1
Q
Child with intergumentary disorder needs to be monitored for :
A
Skin infection or systemic infection
2
Q
Impetigo is a
A
Contagious bacterial infection of the skin caused by group A streptococcus and staphylococcus aureus
3
Q
Impetigo may be caused by
A
Infection
Insect bite
Injured site
Rash , atopic dermatitis, poison oak
4
Q
Site of infection for impetigo
A
Face, around the mouth , hand , neck, extremities
5
Q
Impetigo signs and symptoms
A
Blisters
Erythema
Honey colored crusts
Burning
Secondary lymph node involvement can be present
6
Q
Impetigo intervention
A
Contact isolation and standard use of precautions
Apply topical antibiotic
Cover lesions with gauze bandage or tape
Daily bathing with antibiotics and soap
Warm water
Use of emollient
Child needs to use separate towels, linens, utensils, dishes
All linen needs to be washed with detergent in hot water
7
Q
Pediculosis capitis (lice) is what
A
An infestation of the hair and scalp with lice
8
Q
How long lice can survive from host
A
48 hours
9
Q
How lice is transmitted
A
Direct contact , such as sharing
10
Q
Pediculosis treatment cannot be used on client of what age ?
A
Younger than 6 months
11
Q
Lindane should shampoo should not be used on client of what age ? And why?
A
Younger than 2 years
Neurotoxicity and seizure
12
Q
Pediculosis capitis (lice) teaching
A
Wash clothes in hot water and dried for 20 minutes in hot dryer
Bedding and clothing need to be change daily
13
Q
Scabies is a
A
Parasitic skin disorder caused by infestation of sarcoptes scabiei
14
Q
How scabies is transmitted
A
Closed personal contact
15
Q
Intervention for burn injuries on children
A
Protect the child from further harm and stop the burning process
Assess for patent airway
Begin resuscitation measures CAB
Remove burn clothing and other restrictive items
Cool the burn area under a cool running water
Cover the wound with a clean cloth
Keep the child warm
Call emergency medical services asap
16
Q
Rules of 9
A
17
Q
Fluid resuscitation adequacy is determined based on
A
Heart rate
Urinary output volume
Capillary refill
State of sensorium
18
Q
Scabies characteristics
A
Burrow of fine grayish red threadlike line
19
Q
How topical corticosteroids is apply on the skin
A
Thin layer is rubbed into the area throughly
20
Q
Head lice characteristics
A
White sacs attached to the hair shaft in the occipital area
21
Q
Hemophilia intervention
A
Assess for injuries
Check for bleeding
Apply pressure for at least 15 minutes to superficial bleeding area
Monitor for internal bleeding and hypovolemic shock
Place child on bleeding precautions
Monitor for joint pain or joint bleeding
Treat joint with immobilization , elevation, and application of ice
Monitor for neurological status for signs of intracranial hemorrhage
Monitor urine for hematuria
Administer blood replacement factor
22
Q
Child with bleeding disorder needs to wear what
A
MedicAlert bracelet
23
Q
Iron should not be given with
A
Milk
24
Q
Liquid iron administration teaching
A
Take with a straw and teeth needs to be wash after administration
Give between meals
25
What lab will be abnormal in client with hemophilia
Partial thromboplastin time
Prolonged PTT
26
In what race B-thallessemia is most common
Child of Mediterranean descent
27
What labs may indicate iron deficiency anemia
Red blood cells that are microcytic and hypochromic
28
Characteristics of willebrand disease
Easy bruising
Gum bleed
Hereditary bleeding
Platelets adhere to damage endothelium
29
Most common cancer in children
Leukemia
30
What’s leukemia
Malignant increase in the number of leukocyte, usually at an immature stage in the bone morrow
31
Child receiving chemotherapy needs to be monitored for
Infection
32
What’s hodgkin’s disease
Is a malignancy of the lymph nodes that originates in a single lymph node or single chain of node
33
How to detect metastasis
Computed tomography scan of the liver , spleen and bone marrow
34
Nephronlastoma (Wilms’ tumor )
Is the most common abdominal and kidney tumor of childhood
35
Most common bone cancer in children
Osteogenic sarcoma
36
What to monitor in a child with brain cancer after craniotomy
Incredible ICP
So notify HCP
37
Osteosarcoma teaching
Most common site is the femur
Limping is a manifestation of
Early stage of disease is attributed to normal growing pain
38
Early signs of ICP
Vomiting
39
Hodgkin’s disease characteristics
Presence of Reed-Sternberg cell in the lymph nodes
40
Fever in an infant less than 1 month is a
Medical emergency, contact HCP
41
Temperature level that is considered fever in child
100.4 F
38.0 C
42
Do not administer aspirin to children due to
Reye’s syndrome
43
Weight category
Overweight =>above 85th percentile but less than 95th percentile
Obesity => BMI greater than 95th percentile
Severe obesity => BMI over 120 percentile
44
Diabetic ketoacidosis manifestations
Hyperglycemia
Kussmaul’s respirations
Acetone fruity breath odor
Increaasing lethargy
Decreased level of consciousness
Lethargy
Abdominal pain
Frequent urination
45
How to prevent hypoglycemia before exercising
Extra snack , juice , raisins should be taken
46
Hypotonic dehydration priority assessment
Check amount of urine output
47
Do not administer potassium chloride if
Client has oliguria or anuria
48
Normal phenylalanine level
0-2 mg/dl
49
Signs that fluid deficit is resolving
Capillary refill less than 2 seconds
50
Priority concern for child vomiting
Dehydration
Loss and fluid and electrolytes
Metabolic alkalosis
Atelactasis
Pneumonia
51
Projectile vomiting may indicate
Pyloric stenosis
ICP
52
Signs of dehydration
Sunken fontanel
Neolastic skin turgor
Dry mucus membranes
Decreased tear production
Changes in vital signs
Oliguria
53
How to prevent aspiration
Maintain a patent airway
Turn child one the side
Ask another member to obtain suction equipment
Check respiratory status and lung sounds
Check the character and amount of vomitus
Notify HCP if aspiration is suspected
54
Major concern for child having diarrhea
Dehydration
Loss of fluid and electrolytes
Metabolic acidosis
Orthostatic vitals signs
55
Cleft palate put child at risk for
Otitis media
Hearing loss
56
Complications for GI reflux
Esophagitis
Tissue damage
Failure to thrive
Aspiration of gastric content
Aspiration pneumonia
57
Clinical manifestation for Hirschprung disease
Foul smelling ribbon-like stools
Delayed or absence meconium
Bowel obstruction
Abdominal pain and distention
Failure to thrive
58
How to reduce episode of emesis
Thicken the feeding by adding rice cereal to the formula
59
Intussuception manifestations
Bright red blood and mucus in the stool
Pale
Draw legs up to the chest
Colicky abdominal pain
Red currant jelly like stool
Acute abdominal pain
Distended abdomen
Vomiting
Lethargy
60
Hepatitis intervention
Provide low fat, well balanced diet
Teach the child effective handwashing technique
Remember jaundine is expected to
61
Strabismus is
Conditions where eyes are not aligned
Also called squint or cross eyes
62
How to administer ear medications to a child younger than 3 years
Pull the earlobe down and back
63
How to administer ear medications to a child older than 3 years
Pull pinna up and back
64
After tonsillectomy only suction
If there is airway obstruction because of the risk of trauma to the surgical site
65
Intervention for otitis media
Provide soft diet
Administer ibuprofen for fever every 4 hours as prescribed
66
Epiglottitis is mainly caused by
Haemophilus influenzae
67
Signs for epiglottitis
Tripod position
Drooling
Stridor
Muffled hoarse voice
68
If client got epiglottitis do not
Attempt to visualize the posterior pharynx
Attempt to take throat culture
Take oral temperature
69
Child with respiratory disorder needs to be monitored for
Weight loss
Signs of dehydration
70
Asthma intervention
Administer oxygen by face mask
Administer quick relief rescue meds
Initiating IV line
Administer corticosteroid
Preparing child for chest radiograph
Prepare to obtain sample for determining arterial blood gas levels
71
Tuberculosis is causes by
Mycobacterium tuberculosis
72
Skin test or mantoux test interpretation
Induration of 15 mm or more is considered positive in children 4 years or older
Induration of 10 mm is considered positive in children younger than 4 years and in children with chronic illness or at high risk for exposure to tuberculosis
Induration of 5 mm or more is considered to be positive for highest risk group such as children with immunosuppresive conditions or HIV
73
Intervention for discomfort in lower lobe when client got pneumonia
Encourage to lie on the side the child got the discomfort
74
Cool mist therapy intervention when is causing distress
Hold the child and direct cool mist over the child face
75
RSV transmission method
Droplet and direct contact
76
RSV precautions
Standard
Private room
77
Digoxin administration teaching for children
Hold if apical pulse is less than 90-110 per minute in infant and young children
Less than 70 in older children
78
Hypercyanotic episodes intervention
Calm infant and minimize stimuli
Place in knee chest position
Contact HCP or cardiologist
Administer 100% O2
Administer morphine sulfate
Administer fluid IV
Document
79
Early sign of heart failure
Tachycardia
Tachypnea
Profuse scalp sweating
Fatigue
Irritability
Weight gain
Respiration distress
80
Laboratory that confirm rheumatic fever
Anti-streptolysin O titer
81
Signs and symptoms of kawasaki disease in the acute stage
Fever
Conjunctival hyperemia
Red throat
Swollen hands
Rash
Enlargement of the cervical lymph node
82
Signs and symptoms of aortic stenosis
Activity intolerance
Chest pain
Dizziness when standing for long period of time
83
When to administer oxygen to child with HF
Stressful period
Invasive procedures
84
Nephrotic syndrome manifestations
Proteinuria
Hypoalbuminemia
Hyperlipidemia
Edema
Anorexia
Pallor
Weight gain
85
Peritoneal dialysis intervention
Put client on fluid restriction
86
How to protect exposed bladder due to bladder extrophy
Cover the bladder with non adhering plastic wrap
87
Urinalysis expectation for epispadias
Bacteriuria
88
Seizure’s intervention
Have suction equipment available
Raise side rails of the bed
Pad the side rails
Clear area
Time seizure episode
Place pillow under child head
Loosen restrictive clothes
Remove eye glasses
If vomiting turn to one side
Do not place anything on mouth
Remain with client
Observe for incontinence
Place water proof mattress or pad on bed
Notify hcp
89
Drainage from nose and ear that is positive for glucose indicate
Leakage of CSF
90
Signs of ICP in child
High, shrill cry
91
Kernig signs
Inability to extend leg when the thigh is flexed anteriorly at the hip
92
Brudzinski signs
Neck flexion causes addiction and flexion movement of the lower extremity
93
Reye’s syndrome meds
Ibuprofen
Acetaminophen
94
Cerebral palsy is
Chronic disability characterized by impaired muscle movement and posture
95
Nasotracheal suction is contraindicated in
Client with head injury like basilar skull fracture
96
Reyes syndrome intervention
Provide quiet environment with dim lighting due to cerebral edema and fatty changes in liver caused by it
Check for jaundice
97
Hydrocephalus intervention
Reposition frequently
98
Bone protruding for leg injury intervention
Immobolize the extremity
Check neurovascular function
Cover wound with sterile dressing
Elevate the injured extremities if possible
Apply cold to area
Arrange to transport to ER
99
Skeletal traction intervention
Check the amount of weight to apply
100
Assessment to assess dysplasia of the hip
Ortholani manoeuver
101
Plaster cast teaching
Keep toys , sharp objects away from the cast
Elevate the extremities on pillow for the first 24 to 48 hours after casting to prevent swelling
Notify HCP if numbness and tingling is present
102
Rubeola (measles) transmission method
Airborne
103
Rubella method of transmission
Airborne or direct contact with infectious droplet
104
Mumps intervention
Private room
Standard, droplet, contact precautions implemented
N95 mask
Wear gown , gloves, hand hygiene
Provide soft food that requires no chewing
Apply hot or cold compress to the neck
Apply snug fitting pants to relieve orchitis
Monitor for aseptic meningitis
105
Chicken pox method of transmission
Direct contact , airborne, droplet spread
106
Pertussis method of transmission
Direct contact or droplet
107
Mononucleosis teaching
Monitor for signs of splenic rupture (abdominal pain, left upper quadrant pain, left shoulder pain )
108
Most common symptoms of covid are
Fever , cough
109
Most common opportunistic infection of children with HIV is
Cough (pneumocystis jiroveci)
110
What test detect HIV in infants
P24 antigen essay
111
With what you clean belonging of HIV client
With bleach
112
Kolips spots in rubeola (measles) characteristics
Small blue white spots with a red
base found on the buccal mucosa
Rash begins on the face and spread downward toward the feet
Respiratory symptoms such as profuse runny nose , cough , fever occur before the development of rash
113
When do rheumatic fever presents
After untreated group A beta hemolytic streptococcal infection
114
Fifth disease (erythema infectiosum) manifestations
Intense fiery red edematous rash on the cheeks
115
Sickle cell crisis manifestations
Pallor
Fever
Pain swelling of hand , feet, joint
Abdominal pain
116
Priority intervention for sickle cell crisis
Hydration therapy
Pain relief
117
Cause of hydrocephalus
Closure of cranial sutures
118
Aortic stenosis manifestation
Exercise intolerance
Chest pain
Dizziness
119
Post heart surgery for kid teaching
Cannot participate in physical activity for 2 months
May return to school in 3 weeks but for half days
120
Rheumatic fever labs diagnostic
Elevated antitreptolysin
Elevated erythrocyte sedimentation
Leukocytosis
Positive result on C-reactive protein
Presence of group A beta-hemolytic strep
121
Early signs of heart failure
Tachypnea
Poor feeding
Diaphoresis
122
Right to left cardiac shunt manifestation
Bluish discoloration of the skin (cyanosis)
123
Risk factor for otitis media
Bottle feeding
Household smoking
Exposure to illness from other children in daycare centers such as down syndrome, cleft palate
124
Strabismus intervention if nonsurgical intervention are not successful
Surgery may be necessary to realign the weak muscle
125
What period cleft-lip is performed
First month of life
6 months to 2 years of age
126
What is intussusception
Is a proximal segment of the bowel prolapse into a distal segment of the bowel
127
Gastroschisis priority concern
Odor
128
Appropriate position following imperforate anus surgery
Prone
Side lying with leg flexed
129
Cleft lip palate surgery teaching
You need to use orthodontic nipple on the child bottle
Give child baby food or mix with water
straw , pacifiers, finger need to be kept away from child mouth for 7-10 days
Rinse mouth with water
130
Hirschsprung disease characteristics
Stools are ribbon like
Eating poorly
131
Pyloric stenosis manifestations
Constipation, vomiting of undigested food
132
Hepatitis manifestations
Hepatomegaly
Left upper abdominal quadrant pain
133
Lactose intolerance cause
Frothy stools and diarrhea
134
Food that needs to be avoided for celiac disease
Wheat, Rye, barley , oat
135
Appendicitis preoperative position
Fetal position, side lying with legs drawn up to the chest
136
Inperforated anus characteristic
Presence of an anal membrane
137
Projectile vomiting in pyloric stenosis priority intervention
Surgery
138
Severity of dehydration
Mild dehydration : less than 5% weight poss
Moderate dehydration: 5-10% weight loss
Severe dehydration: 10% or more
139
Strangulated hernia (emergency) manifestations
Vomiting
Pain
Irreducible mass at the umbilicus
140
Sickle cell may be precipitated by what :
Infection
Dehydration
Hypoxia
Trauma
Physical
Emotional stress
141
Von willebrand disease characteristics
Bleeding
Epistaxis
Gum bleeding
Easy bruising
Excessive mentrual period
Causes platelets to adhere to damage endothelium
142
Joint Pain due to hemophilia or hemarthrosis intervention
Apply bivalved cast for joint immobilization
143
What lab value increase due to sickle cell anemia
Reticulocyte count
144
Bleeding into joint of the knee intervention
Measure the injured knee joint to assess for the progression of the bleeding
145
Meds for severe pain due to sickle cell
Morphine
146
Iron deficiency anemia characteristics
Pallor
Porcelain-like skin
Tachycardia
Lethargy
Irritability
147
Sickle cell facts
Is an autosomal recessive disorder
Children with the HbS (sickle cell hemoglobin) trait are not symptomatic
If one parent has the trait and the other parent is normal , it’s 50% chsnce that the offspring will inherit
148
Diagnostic to confirm aplastic anemia
Bone marrow biopsy
149
CD4+ test is used for what
Immune status
Risk and progression of the disease
Need for pneumonia prophylaxis after 1year of age
This test does not specifies specific diagnosis of HIV ( remember)
150
MMR should be given with caution to child with
History of allergy to gelatin , eggs, or neomycin
Allergic to antibiotics
151
Neutropenic child intervention
Child is placed on low bacteria diet
Use sterile techniques
Peel fruits and vegetables before eating
152
If a child is allergic to neomycin do not give what vaccine
IPV (Polio Vaccine)
153
What site do you administer MMR vaccine
Subcutaneously in the outer aspect of the upper arm
154
Scarlet fever manifestation
Pastia’s sign
White strawberry tongue
Edematous and beefy red pharynx
155
Varicella vaccine can be administered at what age
12 month old
156
What vaccine can you give a child at 4 years old
TDAP
Polio
MMR
Varicella
157
Rotavirus vaccine is given at what age
2 and 4 months
158
Meningococcal vaccine is given at what age
11-16 years of age
159
How is roseola transmitted
Through saliva
160
Impetigo facts
Extremely dangerous
Common in humid water
Might show up in an area of broken skin such as insect bite
161
Lindane is contraindicated in client
Younger than 2 years
162
Pediculosis capitus (lice ) characteristic
White sacs attached to the hair shaft in the occipital area
163
Burn injury in child facts
Scarring is more severe in child than in adult
Delay growth may occur after burn injury
At risk for infection
Higher proportion body increase risk for cardiovascular risk
Burn more than 10% of body total requires fluid resuscitation
Increase risk for protein and calories deficiency
164
Cellulitis teaching
Rest in bed
Extremity elevated and immobilized
Warm moist soak apply every 4 hours to relieve pain and promote healing
165
Priority nursing interventions for a child burn
Insertion of urinary indwelling urinary catheter
166
What blood glucose level is considered hypoglycemia
Less than 70
167
Insulin administration rotation teaching
Give 4 to 6 injections in 1 area, about 1 inch apart and then move to another area
168
Humilin R peak time
6 to 12 hours
169
Do not administer potassium if client got
Oliguria
Anuria
170
Client with diabetes practicing sports teaching
Eat extra snack of 15 to 30 grams of carbohydrates
171
Mild dehydration symptoms
Skin color is pale
172
Whenever diebetes client have an illness of blood glucose over 240 it is necessary to check for
Ketones
173
Scoliosis is not
Curative with brace
174
Injury to epiphyseal line put child at risk for
Uneven future growth be because this line is responsible for longitudinal bone growth
175
Primary action of russell traction
Realign a fracture in lower extremity and to immobilize the hip and knee in a flexed position
176
Position when placing pavlik harness
Abduction
177
Hip dysplasia characteristics
Asymmetry of the gluteal fold when the infant is placed prone and the legs are extended against the examining table
178
How is the ortolani manoeuver is performed
Examiner abduct both hips
It is positive if a palpable click on the affected side during abduction
179
Juvenile rheumatoid arthritis symptoms
Joint point longer than 6 weeks
Swollen joint pain
Morning stiffness
History of late afternoon
180
Decerebrate posturing is the
Rigid extension and pronation of the arms and legs
181
Meningitis teaching
Maintain respiratory isolation precautions for at least 24 hours after the initiation of antibiotics
182
Signs that brainstm has been involved after brain tumors surgery
Elevated temperatures
So monitor vitals signs and neurological status
183
Scoliosis is
Abnormal lateral curvature of the spine
184
Meningitis signs and symptoms
Severe headache
Fever
Stiff neck
Change LOC
185
Diffferences for Decorticate and decerebrate posturing
Decorticate posturing : abnormal flexion of the upper extremity and extension of the lower extremities with possible plantar flexion of the hip.
Decerebrate posturing is abnormal extension of the upper extremities with internal rotation of the upper arms and wrist and extension of the lower extremities with some internal rotation
186
Infratentorial tumor removal position
Flat on either side
187
Postoperative intervention for spinal bifida
Elevate the head , this will decrease the chance that cerebrospinal fluid will accumulate in the cranial activity
188
A larger-than-normal fontanel is a sign
ICP
189
Meningitis precautions
Droplet
190
Early signs of ICP
Nausea
191
Cerebral palsy manifestation
Impair movement and posture
Arms or legs are stiff
CP is very low birth weight
Difficulty feeding, poor sulking and swallowing
Crawling with one side used properly
192
Osteosarcoma teschingv
Femur is most common site
Limping is a clinical manifestation
193
Cyclophosphamide indication
Leukemia
194
Cyclophosphamide side effects
Hemorrhagic cystitis
Bone marrow depression
195
Lumbar puncture position
Lateral recumbent, knees flexed to the abdomen and the head bent , chin down
196
Neuroblastoma symptoms
Elevated vanillymandelic acid level in urine , so always do 24 hour urine collection
197
Classic sign of brain tumor
Vomiting
Headache
198
Wilms tumor intervention
Inspect urine for presence of hematuria at each voiding
199
Hypospadias teaching
Circumcision will be delayed.
200
Sore throat and throat may be a sign of
Glomerulonephritis
201
Glomerulonephritis signs and symptoms
Hematuria resulting in dark , smoky cola colored or brown colored urine
202
Food to avoid with nephrotic syndrome
Pickle
Chips
Cured meats
203
Orchiopexy complications
Bleeding
Infection
204
Bladder extrophy teaching
No sphincter mechanism for 3-5 years. Urine will drain freely
205
Loose teeth with tonsillectomy may cause
Aspiration
206
Bad mouth odor after tonsillectomy
Is a normal condition and may be relieved by drinking morex fluid
207
After tonsillectomy what liquid diet do you give
Clear liquid diet (yellow noncitrus Jell-O)
Green gelatin
208
Treatment if viral pneumonia and bacterial pneumonia
Viral pneumonia treated with : supportive treatment
Bacterial pneumonia treated with: antibiotics therapy
209
Post tonsillectomy position
Prone
Side lying position
210
Acute spasmodic episode teaching
Take child out into the cool, humid night air
Place a cool-mist humidifier in the child room
Inhale the steam from warm running water
211
What test screen for strabismus?
Cover-uncover test
Corneal light reflex test
212
Most common location for aspirated foreign body
Right mainstem bronchus in the lower lobe
213
Gastroesophageal reflux disease manifestations
Chronic cough
Abdominal pain
Hoarse voice
Recurrent pneumonia
214
Hepatitis B affect what lab
Elevated alanine aminotransferase level (ALT)
215
How do you contract cryptosporidiosis
Swallow infect water
216
Kawasaki disease teaching
Take temperature for 1-2 weeks
Do not administer live vaccine : MMR, varicella
Needs to be deferred for 11 months after the administration of IVIG
If the skin is peeling this is normal
Give warm baths to help with any joint pain
217
Kawasaki disease manifestations
Strawberry tongue
Bilateral conjunctival edema
Two cervical lymph node measuring 2 cm
Erythema and peeling of the palms and soles of the feet
218
For a child what BMI indicate obesity
95th percentile
219
FLACC scale is used for what type of patient
Nonverbal
220
Cries scale is used for what patient ?
6 months age or younger
221
Most common complications for Hirschprung disease
Enterocolitis
222
Laryngotracheobronchitis (croup) teaching
Antibiotics are not indicated unless bacterial infection is present
223
In piaget operational stage what can the child do?
Ability to think abstractly
224
Anterior fontanel closes when
By 12-18 months of age
225
Toddler toys must be
Strong , safe , too large for swallow or place in ear or nose
226
Toys for toddler
Push-pull toys
Large crayons
Large trucks
Dolls
Nclex prep
flashcards
Decks in class (8)
# Cards
