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Pediatric Study Guide Exam 1 Flashcards | StudBud
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Pediatric Study Guide Exam 1
Pediatric Study Guide Exam 1
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1
Pain management regarding tonsillectomy: Select all that apply
ice chips
hot coffee
pain meds
ice collar
2
Signs/Symptoms of shock: select all that apply
grunting
dyspnea and hypotension
bradycardia
weak peripheral pulses
breath sounds with crackles
tachycardia
3
Stages a hospitalized child goes through: select all that apply
Excitement
Protest
Separation Anxiety
Detachment
Despair
Loneliness
4
Types of shock: cardiogenic & anaphylactic
False
True
5
How to prevent a toddler from having a tantrum?
Providing consistent age appropriate expectations help work through tantrum
providing inconsistent expectations help work through tantrum
6
S/Sx of severe dehydration: select all that apply
weight loss < 10% in infants and 15% in children
weight loss > 10% in infants & 10% in children
extreme thirst, tented skin, no tears, oliguria or anuria
sunken eyeballs, sunken anterior fontanel
cap refill greater than 4, tachycardia, hyperpnea (rapid, deep breathing)
BP progresses to shock, extreme thirst, very dry mucous membranes
7
Lab expectations of rheumatic fever: select all that apply
CRP elevation
elevated magnesium
throat culture
ESR (elevated due to inflammation)
blood antistreptolysin O titer (elevated or rising)
decreased potassium
8
expected recovery time post tonsillectomy is 14 days for full recovery
False
True
9
What to expect from Babinski Reflex?
fingers flex
toes curl inward
toes do not move
toes fan upward and out
10
FLACC scale includes: select all that apply
cry
consolability
fontanel
face
activity
legs
11
Pain assessment for 3 years and older
numerical scale
Face scale
FLACC scale
self report
12
Viral meningitis: cloudy, decreased glucose, positive gram stain
False
True
13
Despair stage: select all that apply
screaming
Withdrawal from others
interacting with others
depression
14
Non-communicating childrens pain checklist: select all that apply
behavior observed for 10 minutes
used on 3 year olds and older
subcategories scale 0-3
verbalizes pain
15
Actions to help chronically ill teens in the hospital to thrive: select all that apply
provide factual information
educated on intercourse
encourage contact with peers
include them in care plan
16
S/Sx of epiglottis: select all that apply
stridor
tripod positioning
tachycardia
Drooling
17
S/Sx of moderate dehydration: select all that apply
BP WNL, normal or sunken anterior fontanel on infants
cap refill greater than 4 secs
weight loss of 6-9% in infants & 6-8% in children
cap refill greater than 2 secs
thirst, irritability, HR elevated, slight tachypnea
dry mucous membranes, decreased skin turgor and tears
18
What nursing action should be done FIRST for low pulse ox readings?
monitor to see if reading comes up on its own
confirm accuracy by looking for good waveform
move probe site locations
place pt supine
19
How a nurse (theirself) deal with dying/death of pt? Select all that apply
express feelings/coping
develop ability for empathy
celebrate
self care / go to funeral
20
Gross motor skills in 18 months: select all that apply
runs clumsily, falls often
jumps in place with both feet
throws ball overhand
throws ball underhand
jumps across the floor
pulls and pushes toys
21
S/Sx of mild dehydration: select all that apply
weight loss of 3-5% in infants & 3-4% in children
slight thirst
anterior fontanel, pulse, BP <- WNL
mucous membranes -> WNL
cap refill greater than 2 seconds
dry mucous membranes
22
Oucher scale is used on 3-13 year olds with pain scale of 0-5 with 6 photographs
True
False
23
Erikson's theory of birth-1 yr old:
autonomy vs. shame and doubt: independence, negative responses
Trust vs. mistrust: meet their needs to build trust
intiative vs. guilt: energetic learners
industry vs. inferiority: skill development and knowledge to society
24
What to do if meningitis is suspected? Select all that apply
Monitor fluid balance, UOP, Neuro status, any pain
head circumference and fontanels for swelling
NPO if decreased LOC, seizure precautions
shrug it off as nothing serious
decrease enviromental stimuli, keep family informed and comfortable
isolate ASAP, monitor for petechia (medical emergency), monitor VS
25
Precautions to take with children who have croup: select all that apply
prepare for intubation, never suction
do not listen to how parents explain baseline for child behavior
Droplet precautions (24 hrs after IV abx has started)
protect airway, dont place anything in the mouth
humidified O2, corticosteroids
IV fluids, IV abx
26
Cardiogenic shock: impaired cardiac function that leads to cardiac output decrease
False
True
27
Nursing care for after death: select all that apply
remain w family and offer support, allow family to communicate feelings
remove tubes/equipment, offer to help with post mortem care
assist with prep involving death ritual
allow family to stay with body as long as desired (no longer than 24hr)
Allow to rock, refer to patient by name
walk pt to morgue with out providing privacy
28
Anaphylactic shock can occur in response to an allergy to latex, drugs, insects stings, or blood tansfusions
False
True
29
examining ears on infants and toddlers: pull pinna down and back
False
True
30
Fall prevention: select all that apply
safety gates for stairs; top and bottom
seats placed on ground or floor, not elevated surfaces
rear facing car seats
crib mattresses in lowest position with rails up
avoid plastic bags
restraints used in car seats
31
How to hold a child for a lumbar puncture?
supine with knees bent
reverse trendelenburg with arms crossed
prone with legs flat
laying on side with knees and head pulled towards each other to create "C"
32
Asthma risk factors: select all that apply
overweight
low birth weight
family history
sex (girls affected more thanboys)
tobacco smoke
sex (boys affected more than girls)
33
Aspiration prevention: select all that apply
age appropriate toys should be provided
hold for feedings, do not prop bottles
small objects like grapes, coins, candy should be avoided
do not warm fluids
sharp objects out of reach
clothing should be checked (loose buttons)
34
Adolescents are at high risk of injury because they have the "invincible" thinking
False
True
35
Safety precaution when weighing an infant
hold hand 1 in over child to make sure he does not fall off scale
add extra blankets to baby if weight is too low
place baby on edge of scale for accurate reading
place baby on scale and leave room for supplies
36
Babinski Reflex should be seen from birth to one year
False
True
37
Gross motor skills in 2-5 yr olds: select all that apply
stands on one foot momentarily
jumps 6ft into air
jumps across floor and off chairs /steps using both feet
takes a few steps on tiptoe
38
Suffocation prevention: select all that apply
avoid plastic bags, no balloons
lock up firearms
no pillows in crib, infants on back to sleep
drawstrings removed from jackets and other clothing
crib mattress fit snug, crib mobiles removed by 4-5 months old
toys with small parts out of reach
39
Respiratory distress symptoms: select all that apply
head bobbing
tracheal tug
nasal flaring
slow HR (bradycardia)
fast HR (tachycardia)
fast breathing(tachypnea), abnormal breathing(retraction), stridor
40
Trust vs. Mistrust:Mistrust develops by lack of needs being met, or if needs are continuously met before being vocalized
True
False
41
Birth weight should be doubled by 5 months old
True
False
42
Cardiac defects that decrease pulmonary blood flow: select TWO
tricuspid atresia
aortic stenosis
tetralogy of fallot
pulmonary stenosis
43
injury prevention of all ages: select all that apply
aspiration
bodily harm, poisoning/substance abuse
motor vehicle, firearms
burns
metabolic conditions
safe sleep, suffocation
44
Nursing actions for rotavirus: select all that apply
monitor I&O's
avoid rectal temperatures
initiate IV fluids
start oral rehydration therapy
obtain baseline height&weight (at the same time daily)
throat culture
45
Protest stage: select all that apply
Screaming
withdrawal from others
Clinging
agression towards others
46
Why do toddlers have tantrums?
result when toddlers are frustrated with restrictions on independence
result when toddlers are not frustrated with restrictions on independence
47
Risk factors for down syndrome: select TWO
paternal age greater than 35
paternal age greater than 55
maternal age greater then 55
maternal age greater than 35
48
Endocarditis: infection of lining of heart and the valves that can enter the bloodstream
False
True
49
Children who are sick with a respiratory illness stop eating b/c they can not breathe and choose to breathe over eating
False
True
50
Findings associated with meningitis for 2yrs - adolescents: select all that apply
seizures, nuchal rigidity, fever, chills, headache, vomiting
positive kernigs and babinski sign
stupor and coma, petechia, joint involvement
chronic draining of the ear
high pitch cry
irritable, restless, progressing to drowsiness, delirium
51
Kawasaki disease expected findings: select TWO
ceberal edema
strawberry tongue
fever
onset fever lasting 5d-2wk that is unresponsive to antipyretics
52
5 year olds and older can use numeric pain scale with ratings of 0-10
True
False
53
Pulse oximetry measures the amount of arterial hemoglobin
False
True
54
Gross motor skills in 2 yr olds
pulls and pushes toys
falls often
creeps up stairs
walks up and down stairs by placing feet on each step
55
Pain assessment for 5 years and older
FLACC scale
Face scale
numerical scale
self report
56
Defects that increase pulmonary blood flow: select all that apply
Tetralogy of Fallot
Patent ductus arteriosus (PDA)
Ventricular septal defect (VSD)
Atrial septal defect (ASD)
57
Asthma education at discharge: select all that apply
administer meds, peak flow meter at the same time each day
indentify triggers and avoid them, asthma action plan ready
Record PEFR results daily to compare, learn how to interpret PEFR readings
learn how to recgonize astham exacerbation, reg exercise for asthma therapy
educate to live life on edge and dont worry about asthmatic behavior
infection prevention techniques, vaccines, meds to prevent bronchus spasms
58
Characteristics of cardiac defects that decrease pulmonary blood flow: select all that apply
obstruction of pulmonary blood flow and anatomic defect
Hypercyanotic spells (blue or "tet" spells)
R to L shift allowing deoxygenated blood to enter the systemic circulation
L to R shift allowing oxygenated blood to enter systemic circulation
59
Proper pain assessment scale for 4yrs and older?
self report
numerical scale
face scale
FLACC
60
FACES pain scale used on 3-18 year olds with rating of 0-5 scale and 6 faces
False
True
61
How to check for Babinski reflex?
smack bottom of infants foot
pat top of babys foot
stroke outer edge of the sole of an infants foot towards toe
pinch the pinky toe
62
Poisoning prevention: select all that apply
working smoke detector
safety locks on cabinets w/ cleaners, toxin/plants kept out of reach
meds kept in childproof containers, away from reach
poison control # kept near phone
avoid lead paint
working carbon monoxide detetcor
63
examining an ear on children greater than 3 years: pull pinna up and back
False
True
64
Findings associated with meningitis in 3mo - 2yrs: select all that apply
fever, irritability, vomiting
seizures w/ high pitched cry
restlessness
babinski sign and kernigs are not reliable
delirium
bulging fontanel, nuchal rigidity, poor feeding
65
Pain assessment (in general) on a child? select all that apply
guarding
loud cry
no cry
ask parents how pain meds have been working
66
Pain assessment scale for 2 months to 7 years
numerical scale
face scale
self report
FLACC scale
67
Preferred place to give IM injection on an infant is the VASTUS LATERALIS
True
False
68
Where to perform painful procedure on a child?
out of their safe place and into a treatment room
at the play area
in their safe place
in another pt room
69
Detachment stage: select all that apply
withdrawal from others
forming new relationships
interacting with strangers
happy appearence; trust is being build
70
Symptoms of bronchiolitis: select all that apply
cyanosis
fever
tachypnea
lethargy
copious secrfetions
clumsy
71
Kawasaki disease: acute system vasculitis (mucocuntaneous lymph node syndrome)
True
False
72
How to give oral medications to an infant: select all that apply
blow directly into their mouth/face
stroke infant under the chin to make them swallow
semi reclining position
side of the mouth
73
Findings associated with meningitis in newborns: select all that apply
difficult to diagnose, vague signs
V/D, fever or hypothermia, neck is supple w/o nuchal rigidity
bulging fontanel is a late sign
seizures
poor muscle tone, poor "sucking", weak cry, refusing feedings
not present at birth, progresses within a few days
74
Patho of cystic fibrosis includes: Select all that apply
mucus glands that secrete thin clear liquids
inherited mutated gene
mucus glands that secrete an increase in thick, tenacious mucus
leads to mechanical obstruction to organs (pancreas, lungs, liver, SI)
75
Cardiac defects that are obstructive: select all that apply
coarctation of aorta
pulmonary stenosis
clubbed fingers
aortic stenosis
76
Drowning prevention: select all that apply
secure fencing around pools
do not warm fluids in microwave
do not leave unattended around tub, toilet, cleaning buckets, drainage area
close bathroom doors
77
Cardogenic shock is ttypically seen after a child has had heart surgery
False
True
78
At 2 months old proper pain assessment will be use of the face scale
True
False
79
What should be assessed in a child with speech delays?
never learned letters
hearing impairment
swallowing difficulty
being stubborn
80
Burn prevention: select all that apply
Do not warm fluids in microwave, temp of bath water- check with elbow
hot water heater < 120º, handles turned in, pots to back of stove
crib mattress in lowest position
cover outlets
smoke detectors
sunscreen
81
Common complications following a tonsillectomy: select all that apply
head bobbing
dehydration
chronic infection
hemorrhage
82
Ways to provide safe sleep: select all that apply
sleep in own bed with only crib sheet
place prone
place on back
do not add extra toys, blankets, pillows
swaddle child until able to roll, then use sleep sack
sleep in bed with parents or guardian
83
Risk for seizures: select all that apply
shigella, salmonella, metabolic conditions
safe sleep, aspiration
fever, cerebral edema, anoxia
toxins or drugs, lead poisoning, tetanus
hypoglycemia
intracranial infection or hemorrhage, brain tumors or cyst
84
Bodily harm prevention: select all that apply
anchor heavy objects and furniture so they can not be overturned onto child
Sharp objects out of reach
secure fencing around pools
infants should not be left unattended w/ any animals present
85
Bacterial meningitis: clear, normal glucose, negative gram stain
True
False
86
Motor vehicle injuries: select all that apply
rear facing until 2 or height recommended
should not be left in parked cars
safest area for infants/children- backseat until 12
no rear facing seat in front seat with airbags
infant only, convertible infant toddler car seats
no pillows in crib
87
Gross motor skills in 15 Months: select TWO
walks with help
creeps up stairs
runs up stairs
Walks with out help
88
Nursing care for dying pt: select all that apply
post mortem care
allow for anticipated grieving
attempt to maintain a normal environment
communicate honestly and respectfully
encourage independence, provide privacy, provide support
encourage guardians to stay with child
89
S/Sx of intussusception: select all that apply
sudden episodic abd pain, screaming w knees drawn up to chest in pain
abd mass (SAUSAGE SHAPE)
stools mixed w/ blood and mucus that resemble jelly
vomiting, fever, tender abd, distened abd
urinary retention
diagnosed bu ultrasound
90
anaphylactic shock: results from hypersensitivity for foreign substance, leads to massive vasodilation and capillar leak
False
True