2513 Exam Blueprint
Modules: 7, 8, 9 & 10
Dosage calc – 3 problems
What are techniques for administration of ear drops (less than 2 versus older than 2)
What are tips for helping a child take oral medication?
Hold infant in semi-reclining position.
Stroke infant under chin while holding cheeks together to promote swallowing.
Hold small child upright to prevent aspiration
Administer medication in small amts on side of cheek to allow and promote swallowing
Mix med in small amount of sweet non-essential food (i.e. apple sauce).
Add flavoring if able
Reward small child with prize
What are teaching tips for use of a metered-dose inhaler? SATA
What’s important to know about the newborn/infant nose and breathing? What assessments are important? p. 932
- Newborns / infants are OBLIGATORY nose breathers
- DO NOT do anything to occlude the nares.
What are post-tonsillectomy nursing cares?
Positioning: Facilitate drainage. Elevate HOB when awake.
S/sx of bleeding: Frequent swallowing, clearing throat, bright red emesis, tachycardia, pallor.
Liquid analgesics (on a reg schedule)
Teracaine pops as prescribed
Ice collar
Ice chips, small sips water, initiate clear liquid diet as tolerated.
Discourage dairy products, red colored products, and citrus products.
Discourage coughing, throat clearing, and nose blowing. AVOID STRAWS.
What are therapeutic interventions to manage croup (bronchiolitis)?
- Supplemental O2 to keep O2 sat ≥ 90%
- Encourage fluid intake if able to tolerate PO intake
- Maintain airway
- Meds: DO NOT GIVE BRONCHODILATORS. CORTICOSTEROIDS controversial. ATBX if infxn present.
- DO NOT perform CPT
- Suction PRN
- Encourage breastfeeding
, What are symptoms of streptococcal pharyngitis and complications/risks?
- S/sx:
Pharyngitis
H/A
Fever
ABD Pain
Inflammation of pharynx, covered with exudate (be 2 nd day of illness).
- Complications / Risks:
Rheumatic fever
What are head injury assessments?
LOC
Minor injury
- Loss of LOC / drowsiness Progression of injury:
- Period of confusion - Changes in VS
- Vomiting - AMS
- Pallor - Focal neurologic deficits
- Irritability - Increased agitation
- Lethargy
Severe Injury:
- Increased intracranial pressure in INFANTS - Increased intracranial pressure in CHILDREN
* Bulging fontanel, distended scalp veins * Nausea
* Separation of cranial sutures * Forceful vomiting
* Irritability * H/A
* Restlessness * Blurred vision
* Increased sleeping * Increased sleeping
* High pitched cry * Inability to follow simple commands
* Poor feeding * Decline in school performance
* Sun-setting sign * Seizures
- Late findings
* Altered pupillary response
* Posturing (flexion or extension)
* Bradycardia
* Decreased motor response
* Decreased response to painful stimuli
* Cheyne-Stokes respirations
* Optic disc swelling
* Decreased LOC
* Coma
, Skull FX
- Misshapen skull (depressed)
- Leakage of CSF from nose or ear
- Basilar: Blood behind TM, over mastoid process, or around orbits
Open: Tissue laceration over FX. Possible CSF leakage
Growing: Skull defect, scalp edema, neurologic changes can occur months or years after injury.
What is included in a health history for fevers?
Review ALL symptoms, signs and blood work?
Early SX Late SX
- Low grade fever - Hematuria
- Pallor - Pain
- Increased bruising and petechiae - Ulcerations in mouth
- Listlessness - Enlarged kidneys and testicles
- Enlarged lymph nodes, liver, joints - S/sx of increased of ICP
- ABD, leg, joint pain
- Constipation
- HA
- Vomiting and anorexia
- Unsteady gait
LABS – CBC
Anemia
Thrombocytopenia (low platelets)
Neutropenia (low neutrophils)
Leukemic blasts (immature WBCs)
Blood smear (immature WBCs)
What are signs/clinical manifestations/assessment findings in a child with bacterial/viral pneumonia? (lung sounds) SATA
High fever
Cough (productive or non-productive) (white sputum).
Tachypnea
Retractions and nasal flaring
Chest pain
Dullness with percussion
Adventitious lung sounds: Rhonchi and fine crackles (Bacterial)
Pallor that progresses to cyanosis
Irritability, restlessness, lethargic
ABD pain, diarrhea, anorexia, vomiting
Modules: 7, 8, 9 & 10
Dosage calc – 3 problems
What are techniques for administration of ear drops (less than 2 versus older than 2)
What are tips for helping a child take oral medication?
Hold infant in semi-reclining position.
Stroke infant under chin while holding cheeks together to promote swallowing.
Hold small child upright to prevent aspiration
Administer medication in small amts on side of cheek to allow and promote swallowing
Mix med in small amount of sweet non-essential food (i.e. apple sauce).
Add flavoring if able
Reward small child with prize
What are teaching tips for use of a metered-dose inhaler? SATA
What’s important to know about the newborn/infant nose and breathing? What assessments are important? p. 932
- Newborns / infants are OBLIGATORY nose breathers
- DO NOT do anything to occlude the nares.
What are post-tonsillectomy nursing cares?
Positioning: Facilitate drainage. Elevate HOB when awake.
S/sx of bleeding: Frequent swallowing, clearing throat, bright red emesis, tachycardia, pallor.
Liquid analgesics (on a reg schedule)
Teracaine pops as prescribed
Ice collar
Ice chips, small sips water, initiate clear liquid diet as tolerated.
Discourage dairy products, red colored products, and citrus products.
Discourage coughing, throat clearing, and nose blowing. AVOID STRAWS.
What are therapeutic interventions to manage croup (bronchiolitis)?
- Supplemental O2 to keep O2 sat ≥ 90%
- Encourage fluid intake if able to tolerate PO intake
- Maintain airway
- Meds: DO NOT GIVE BRONCHODILATORS. CORTICOSTEROIDS controversial. ATBX if infxn present.
- DO NOT perform CPT
- Suction PRN
- Encourage breastfeeding
, What are symptoms of streptococcal pharyngitis and complications/risks?
- S/sx:
Pharyngitis
H/A
Fever
ABD Pain
Inflammation of pharynx, covered with exudate (be 2 nd day of illness).
- Complications / Risks:
Rheumatic fever
What are head injury assessments?
LOC
Minor injury
- Loss of LOC / drowsiness Progression of injury:
- Period of confusion - Changes in VS
- Vomiting - AMS
- Pallor - Focal neurologic deficits
- Irritability - Increased agitation
- Lethargy
Severe Injury:
- Increased intracranial pressure in INFANTS - Increased intracranial pressure in CHILDREN
* Bulging fontanel, distended scalp veins * Nausea
* Separation of cranial sutures * Forceful vomiting
* Irritability * H/A
* Restlessness * Blurred vision
* Increased sleeping * Increased sleeping
* High pitched cry * Inability to follow simple commands
* Poor feeding * Decline in school performance
* Sun-setting sign * Seizures
- Late findings
* Altered pupillary response
* Posturing (flexion or extension)
* Bradycardia
* Decreased motor response
* Decreased response to painful stimuli
* Cheyne-Stokes respirations
* Optic disc swelling
* Decreased LOC
* Coma
, Skull FX
- Misshapen skull (depressed)
- Leakage of CSF from nose or ear
- Basilar: Blood behind TM, over mastoid process, or around orbits
Open: Tissue laceration over FX. Possible CSF leakage
Growing: Skull defect, scalp edema, neurologic changes can occur months or years after injury.
What is included in a health history for fevers?
Review ALL symptoms, signs and blood work?
Early SX Late SX
- Low grade fever - Hematuria
- Pallor - Pain
- Increased bruising and petechiae - Ulcerations in mouth
- Listlessness - Enlarged kidneys and testicles
- Enlarged lymph nodes, liver, joints - S/sx of increased of ICP
- ABD, leg, joint pain
- Constipation
- HA
- Vomiting and anorexia
- Unsteady gait
LABS – CBC
Anemia
Thrombocytopenia (low platelets)
Neutropenia (low neutrophils)
Leukemic blasts (immature WBCs)
Blood smear (immature WBCs)
What are signs/clinical manifestations/assessment findings in a child with bacterial/viral pneumonia? (lung sounds) SATA
High fever
Cough (productive or non-productive) (white sputum).
Tachypnea
Retractions and nasal flaring
Chest pain
Dullness with percussion
Adventitious lung sounds: Rhonchi and fine crackles (Bacterial)
Pallor that progresses to cyanosis
Irritability, restlessness, lethargic
ABD pain, diarrhea, anorexia, vomiting
