Child Health- resp, autism, congenital heart defects, burns

Children in Respiratory distress may be ___ to improve ventilation

cardiopulmonary bypass device used when Respiratory failure is severe

Positioning for child in respiratory failure

Broad classification of upper airway illnesses caused by inflammation and swelling of epiglottis and larynx, extending into trachea and bronchi

spasmotic laryngitis and laryngotracheobronchitis are ___, but tracheitis and epiglotitis and ___

why is the subglottic area of the airway susceptible to occlusion

type of croup often caused by the human parainfluensa virus

least serious type of croup with an abrupt onset and afebrile

type of croup with mild fever (less than 40) and a gradual onset

potentially life-threatening type of croup with an onset over 2-5 d, a fever over 39, and thick secretions

type of croup that is a life-threatening emergency with an onset over hrs, a fever over 39

type of croup with sore throat, dysphagia, drooling, red epiglottis, and no croup cough

In bacterial tracheitis, the pt prefers __ position, while in epiglottis, the pt prefers __ position

throat __ and inspection of the mouth and throat are CI with LBT or epiglottitis because anxiety may cause laryngospasms and airway occlusion

Rapid acting bronchodialators (beta agonists, beta adrenergics) are given for which types of croup

medications that temporarily improve symptoms of croup through bronchodilation and decreasing mucous secretion

Medications for longer relief of viral croup symptoms

besides maintaining adequate body fluids, hydrating the patient also...

Prophylactic ___ is given to child under 48 mon with epiglottitis caused by H. influenzae

Most common virus that causes bronchiolitis

Nearly all children have been infected by ___ by 2 years, and are often reinfected as there is no immunity built against it

Damage to airways by RSV

Symptoms of mild bronchiolitis

symptoms of severe broncchiolitis

When are chest physio, bronchodilators, and corticosteroids indicated for bronchiolitis?

interventions for bronchiolitis

When is IM palivizumab given to children

list 5 types of autism

autistic disorder with impaired social, behavioural, and communication development, which is usually noted during the 1st year of life

Asperger symptoms:
-Impaired ____ interaction
-normal ____ development,
spelling and vocabulary
-abnormal ___ and ___ of voice
-low ____ formation, comprehension, and ___ flexibility
-Some times have high ___ in some ares

Type of autism in which the child appears to be normal for first 6-18 mon, and then has symptoms of progressive ataxia, hand-wringing, dementia, growth delay

Why does Rett disorder only occur in females?

Type of autism in which the child appears normal until 2-5 yrs, and then declines/regresses in many areas of functioning

Category of autism that includes severe social impairment without meeting the criteria for any other type of autism

what fraction of children have autism spectrum disorder?

Risk factors for ASD:
1. gender: ___
2. ___ concordance
3. 5 other conditions:
4. ___ exposure during pregnancy being investigated

What are the 4 red flags of ASD?

What are signs of impaired socialization in an autistic child

What are signs of impaired communication in an autistic child

What are signs of impaired behaviour in an autistic child

What are medications for autism?

What are some examples of complementary therapies parents try for kids with autism?

What are some ways to stabilize the environmental stimuli for a child with autism?

What are some tips for communicating with a child with ASD?

a defect in the heart or great vessels or persistence of a fetal structure after birth

prevelence of CHDs: ___/1000

Risk factors for CHDs (6)

What are 3 categories of CHDs

Which of the 3 categories of CHDs is decribed by the following symptoms: tachcardia/pnea, CHF, poor weight gain, diaphoresis, periorbital edema, and frequent RTIs

Which of the 3 categories of CHDs is described by the following symptoms: cyanosis, hypercyanotic episodes, poor wt gain, polycythemia

Which of the 3 categories of CHDs is described by the following symptoms: decreased pulses, increased cap refill time, decreased urinary output, CHF and pulmonary edema

What does the ductus arteriosis connect?

which category of CHD is a patent ductus arteriosis?

CHD where oxygenated blood returns to deoxygenated pulmonary artery from the aorta, increasing pulmonary BF

The ductus arteriosis usually closes within __ d, but may commonly not close in preterm infants

when pulmonary BF increases, pulmonary capillaries ___ leading to pulmonary ___

Increased pulmonary BF may lead to right ventricular ___because it is pumping against extra resistance

What are symptoms of CHD: increased pulmonary BF

Opening between the atria so that oxygenated blood moves from L atrium to deoxygenated R atrium and reenters pulmonary circulation

Opening in ventricular septum so blood moves from L to R ventricle and reenters pulmonary circulation

if the foramen ovale doesn't close, it is a type of which CHD?

IV ibuprofen or indomethacin may be given to tx which infant heart defect

When is surgery indicated for an ASD?

When is surgical closure of a VSD indicated?

Type of CHD that increases pulmonary BF and involves defects to the atrial/ventricular septa, and the bicuspid and tricuspid valves

When is surgery done on an infant with an atrioventriular canal defect?

name 4 types of CHDs that increase pulmonary BF

CHD category that results from obstruction of BF from right side of the heart to the lungs

Why does right to left shunting occur in CHDs that decrease BF to the lungs?

what is the classic sign of CHD: pulmonary BF decreased

Why do CHDs with decreased pulmonary blood flow result in polycythemia?

Polycythemia in children with CHD: decreased pulmonary BF increases risk of...

Why are children with decreased pulmonary BF and a septal defect at increased risk of systemic infection

Why may a hypercyanotic episode (with decreased pulmonary BF and septal defect) be common in the morning?

What are symptoms of CHD: decreased pulmonary BF?

CHD: narrowing of pulmonary valve, valve area, or pulmonary artery; may or may not have open foreamen ovale

CHD: combination of pulmonic stenosis, VSD, Right ventricular hypertrophy, and overriding of the aorta

when is surgery usually done for tetrology of fallot?

CHD: tricuspid or pulmonary valve is absent so that the only route to the left ventricle is the foramen ovale and the only route to the lungs in the ductus arteriosis from the aorta to the pulmonary artery

Why is prostaglandin E indicated for children with CHD causing decreased pulmonary BF, transposition of the great arteries,

hyperpnea

Signs of a hypercyanotic episode

What symptom occurs with severe hypoxemia related to respiratory failure or shock that warns of imminent cardiac arrest?

Children with a cyanotic heart defect usually do not have a PaO2 greater than ___mmHg, while the PaO2 with respiratory or neuro problems will be higher

What are side effects of prostaglandin E1?

How is polycythemia, due to CHD: decreased pulmonary BF treated?

Why are antibiotics given to children before heart surgery and 6 mon after?

What position should you place an infant in who is experiencing a cyanotic episode?

What meds may be given to an infant during a hypercyanotic episode if other tx is not effective? Why?

list interventions for hypercyanotic episodes

transposition of the great arteries

infants with transposition of the great arteries often have tachypnea greater than 60 without ___ or ___

What procedure may be initially performed on an infant with transposition of the great arteries until corrective surgery can be done at 1-3 wks?

mixed CHD in which a single artery trunk empties both ventricles and provides circulation for the pulmonary, systemic, and coronary circulations; usually with a VSD

Mixed CHD in which the pulmonary veins empty into the right atrium (instead of left); blood can only get to the systemicc circulation through the foramen ovale.

Mixed CHD in which the aorta and pulmonary artery both arise from the right ventricle and the only outlet for the left ventricle is a VSD

CHD category caused by a stenotic valve or great vessel

narrowing at or near the aortic valve

What are symptoms of CHDs obstructing systemic BF?

What could result from decreased BF to the GI tract in infants with defects obstructing systemicc BF?

Why is prostaglandin E given to keep the ductus arteriosis open for defects that obstruct BF?

CHD: constricted descending aorta

CHD: absent or stenotic mitral or arotic valves associated with a small left ventricle and aortic arch

Disorder in which heart function is impaired and cardiac output is inadequate to meet body circulatory and metabolic needs

What categories of congenital heart defects cause CHF

In CHF pulmonary BF ___ resulting in ___, and systemic BF ___

Defects that obstruct systemic BF cause hypertrophy, and eventually heart cannot keep up with demand and CO is inadequate. When CO is inadequate, BP ____ and perfusion ___, causing activation of ___ which leads to...

Symptoms of CHF

What is the 1st goal of medical management of CHF in children

How do diuretics help tx CHF?

What are 5 examples of inotropic medications?

What is a medication used to tx CHF that decreases afterload and heart workload?

When are inotropic medications prescribed for CHF?

What is the action of dopamine when used to treat CHF?

What is the action of dobutramine when used to treat CHF?

What is the action of digoxin when used to treat CHF?

What is the action of carvedilol to treat CHF?

Why does a child's skin absorb topical medications faster and layers separate easily with blistering

Why do children lose heat quickly through their skin?

what is the pH of an infant's skin at birth

What two factors increase risk of inflammation and irritation of skin in infants

list four types of burns

Describe a 1st degree (superficial partial thickness) burn

Describe a 2nd degree (partial thickness) burn

Describe a 3rd degree (full thickness) burn

Describe the pathophysiology of burns

tough, leathery scab that forms over burned areas

what causes poor cap refill and ischemia with burns?

What are signs of airway inflammation due to burns?

Why might PRBCs be indicated for a pt with a burn?

Why should a burn pt be put on a high protein, high carb, low fat diet?

Why might a person with a burn need insulin

why is propranolol prescribed for a person with burns?

symptoms of autism on the autism Calgary checklist

What are the 9 areas of respiratory assessment of a child with a respiratory condition?

List potential life threatening symptoms of bronchiolitis

What children may require RSV prophylaxis?

What are 7 topics of nursing are to focus on for a patient with burns?

What are two priorities in initial tx of an acute burn?

Why would a child with a burn have a fever without infection?

What is the Parkland Formula for fluid needs of a burned child?

Which CHD is most common in children with Down Syndrome?

What May untreated ASD lead to?

What is the most common CHD

T/F 60% of VSDs close spontaneously in the first 2 yrs of life

Why are children with VSD often tx with high calorie feeds?

What medication is used to treat a CHD: patent ductus arteriosis?

How are chromosomes abnormal in down syndrome?

Possible symptoms of Down syndrome:
1. Wide space between ___ and ___ ___
___ loss
Increased incidence of ___
hypotonia
___ head
____ forehead
___ neck
____ eye folds
___ nose
____, ___ set ears
____ tongue
____ ____ across palm

A child has RSV. List the following in order of priority:
Activity intolerance
Feeding pattern
impaired perfusion
FVE related to HF and pul overload
Risk for infection

Why would restraint by swaddling be appropriate during necessary procedures on children with respiratory distress?

What are 5 components of programming for ASD by CBE

Why is the right ventricle proportionally larger at birth

Until the age of 5, CO is dependant on ___

What are the 9 components of assessment of a child with CHDs

What are nursing interventions for CHD

The immature infant heart is vulnerable to __ and __ overload

What are early signs of CHF?

Why is head bobbing a sign of CHF

What is a consideration to monitor for with edematous skin

Why should O2 be used with caution in pts with CHF?

What serious complication could RSV lead to in children under 3