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NUR2513 Exam 3
MCH – Exam 3
7 (Chp 34, 38, 40, 41): Interventions for hospitalized peds client, Respiratory, Cardiac Diseases/Disorders
• What are techniques for administration of ear drops (less than 2 versus older than 2)
- < 3 yo: down & back
- > 3yo: up & back
- Instill medication, hold child’s head sideways to ensure med fills the ear canal
• What are tips for helping a child take oral medication?
- Have child in a comfortable position in the parent’s lap – do not lay flat
- Syringe against the cheek
- Pinch cheeks together
- Mix w/ small amount of food (apple sauce for ex.)
- Do no mix in a full bottle
- Instill medication slowly, reward later
- Be sincere, do not like, do not say it taste like candy
• What are teaching tips for use of a metered-dose inhaler?
- Shake the inhaler, exhale deeply
- Activate the inhaler, place in the mouth as the child begins to inhale
- Take a long slow inhalation, hold breath for 5-10sec
- 1 puff at the time, wait 1min between puffs
- Steroid inhaler: wash/clean mouth after dose to avoid thrush
• What’s important to know about the newborn/infant nose and breathing? What assessments are important?
p. 932
- Babies are obligated nose breathers
- Assess for nasal flaring, patency (1 nostril at the time)
- Retractions, suction mouth before nose
- OG tube preferred
• What are signs of dehydration? (see below)
- Prolonged cap refill, abnormal turgor, abnormal respiratory pattern, mottling, tachycardia
- Dry mucous membranes, absence of tears
- Mild/Moderate: PO challenge (oral rehydration)
- Severe: IV fluids
• What are interventions for mild/moderate versus severe dehydration from gastroenteritis? pp. 1062-1063
- Oral rehydration
- IV fluids: Isotonic NS
- Up to 10kg: 100ml/kg
, 2
- 11-20kg: 1000mL + 50mL/kg for each adtl kg over 10kg
- > 20kg: 1500mL + 20mL/kg for each adtl kg over 20kg
• What are therapeutic interventions to manage croup (bronchiolitis)?
- Most common cause: RSV
» Less severe: antipyretics, adequate hydration, nasal suction & saline, avoid tobacco exposure
» Bacterial: abx
» Viral: cold air, shower steam, decadron, no cough meds – dries out & thickens secretions
- Monitor for a patent airway, O2 sats, stridor: if high high pitch sound presents, give racemic Epinephrine
nebulizer
• What are symptoms of streptococcal pharyngitis and complications/risks?
» S/S: fever, difficulty swallowing, sore throat, H/A, stomach ache, bright red tonsils/pharynx
» Tx: Abx (Penicillin, Cephalosporin), treat symptoms w/ analgesics, fluid, rest
» Compl.: Rheumatic fever or Glomerulonephritis (abx may help the chances of occurrence and shortens
duration of symptoms)
• What are post-tonsillectomy nursing care?
- Report frequent swallowing (indication of bleeding)
- Signs of bleeding: 𝖳 RR, frequent swallowing, throat clearing, anxiety
- Clear cool liquids/ice chips: nothing red, citrus or milk products
- Do not use straw, position for drainage, limit activity to prevent bleeding/hemorrhage
• What are signs/clinical manifestations/assessment findings in a child with pneumonia?
» S/S: High fever, tachy, cx/abd pain, chills, productive cough, fatigue, crackles, elevated temp, anxiety, resp.
distress
- May have blood tinged sputum for the 1st 24-48h thick sputum
- Dullness on percussion Total consolidation
- Labs: will indicate leukocytosis
» Tx: IV therapy, Abx, antipyretics, assess O2 star frequently, humidified O2 may help labored breathing
- CPT: encourage movement of mucus, prevent obstruction
- Reposition child to prevent pooling of secretions
• What are signs/symptoms and treatments of viral pneumonia?
» S/S: those of an URI, fatigue. Leads to diminished breath sounds, rales
» Tx: Rest and antipyretics
• What are treatments and teaching topics for management of cystic fibrosis?
- Autosomal recessive, affects respiratory, GI, reproductive
» Tx: respiratory, CPT, Abx (Tobramycin, Azythromycin)
- Bronchodilators, anticholinergics, dornase alfa ( mucous viscosity)
- Vitamins ADEK, pancrelipase, aerosol therapy
» Teach: take pancrelipase 30min before meals
NUR2513 Exam 3
MCH – Exam 3
7 (Chp 34, 38, 40, 41): Interventions for hospitalized peds client, Respiratory, Cardiac Diseases/Disorders
• What are techniques for administration of ear drops (less than 2 versus older than 2)
- < 3 yo: down & back
- > 3yo: up & back
- Instill medication, hold child’s head sideways to ensure med fills the ear canal
• What are tips for helping a child take oral medication?
- Have child in a comfortable position in the parent’s lap – do not lay flat
- Syringe against the cheek
- Pinch cheeks together
- Mix w/ small amount of food (apple sauce for ex.)
- Do no mix in a full bottle
- Instill medication slowly, reward later
- Be sincere, do not like, do not say it taste like candy
• What are teaching tips for use of a metered-dose inhaler?
- Shake the inhaler, exhale deeply
- Activate the inhaler, place in the mouth as the child begins to inhale
- Take a long slow inhalation, hold breath for 5-10sec
- 1 puff at the time, wait 1min between puffs
- Steroid inhaler: wash/clean mouth after dose to avoid thrush
• What’s important to know about the newborn/infant nose and breathing? What assessments are important?
p. 932
- Babies are obligated nose breathers
- Assess for nasal flaring, patency (1 nostril at the time)
- Retractions, suction mouth before nose
- OG tube preferred
• What are signs of dehydration? (see below)
- Prolonged cap refill, abnormal turgor, abnormal respiratory pattern, mottling, tachycardia
- Dry mucous membranes, absence of tears
- Mild/Moderate: PO challenge (oral rehydration)
- Severe: IV fluids
• What are interventions for mild/moderate versus severe dehydration from gastroenteritis? pp. 1062-1063
- Oral rehydration
- IV fluids: Isotonic NS
- Up to 10kg: 100ml/kg
, 2
- 11-20kg: 1000mL + 50mL/kg for each adtl kg over 10kg
- > 20kg: 1500mL + 20mL/kg for each adtl kg over 20kg
• What are therapeutic interventions to manage croup (bronchiolitis)?
- Most common cause: RSV
» Less severe: antipyretics, adequate hydration, nasal suction & saline, avoid tobacco exposure
» Bacterial: abx
» Viral: cold air, shower steam, decadron, no cough meds – dries out & thickens secretions
- Monitor for a patent airway, O2 sats, stridor: if high high pitch sound presents, give racemic Epinephrine
nebulizer
• What are symptoms of streptococcal pharyngitis and complications/risks?
» S/S: fever, difficulty swallowing, sore throat, H/A, stomach ache, bright red tonsils/pharynx
» Tx: Abx (Penicillin, Cephalosporin), treat symptoms w/ analgesics, fluid, rest
» Compl.: Rheumatic fever or Glomerulonephritis (abx may help the chances of occurrence and shortens
duration of symptoms)
• What are post-tonsillectomy nursing care?
- Report frequent swallowing (indication of bleeding)
- Signs of bleeding: 𝖳 RR, frequent swallowing, throat clearing, anxiety
- Clear cool liquids/ice chips: nothing red, citrus or milk products
- Do not use straw, position for drainage, limit activity to prevent bleeding/hemorrhage
• What are signs/clinical manifestations/assessment findings in a child with pneumonia?
» S/S: High fever, tachy, cx/abd pain, chills, productive cough, fatigue, crackles, elevated temp, anxiety, resp.
distress
- May have blood tinged sputum for the 1st 24-48h thick sputum
- Dullness on percussion Total consolidation
- Labs: will indicate leukocytosis
» Tx: IV therapy, Abx, antipyretics, assess O2 star frequently, humidified O2 may help labored breathing
- CPT: encourage movement of mucus, prevent obstruction
- Reposition child to prevent pooling of secretions
• What are signs/symptoms and treatments of viral pneumonia?
» S/S: those of an URI, fatigue. Leads to diminished breath sounds, rales
» Tx: Rest and antipyretics
• What are treatments and teaching topics for management of cystic fibrosis?
- Autosomal recessive, affects respiratory, GI, reproductive
» Tx: respiratory, CPT, Abx (Tobramycin, Azythromycin)
- Bronchodilators, anticholinergics, dornase alfa ( mucous viscosity)
- Vitamins ADEK, pancrelipase, aerosol therapy
» Teach: take pancrelipase 30min before meals
