NCLEX Review _ UWORLDPediatrics

NCLEX Review _ UWORLDPediatrics -Normal Vital Signs in Peds • 1 -12 months pulse: 100-160/min • 1-12 month resp : 30-60/min • Blood glucose for infant: 40-60 mg/dL within first 24 hours o Hypoglycemia in infant:  Jitters  Cyanosis  Tremors  Pallor  Poor feeding  Retractions  Lethargic  Low o2 sat  seizures Appendicitis • Right lower quadrant pain • Nausea • Vomiting • High WBC • Requires emergency surgery to prevent rupture • Once appendix ruptures, pain is relieved temporarily and will return with full blown peritonitis & sepsis Tooth Avulsion • Permanent teeth came out • Place in cold milk immediately to have an hour of time before tooth dies • Take to emergency room immediately to avoid loss of tooth Esophageal Atresia • Esophagus and trachea do not close properly • Must b corrected with surgery • Infant may have: o Frothy saliva o Coughing o Choking o Drooling o Distended abdomen o Apnea/cyanosis while feeding Hypertrophic Pyloric Stenosis • Apnea • Choking • Cyanosis due to aspiration of fluid while eating • Projectile vomiting is CLASSIC manifestation Retinoblastoma • Tumor in childhood • Intraocular malignancy occurring in kids less than 2 • Recognized when parents report white glow of pupil while taking photograph • Absent red reflex • Strabismus is another common sign • Visual impairment is late sign indicating advance disease • Tx: o Radiation o Enucleation (removal of eye) & fit for prosthesis o May be hereditary Neonatal Abstinence Syndrome • Born to opioid dependent mother • Experiences withdrawal 24-48 hrs after birth • Baby is irritiable, jittery, high pitch cry, sneezes, diarrhea, vomit, poor feeding • Place baby in side lying position while swaddled to minimize stimulation • Use pacifier between feedings • Place in quiet, dim lit part of nursery • Tx with opioid therapy Chicken Pox • Airborne spread of secretions and direct contact of open lesions • Most contagious 1-2 before rash and after onset but before crusted lesions • Negative air flow room • Antihistamine for itchy and acetaminophen for fever…no aspirin! Strabismus • Disorder of misalignment of eye from birth defect or acquired weakness • Crosseyed • Common treatment is to wear patch over strong eye; surgery may be required if this is not successful RSV • Common cause of infection in infants and kids • Winter time • Bronchiolar swelling and a lot of mucus • Rhinorrhea, fever, cough, lethargy irritability, poor feeding • Severe causing tachypnea, dyspnea, poor air exchange Treatment: • Supplemental oxygen & suction • Elevate head of bed to improve breathing and secretion clearance • Antipyretics for fever and comfort • IV fluids for dehydration from fever, tachypnea, poor oral intake • Transmitted via direct contact with respiratory secretions; contact isolation required w/ droplet precautions if 3 ft from client • Palivizumab is given IM once monthly during winter/ spring to prevent RSV in kids with high risk CPR in kids • Kids often develop resp distress & bradycardia before cardiac arrest • Perform rescue breathing for 2 min • If pulse still less than 60 with signs of poor perfusion, treat as pulseless; start compressions • Rescue breaths: 1 breath every 3-5 secs / 12-20 breaths/min -Intusuception in 6-36 months: one section of bowel telescopes over another blocking passage of intestinal contents, interrupts blood supply, intestinal tears; EMERGENCY • Inconsolable crying • Drawing up of legs towards abdomen • Stools with mucus & blood (currant jelly stools) • Vomiting • Peritonitis can occur o Fever o Abdominal rigidity o Guarding o Rebound tenderness o Fatal if not treated quickly!! ……………………………………………..CONTINUED………………………………………