1
Q
Congenital Heart Defects
A
- “Either TRouBLe or No TRouBLe”
- TRouBLe
- R-L - Right to Left shunt
- B - Blue (Acyanotic)
- T - starts with the letter “T”
- ex. Trunkus arteriosis, Transposition of great vessels, Tetrology of Fallot, Tricuspid stenosis, TAPZ, Left ventricular hyperplastic syndrome (exception to “T” rule)
- No TRouBLe
- ex. Patent foramen ovale, Ventricular Septal defect, pulmonary stenosis
2
Q
CHD symptoms
A
- Regardless of diagnosis - “TRouBLe”
- Murmurs
- Echocardiogram rx
3
Q
Tetralogy of Fallot defects
A
- “VarieD PictureS Of A RancH”
- Ventricular Defect
- Pulmonary Stenosis
- Overriding Aorta
- Right Hypertrophy
4
Q
Toys
A
- Safety considerations
- Size (no small toys for children under 4)
- No metal toys if oxygen is in use (sparks)
- Beware of fomites (non-living object that harbors microorganism)
- Worst: plush toys, stuffed animals
- Least: plastic toys that can be disinfected
- Always go younger because children regress when sick and you want to give them as much time to grow
5
Q
Toys (0-6 months)
A
- Age considerations
- 0-6 months (sensorimotor)
- Musical mobile (best), something large and soft
- 0-6 months (sensorimotor)
6
Q
Toys (6-9 months)
A
- 6-9 months (teaching object permanence)
- Cover/uncover toy (jack in the box)(best), firm but large (wood/hard plastics allowed)
- Peek-a-boo
7
Q
Toys (9-12 months)
A
- 9-12 months (vocalization)
- Verbal toy (tickle me elmo), talking books
- Purposeful activity with objects
- Avoid answers for children under 9 months
- Build, sort, stack, make, construct
- Avoid answers for children under 9 months
8
Q
Toys (1-3 years)
A
- 1-3 years (toddlers) (developing gross motor skills)
- push/pull toy (wagon)
- Parallel play (play alongside, not with)
- Avoid toys that require good finger dexterity
9
Q
Toys (Preschoolers)
A
- Fine motor skills (fingers) and balance (dance, ice skating, tumbling)
- Cooperative play (playing with each other)
- Like playing pretend
10
Q
Toys (School age 7-11 years)
A
- 3 Cs
- Creative (give blank paper)
- Competitive (winners/losers)
- Collective (baseball cards/barbies)
11
Q
Toys (Adolescents 12-18 years)
A
- Peer group association
- Allow adolescents to be in each other’s room unless
- Fresh post-op (<12 hours)
- Immunosuppressed
- Contagious
12
Q
Sensorimotor (0-2 years)
A
- Characteristics
- totally present-oriented
- only think about what they are doing in the present
- Teaching
- Teach as it happens
- Tell them what you’re doing as you’re doing it
13
Q
Pre-Operational (3-6 years)
A
- Preschooler
- Characteristics
- Fantasy-oriented, illogical, no rules
- Teaching
- can teach slightly ahead of time (morning of)
- Use play, toys, and stories to teach
14
Q
Concrete Operations (7-11 years)
A
- Characteristics
- Rule-oriented, no abstract thinking, can teach skills
- Teaching
- Can teach days ahead of time
- teach by age-appropriate ready and demonstration
- Role play is ok
15
Q
Formal Operations (12-15 years)
A
- Characteristics
- Able to think abstractly
- understands cause-effect
- Think like adults emotionally
- Teaching
- treat like an adult
16
Q
Poisoning
A
- Most common in 2 years old
- Damage to oral mucosa
- Lye & caustic cleaners
- Risk for seizures from
- Drugs
- Insecticides
17
Q
Acne
A
- caused by P. acnes
- Treatment (takes 4-6 for results)
- Vitamin A
- Antibiotics
- Tetracycline
- Take on empty stomach and avoid sunlight
- use additional contraceptives
- No dairy products
- Tetracycline
- Retinoids (Accutane - vitamin A analog)
- S/E
- Inflammation of the lips
- Causes birth defects
- S/E
- Causes
- Hereditary, bacterial, hormonal
- worsened by stress
- Teaching
- wash face 2x/day
- Comedone (blackheads and whiteheads)
18
Q
Hospitalization & Peds
A
- Infant fears separation from love object
- Toddler fears separation from family
- may engage in stalling before painful procedures
- may require physical
- Preschooler fears separation and mutilation
- may require restraints during painful procedures
- School-age child fears separation from age group
- will physically resist the nurse
- Adolescent fears separation from peers and loss of independence
- will physically resist the nurse
19
Q
Otitis media
A
- Infection of middle ear
- S/s
- Hearing loss
- Feeling of fullness in ear
- Hyperpyrexia (fever)
- Drainage from the ear
- Complications
- Perforation of the ear drum
- miningitis/mastoiditis
- Cholesteatoma
- cyst in the ear
- Treatment
- Systemic antibiotics
- Antibiotic ear drops
- tube in ear to drain
- Interventions
- no swimming, showering
20
Q
Cleft lip/palate
A
- Cleft lip
- lip open to the nares
- Repaired between 10 weeks to 6 month
- Use large-holed, soft nipples
- Post–op
- try to prevent crying
- not allowed to breast
- Wear logan bow
- prevents stress on suture lines
- remove gauze before feeding
- cleanse with peroxide and saline after eating
- never lie on abdomen
- Cleft palate
- roof of mouth open to nasopharynx
- repaired between 1 and 5 years
- One at 12-18 months
- one at 4-5 years (delayed due to development of teeth
- Post-op
- can cry
- may breast feed
- Overview
- Both need more frequent bubbling, burping
- Should be fed in almost upright position
- Long term problems with hearing, speech, and teeth
- elbow restraints used post-op
- rinse mouth after feeding post-op
21
Q
Epiglottitis
A
- Most common in 1-8 years
- Bacterial
- S/s
- Fever >102
- Muffled voice
- Drooling
- Stridor
- Lack of cough
- Breathing leaning forward with flaring nostrils
- Symptoms that precede an intubation
- restlessness
- Tachy
- Retractions
- Never put anything in the mouth
- Treatment
- Penicillin
- Ampicillin
- Prevention
- Children 2 months and over should receive flu vaccine
Mark Klimek
flashcards
Decks in class (21)
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