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Do NOT give aspirin to children. It is associated with Reye’s syndrome, a rare but life-threatening condition affecting the liver and brain. ➡️ Use acetaminophen or ibuprofen instead (age-appropriate dosing). Assessment in severe diarrhea Priority assessments include: Signs of dehydration: dry mucous membranes, sunken fontanel (infants), poor skin turgor Decreased urine output Tachycardia, lethargy Electrolyte imbalance (monitor labs if severe) Blood pressure in coarctation of the aorta In Coarctation of the aorta: Higher BP in upper extremities Lower BP in lower extremities Weak or delayed femoral pulses Care of cleft lip suture site Clean with sterile saline or water after feedings Apply prescribed ointment Keep site dry and intact Use elbow restraints to prevent touching Feed with special nipple or dropper (avoid trauma) Erikson: Industry vs. Inferiority (school-age child) Appropriate statement: ➡️ “I’m proud I finished my project all by myself!” Shows productivity, accomplishment, and competence Concerning statement before appendectomy Red flag statement: ➡️ “I’m going to die during the surgery.” Indicates fear, misunderstanding, and need for clarification and reassurance. Cotton ball game for deep breathing Place cotton balls on a table Have child blow them across using deep breaths ➡️ Encourages lung expansion and prevents complications like Atelectasis Data supporting failure to thrive Signs of Failure to thrive: Weight below 5th percentile Lack of expected weight gain Delayed development Poor feeding or lack of interest in eating Developmental task of an adolescent (Erikson) Stage: Identity vs. Role Confusion ➡️ Key task: developing a personal identity and sense of self Example: exploring beliefs, career goals, relationships Discharge teaching after sickle cell crisis (hydration) For Sickle cell disease: Encourage increased fluid intake Avoid dehydration (can trigger crisis) Drink water regularly, even without thirst Monitor for signs of recurrence (pain, fatigue) Drooling and croup Drooling is NOT typical of croup. ➡️ It suggests a more serious airway condition like Epiglottitis ⚠️ This is an emergency—do NOT inspect the throat; maintain airway and call for help. First action for a 2-year-old with acute gastroenteritis ➡️ Assess hydration status first (check mucous membranes, tears, urine output, fontanel, behavior) First medication in an acute asthma attack ➡️ Short-acting bronchodilator: albuterol (Relieves bronchospasm quickly in Asthma) Handwashing and cystic fibrosis For Cystic fibrosis: ➡️ Strict hand hygiene is essential Prevents respiratory infections Avoid close contact with sick individuals Heart rate and airway obstruction ➡️ Tachycardia occurs early (due to hypoxia and stress response) ⚠️ Bradycardia is a late, ominous sign History question for acute rheumatic fever Ask about: ➡️ Recent untreated strep throat Linked to Acute rheumatic fever How long does an ostomy for Hirschsprung’s disease last? In Hirschsprung’s disease: ➡️ Usually temporary Remains until definitive surgery (“pull-through”) heals Often reversed in a few months Pulse oximeter probe rotation ➡️ Rotate site every 4 hours (prevents skin breakdown and ensures accuracy) Proper action for adolescent in sickle cell crisis For Sickle cell disease: ➡️ Increase fluids and manage pain Encourage hydration Administer prescribed analgesics Provide oxygen if needed Promote rest Piaget stage for abstract thinking ➡️ Formal Operational Stage Begins around age 11+ Allows abstract reasoning, hypothetical thinking Piaget stage where object permanence develops ➡️ Sensorimotor Stage Birth to ~2 years Infant learns objects still exist even when out of sight Misunderstanding use of infant car seat Incorrect understanding: ➡️ “I can place the seat facing forward once my baby is 6 months.” ❌ Correct: Rear-facing as long as possible (until height/weight limit) Mouth position for infant pain relief ➡️ Slightly open mouth with relaxed tongue during sucking Seen with pacifier or sucrose use Promotes comfort and analgesia NGN: Care for infant with cyanotic heart defect For Cyanotic heart disease: Actions to take: Place in knee-chest position during episodes Administer oxygen Keep child calm (crying worsens hypoxia) Give morphine if prescribed (reduces oxygen demand) NGN: Actions for hypercyanotic (“tet”) spells Seen in Tetralogy of Fallot Indicated: Knee-chest position Oxygen Morphine Calm/comfort child Contraindicated: Forcing activity Allowing prolonged crying Delaying treatment NGN: Adolescent cardiac prescriptions (anticipated vs contraindicated) Anticipated: Beta-blockers (↓ cardiac workload) ACE inhibitors Activity modification if needed Contraindicated (generally): Strenuous, competitive sports (depending on condition) Dehydration Stimulants without provider approval NGN: S/S comparison (viral URI vs serious airway conditions) Acute viral nasopharyngitis Runny nose, mild cough, low fever Laryngotracheobronchitis Barking cough Stridor Hoarseness Epiglottitis Drooling High fever Tripod position No cough NGN: Croup vs epiglottitis vs foreign body aspiration Croup Barking cough, gradual onset Epiglottitis Drooling, dysphagia, sudden severe distress Foreign body aspiration Sudden onset Choking episode Unilateral breath sounds Normal behavior of an 8-month-old when parents leave ➡️ Separation anxiety (crying when parent leaves) Normal developmental milestone Nutritional needs of toddlers ➡️ Growth rate slows, so appetite decreases “Picky eating” is normal Small, frequent meals recommended Pain scale for a 3-year-old ➡️ FACES Pain Scale Uses facial expressions Appropriate for ages 3+ Parent teaching about regression during hospitalization ➡️ Regression (e.g

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