Care of a child ATI Remediation Notes(questions and answers)

Prophylactic antibiotic therapy for what burn injury? NONE do not do this for any type of burn clinical manifestations of Celiacs disease steatorhea, diarrhea, malabsorption, weight loss Indication of pertussis "whooping cough" dry hacking cough usually at night Juvenile Idiopathic Arthritis encourage frequent activity and movement... don't want long naps or rests Pneumonia symptoms dyspnea (labored breathing), chills, fever, cough, dark sputum, diarrhea, High WBC What to do when a child has epiglottis Sit up right, monitor oxygen, respiration's closely DO NOT- put anything in the mouth or take a throat culture Tonic Clonic Seizure actions lay on side lying position, move hazardous objects, move pillows DO NOT place anything in the mouth, do not try to hold them down (need to let them seize freely) Car seat safety 45 degree angle to prevent airway obstruction the shoulder harness is placed in slot or below infants shoulders, retainer clip placed at the level of the infants arm pits Vaccine at birth Heb B (also given vitamin K) 2 Month vaccine DTaP RV IPV HIB(influenza B) PCV Heb B 4 Month Vaccine Dtap RV IPV Hib PCV 6 Month Vaccine Dtap IPV PCV RV Hib Hep B 6-12 month vaccine seasonal flu shot each year 12 month Vaccine Heb A Heb B Varicella MMR How to administer shot to children/newborns give sucrose pacifier apply lidocaine mixture 60 min before shot smallest gauge possible around 24 vastus lateralis secure child if needed relief for pain with opioids are best.. when also given other analgesics, to provide the most relief and to lower risks of Respiratory distress etc.. Expected findings of meningitis nausea, irritability, headache, photo phobia newborn: poor muscle tone, weak cry, poor suck, refuses feeding, fever or hypothermia 3monthes-2years: seizures, high pitched cry, bulging fontanels, brudzinski or kernig sign Nursing action before lumbar puncture to check CSF for meningitis have them empty bladder side lying position: head flexed with knees up monitor for bleeding, hematoma, or infection Suspected meningitis droplet precautions right away, petechiae or purpuric type rash needs immediate attention, signs of intercranial pressure infant: bulging fontanel, increased head circumference, high pitch cry, bradycardia, respiratory changes child: vomiting, bradycardia, respiratory changes, headache, irritability Reye syndrome symptoms lethargy, vomiting, hyperventilation, organ changes, coma, seizures, loss of consciousness lab test during reye syndrome ALT(liver enzyme) elevated ammonia level elevated electrolytes altered coagulation time extended visual screenings 10 feet away, wearing glasses if needed, both eyes open, just cover each eye, tumbling E chart or Snellen chart Metered dose inhaler shake, use spacer, deep breath in 3-5 sec, DPI dry powder inhaler dont shake, hold breath after taking 5-10sec, can use spacer Hypoxemia inadequate oxygen in the blood hypovolemia and hypoventilation can lead to this. early signs: tachypnea and tachycardia, restless, pallor, respiratory distress late: confusion, cyanosis, bradypnea, bradycardia, hypotension/hyper Measles symptoms fever, koplik spots, cough, red eyes, conjunctivits, sore throat, rash medication for varicella? acyclovir What labs are elevated with dehydration? (possible signs during diarrhea) elevated BUN, Hgb, Hct, creatinine, urine specific gravity Tests for diarrhea labs, stool test, CBC, and urinalysis Language at 2 years old about 300 words, multi word sentences How to deal with child who who has sleep terrrors It is normal unless there are concerns about danger to themselves. Dont wake them up Use night lights dont let them sleep in parents room Response to death: 3-6 years: magical thinking of death, not permanent, child can feel guilt or shame as thoughts can cause death, see death as punishment 6-12 years: usually a good grasp on death, wonder what happened to body, wonder about funeral service, may act out Dietary restrictions for Phenylketonuria need to keep it between 2-8 mg/dl exclusive breast feeding may be restricted due to it containing phenylalanine put on formula low in this 20-30 per kg diet restriction right after birth low protein diet. Foods such as meat, fish, eggs, milk, cheese, and nuts are excluded as they contain high levels of phenylalanine. Erythromycin treats pertussis (whooping cough), rheumatic fever, chlamydia, pneumonia Tobramycin ● Neomycin ● Streptomycin ● Paromomycin aminoglycosides: cannot mix with penicillin in same IV assess for: tinnitis, headache, vertigo, nausea, dizziness digoxin When to hold: Negative effects: positive effects: hold if infant pulse is under 90 or child pulse is under 70, or if patient has hyperkalemia negative is lower heart rate too much, dysrythmia, vomiting, nausea Positive effects: control heart rate, stop shortness of breath, improve O2 stats how to administer Liquid ferrous sulfate wait if patient has taken antacid or milk, mix with juice or other liquid to prevent teeth stains, best if taken on empty stomach Dornase Alfa decreases the viscosity of mucus and improves lung function take once or twice a day, teach about nebulizer use (10-15 min, connect to air source, deep breathing) diagnostic testing for cystic fibrosis Need to do sweat chloride test: child must be well hydrated and sweat collected from two spots Confirmation of cystic fibrosis from test chloride greater than 40 for infant and 60 for others sodium greater than 90 Signs of shock Decreased blood pressure; rapid, weak pulse; mottled to gray skin color; changes in mental status, dyspnea, breathing with crackles, hypoxemia Hypoxemia: clubbing, cyanosis, poor weight, yacht, dyspnea, polycythemia