243 Midterm Flashcards by Madelyn Shipley

What extent of dehydration is this preschooler experiencing?
-Less than 5% of wt loss
-BP 100/60
-HR 140
A- Mild
B- Moderate
C- Severe

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What extent of dehydration is this preschooler experiencing?
-Gray
-BP 90/50
-HR 170
-Oliguric
-5-9% of wt loss
A- Mild
B- Moderate
C- Severe

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What extent of dehydration is this preschooler experiencing?
-Tenting skin turgor
-Anuria
-BP 80/40
-HR thready @ 185
-10% of wt loss
A- Mild
B- Moderate
C- Severe

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What extent of dehydration is this school-age child experiencing?
-Dry MM
-BP 110/70
-Cap refill <2
-HR 110
A- Mild
B- Moderate
C- Severe

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What extent of dehydration is this school-age child experiencing?
-Poor skin turgor
-BP 90/55
-Oliguria
-HR 130
A- Mild
B- Moderate
C- Severe

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What extent of dehydration is this school-age child experiencing?
-Anuria
-BP 80/50
-Cap refill >3
-HR 145
A- Mild
B- Moderate
C- Severe

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What extent of dehydration is this 8 month old experiencing?
-BP 90/60
-Flat fontanelles
-HR 90
A- Mild
B- Moderate
C- Severe

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What extent of dehydration is this 8 month old experiencing?
-Sunken fontanelles
-BP 70/50
-HR 135
A- Mild
B- Moderate
C- Severe

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What extent of dehydration is this 8 month old experiencing?
-BP 60/40
-HR 150
-Cap refill less than 3 seconds
A- Mild
B- Moderate
C- Severe

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With radiation burns, what do you need to be aware of? (Select all)
A- Appearance of burn does not indicate how deep or broad burn extends
B-Involves hypodermis
C-Most common form is from nuclear power accidents
D-Tends to be superficial

A
D

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What needs to happen before swelling occurs from inhalation burns?

Intubation and early airway management

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Put these priorities of care for burns in order of most importance to least:
A-Wound care
B-Fluid resuscitation
C-Assess for complications
D-Establish and maintain airway

D
B
A
C

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What is the major concern within the first 48hrs of a burn?
A-Edema
B-Loss of airway
C-Hypovolemic shock
D-Loss of skin

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What do we need to implement for the first 24-48hrs after a burn?
A-Insert NG tube
B-NPO
C-Debridement
D-I&O

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What are some treatment options for burns? (Select all)
A-Silver sulfadiazine
B-Medihoney
C-Calcium algonate
D-Biosynthetic or synthetic coverings

A
D

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What is: a gentle methos of debridement that cleans the body and also removes loose eschar that has formed over the burn wound site
A-Maggot therapy
B-Mechanical debridement
C-Hydrotherapy

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Which dressing increases risk for hypothermia?
A-Open
B-Closed

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True or false:
-You wrap burned fingers and toes together to prevent hypothermia

False - wrap separately

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What is the purpose of Jobst burn garments?
A-Increase blood flow to burn site
B-Decrease blood flow to burn site
C-Improve the look of injured skin/faster healing
D-Although it takes longer to heal, the scar is less visible

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What disease is:
-Caused by absence of parasympathetic ganglion cells within muscular wall of distal colon and rectum
A-Short bowel
B- Hirschsprung’s

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What is a complication of Hirschsprung’s disease?
A-Less water absorption due to affected colon
B-Affected portion has no peristaltic action
C-Frequent vomiting and diarrhea leads to dehydration

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When should infants be considered for Hirschsprung’s disease?
A-When they don’t pass meconium within 24-48hrs
B-Has less than 4 wet diapers a day
C-Baby is severely constipated
D-Distended abdomen

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S/S of Hirschsprung’s disease (Select all)
A-Ribbon or pellet-like stools
B-Hematuria
C-Bilious vomiting
D-Poor weight gain/feeding intolerance
E-Abdominal distention
F-Severe, shooting abdominal pain

A
C
D
E

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Nursing pre-op care for Hirschsprung’s disease (select all)
A-NPO for 12hrs
B-IV/NG tube
C-Contrast enema to diagnose enterocolitis
D-NPO for at least 6-8hrs

B
D

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What is the preferred kg for children to undergo surgery for Hirschsprung's? A-8kg B-15kg C-10kg D-12kg

Reasons for Organic FTT (select all) A-Cardiac/pulmonary B-Endocrine C-Neuromuscular D-Lack of food provided E-Absent mother F-Renal/GI

A B C F

S/S of organic FTT (select all) A-Low weight B-Uninterested in play C-Delayed development D-Listless E-Does not react to strangers

A C D

S/S of short bowel syndrome (Select all) A-Nonorganic FTT B-Profuse watery diarrhea C-Electrolyte imbalances D-Intense hunger E-Dehydration/Malabsorption

B C E

Complications of short bowel syndrome: (Select all) A-Liver failure/ Cirrhosis B-Encephalopathy C-Cholestasis (Sluggish gallbladder) D-Bacterial overgrowth syndrome

A C D

What is the most important med out of these to give babies with short bowel syndrome: A-Famotidine B-Lansoprazole C-Medium chain triglyceride oil D-Loperamide hydrochloride

Because the tongue is bigger in reference to the head in pediatrics, what complication could occur?

Swelling can cause loss of airway faster than an adult

What is different about the trachea in kids than an adult?

It is shaped like a V

What complication can arise because of the difference in the trachea and larynx in kids (select all) A-Objects can more easily get stuck B-Less airflow C-Malnutrition due to small portions of food D-Additional resistance due to narrow lumen

A D

How do nurses document retractions in infants? A-How many ribs flare out B-Where the chest is being sucked in C-The force of contractions by feel D-Breaths per minuet + how many ribs are visible

What type of retraction is: -Note sucking in UNDER the sternum A-supraclavicular retractions B-subcostal retractions C-substernal retractions D-intercostal retractions

What type of retraction is: -Note sucking in ABOVE the clavicle A-supraclavicular retractions B-subcostal retractions C-substernal retractions D-intercostal retractions

What type of retraction is: -Note sucking IN BETWEEN ribs A-supraclavicular retractions B-subcostal retractions C-substernal retractions D-intercostal retractions

What type of retraction is: -Note sucking UNDER the costal margin (underneath the ribcage) A-supraclavicular retractions B-subcostal retractions C-substernal retractions D-intercostal retractions

What is: -Increased work of breathing with adequate gases -Inability to maintain normal blood gases A-Respiratory failure B-Respiratory insufficiency C-Respiratory distress syndrome

What is: -Inability of respiratory apparatus to maintain adequate O2 with hypercapnia A-Respiratory failure B-Respiratory insufficiency C-Respiratory distress syndrome

How long and how many times can you suction a trach on a child? A-15 seconds, max 4 times B-12 seconds, max 3 times C-12 seconds, max 4 times D-10 seconds, max 3 times

S/S of tonsilitis: (select all) A-Difficulty swallowing B-Exudate on tonsils C-Foul breath D-Low grade fever E-"Kissing tonsils" F-Palatal petechiae

A B C E F

Presentation of tonsilitis: (Select all) A-Acute onset B-Concurrent headache C-Intolerance of hot beverages D-Dysphagia E-Stomach ache F-Ringing in ears

A B D E

On exam, what would you see if a child has tonsilitis? (Select all) A-Appearance of closed airway B-Yellow exudate C-Tonsillopharyngeal erythema D-White spots on tonsils E-Enlarged anterior cervical glands

B C E

Risk factors for tonsillitis? (Select all) A-Age 3-10 B-Exposed to bacteria or viruses C-Poor dental brushing/care D-Age 5-15

B D

Treatment for tonsillitis: (Select all) A-Cool-air humidifier B-Hot tea at bedtime C-Antibiotics D-Possible Tonsillectomy and Adenoidectomy E-Saltwater gargle F-Follow up with dentist

A C D E

How can tonsillitis affect the airway? (select all) A-Obstructive sleep apnea B-Pus from tonsils clogs airway C-Peritonsillar abscess D-Tonsillar cellulitis

A C D

If a child is not treated or fails to complete antibiotics for tonsillitis, what complications may arise: (Select all) A-Sepsis B-Rheumatic/ Scarlett fever C-Poststreptococcal reactive arthritis/ glomerulonephritis D-Long term vent needed

B C

What teaching can we include for post- tonsillectomy: (Select all) A-Observe for bleeding - frequent swallowing B-Expect foul breath C-Warm compress PRN D-Report fever more than 101F E-Tylenol Q2hr

A B D C- not heat, but Ice collar

What teaching can we include for post- tonsillectomy: (Select all) A-DO NOT give red fluids/food B-Allow them to be prone for comfort C-No lifting, bending, straining D-Ear pain can be present

A C D B-DO NOT put them prone

If a child present with these symptoms: -Tripod position with chin thrust out, drooling excessively -Sudden onset of high fever, difficulty swallowing What would you think is causing this: A-RSV B-Swallowed a battery C-Epiglottitis or Supraglottitis D-Asthma

Asthma or RSV? -Tachypnea/ retractions -Intermittent fever -Hypercapnia -Rhinorrhea -Decreased breath sounds

RSV

Asthma or RSV? -Cough -Vomiting -Decreased O2 sats -Wheezing -Apnea

RSV

Asthma or RSV? -Tachypnea/retractions -Cough -Wheezing -No fever -Decreased breath sounds

Asthma

Asthma or RSV? -Decreased O2 sats -Chest tightness and allergic salute -Prolonged expiratory phase -Apnea -Hypercapnia

Asthma

Asthma or RSV? -Mucous plugging -Inflammation -Airway swelling -Increased mucous production -Infection -Bronchoconstriction

RSV

Asthma or RSV? -Inflammation/hyperresponsive -Airway swelling -Autoimmune/trigger -Bronchoconstriction -Increased mucous production

Asthma

Asthma or RSV? Complications: -Impaired gas exchange -Airway obstruction

Both

Asthma or RSV? The nurse would get these diagnostic tests: -Nasal swab -CXR -CBC and BMP

RSV

Asthma or RSV? The nurse would get these diagnostic tests: -PFTs -CXR -CBC and BMP

Asthma

Interventions for Asthma or RSV? -High humidity O2 -Bronchodilators -Inhaled diuretics -Palivizumab -Ribavirin -Nebulized epinephrine -Increase fluid intake

RSV

Interventions for Asthma or RSV? -High humidity O2 -Bronchodilators -Corticosteroids -Leukotriene modifiers -Daily preventive meds -Increase fluid intake

Asthma

What med is used to: -Prevent RSV -Receives it for 5 consecutive months until they are 3 -Administered before RSV season, then monthly thereafter during RSV season A-Ceftriaxone B-Ribavirin C-Leukotriene modifiers D-Palivizumab

What needs to be implemented for kids with RSV? (Select all) A-Incentive spirometry as tolerated B-Contact isolation C-Stop PO feeds if RR above 60 or O2 below 90% D-Place face down and butt up to help mucous drain

B C

What type of asthma is: -Daytime symptoms less than twice a week and night symptoms less than once a month A-Mild persistent B-Moderate persistent C-Mild intermediate D-Severe persistent

What type of asthma is: -Daytime symptoms more than twice a week but less than daily -Nighttime symptoms more than twice a month A-Mild persistent B-Moderate persistent C-Mild intermediate D-Severe persistent

What type of asthma is: -Daily s/s -Nighttime s/s more than once a week A-Mild persistent B-Moderate persistent C-Mild intermediate D-Severe persistent

What type of asthma is: -Continuous s/s with frequent exacerbation A-Mild persistent B-Moderate persistent C-Mild intermediate D-Severe persistent

S/S of cystic fibrosis: (select all) A-Barrel chest/clubbed fingers B-Enlarged tongue C-Cyanosis/wheezing D-Chronic cough E-Thick, honey like mucus F-Decreased LS in R lung G-Frequent infections

A C D E G

What is the difference between normal sweat and CF sweat? A-Yellow tint B-Thicker C-More salty D-Non-existent due to dehydration

Put these in order of what you give first through last for CF: A-Theravest - mobilize secretions B-Mucolytic - Loosen mucus C-Inhaled Tobramycin - prophylaxis D-Bronchodilator - Open airway E- Flutter valve - Remove secretions

D B A E C

Diet for CF kids: (select all) A-High CHO, high PRO B-Restriction on fats C-3 meals plus 2 snacks D-Meals must be scheduled around PO pancreatic enzyme E-BS check before meals

A C D B- NO restriction

Diet for CF kids: (select all) A-Supplement potassium B-1.5-2x normal caloric intake C-More Na+ in summer months D-Only water, no juice

B C

True or false: -Kids with CF can graze or eat without taking pancreatic enzyme if is 0% fat

False - must take before every meal

True or false: -Enzymes for CF kids cannot be placed on a fatty food on the first bite

True

Do you want to put the enzyme for CF kids on acidic or alkaline food?

Acidic

What does a CF kids appearance look like? (select all) A-Sallow skin B-Tall and lanky C-Buttocks and thighs may atrophy D-Dry MM E-Distended abdomen

A C E

Asthma, RSV, or Cystic fibrosis? The inflammatory process causes: -Leads to scarring, airway remodeling, and reduced lung function over time -May affect the heart overtime

Cystic fibrosis

Asthma, RSV, or Cystic fibrosis? The inflammatory process causes: -The inner walls of the bronchi become inflamed, narrowing the airways and making it harder to breathe -Trigger mucus glands to go into overdrive, clogging the already narrowed passages -Smooth muscles around the airways constrict, further reducing airflow

Asthma

Asthma, RSV, or Cystic fibrosis? The inflammatory process causes: -Swelling narrows the airways, making it harder for kids to breathe -Triggers excess mucus production, which clogs the already narrowed airways and worsens breathing difficulties -Wheeze or show signs of labored breathing, like chest retractions or nasal flaring

RSV

Describe the STEP approach to treating asthma: Step up- Step down-

Step up: If asthma symptoms worsen or control is poor, treatment intensity is increased. Step down: If asthma is well-controlled for several months, medication may be reduced to minimize side effects.

243 Midterm Flashcards

(81 cards)