating mechanism in the spinal cord that facilitates or inhibits pain transmission.

CRP

C- reactive protein (________)- blood test used to measure the level of inflammation in the body; may indicate conditions that lead to cardiovascular disease.

Infant Hospitalization

________- separation anxiety.

Parental stressor

________- Poor communication.

'Point of care

________ testing ' (POCT)- a form of testing in which the analysis is performed where healthcare is provided close to or near the patient.

At what percentile is a child at risk for developing obesity

Infant Hospitalization

separation anxiety

school age hospitalization

seperation

child stressors from life threatening illness

anxiety/fear of dying

parental stressor

Poor communication

Family Presence During Resuscitation

standard of care

Siblings of ill children

Experience considerable stress related to sibling's illness

Toddler

can't tell death from separation

Preschooler

death is temporary, magical thinking about causation

School-Age Child

death is permanent; may assign guilt or blame

Adolescent

understands death, but sense of invincibility can conflict

Nurses' Coping with Caring for a Dying Child managing

Extra consideration is required for the nurse

Debriefing sessions

Nurses should feel free to express their sorrow and grief

family centered care

Caregivers should partner with parents to care for their child

Clarification by reflection

ask 'why?'

Empathy

Acknowledge and validate feelings

managing conflict with families

Be aware of oblique verbal and non-verbal cues

assessing the family

How much can the child communicate and understand at their developmental level

Family Stressors

All families experience stressors

Pediatric Assessment Triangle (PAT)

Appearance, work of breathing and circulation to the skin

respiratory pointers

Always expose the trunk of younger children, not only for better auscultation, but to visualize their work of breathing

definition of pain

Pain is whatever the person experiencing pain says it is, existing whenever the person says it does

gate-control theory

Gate control theory refers to a gating mechanism in the spinal cord that facilitates or inhibits pain transmission

acute pain

-Sudden onset and continuing for a limited period; experienced during and after procedures, postoperatively, from fractures, and from other bodily insults or injuries

chronic pain

-Unpredictable time limit, unlikely to resolve quickly, affecting child's ability to live a normal life; experienced in conditions such as juvenile idiopathic arthritis, sickle cell disease, and cancer

Wong-Baker FACES scale

a scale with drawings or pictures that clinicians use to assess pain in the cognitively impaired client

non-opioid analgesics

acetaminophen

Health Promotion

Activities that increase well-being and enhance wellness and health

Health Maintenance

Activities that preserve an individual's present state of health and prevent disease or injury occurrence; focuses on known risks

Primary prevention

activities decreasing opportunities for illness or injury

tertiary prevention

reduction in consequences with aim of full restoration

nurses role of health supervision

Update health history

questions to ask yourself during assessment

Do infant and parent have close physical contact, eye contact, and vocalization during visit

Nutrition for infant and toddlers

Infant will triple birth weight by 1 year of age

infants and toddlers sleep

Rapid transition to sleeping 10-12 hours at night with 1-2 naps during the day

school aged sleep

Sleep 8-12 hours at night; sleep hygiene practice is important

adolescents and sleep

Need 9 hours of sleep, get 6 hours average; internal clock change

injury and toddler injury prevention

Discuss how parents can maintain a safe environment

school aged children and adolescents

More independence and activities lead to injury

infant and toddler disease screening prevention

Immunizations

infants and mental health

Temperament

Self-concept

self-evaluation in specific areas such as appearance

adolescent disease treatment and screening

Screening tests during adolescence

things to assess for among adolesents (5 topics)

smoking/vaping

mental health links in adolescence

Gaining independence

adolescent assessment (what to ask)

Ask what the teen is proud of

Macronutrients

carbohydrates, proteins, and fats

Infant Nutrition

Breastfeeding up to 6 months preferred

toddler nutrition

High metabolic demands of infancy slow down

Physiologic anorexia in toddler

this is common and occurs round 18 months due to decreased metabolic demands